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Lap_dancer's Journal

A blog by Lap_dancer

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I'm with The Band

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Here I am, Stuck in the middle with you

What is the one thing that you find most discouraging? Friends that let you down?, betrayal?, false hope?, for me it is discouragement. The thing I find most discouraging is discouragement. After all the journeys, Colorado for the Band, I had hope of finally feeling normal. Just when normal started touching my skin something else felt abnormal One year later I sit here with another narrative from a CT scan of my spine: Findings: Alignment abnormality is noted with mild levoscoliosis (isn't that what Herminone Granger said as a spell articulate?) and straightening of the cervical spine alignment. *and if I was wondering within myself that it didn't sound too bad I could read on** There are multilevel mild facet disease changes and mild/moderate disc disease changes with moderate disc disease noted of the mid and lower cervical spine from C4-5 thorugh C6-7. Mild canal narrowing and miltilevel mild neuroforminal disease* *Google this for definition changes are seen thorughout the cervical spine. No fracture of subluxation is noted. There are mild anterior/posterior spondylotic changes from C4-5 through C6-7. Impression on the next two pages: Mild Alignment abornmality and mild diffuse face and disc disease as above. So the pain in my back is worse than above and there are more Latin words. The medication worked until I didn't crap for five days. Nausea, lumps in my stomach and around made me think the medicine that took the pain away left something. A tradeoff. Back to the pain doctor tomorrow. http://www.spine-health.com/treatment/pain-medication/narcotic-pain-medications

January 12, 2009

1

The Really Big Show

It's Wednesday, January7th. I woke up this morning (with a wine glass in my hand, whose wine? what wine?...-Frampton) I woke up and got out of bed. I slept well last night. This is a big treat for me. For years the other person that is attached to the front part of my body in the form of fat prevented me from sleeping on my stomach. If I tried, my head would not touch the pillow but would hang precariously shoving my breasts up under my already tripled chin. Not comfortable. The first part of my body that noticably changed was my chin. I lost one chin, and believe me I'm not looking for it, another chin and now remains a slight flop. The stomach dropped as well. Although still there, it no longer swings from side to side and I'm not embarrassed to trot when I find the strength. In the past, a trot or slight increase in momentum caused my stomach to swing like a pendulum back and forth. So last night I had the good grace of sleeping on my stomach. I'm definately losing volume. It's because of all the rehersals. Every day I rise and I practice the habits of slow chew, no liquids with meals, protein first, avoiding altogether the things that use to fill my pantry and my stomach. By now it is habit. I'm not so fooled by the smaller sizes in clothing, the compliments which come as a nice change in my life. I know I haven't arrived and though I see the friend in the front of my body disappearing, part of her personality will remain with me and remind me of what we have been through together. The rehersals and daily habits I'm developing will some day lead me to The Really Big Show. That day when I wake up and I step on the scale and there it is...that number. It's a simple number but it represents so much. It represents the end of a long journey. It SHOWS me that I can do it. That I believe in myself enough to know that this obstacle can be overcome. By then I will be able to pick up Christopher and swing him around. I'll be able to place him on my lap and go on Disney rides and walk the park without becoming breathless. By that time I will be shopping with my sister :thumbup: and putting on clothes that are stylish and fit (and are not made by Coleman or bought at REI ..think: camping and tents...kidding). It is going to happen, this show that I am rehersing for. I believe. I know. I will succeed!:sleep::confused::eek:

January 7, 2009

1

If Six Were Nine and Other Experiences in Lavender

Part of the joy in my life comes from a group I call my "Bohemian Brothers and Sisters", the artsy fartsy musicans, painters and potters that I share my muses with. There is Dave, an amazing musician that despite a lifetime of diabetes, he is a career musician, makes a living at playing guitar ( just like a ringin' a bell), there is Glenn, a photograher who captures the money shot in less than five frames. I have Lia, she moved to Florida from the Pacific Northwest and with her she brought the aroma and eloquent love of coffee. She turned me on to Kona, roasted and freshly ground on the spot and then brewed for a cup of coffee like no other. All the memories I have of this collective has nothing to do with food. What binds us together is our passion for creating be it music, art or the promotion and support of artists in my community. It was my withdrawal from this group and socially that was my first indication that something else was goin on besides aches and pains and a depression leeching into myself that seemed to come from no where beginning about five months after my Lap-Band Surgery. Where do all the emotions go when you cannot stuff them down? The question I journaled to myself one day was this: "what do you do with all of the emotions you use to eat over?" It opened up a cave of pain that I decided to explore. From my artist group there are writers and one afternoon amid books and coffee and conversation came a discreet one on one topic between a writer and myself. She said two words: "Lavender Sisters" and Lavender Power and the story of a woman by the name of Angela Shelton. Angela Shelton was doing a short film documentary on women named Angela Shelton (her name). She was travelling the U.S. and stopping randomly, getting the phone book and looking up the Angela Sheltons all across America. What she discovered in that process was that many of the Angela Sheltons she met had something in common, many of these women had been abused. This lead to Angela's shifting her documentary theme to that of women and abuse. She documented her story/their stories. From this grew an organziation called Lavender Power which encompasses survivors of Domestic Violence, sexual abuse, rape support, survivor, child abuse, addictions, violence, healing, trauma, and features recognized individuals who reveal their own abuse stories and ways to help overcome the past. Mo'Nique, comedian and actress, was recently featured in Essence where she revealed abuse at the hands of her brother. Her story reads: The comedian says her brother molested her four times over the course of four years. He often used candy to lure her into the bathroom, where much of the abuse took place. ¢®"He still acts like he doesn't know what I'm talking about. So screw hurting your feelings. You need to get your feelings hurt, and you need to get some help." "My father was very upset, but it never got mentioned again. I'll never forget my mother saying, "If" it's true, it will surface again, and I remember thinking, Why would I lie? Why is there even an "if" in this? I was angry with them for so long, because I felt as if they should have seen what was happening Her brother, she said went on to serve 15 years in prison for sexually abusing another girl and never made amends for the abuse." As I began to journal my own pain, the hazy memories of my six year old self became clearer and then I knew their names, where they lived on my block, the hook (candy), a pup tent, some boys and myself, a little girl alone, afraid, and fleeing froma pain that left me wetting my pants as I ran through the neighbor's backyard to the safety of my own home. It doesn't matter now that my jumbled words could not find the adult vocabulary to describe to my mother what had happened to me or that soapy hand of hers coming out of the sink of dishes she was washing just long enough to slap my face for ' playing with boys'. The event remained painfully hidden until one Saturday afternoon when I was fooled into believing my friend, the brother of one of the boys, was downstairs waiting for me and he had, I was told, new toys, candy and when i got to the foot of the basement stairs I was coaxed further into the darkness only to find four boys and my friend no where to be found. Therapy helped. So did joining the Lavender group. So did finding out that 40% of depressed/morbidly obese women had some type of abuse experience. Myself included. So when we stop stuffing down the pain, it rises to the surface of our memories. From there it goes where? It comes out. It manifests itself still only this time we must face the ugly memories or face a lifetime of relapse into the old ways we relieved ourselves. for more information: Lavender Wikipedia http://www.freewebs.com/mypainfulsmiles/lavenderwikapedia.htm http://www.freewebs.com/mypainfulsmiles/index.htm

