Tag Archives: Fep BCBS

A Few Books

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Today is surgery day (I actually wrote this last Friday!), so I figured I’d share with you a couple of books that I have purchased to read post op.  Granted I skimmed through each of them last week, but I’ll be looking forward to going more thoroughly through them this coming week to two weeks.

Weight Loss Surgery for Dummies

I’ve read through this one the most (and by read, I still mean skimmed…reading has yet to be done!)  I might have been a bit late on the wagon for picking up this book, since it starts with information on how to choose both a surgeon and a surgery, but that is also only the first 1/4-1/3 of the book!)  I would highly recommend this to anyone still in the contemplation side of WLS.  It also offers information about why choosing a program with good aftercare is important!  Past the first stage of picking your surgery, it goes on about how to prepare for surgery, what to expect, what to pack, what to have on hand when you get home, etc.  As the Amazon write up says “Your authoritative guide to weight loss surgery — before, during, and after”

Weight Loss Surgery for Dummies Cookbook

This one I’ve skimmed through the least.  It does have information for all stages of post op living, including clear liquids, soft/mushies, and solid foods.  It has meal planning tips, portioning tips, tons of recipes, and appears to have lots of useful random tips in it as well!

Eating Well After Weight Loss Surgery

The recipes in here look fantabulous. They are all fairly small portions, and the book even recommends how to serve them and in what quantities based on what surgery you’ve had. Granted it doesn’t account for the Sleeve specifically, but it does include Lap Band, DS, and Gastric Bypass. My doctor said to lean somewhere between Gastric Bypass and Lap Band, so that is my plan. Many of the recipes in here are even Hubs friendly, so I can eat one WLS patient portion and he can have the rest for dinner and lunch the next day (or all for dinner knowing his 6’5 appetite!)

My check-in time today is 11:30AM EST, and surgery is set to begin at 1PM EST.  Hopefully I’m doing well right now!

Random Thoughts

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This is a completely random post!  I have a lot of things running through my head right now.

Healthy Eating Emails

Like most of you, I get a ridiculous number of emails in regards to healthy/clean living, weight loss, exercise, etc.  I had a moment on Wednesday when I suddenly realized how few of those emails will pertain to me post op.  Particularly the ones that talk about eat this and not that or the ones that talk about portion sizes.  I will have a built in portion sizer.  The exercise ones will still of course pertain to me!

Primary Care Physicians Release

On Tuesday I had my final appointment with my PCP, where I had to get them to sign a release form for my surgery.  They looked through my labs done the previous week, checked out my EKG, my lung x-rays, etc. and within minutes I had a signed approval form.  I for some reason thought that this process would be more complicated.  I figured they would at least challenge me on the surgery, which they didn’t.  NICE.  I go to a physicians group, most of the time I can get my regular PCP, but she wasn’t available for the appointment, so I got a different person.  From his name, I was expecting an older Jewish guy, instead, I was faced with a guy who I’d be certain hasn’t finished med school and was wearing skinny slacks…

Liquid Diet

I for some reason keep counting down the days of my liquid diet.  Completely silly of me.  Post op I will be on full liquids again for 14 days!  At least for now I am chewing my dinner.  The whole chewing the dinner thing will stop as of Friday though.  I have to be on clear liquids on Saturday and Sunday.  Fun, right?

Final Nutritionist Appointment

I had this final appointment on Wednesday.  The nutritionist went through my labs that were pulled on the 8th, and went over what supplements I need to be sure to get in post op based on the results of my lab work.  They also worked with me on a schedule for eating and what to expect post op with my full liquid diet.

Final Pre-Op Visit with Surgeon

Dr. Mo was as nice as can be per usual.  He’s such a great doctor and I am so happy that I have him doing my surgery.  Hopefully I still believe that on Monday afternoon!

Freaking Out?

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Not yet, not this lady.  I have no idea how that is possible.  I figured by 5 days pre-op, I’d be well on my way to meltdown central, but I’m not.  I’m getting more and more excited each day at what my new life with Sleevie McGavin will bring me.  I am sure though, that as soon as I get changed into my hospital gown on the 22nd, and they start the IV’s, I will be a complete and total disaster.  Prepare for tears.

I can’t believe that I am only 5 days away from completely altering not only my life, but my internal anatomy.  I certainly have fears, but I also am full of hope.

