Sunday, August 10, 2008

My Surgical Consult

I finally had a surgical consult! I can't believe it's taken this long. I decided to look into Weight Loss Surgery (WLS) back in February. I was taking my time because I knew I couldn't take off from work until this year's QuickBooks was done. But, still, it's been a wild and very long ride. I've been cancelled two times, for example.

But third time's a charm, it seems, and this time it really happened. And then I got so busy that I didn't get anything written down and I can't remember everything I was going to say! I'll try to reconstruct.

The consult started late. Apparently this is a theme with Dr. Awesome. I had been somewhat prepared for this and called ahead to see if he was running behind. They said he was by about 15 and I tried very hard to be 15 min. late but I could only manage about five. I just can't be intentionally late, I guess. I brought some stuff to read, but next time I'll bring something to eat (since it was lunch time).

I ended up at the San Jose satellite office and, I have to say, I don't like it. It's part of a plastic surgeon's office and I think cosmetic surgery is stupid. (Not reconstructive surgery -- that's awesome.) I can't believe people pay good money so they can look like The Joker. Plus there were brochures with pictures of beautiful women saying things like "parentheses don't belong on your face" as if there was something wrong with them; every room has a scale, even the bathrooms; and the decor was designed to make you think you were at a fancy spa and not a doctor's office. It was creepy.

Then I went into Dr. Awesome's office and we talked. He wanted to know what questions I had and I had a ton. We talked about my worry that they wouldn't be able to do the surgery laparoscopically due to my rib cage. He told me that there was no reason I couldn't have had my gallbladder out without being slit down the front. (Reading between the lines: my gallbladder surgeon was an idiot.) I went through my rationale for picking the sleeve and he agreed with my reasoning for picking this particular surgery.

Some points:
-I should expect to lose at least 80% of my excess weight. (But we didn't talk about a goal weight.)
-I'll need to be on Lovenox for a few weeks after the surgery -- I just love shooting myself up (Not) -- due to my history of pulmonary embolism.
-Hunger tends to come back around 14-18 months but it's never like it is now
-Most people need to get to goal by 12 months because the longer you go, the more you start pushing the rules and the harder it gets.
-Less than 5% of sleeve patients can't get enough B12 from food.
-I'll probably still have excessive facial hair even if after I lose weight (Expected, but still disappointing.)
-I might have a hiatal hernia and, if so, he'll fix it during the surgery, but either way my recent horrible heartburn should be better with the surgery.
-I don't need to do an autologous donation so I guess I'll give at the blood drive at work next week and not worry about it.

Then he asked me questions about my medical history. At the end, he handed over four pages of stuff. They have everything set up so that the doctor checks off little boxes on the form based on what you tell them and it turns into a prescription for your PCP. There is also a master checklist. I thought that was so cool! I love systems and organization so having something like this that makes it less likely to forget a pre-op requirement and organizes it all makes me smile.

I was sure that LapSF and Dr. Awesome would be well suited to my own approach to health care and, so far, that hunch is panning out.

Here are all the tests I have to get:
-Psychologist Referral -- but they'll accept the one I already had done, which I expected
-Registered Dietician Consultation -- but they'll accept the one I already had done, which I didn't expect
-Nine different blood tests (within two weeks of the surgery)
-Pre-op History and Physical including a PAP and Mammogram done with in a year (which I have already done)
-Upper GI
-Cardiac Stress Test

I also received a 35-page Post-op guide that has all the info I need about pain management, eating, exercising, etc. for after the surgery and a 30 page Pre-op guide that is more about why have the surgery and which surgery to have. Dr. Awesome said it would probably be more interesting to my family such as my husband since it was clear I had researched pretty thoroughly before I got there. I lent it to my mom when she was up for the wedding and I think it helped her feel a little better about deciding to get the sleeve (vs. the Lap Band).

Then I left. Then I came back because I forgot to pay. Oops. I got to use my FSA debit card though so that's good. I was a bit worried about cash flow since I have to pay for the surgery up front and I was planning to use a combination of my annual bonus and my FSA account.

I called up my PCP as soon as I got back to start scheduling all those tests and got some bad news. She's on vacation until the end of August!! So I went to see a different doctor within the practice -- the one Mr. Mac sees -- and he was kind of resistant to the whole thing. I don't think he liked some other doctor telling him what to do. Dr. Boyer (my doc) will be fine with it, but I can't wait that long. I'll probably have her do the lab work and Physical when she gets back since they need to wait until just before surgery and I got Dr. Whiny to give me a referral for the other tests in spite of himself.

I just realized I haven't got a blog name for Dr. Boyer. I'll have to think on that. I guess I could call her Dr. PCP but she deserves a better name than that to reflect how great she is.
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