January 7, 2009

1

Lighten Up from 9 Ways

Lighten Up Resolution: Lose weight Make it stick: This resolution seems to make its way on the list every year. But in 2009, you can easily make room for fitness in your life by simply making room for it in your house. Any extra bedroom or den can be transformed into a mini fitness studio. Bring Sexy Back Resolution: Increase my sex life Make it stick: To keep this promise, start from the ground up. Help set the mood with a bedroom that is free of clutter, kid’s toys, and other distractions. 1. Clean Up Your Act Get rid of all the junk that accumulates in your bedroom. Don't use it as a dumping ground for kids' art projects, laundry, newspapers, and magazines. No one feels sexy going to bed in a warehouse. First, get everything up off the floor. Store the things that warrant it and trash the things that don't. Clear of the surfaces of chests and tables, and only replace what is meaningful or pretty. You don't want to see anything that reminds you of chores or obligations. Everything your eye lands on should make you feel relaxed and confident 2. Can the Can Lights Overhead lighting is notoriously unflattering. There's nothing sexy about a well-lit room. You want shadows, highlights, and the soft glow of filtered light. Place lamps with ivory shades on each side of your bed, and make sure the bulbs are no more than 60 watts. For even more impact, replace the white bulbs with pink-tinted bulbs. Everybody looks good in this light -- the only thing more flattering is candlelight, and pink light bulbs don't pose a fire hazard. 3. Scents and Sensibility Take the same approach to smell that you took to sight. Get rid of anything that doesn't smell great. Remove the laundry hamper to a bathroom or closet. Evict the dog, just for one night. Wash everything, down to the mattress pad. And make up your bed with the sheets folded back invitingly, the way they do in fine hotels. Choose a scented candle with care. One that's too floral may be off-putting. A better bet is one that smells fresh and clean, like Jo Malone's Grapefruit. The flicker of candlelight will enhance your sexy lighting scheme. 4. Soundtrack The "Law & Order" theme song is not sexy music. Turn off the television! Better yet, remove it from the bedroom. The bedroom should be for two things only: sleep and sex. Put a small stereo in your bedroom and play your favorite music -- it's a great mood enhancer. If you're worried about being overheard by children or neighbors, add sound insulation. Hang curtains and roll out a thick rug -- fabric absorbs sound. Next: 5. Ban the Beanie Babies 5. Ban the Beanie Babies The bedroom is your own private sanctuary, but beware what message you're sending by using it as a display case for your hobbies. Stuffed animals are a no-no, as are too many tiny pillows. What looks good in a bedding store can appear fussy and high-maintenance at home -- not the message you're trying to send. 6. Take a Look Add a mirror somewhere. It doesn't have to be attached to the ceiling, but a cleverly positioned mirror, or even a mirrored piece of furniture, can really spice things up. It will add glimmer and shine, both sexy qualities. A closet door left "accidentally" ajar, with its inside mirror angled toward the bed, can give you a thrill without risking embarrassment. By Lydia Somerville, Senior Editor

January 7, 2009

1

In the Mouths of Babes

People become protective of the babes of the world when it comes to things like smoking while pregnant, or drinking, using appropriate language and otherwise setting a good example. I don't ever recall once hearing anything about setting a good example for my family but eating healthy choices. Where were the articles, WALK-A-THONS, bumper stickers and billboards advocating the wise choices of food? How about a "No Sugar Saturday"? It's January now so of course the channels are filled with weight loss tips, diet promotions and being morbidly obese since 1992, this year is a little bit different. Looking at close to 100 gone off this body, my frame can now feel the efforts beginning to shed. Unfortunately, while compiling some digital photo files, I came across recent pictures of my two adult children and both of them are now morbidly obese. They are only in their early twenties. I am feeling terribly guilty for serving way too many soup casseroles and late night meals. I also wish we had done much more physical activities together. Bike riding, swimming, but it wasn't a priority...work was. My late nights out earning extra income and pulling into the drive-thru at 10 PM for dinner did nothing to promote a healthy lifestyle as a priority for my kids and THAT is what rubbed off on them. Aside from a game show or reality event I hope in many homes across America there are families sitting around watching the biggest loser and learning. I hope mom and dad get some tips that show up in conversation or on the dinner table and the lives of more than a few are changed to a healthier one. As for me, I will join the Discovery Challenge this year as part of my tools to discovering yet more about the me within that is crying to get out. I have the keys and I'm going for the door.