FEARS

  • Getting a leak in my new sleeve.
  • Getting nauseous from the anesthesia.
  • PAIN
  • Having a complete meltdown as they roll me into the surgery room, full of snotty, ugly cry tears.
  • Having to share a room with someone in recovery that insists on talking incessantly.  Note to self-ask surgeon about recovery room.
  • This being yet another attempt at weight loss that I won’t be successful at.  This just might be my biggest fear.

HOPE

  • For the first time in my adult life being a “normal” size.
  • Being able to live a long life with my family and friends.
  • Being able to be a good role model for me and Hubs future children (or child…let’s start with one)
  • Being able to shop in normal stores.
  • Being able to be successful FINALLY in the world of weight loss and healthy living.

Even though there are more Fears listed, I internally have way great hold on my Hopes at this point.  I am so excited for this journey to actually begin.  I know that there are going to be a few rough days/weeks ahead of me, but a bit of pain for a life long path of health seems worth it to me.  Ask me this again on Day 3 or Day 4 when I’m kicking myself for doing this, ha!

The liquid diet is going really well.  I’ll admit though, that I ate three meals on Sunday BUT before you freak out, I will tell you that I actually ate fewer calories than I do on the 5 shakes and a “lean and green” dinner.  My carbs were also right about on par.  Today is day 10 of the pre-op diet, and I am down about 8-9 pounds!!

Getting in my H2O Post Op

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If you spend any time over at ObesityHelp.com reading the Vertical Sleeve Gastrectomy Forums (wait, you don’t read those??? Ha!), you know how many posts there are about not being able to get in your water post op.  There is a really good post on the forums over there that I found, and I wanted to post it here for anyone else who might be pre-op wondering how exactly they will get 64oz of water in a day, on top of 16 oz of protein shakes, into a swollen stomach that holds approximately 2oz at a time.

This is something I want all you pre-ops to practice a bit until you really KNOW what it is to sip. It will stand you in good stead in those early post-op weeks when you are thinking you’ll barf yourself to death on more than 16 oz. of fluids.

Get the following: a measuring teaspoon, a measuring tablespoon, a single size shot glass. Sit down with them and a glass of fluid of choice. Oh, and get a stopwatch or digital timer.

I shall divide this exercise into three parts. Please try all three.

1. Let us begin with the shot glass. Pour out a shot of water and down it by sucking it through pursed lips–sipping, not chugging–in one swallow. Feel how big that swallow is? Practice it several times until you KNOW how it feels.

Once you KNOW this feeling, take out that timer and take a full minute to ingest that jigger of water. TIME YOURSELF and make yourself do it over a full minute, NOT in one swallow.

64 oz. per day means doing one of those shot glasses 64 times. If you take a full minute to empty that shot glass, you will spend a total of 64 minutes of your whole entire day drinking.

2. If you fear this will be too much water to ingest in one minute, take the tablespoon and repeat the exercise. A tablespoon is 1/2 oz. So, by drinking a tablespoon of fluid in one minute (USE THE TIMER AND TAKE THE FULL MINUTE TO DO THIS), you will spend two hours and 8 minutes of your day drinking.

3. Think this is impossible? Repeat the exercise using a teaspoon. Doing a teaspoon per minute (TAKE  THE FULL MINUTE!!) will take you six hours and 24 minutes of your day.

Okay? Don’t tell me 64 ounces is an impossible amount of fluid to ingest in a day. You can do it and still have LOTS of time to sleep, poop, walk etc. Yes, you will feel it. It might be uncomfortable. You might have nausea. If you do, get it medicated. Use your acid reducer and your antiemetic. If you can’t keep down a teaspoon of water per minute, you are in trouble and belong in your doc’s office or in the ER. It might feel like pure **** to keep it down, but that’s basically tough bananas. Keeping it DOWN is what counts. Feeling good while you keep it down does NOT.

It might take this kind of work to hydrate yourself early postop. Get your head around it NOW.

Source

I have such a hard time grasping the idea of not being able to drink 120+oz of water a day like I do now.  I know though from reading blogs of people who are post-op and the various forums, that it really is a challenge.  Since I am now 6 days pre-op, I’m going to follow the plan above to get myself used to drinking more slowly.

PS-Some doctors office allow the protein shakes to count towards your daily fluid intake, my doctors office specifically allows for it, others do not.  Please follow the requirements of your doctor.

Pre-Op Liquid’ish Diet

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Side Note:

TEN….10….123456789…10 Days until Surgery!

