I'm so FREAKING excited!

Who knew I'd ever be excited about a 2000 calorie diet? Certainly not me, and yet, here I am, completely thrilled for this next step in my process.

Today was the day I met with the bariatric dietitian at my surgeon's office. While officially this is just one of the hoops I have to jump through, unofficially it was a phenomenal visit. She was so sweet, and treated me like my weight issues were no big deal. It's nice to be treated as a person with a problem that needs resolving instead of a pariah. We discussed my eating history from the time that I first noticed a problem until present day, and the steps I'll be walking to get me to my surgery date.

This post may be a little too technical for anyone who isn't going through the process, but part of my reason for writing it down is so that I remember! Before I get into the boring details however, I just want to say a quick thank you to everyone who has read this so far. The feedback I've gotten has been so great, and I really appreciate all of the people who have chosen to walk this road with me, and support me as I get healthy. I'm so blessed by you all...friends at last!!!! And it's AMAZING!!

So..I'm on target for my surgery in June. My insurance company's requirements are sort of strict, and a real pain in the posterior, but I'm doing all I can to meet them, and not give them any room to not approve the surgery. I have to:

• Visit my primary care physician once a month for 6 months to discuss weight loss only
• Have a psychological exam to ensure that I am a good candidate for surgery
• Meet with a bariatric dietitian to discuss the post-op requirements and changes to be made
• Have a BMI of 35 or higher
• Not gain any weight from my first visit to the surgeon to the last one right before everything is submitted to insurance

As of today's visit to the dietitian, I am down 3 pounds from my first weigh-in on the 3rd. I've met with the her, and have had the first visit with my PCP. I am seeing a therapist, but she is not allowed to do the psych exam, so I will have to make an appointment with one of the providers that is approved by the surgeon's office, and finish my visits with my doctor. Everything should be ready to go to  my insurance company in mid-May, and I'm shooting for a surgery date in mid-June, so that I'll have most of the summer break to recover while my kids go to camp.

Today's appointment was really good, as I was able to ask a lot of the questions I've thought of since my first meeting with my surgeon. I'm glad to know that the practice I've chosen believes in doing very tight sleeves (more restriction) then larger ones. They also do a liver shrinking diet for two weeks prior to the surgery to make sure that they can be as safe as possible. That's a nice way of saying brutal, evil, no sugar, 1000 calorie mostly liquid diet. Bleh. But, that's okay; it'll get me ready for the 2 weeks post op when I will be having all liquids. Not all doctors do that, but by keeping patients on liquids, there's less of a chance of a leak or bleed post op. I'm all in favor of not doing either of those things! I'll come home from the hospital with a drain - I'm so grossed out by that it isn't funny. I'm trying not to think too much about it, as it gives me the willies. And then after a week, I'll have it removed, and then it's just recover, and mend. I'll be eating probably about 500 calories a day for the first 4 months, and then it'll probably go up gradually until I'm at about 1000 by one year out. They encourage exercise post-op, and will set me up with a gym program at that time. While I'm doing the pre-op stuff, exercise isn't a huge focus, so it's mainly just increasing activity. Taking more steps, parking further away from buildings, stairs instead of elevators, etc. The only other thing I'm doing now until the time of the pre-op diet is eating only 2000 calories per day, with an emphasis on protein and fat, and minimal carbs. That is the way I will be eating the rest of my life, and the dietitian recommended I get started now, so that it won't be as much of a shock post op. The last thing she told me is that my desired goal weight is too low. She told me that I need to aim for between 150 and 155, since at the end of it all, 10 pounds will be non-metabolic skin. Again...ew. Sorry for the mental image on that one!

It feels good to have a plan, and to know the way forward. I know that the six months will pass quickly, and that by the time my son is a rising first grader, I'll be dealing with shrinking my liver and abdominal drains (ew). Patience has never been my strong suit, so this may be an excellent time to practice. Good things come to those who wait, and the journey of a thousand miles begins with one step. As I am now starting to sound like a fortune cookie, I will end this.

Until next time.
MR