January 7, 2009

1

Truckin'

what a long, strange trip it's been... I had lost 25 lbs for our trip to Seattle. I thought I looked fabulous. But in this photo I was sitting, instead of standing, because I had been on my feet about twenty minutes so I was pretty beat. I also didn't want my hanging stomach to show in a photo, it was halfway down my legs and the girth would be obvious, so I sat. But goofing around, my husband caught this photo anyway HOW TO HIDE fat in a PHOTO and on this cruise, I hid behind a deck chair, put my hand over my chin. And he said to me, "Patty, think about all the things you would have done on our cruise if you didn't have as much weight to carry around." So often I felt like a freak of nature. But I kept going.

January 3, 2009

1

What a long strange trip it's been and my luggage.

Taken less than an hour before my surgery. What I use to look like, normal, healthy. 128 lbs. in 1978. It's not how long your journey is that matters, it's how much luggage you are carrying. Losing my luggage.

January 3, 2009

2

When it begins to slow down check and then check again

About eight months ago my weight hung around three hundred pounds like un wanted company. I checked my food intake, looked at my card to see if I was green. I had my last fill in Feb. 2008. I had great restriction and felt like I finally hit my sweet spot. Long spaces of time between meals, not even thinking about food, obsessing about food is more like it. That was gone. Drinking my meals, gone. Gulping food, gone. I had retrained myself successfully but each time I tried to do the rest of it, the working the body to strengthen it I got nothing but pain. The more weight I lost, the greater the pain. This wasn't part of the bargain, sure, my knees stopped hurting, my feet stopped hurting, no more diabetes medication, no more snoring. This part I had hoped for but the pain. It radiated down my spine. It shot down my right leg. I felt stabbing pains in my groin and lower stomach. The more I walked the worse it got. The only thing that gave it remedy was bed rest. My life was work and then going to bed. It was easy to see why my weight had slowed up. It took getting caught at work not being where I should have been because the distance required walking was too much, and having my boss sit me down and confronting me to force me to confront the pain. What the truth was and is remains. That I have lost over eighty pounds, over fifty since being banded, and despite have good restriction and food control I am unable to walk any distance or stand longer than five minutes. I stepped back from focusing on the scale and focused on cause. I started with my doctor who ordered an MRI of the area most disturbing. It came back and there was part of it: arthristis, bulging disc, compressed vertabrae, scoliosis. My lower spine was a mess. To keep me working, I cannot afford to stop working, I was placed on morphine and it helped slightly. In late November I went to the Cleveland Clinic in Weston, Florida. A second MRI was done, a CT Scan of my abdomen, revealed the beautiful band Dr. Kirshenbaum had inserted was exactly where it was suppose to be. My band was fine. I had a hiatel hernia though. I had a hernia filled with fat in my stomach near my navel. This will need to be repaired when they do the surgery to remove the skin that is becoming part of the problem. I will need a lower body lift. My stomach had gotten so large and now that it was shrinking, my body was redistributing the weight and it was pulling higher up on my spine. In that location where I had the most stress from my stomach, the spine slides out of place. The nickname is SPONDY and the long name is two other versions of SPONDY that I was diagnosed with also in my cervical spine. The next test will be a CT Scan of my entire spine. Now that they found one, two maybe three or four sources of the pain, no one is stopping the doctors. This next year will be filled with rehab. Physical and Occupational. When I get over this hump I have the vision of a better life, the same vision that got me started. Onward I go...

December 25, 2008

1

Photos and getting near the present

Picking it up now, I am glad I journaled those words. I'm glad moreso that I took the photos that reveal the mass attached to my body. I'm coming up on two years now. My anniversary and birthday is April 17th. It feels more like a birth. The unexpected hit me hard and I wasn't prepared. Foremost I had to speak the truth, what my real weight was, the peak weight. It was documented when I went to the hospital so I know just how big I got but fearing I would be turned away, jeered, and yelled at, like the local doctor who refused to consider me as a patient and told me if I didn't lose weight ..I wouldn't fit on his surgical table.. It's amazing how much abuse you are willing to take when you are so desperate. It was 392.8 I can say it now, I was close to four hundred pounds. I'm not there anymore. Motivated by the rejection and spurred on by the hope of getting a band, I began slowly losing a pound at a time by mostly starving myself. I wanted it so bad. Looking back I think I was at around 370 when I first spoke to Dr. Kirshenbaum's office. The day before banding I was 352. I kept going...still going...with more walls going up than I could imagine.

December 25, 2008

1

The words that lay low in my soul

11:37p A long thoughtWhen does it become necessary to elevate your dispair to a level of desperation. Such is the case of myself. No one can possible know the depth of depression to rise in the morning and swing my legs off the side of the bed and pause , feeling the rush of blood to my head...dizzy...grabbing the headpost of my bed and bracing myself as I pull hard for support to rise from my bed. Walking on the sides of my feet because THAT is less painful than walking flat footed across to the toilet. By then I am winded. And this lifestyle is okay? This lifestyle is not life threatening enough to look at a procedure that gives pause to the cycle of death by dietlessness. new word. on I go............