On Monday I started my pre-op liquid diet after a weekend of complete indulgence.  I am doing a sort of hybrid liquid diet, 4-5 shakes a day and then a “lean and green” dinner comprised entirely of veggies and protein.  Here is what a day looks like:

My husband is likely getting very tired of protein with asparagus/zucchini/peppers/onions, since I have made those (along with mushrooms for me!) every night this week.  I have made him pasta a few times to give him some semblance of normalcy, though he might hurt me if he sees another onion.

My dinners this week have been great!

Monday- Pan seared cod w/ roasted peppers, onions, zucchini, and mushrooms.

Tuesday-Crab cake (sans bread crumbs) mixture stuffed in mushrooms and chunky pieces of pepper for me, crab cakes and pasta for the hubs.

Wednesday-Roasted shrimp w/ roasted peppers, onions, asparagus, and mushrooms.

Thursday-An amazing pot roast in the crock pot that I paired with grilled peppers and onions, with a little bit of cheese and sour cream on top (think burrito bowl without the rice and beans) and the hubs put his on tortillas.

Tonight-Chicken Meatballs with spaghetti squash for me and real spaghetti for the hubs.  Topped with homemade marinara (sugar free!)

Overall this week has been very easy.  I did cheat one day and had a 3×3 piece of cake.  There were THREE baby showers at work on Wednesday, and enough food leftover for them to feed a rather large village.  I was feeling so strong and then BAM, just slipped.  I didn’t even really think about it until after I was eating the cake.  I was right back on track when I got home.  Over all my calories have been between 1000-1100 a day and my carbs have been less than 50 grams (except on cake day.)  The liquid diet that the doctor would put me on would have me intake 1200 calories a day and about 40-50 grams of carbs.  So I think I’m balancing things out fairly well.

Tomorrow we have a ton of appointments, which will have us out of the house almost all day long.  I’m contemplating either doing my “lean and green” meal at lunch time or just sticking with the protein shakes and keeping the real food for dinner.  The problem with that is we will likely have to eat lunch out (poor hubs has to eat!) and it would be strange and tough to just sit there and watch him eat.  I am going to pack a cooler for my shakes for my snacks though!

Hope everyone has a great weekend!

Insurance…

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Anyone having gone through insurance approval for surgery before might know what an effin’ nightmare it can be.  This time was no different, but it was probably better for me than some others.  Here is a time line:

  • 7/27 Surgeons office submitted the insurance packet.  In the past, the surgeons office usually hears back in less than a week from my type of insurance (Federal BCBS) One week would be 8/3.
  • 7/28 Insurance acknowledges receipt of the insurance packet.  I know this because I’m OCD and I called to ensure that they received everything that they needed.
  • 8/2 I call the insurance company to get an update.  Let’s face it, I’m over eager and I wanted to see if there was an answer yet.  I was told that they expected an answer no later than Thursday.
  • 8/4…it’s Thursday, so I call the insurance company.  They say that there is a note in the file stating they spoke with person X in the surgeons office on Monday and that person was supposed to send a particular document.  They wouldn’t know anything until the received that document.  The issue with all of this is 1-No one by that name works in my doctors office and 2-No one has ever heard of this form.
  • 8/5 I call the doctor’s office to speak with the insurance coordinator to find out what is going on.  She’s off on Fridays.  Shoot me in the foot NOW.
  • 8/8 I am over in the hospital complex for a bunch of other pre-op appointments and decided to swing by the surgeons office and see what can be done to get things that are needed to insurance.  The insurance coordinator is shocked that I got that information from the insurance company on 8/4 because on the exact same day she received

VERBAL APPROVAL FOR MY SURGERY!!!!!

So it’s official, I am pre-op!  I wanted to kiss the insurance coordinator!  She said she was going to call the insurance company to find out what is going on, but that she knows that I am approved and am fine to go!  Wooooooo Hoooooooooooo.

All of this probably wouldn’t be so stressful if we weren’t also going through approval for a new house…and because the way we have things scheduled for the rest of the year.  It is all working out, and I couldn’t be happier!

Appointments, Appointments, Appointments…and a Liquid Diet.

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Monday I was scheduled for several appointments, most of which required that I fast for at least 12 hours prior to the appointments.  This was completely fine with me after my weekend of indulgence AND since I was set to start my liquid pre-op diet.

