Friday, October 29, 2010

Mixed Reviews

I saw the surgeon yesterday for one of my monthly appointments before the surgery. He was very impressed with my nearly two weeks of quitting smoking. He was not impressed with my four pound weight gain. It's true: I quit smoking and discovered "New York Cupcakes" in Bellevue. Oops.

It's funny, the pendulum of my eating issues. My eating at night has gotten much better, but my snacking on sweets since giving up cigarettes has gotten worse. I will need to monitor this all closely, figure out how to walk the delicate balance of taking care of myself.

My biggest challenge in writing a blog that I hope people might actually read is, well, not what I was originally going to say. I guess my *biggest* challenge will continue to be consistency. It is difficult for me to make time to blog daily. My second biggest challenge will be organization of thought. On my personal blog, I am very self-indulgent with my thoughts and how I put them out there. Here, as I'm trying to document my experiences with my health...I'll have to be careful to present information chronologically so it makes sense. Regular blogging would help in this regard. Oh, snap!

So...before I tell you about my appointments with my general practitioner and my bariatric surgeon yesterday, I need to back things up. In preparation for the surgery, I've had a barrage of tests done. Lots of lab work, x-rays, EKG, psychological screening, etc. In time, I'll work my way back to describing each of these experiences.

For now - I'll focus on the blood work. My original blood work came back low in two major areas: iron (hematocrit) and vitamin D. The vitamin D wasn't a surprise to me; I had started taking supplements early this year when my levels tested low at my GPs. It was rather surprising, though, that these levels had not improved one iota even after taking the supplements. More on this later.

The hematocrit levels were bad enough that I was sent for additional testing. Here, my ferritin levels were below testable range. Wikipedia, the source of all things true and accurate on the internet (snort!) says, "Ferritin serves to store iron in a non-toxic form, to deposit it in a safe form, and to transport it to areas that it is required."

Because of these low levels, I was referred to a hematologist, whom I will see next week. Interestingly, my GP, who has been my primary physician since I was 12 or so, said he would not have referred me to the hematologist. Here is where I get some conflicting information. The doctor who referred me to the hematologist said it would take upwards of seven months of iron supplements to get my levels within the normal range. My GP said my levels would improve quickly with iron supplements. However, since I do have a long history of being a whiny baby intolerant of iron supplements, my GP thinks the hematologist is a good idea. When I was pregnant, I took prescription pre-natal vitamins because they were the only ones in which I could tolerate the iron. I get sick, stomach aches, yucky iron burps and constipation with OTC iron supplements. My GP said he would not be able to convince my insurance company to pay for an IV iron supplement without a months-long trial period to demonstrate my intolerance. However, he said if the hematologist wants me to have an IV iron supplement, it will be approved without question.

None of the doctors, thus far, have thought that my low iron levels would preclude me from having the gastric sleeve in January. I, on the other hand, think it would be an unnecessary risk to have the surgery without fixing it. My appointment with the hematologist is on Monday, and in the meantime, I get to smear poop on a card on three separate occasions to bring in to him as an introductory gift: their way of making sure I'm not losing blood in my stool due to an ulcer or polyps or other nefarious means.

In talking with my GP yesterday, he said my initial iron levels were not low enough that he would have sent me for additional testing. Wikipedia, again the most truthful and incontrovertible* online source, says "The hematocrit (Ht or HCT) or packed cell volume (PCV) or erythrocyte volume fraction (EVF) is the proportion of blood volume that is occupied by red blood cells. It is normally about 48% for men and 38% for women." My level is one number below the listed range: this is good enough for my GP, but had my other doctor sending me off to a lab, garnering a test result that said ABNORMAL for ferritin. I think I'm having a crisis of faith with my GP right now. He is unconcerned that my vitamin D levels are just below the acceptable range, unconcerned that my iron levels are just below the acceptable range, and unconcerned that my vitamin B-12 levels are at the low end of the acceptable range. These three things are big indices of how much energy you have, and I have NO ENERGY. I don't want to be just outside the range, or even at the bottom of the range. Grr.

(*incontrovertible. I first typed this as "incontrofutable," but copied and pasted it into bing because it didn't look right. Note to self: when the *only* hit bing returns on your word is to, who says, "It has been argued with triumphant certainty as established with incontrofutable evidence that the whole story of chapter 2, with all its pathetic and romantic incidents, is a ..." then you are making words up. Along with someone at I have decided that my word invention is a combination of incontrovertible and indisputable.)

Tuesday, October 26, 2010

First Step, First Post

I've decided to start blogging my journey to rebirth as a single, non-smoking, height-weight proportionate mother of three. I'm an experienced blogger, but want this blog to focus on my process of re-inventing my body and mind, following many years of deferred maintenance.

I'm Julie. I'm 40 years, 9 months and 16 days old. Very shortly after my 41st birthday, in January 2011, I plan to have a sleeve gastrectomy. I'm lucky, because this is a covered benefit of my health insurance.

To recap my process thus far:

1) On September 28th, I attended an information session for bariatric surgery through my local hospital. I'm not sure what I was expecting, but what I found was myself and another potential patient and a very kind surgeon who sat and answered my questions until I ran out.

2) September 30th, I met with the surgeon in his office to discuss my specific issues relating to bariatric surgery. I'll recap this discussion in a separate post; right now I'm just building a timeline. The surgeon sent me off on a scavenger hunt of related appointments and tests, brief descriptions of which follow.

3) October 6th: Dropped by the hospital and had extensive blood work done, as well as a chest x-ray and EKG.

4) October 7th: I met with the nutritionist at the hospital. This was the first of several visits before and after the surgery.

5) October 7th, still: Attended my first bariatric surgery support group meeting. Much more on this later.

6) October 12th: Delayed by a traffic accident and missed my appointment with a psychologist to get a mental health screening to assess my mental well-being for the surgery.

7) October 14th: Met with the Sleep Disorder Clinic doctor as a prelude to an overnight sleep study to see if I, like many morbidly obese people, have sleep apnea.

8) October 15th: Genuinely forgot it was my ex-husband's birthday when he stopped by to leave something for the kids. Can this be a sign of moving on? Also, there was a cancellation at the sleep study, and I was able to get in for a sleep study that night! More on this later.

9) October 16th: QUIT SMOKING!!! Had my first accupuncture appointment related to my decision to quit smoking. Smoked my last cigarette at 8:15 a.m.

10) October 19th: Had that appointment with the psychologist that I originally missed. Seemed to pass myself off as a relatively normal, well-adjusted person. No mean feat, considering this was the same clinic I visited when I was going through my divorce and its aftermath!

11) October 20th: Follow-up accupuncture appointment for quitting smoking.

12) October 20th, still: Ooops - the Sleep Disorder Clinic doctor does not like the results of my blood tests. He sends me for additional blood work. Much more on this later!

13) October 21st: Attended a Hypnosis to Quit Smoking class at the hospital. No, I am still not smoking, but I need to arm myself with all the weapons I can get in this particular battle!

14) October 25th: Had my follow-up appointment at the Sleep Disorder Clinic to discuss the results of my sleep study and my blood work.

15) October 26th: Am about to make myself late for another accupuncture appointment for quitting smoking while I work on this blog timeline.

16) October 27th: Ooops, yes, I have sleep apnea! Going in for a second overnight sleep study to get fitted and calibrated for a CPAP machine.

17) October 28th: Finally! A second appointment with my surgeon to go over all these appointments and tests I've been doing!

18) Crud. Somewhere in here, I forgot to list my first appointment with the physical therapist. Again, this is the first of several appointments pre- and post-surgery.