December 25, 2008

1

And the WORD was NO. No insurance paying..desparate people do desperate things

Sulking within myself I spent the next six weeks feeling it was all a waste. Then I found a website, LapBand Talk. I wasn't alone. Loads of rejection just like my own story with my insurance. Then it came to this day: Just beforeIt is less than 24 hours before my flight to Denver. I'm thinking of John Denver's song "Rocky Mountain High" because it takes me back to 1976 and happier times. I think of patchwork quilts and Earth shoes, incense and anything natural down to makeup. I'm showing my 70's. I'm finding the place where the trees outside are golden, fall is in the air of my mind. I can smell leaves burning on the cool breezes and comfort settles over my self. Once there I can open up to anything. The raw emotions that well are not as intense, do not pain me as much and I can allow the emotions to course through me. Why did she call me 24 hours before my flight, after the arrangements were made, after the time is off from work, when I am going to get the surgery. Why? I know the answer but to confront her would only produce the script of posts I always hear, like a high school yearbook where everybody wishes the same but doesn't always mean it. Her need is so powerful her human condition and that of my sister seems profoundly sad. I sit here feeling sadness for them and for the need to tear down that which they fear, things they cannot control. This is my journey. As long as I remember and when I didn't know how to say those words it seems that has always been the straw I drew. Stay in your room, read a book quietly and stay out of the way as much as you can. Walking into mom and dad's room and my sister sitting on the bed deep in talk with mother. What was that like? To share your deepest thoughts, your dreams, your problems with your mother. She only had time for the oldest one. I learned young to find my answers in magazines, ask my friends or their older sisters. Listen to their mothers. I realize now that the women who influenced me most were not biological at all. My teachers at school. There was my Health teacher in 7th grade who was fit, put together every day with coordinating clothes, heels and patterns that were interesting. Her color choices were vivid and jewelry boldly accenting her wrist or neck. How she described a woman's period "just a couple of tablespoons of blood, that's all" made sense in a simplistic way. Compare that to mother's talk to me in the parking lot of Bate's Burgers one spring night when I was filling out an application for summer camp. The question? "Does your child know about menstruation?" I asked what that meant. I must have been 10 or 11. "Well I guess you're old enough to know". I knew that "old enough" meant something in my family. There were the haves and have-nots of knowledge in my house growing up and it had everything to do with age. I compare that with how I raised Crystal and no topic was off the table. I told her what jacking off meant, slut, cunt, names for "intercouse": fuck, bang, and anything else she heard at school. Why lie? Why hide anything? No big secrets to knowledge, it will empower her. I use to work with a woman who lived in a lovely apartment in Louisville, Kentucky. We worked together at a store in the mall and one snowy night when traffic outside the store was slow save for the occasional lone figure walking the mall, the blizzard outside persuaded her to talk about a sexual encounter on another night years before with a musician who played the guitar by the fire while it snowed outside. Lying nude, she reached over and touched him and he became so overwhelmed he shot his load before hello. She also shared her mother's philosophy about telling her everything in life that were taboo subjects so that by the time she got to middle school and she heard whispered words by girls huddled around talking about "it', she was able to cut through the bullshit of misinformation and correct them; "That's not right" "That's not what it means". I embraced that idea then and decided if someday I ever had a child, I would follow the same teaching. I saw my friends enjoying intimate moments with their moms. There was the time I was at Lula's house and her mother "Gertie" was sitting in the living room talking about school board members. She has known most of them since they were kids and had grown up in the community. A political voice, Gertie Jung was unlike any woman I had met. Fire red hair, and eyes that seemed to pierce through any fog of bullshit, Gertie had an opinion or story for just about everyone. She encouraged her girls to be independent within reason but more than anything she encouraged them to have a political opinion, hers preferably. It was 1976 and from her I gleened a strong political interest. That year we worked the polls where both Lula's parents ran for office. We spent an entire day in the old gym at the elementary school that once housed the old high school. It sat on the top of a hill just off the road in the little town where Lula lived. Those moments, those places were lightyears away from my house where opinions were given but not received. Who was running for office? Who knew. And what to think was gleaned from the Fabian haired preacher at our church. I think back then and realize that while at home, I had two moments, staying in observation mode and out of the picture or out of the house. The less anyone knew about me the better. So here it is the night before my flight to Denver where I'll take on a new persona, a new journey to truly getting healthy. I wish most to find my old self underneath these layers of someone I am hiding from. Church could not save me from myself and it has nothing to do with faith or belief. I know so many people who purchase diet programs, pills, join clubs with faith that they will arrive to that goal in their minds. Still, six months later, perhaps smaller or in my case, about the same having lost and gained, failure looms over their heads. Faith and Fail are only different by two letters. Flying into a different time zone, one mile above sea level, I do have faith. I have faith that whatever I do different from what I have done is better than repeating a cycle of failure. Chris will be by my side but I know there will be the moment when my room will be empty, I will be prepped and ready to go in. I have no fear. None. I will be alone as I have been alone many times. All that I gain in my strength comes from those who have gone before me. The ones who talk to me about what to expect, those who suffer with this disease as I have. Those who feel pain when they walk and judgement by their appearance. Those who know they were passed over for one prettier, whose absent credentials or soft work experience are compensated by a thin appearance, or the flash of a white smile. They know. In my mind I hold their hands, I hug them around the neck if the waist does not accomidate. They are my brothers and sisters. They are the ones that come to me as a new family. Onward we go with faith of a life filled with possibilities.