Appointments:

  • Nurse/Patient Interview.  This appointment was about 90 minutes long.  I received my pre-op EKG, a special body wash that I have to start using 2 days pre-op, lots and lots of information about what to expect while in the hospital.  I asked if I could have toe nail polish on.  The nurses response “heck yeah, go get a mani and pedi before surgery!”  Yay!  I also learned that either Mama Scale or Brent will have to give me a shot each day for 10 days after surgery.  Mama Scale, are you reading this?
  • Blood Work and Urinalysis.  Incredible quick and simple.  The gentlemen who drew my blood did an amazing job.  I asked him if he could do my IV for surgery.  They took 12 vials of blood!
  • Ultra Sound.  This covered most of my major organs; gall bladder, liver, kidneys, stomach.  I was expecting this to be super quick, but it actually took about 20-30 minutes.  It didn’t hurt, but it certainly wasn’t comfortable.  She was pressing really hard into me at some points.  I guess my extra padding was in the way!
  • Chest X-Rays.  Super easy.  They took three pictures.

Only three appointments left until surgery!  Time is starting to fly by.

Liquid Diet:

My doctors said if I didn’t lose 10-15 pounds, I’d be required to be on a liquid diet for 5-10 days pre-op.  Since I went overboard this weekend, I was way up on the scale Monday morning.  I made the executive decision to go on liquids 4-5 times a day and then do a “Lean & Green” dinner a’la Medifast to get the pounds off.  Once I meet with the surgeon next Thursday for my final appointment, I should be down enough that he might only require the 5 day liquid diet.  Either way, it will help me lose the weight to shrink my liver over the next couple of weeks!

Surgical Review Class

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I’m a bit behind in posting. I have had a very busy few days, which has thrown me off of my posting schedule a bit!
Last Thursday, I had a four hour surgical review at the hospital. The surgical reviews purpose is to go over everything that you should except from a few days post op until the time that you are discharged from the hospital. The review was incredibly helpful. There were about a dozen or so people in the class, and we were grouped together by the type of surgery that we were having. I wound up meeting gentlemen who is having his sleeve exactly one week prior to mine, so we exchanged email addresses and are going to try to keep in touch.

 

During the review class, we were given a packet of information specific to our types of surgeries. There were all sorts of things in the packet, including:

 

• Nutritional supplements to have on hand once I get home from surgery.
• Liquid Diet (2 weeks post op, I’ll do a full post on this at some point.)
• Mushie Diet ideas for once the liquid diet is over. I’ll do a full post on this at some point. Think 2 Tbsp of soft protein, 1 Tbsp of pureed veggies, and if you can handle more it 1 Tbsp mashed fruit.
• What to look for in a protein shake (100% Whey Protein Isolate, 20 grams of protein per serving.)
• What medications we can and can not take leading up to surgery. No NSAIDS 2 weeks pre-op, so no Aleeve, Aspirin, Advil, etc. Tylenol for this lady!
• We went over various do’s and don’ts post op. For example, the doctor doesn’t want us drinking for at least one year post op.
• We went over what to expect when I check into the hospital, what to have with me and what to have Mama Scale and the Hubs hold onto.
• The VSG is approximately 90 minutes, perhaps 15 minutes more for my hiatal hernia repair.
• I will spend approximately 2 hours in the recovery room, a little more if a regular room isn’t ready for me.
• At approximately 6 AM I will do a barium swallow to check for leaks.
• Once I do the barium swallow I’ll be allowed more than ice chips, they will bring me protein jello, protein broth, and cranberry juice. They want us to do the jello or broth first, no matter how thirsty we are. Then it’s our job to sip sip sip sip sip.
• I received my Incentive Spirometer, which is a wacky contraption that you use while taking a deep breath. It measures how much air your inhaling. I am required to use it 5-6 times a day pre-op to help build up my lungs strength. Post op you have to use it every hour to rebuild your lungs strength since they will have a hard time recovering from the breathing tubes they use during surgery.

 

I am sure there is more to it than this, but this is what I can remember at this moment!

VLC Diet Day 2

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Yesterday went really well on low carb.  I wound up coming up with a new recipe last night for dinner, which I will hopefully get a chance to post either tomorrow or Friday.  It is for Mock Loaded Nachos, which were delicious!

My carbs were a little higher than the PA recommended yesterday, but overall they were still way lower than normal.  My goal today is to stay under 50 total carbs.