December 25, 2008

1

A letter of appeal to the Review Panel

Date Printed: January 5, 2007: 10:48 PM Supplemental Letter for January 9, 2007 January 3, 2007 Dear Review Panel: Presented to you for review is my case for a gastric procedure known as a laproscopic banding procedure or "Lap-Band". In a lower review, BCBSFL did not dispute that I meet the criteria for the Lap-Band procedure. There is no dispute that I would benefit from weight loss surgery and there is no dispute that losing weight would be beneficial to my health. At issue is the coverage of this surgery and the exception I am requesting for this exclusion. Ironically, I received a phone call a few weeks ago from BCBSFL's new Diagnostics Program that offers support to wellness. Through this program, I gained beneficial information in the form of a booklet, catalog and DVD on the very weight loss surgery I am requesting. There is evidence in my medical records that I have tried for years multiple weight loss regimens and used pharmacotherapy for obesity under the supervision of my physician, Dr. Alan Sichelman. For my mental state, it is documented by my therapist, Jane Fenby, that I have a full understanding of what this procedure entails and that it will be a lifetime commitment on my part. There is no indication that I am unstable, misinformed with perceptions of unrealistic expectations; Rather so, that I have pursued this avenue under the direction of my primary care physician and other medical personnel, with cooperation, information and education; That I am laying the course for my surgical event and post surgical life by the compass of these individuals and their combined medical expertise demonstrates I am an individual who very much wishes to be healed. Unquestionably, I am ill and feel I am fighting for my life. As a result of my severe morbid obesity, I suffer from sleep apnea, diabetes, depression, back problems, joint pain, hypertension, migraines, Pictures will show my condition and the severity of my obesity. It is true that my life is endangered. This procedure will prevent the worsening of my condition, alleviate present harmful medical conditions and perhaps cure them. It is the conclusion of my physican(s) and myself that I am in need of this operation. Please authorize my surgery. Additional: As providers of health care coverage, Blue Cross and Blue Shield has historically authorized weight loss surgery. Currently, Blue Cross and Blue Shield of North Carolina cut in half hospital re-admissions "by the twelve surgeons in North Carolina that are designated as centers of excellence for bariatric (obesity) surgery." Additionally, BCBSNC was one of the first insurers in the nation to officially recognize centers of excellence for bariatric surgery. Illinois also follows this model as well as South Dakota, Iowa, Michigan and several other states. In recent publications in the Tampa Bay area, BCBSFL appears to be using bariatric surgery denials as a financial decision rather than one in the best interest of patient care. I must express my concern that with sufficient evidence from their medical providers and informed decisions with which they move forward, it is very troubling that patient/physician decisions of health necessity are disrupted, ignored and denied, superceded by a focus on cost. It is hoped that Florida will soon follow the successful excellence practice as established by Blue Cross and Blue Shield in other states. Patricia Reeves

December 25, 2008

1

APPEALS LETTERS: Whatever it takes.....

Letter of appeal [04 Jan 2007|05:47pm] Dear Maryann: Thank you for our conversation today regarding my Physican to Physican review and Level Two Appeals. I understand that you will contact Dr. Sichelman and let their office know what time to phone in for the meeting. I won't be calling in as I believe the final information I would send would be these photos. I'll add captions to each one so that your team can understand what the photo is of. First, I was not able to capture my entire body by myself because it is too large. I used the bathroom mirror so I apologize for the lack of clarity. Please let me know if you wish to have clearer photos and full body. My husband will be home later and can take them for me. Photo 019: On the bed taken from below my stomach looking up towards my face. This is how I must sleep because my stomach is large and gives me back pain if I lay on my back. The fat folds present on my body create havens for infections in the form of yeast infection and trapped moisture from perspiration or the shower. Eventually I will produce a small red blister (022 photo) that if not controlled can spread into a very painful rash. I use hydrocortizone solution on my skin on a regular basis. You can see the scaring that has already taken place under my breasts. This is also true under my stomach. These pictures illustrate the depth of the fat folds which are up to 12 inches in depth. I am attempting to hold up my stomach when I sit but can only lift the front portion. 002 , 003 and 006 and 009 for a fuller body view of how low my stomach drops. The stomach falls between my legs and when I urinate on the toilet part of my stomach drops into the bowl if I am not careful. I've never "hit water" but the bacteria contact is what I feel is responsible for these random blisters and odd "pimple" like discs that appear on my skin in that region. They can sometimes leave a scar.(003) There is one healing on the underside of my stomach in this photo. I have also lost much sensation in my genital area and as a result do not experience sexual pleasure. This is the part I referred to impacting my husband and our spousal relationship. Photo: 002. 005 and 006, 009. This is a lower viewpoint of my front stomach. The navel is about six inches or more below the center of my stomach. There is a tiny tear in my skin below the navel.005 I have a serious balance problem as after walking for a few minutes my body pulls forward and down. My back becomes sore/painful and weak. My legs also tire and my feet begin to ache. The position I am standing in against the bathroom wall is what I typically do if I am in a store and there is no cart to support my weight. 009. I lean against a wall or rack. Most of the time I simply don't go out. Walking is becoming too painful. Again, if there is anything else I can send visually to put a name with a face and body, please let me know. I would appreciate confirmation the photos came through clear for you. Thank you. Patty Reeves

December 25, 2008

1

Appeals letters

Appealing this thing to BCBS/Level II appeals to insurance [03 Jan 2007|05:53pm] Level II Supplemental Letter for January 9, 2006 January 3, 2006 Dear Review Panel: Presented to you for review is my case for a gastric procedure known as a laproscopic banding procedure or "Lap-Band". In a lower review, BCBSFL did not dispute that I meet the criteria for the Lap-Band procedure. There is no dispute that I would benefit from weight loss surgery and there is no dispute that losing weight would be beneficial to my health. At issue is the coverage of this surgery and the exception I am requesting for this exclusion. Ironically, I received a phone call a few weeks ago from BCBSFL's new Diagnostics Program that offers support to wellness. Through this program, I gained beneficial information in the form of a booklet, catalog and DVD on the very weight loss surgery I am requesting. There is evidence in my medical records that I have tried for years multiple weight loss regimens and used pharmacotherapy for obesity under the supervision of my physician, Dr. Alan Sichelman. For my mental state, it is documented by my therapist, Jane Fenby, that I have a full understanding of what this procedure entails and that it will be a lifetime commitment on my part. There is no indication that I am unstable, misinformed with perceptions of unrealistic expectations; Rather so, that I have pursued this avenue under the direction of my primary care physician and other medical personnel, with cooperation, information and education; That I am laying the course for my surgical event and post surgical life by the compass of these individuals and their combined medical expertise demonstrates I am an individual who very much wishes to be healed. Unquestionably, I am ill and feel I am fighting for my life. As a result of my severe morbid obesity, I suffer from sleep apnea, diabetes, depression, back problems, joint pain, hypertension, migraines, Pictures will show my condition and the severity of my obesity. It is true that my life is endangered. This procedure will prevent the worsening of my condition, alleviate present harmful medical conditions and perhaps cure them. It is the conclusion of my physican(s) and myself that I am in need of this operation. Please authorize my surgery. Additional: As providers of health care coverage, Blue Cross and Blue Shield has historically authorized weight loss surgery. Currently, Blue Cross and Blue Shield of North Carolina cut in half hospital re-admissions "by the twelve surgeons in North Carolina that are designated as centers of excellence for bariatric (obesity) surgery." Additionally, BCBSNC was one of the first insurers in the nation to officially recognize centers of excellence for bariatric surgery. Illinois also follows this model as well as South Dakota, Iowa, Michigan and several other states. In recent publications in the Tampa Bay area, BCBSFL appears to be using bariatric surgery denials as a financial decision rather than one in the best interest of patient care. I must express my concern that with sufficient evidence from their medical providers and informed decisions with which they move forward, it is very troubling that patient/physician decisions of health necessity are disrupted, ignored and denied, superceded by a focus on cost. It is hoped that Florida will soon follow the successful excellence practice as established by Blue Cross and Blue Shield in other states. Patricia Reeves

December 25, 2008

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The Fat Lady is Tuning UP, Dec. 20, 2006

Embarrassing, Humilating, Why I hate going out in public and eating... I think there is something very wrong with a person who never wants change. Cenophobia or Centophobia- Fear of new things or ideas. Decidophobia- Fear of making decisions. http://phobialist.com/ The Fat Lady is Tuning Up [20 Dec 2006|10:05am] [ mood | bouncy ] Last night was my mother's 75th birthday. There is a special seafood restaurant on the edge of the Cotee River that serves their dinners with shiney oak floors, high polished brass shipboard props and taxidermed fish floating through the air. We do love our appetizers. Vidalia onions, sliced medium, dredged in cracker meal and fried right. Here came this plate heaped high and hot. Out of the six people at our table, the other server placed the dish directly in front of me and not blinking he looked me square in the eye and asked if I would like a refill on my tea. "Sure", I said. I looked at the rest of my family and they didn't see what I saw. The server automatically thought the food went to the fattest person at the table! Being my usual sarcastic yet jovial self, I hunched over that plate like a dog on a meat wagon and annouced to the waiter " I'm good " while I grabbed a hot ring. My husband immediately picked up on it, my sister didn't, my mother was more wondering why HER rings were not down at her end of the table. It's that assumption. Like it never goes away or it goes so far away assumption has crossed the space-time continuum and will meet me sometime next year. Like the booths at (Belly Deli) restaurant. Who believes that the average human has the body circumfrence of a medium sized vase? So I got to the point of asking for a "Belly Booth". Hey, who wants a gastric bypass with your dinner? Reflux with your dessert? "No thanks, I'm good".

December 25, 2008

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The Appeals Process Begins 11/2006

THE FIGHT BEGINS [02 Nov 2006|08:09am] Hello Maryann: Please note the following BCBS finding and add to my review for the Level II panel prior to the meeting. Perhaps inter-office documentation will have a broader scope on this. PR November 2006 The following Assessments and Special Reports were acted on at the November 2, 2006, Blue Cross and Blue Shield Association Medical Advisory Panel (MAP) meeting: Laparoscopic Adjustable Gastric Banding for Morbid Obesity The MAP concluded that laparoscopic adjustable gastric banding for morbid obesity meets the TEC criteria, when performed in appropriately selected patients, by surgeons who are adequately trained and experienced in the specific techniques used, and in institutions that support a comprehensive bariatric surgery program, including long-term monitoring and follow-up post-surgery. Source: Blue Cross and Blue Shield Technology Evaluation Center, November 2, 2006 http://www.bcbs.com/betterknowledge/tec/press/

December 25, 2008

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Our Meeting, October 17, 2006

Last night was my first meeting with the support group. The new attendees were there by 6 PM for the lecture on the gastric procedures. Already I am feeling like a graduate of Novice University. Chris and I arrived about a half an hour late and caught the tail end of the presentation. Next month I think he and I should go to the 6 PM orientation so he can understand what is happening. Chris seems as eager for me as I am for myself. He has questions like he did when I was pregnant with the children. In a way, I feel like I am pregnant again and giving birth to a new self in as little as six months. I remain very hopeful, hope I have not felt for a very long time.

December 25, 2008

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Marilyn Knows: Words Part II