Nutrient Calories
Fat 82.6g 47.7%
Cholesterol 658.9mg
Sodium 3,745.1mg
Carbohydrates 58.7g 15.1%
Fiber 14.9g
Sugars 11.2g
Protein 145g 37.2%

Breakfast: 304

Egg (1 Whole)
2 Servings
140
Sausage, Turkey, Patty
2 Ounces
90
Sauce, Pesto
1/2 Ounce
74

Lunch: 261
Salad Dressing, Ranch, Light
2 Tablespoons
77
Lettuce, Boston, Fresh, Shred/Chpd
2 Cups
14
Bacon Bits, real, svg
2 Each
50
Cheese, Blue, Crumbled
1/8 Cup
60
Cheese, String, Light
1 Piece
60

Dinner: 534
Ground Beef 93/7 Raw
4 Ounces
170
Cheese, Cheddar, Shredded
1/4 Cup
114
Onion, white, fresh, chpd
1/2 Cup
32
Sour Cream, Light
3 Tablespoons
62
Dip, Salsa Con Queso, Med
2 Ounces
66
Peppers, Bell, Green, Sweet, Fresh, Med, 2 1/2″
1 Each
24
Refried Beans, Traditional
1/3 Cup
67

Snacks: 474
Cheese, String, Light
1 Piece
60
Nuts, Almonds, Whole
15 Each
104
Protein Shake-Chocolate
1 Container
160
Jay Robb Whey Protein – Chocolate
1 Serving
110
Milk, Almond, Original, Unsweetened
1 Cup
40

Very Low Carb (VLC Diet)

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When meeting with the Physician’s Assistant (PA) last week, she noted that I was down only 4 of the 10-15 pounds the doctor wanted me to lose pre-op.  The reward for losing those 10-15 pounds is not having to go on a liquid diet.  If I don’t meet that 10-15 pound expectation, I will be required to go on a 7-10 day liquid diet prior to surgery.

The PA seemed to think that I can easy meet at least the 10 pound goal very easily.  She said in the long run she thinks very low carb diets (VLC) (think Atkins phase 1) are neither healthy nor sustainable, but because this will be for such a short period of time, I should give it a try.  I really only have one event in the next 20 days that I am going to allow myself to indulge, besides that I am officially following a VLC diet for 21 days (started yesterday.)

Since I will be spending at least two weeks post-op on liquids, I am going to do my best to get the last 6-11 pounds off over the next two weeks or so.  I have to have the weight off by the last appointment with the surgeon pre-op, which is August 17th.  I know that if I keep focused I can do this.  August 6th is a big wine evening at my Dad’s house that I’ve been looking forward to for some time now, so that is the one time that I am going to go ahead and indulge.  It will be my “last supper” so to speak prior to surgery.

My food journal from yesterday is as follows:

Breakfast: 304
Egg (1 Whole)
2 Servings
140
Sausage, Turkey, Patty
2 Ounces
90
Sauce, Pesto
1/2 Ounce
74

Lunch: 201
Salad Dressing, Ranch, Light
2 Tablespoons
77
Lettuce, Boston, Fresh, Shred/Chpd
2 Cups
14
Bacon Bits, real, svg
2 Each
50
Cheese, Blue, Crumbled
1/8 Cup
60

Dinner: 276
Ground Beef 93/7 Raw
4 Ounces
170
Squash, Zucchini, w/ Skin, Fresh, Lrg
1/2 Each
27
Oil, Olive, Extra Virgin
1/2 Tablespoon
60
Eggplant, Fresh, Cubes
1/2 Cup
10
Peppers, Bell, Green, Sweet, Fresh, Sliced
1/2 Cup
9

Snacks: 635
Protein Shake-Chocolate
1 Container
160
Cheese, String, Light
2 Pieces
120
Nuts, Almonds, Whole
15 Each
104
Jay Robb Whey Protein – Chocolate
1 Serving
110
Milk, Almond, Original, Unsweetened
1 Cup
40
Almond Butter
1 Tablespoon
101

My nutritional stats from yesterday:

Nutrient Calories
Fat 80.8g 51.5%
Cholesterol 613.5mg
Sodium 2,777.2mg
Carbohydrates 35.5g 10.1%
Fiber 11.9g
Sugars 11g
Protein 135.7g 38.4%

Not too shabby for the first day of low-carbing it!