Now, about real psychological issues. On one list on which I participated for a long time, the subject of childhood abuse came up and a surprisingly large number of people, mostly female, but some men too, had been abused as children. I don't know if there's been any research to see if there is any link between childhood abuse and obesity, but I bet there is one. But of course, that is apocryphal. Just my gut suspicion. America is a food-centric society these days. If you doubt this, watch the ads on TV. Count how many ads there are for food in a given hour. I never really noticed it until after surgery when I felt absolutely bombarded with ads for pizza, burgers, fried chicken, ribs, Italian food, soda, beer ... and more and more. For a while it made me crazy. Now it just makes me queasy. I look at ads with happy (thin!) people scarfing down chunks of pizza and fried chicken and all I can see is grease. Yuck. Last I heard, the average woman in this country wears a size 16 ... AND our sizes are MUCH bigger than they were 30 years ago. If you doubt that, go buy some clothing made during the 50s based on your current size and you'll discover that they won't fit. Americans are MUCH bigger ... in every way ... than they used to be. We are, on the whole, overweight. Some of us are just a little overweight, some much more so. How many restaurants sell themselves on serving big portions, eh? The morbidly obese are not exactly their singular target audience, so eating a lot must be a pretty prevalent phenomenon. So maybe ... just maybe ... we who have been or still are morbidly obese somehow think that we have ever so much more baggage than Normal People, whoever they may be. I have a theory. It is unscientific, unproven, and as such is merely my subjective thoughts on a clearly delicate subject. I think most people overeat some of the time. A lot of people overeat most of the time. Some people overeat all of the time. I don't think that psychology accounts for it, except for a small percentage. We live in a society where food is plentiful and cheap ... where fatty, rich food tastes really good. Food is a social function. We get together and we eat. Because we can eat more than we need, we do. In societies where food is scarce, people eat less. In societies where overeating is anti-social, people are -- on the average -- thinner. Some of us are genetically pre-disposed to gain weight and for whatever reasons, are also more inclined to not lose it. That's why it's so common to see multiple siblings in various sizes, even though they've all had essentially the same upbringing. I have two siblings. My brother is overweight, but not fat. My sister is thin. I was fat, now thin. My father was fat, lost it all, kept it off for the rest of his life (50 years to date). My mother never let herself get fat, but she had the discipline of a Marine drill instructor. If she gained five pounds, she immediate increased her exercise, decreased her intake, and lost it. Of her five siblings, 3 were heavy, 3 thin. In my dad's family, the women were fat, the men thin, except for my father who was fat then thin. Does this prove anything? I dunno. Does it? Many of us have really bad eating habits. I'm not sure that bad eating habits are quite the same as Serious Psychological Issues. I think we beat ourselves up a lot. I think we incorporated other peoples' judgments of us into our opinions of ourselves. I think that because we feel that we have somehow failed, that we are more inclined to fail. Whether it's ghrelin levels, sociological conditioning, childhood trauma, low self esteem, some combination of the preceding or whatever, WLS works better than any other solution for the disease of morbid obesity. The rate of long term success for any traditional diet program is poor. And for those of us with complicated medical issues, dieting success percentages approach zero on a close order. And finally, I find it interesting in a society where the average woman is pretty hefty that somehow, those who are more than a little hefty come in for so much abuse. Is it because the merely overweight amongst us feel somehow better because they aren't as big as we are? And when we have surgery and lose the weight, why do so many of them get so hostile? Maybe they feel a little threatened, eh? Maybe even jealous? Maybe by the time the next generation grows up, there will be better, less drastic, solutions to overweight. In the meantime, this one works. Marilyn Marilyn Armstrong Open RNY 3/4/02 Starting weight 258lb., current 110lb. (more or less) at 5'3"

December 25, 2008

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Marilyn KNows: Words from one who knows the Journey

Obesity, Psychology and Weight Loss Surgery by Marilyn Armstrong co. 2003 (write to author for re-print permissions) Okay. Time to shove my (unasked) oar in these waters. I am a gastric bypass patient (3/4/02) who has had multiple complications. In fact, I still have multiple complications. AND I have lost much more weight than I intended and am now downright skinny, although others seem more disturbed by it than I am. And no, I do NOT regret the surgery. Sure the complications have made my life difficult. Sometimes, my life has been beyond difficult ... downright impossible. But thin is STILL better. I am not complaining. I also greatly question Weight Watchers' stats. Do they count the dropouts who do not lose weight, cannot keep on track, and are too embarrassed to continue to come to meetings? Or do they only count those who stay in the program? This is a pretty self-selecting sample. The people who stay with the program are, for the most part, people who are succeeding at it so the statistics will clearly show that IF YOU CAN STAY WITH THE PROGRAM, YOU WILL LOSE WEIGHT. Maybe you'll even keep it off, although I doubt they have tracked the stats on those who do well, then stop coming. What happens to them? I lost weight on every single diet I was ever on until right before surgery when my battered metabolism just gave up and refused to lose weight no matter how little I ate. Jennie Craig got me down 85 lbs. and I kept it off (or most of it, anyway) for more than ten years ... then stuff happened and I threw in the towel, regained all of the weight I lost and added about 40 bonus pounds. Why? It's a long boring story and I'll skip it for the nonce. So here I am, 19 months post op. Am I happy with my weight? Yes, although I admit that 10 - 15 more pounds would probably look a bit better ... but I'm a little frightened of trying to gain weight and in any case, I figure once the docs get my other issues sorted out, I'll probably put on a few pounds as a matter of course. My body has a natural set point and after I can eat more normally, I expect that I'll find it. Am I happy about food? No. I really can't eat much and am highly limited in my choices. It has certainly taken the fun out of food for me, but I have learned to enjoy table talk and ambiance and discovered that there are other reasons for dining than just eating. Would I like to be able to eat a bit more normally? Sure, but life goes on regardless. Has my marriage fallen apart? No, it hasn't. Is it better? No, it's about the same as it was. Whatever problems we had before, we have now. The strong points are still strong. The weak points are still weak. IMHO a lot of people have crappy relationships and all it takes is one big precipitating event and the whole house of straw comes tumbling down. Are morbidly obese people inclined to have crappy relationships more than "regular" people? What do YOU think? Take a person who feels physically poorly much of the time, probably has a self-esteem issue -- if not from some childhood issue, than certainly as a result of being a very fat adult in a society that idolizes "thin" and voila -- low self esteem served up on a silver platter. I know a lot of divorced couples. I've been divorced too. In fact, the stats in the northeast are something like 1-in-3 regardless, and probably among certain professions (like media, say -- and yes, I do speak from experience here) it's a lot higher. Also higher in cities than in the country. Also higher among those with higher incomes. Divorce is very very very common in our society and a sampling of ten couples who didn't make it post WLS hardly constitues a meaningful sample. Among the Weight Loss Surgery (WLS) couples I know -- maybe 30 couples in all -- only one actually went to divorce ... but they weren't in great shape before. Other couples had a bunch of issues to sort out, but thus far (in this last 19 months that I've been paying attention to this stuff) seem to be working it out ... as least as far as they are concerned. Others might argue the point and some of them would probably be better off divorced ... Should there be a better way to lose and keep off weight than massive reconstruction of the digestive tract? Yes, I really wish there were. This procedure is very drastic and not for the faint of heart. If you are doing it so you'll look better in your clothing and that's all, well, that's not good enough to get you through any rough times that might develop. But I think most of us did it because we believed that it was the last-best chance for a healthy life. In some cases, it was do or die, quite literally. As for me, I was either going to lose at least 100 pounds or probably be confined to a wheelchair for the remainder of my time on earth. That was not much of a choice. Part II continued

December 25, 2008

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October 9, 2006 Insurance

Shall we dance? It occurred to me while being on HOLD with my insurance company that I am an I.D. to them. A subscriber. So far this subscriber has done everything prescribed to jump the hoops one step closer to the belly dance. So far I've had the ignorant, prejudiced dietician with the health department tell me I need to learn more self control. She also felt the need to tell me this procedure could kill me. And my lap band procedure relates to 12 grapes with carbs how??? She never did mention the food groups but did find time to reveal what she was really thinking, well...you could tell she was thinking it. That all fat people just haven't enough will power. That's it. When it comes right down to it we choose not to turn away from a wrong food choice and it's all our fault that we are obese and we deserve every heart attack, stroke and disease that comes our way. She isn't alone. You can almost see it on the faces of some folks. The way they look at someone who is heavy. No, strike that, let's just call it fat. Not "large, plump, round, PLUS (that's one of my favorites)". It's fat. Let's just come on out with it. and my feet hurt, my back hurts, my legs hurt, my shoulders hurt. I dream of a year from now when I can walk comfortably. I dream of the day when I can run. I dream of the day when I can cover the distance and not breath heaving with each inhale. I have taken a vow to not forget these moments of my life as they are and have been for the past 20 years. The slow rise on the scale. The first time I hit 300. "Don't ever hit 300" she told me in 1993. That was 13 years ago. I past that number a long time ago. So Linda, I didn't listen. Dad, I guess your heart attack didn't hit me hard enough despite the panic disorder it left me with. Grandmother, your diabetes ate away at you, like Pop, losing his legs, but this food addiction has me so hard by the throat I must resort to drastic measures. I must not be the first. United States Patent 5226429 A gastric band adapted for laparoscopic placement around the stomach and a method for deploying the band is described. The band is useful for creating a small pouch with a reinforced stoma in the stomach for the treatment of obesity. A first cannula is introduced into the abdominal cavity. Following gas insufflation, a camera for observing the placement of the band is introduced into the abdominal cavity by means of the first cannula. Two additional second and third cannulas are placed within the abdomen.

December 25, 2008

1

The insurance challenge begins

Trying to weigh down the heavy. You would think with all of the excersion I've experienced in my life, the insurance industry would understand that NO simply means an obsticle to overcome. Don't they appear to be the first to confess that WE the obese of America, have a difficult time accepting NO? So why all the fuss? Why the obstacles to my surgery? Get this. Today my insurance company told me they have no list for dieticians or nutritionists. Nothing. Nada. Job description for nutritionist: Counsels participants in response to their nutritional needs in attempting to motivatepositive changes in behavior which will affect their nutritional status and possibly preventfuture medical problems, Develops/teaches classes to participants, meeting the Nutrition Education objectivesdeveloped to meet the needs of the target population 4.Establishes methods of evaluating achievement of nutrition education objectives. 5.Develops/implements nutrition in-services for the staff, enabling Nutrition Technician toteach nutrition education classes and counsel participants. ......................................................................... Sounds preventative to me! Which leads me to believe that staying FAT keeps the medical industry in business. Let's see we have The heart: Cardiologist The lungs: Pulminary The stomach: Gastro Blood chemistry: All that lab work. and most of all THE MEDICATIONS! I'm on NINE. More on this subject later.

December 25, 2008

1

Sharing my find

Lap DanceThat's what I'm calling it. I'm going to do the Lap Dance, I'm going to be Lap Dancing. Still waiting to hear from the physician's office. I will call them once I get home. I may take tomorrow off. I have an urgent urgency to get this done. Last night I told my daughter. It was almost 3 AM, I couldn't sleep. My intention was to tell no one, just my husband. I stayed up because I am so excellerated in my hyper mental state that my normal LULL to bed is gone. She was up from coffee. We sometimes adjourn to a room by ourselves for lovely talks that can go on for several hours. I hesitated in telling her. Because I have an absolute drive for no one to know (more on that later) I am fearful the secrecy will be compromised. But after assurances that she promises not to tell, I told her. I swore her to keep it a secret, to tell no one. She understood with almost no explanation necessary. And so now I wait for the call. I wait for the OK, GO. Waiting you'd think but I know better

December 25, 2008

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The Band

Lap-Band: Laparoscopic Gastric Banding [07 Sep 2006|08:41am] What is it? The Operation: The idea behind the operation is to create a small pouch in the upper part of the stomach with a controlled and adjustable stoma, without stapling, thus limiting food intake. A gastric band device is introduced through tiny (1cm) incisions in the abdomen and is placed around the upper part of the stomach. The resulting pouch (or the "new stomach") dramatically reduces the functional capacity of the stomach. The band has a balloon from the inside that is adjustable and can reduce stoma size, thus prolonging the period of fullness. The operation is performed under general anesthesia and can last between 30 minutes and 1 hour. The Band is fitted around the uppermost part of the stomach, forming a 15cc small pouch. It is designed so that it can be inflated or deflated at any time after the operation. This helps the patient continually lose weight until they reach their goals. The restriction takes place in the radiology suite and normally takes 15 minutes. This simple procedure is painless they inject saline into a port placed under the skin in the wall of the stomach. The tube that comes off of the band leads to the port. The positives: - No cutting of the stomach - No stapling of the stomach - Calibrated pouch and stoma size - Can be adjusted to patient's needs after surgery with no operation to adjust the stoma - Laparoscopic removal possible - Fully reversible - Short hospital stay (does not exceed 48 hours) Lap Dance That's what I'm calling it. I'm going to do the Lap Dance, I'm going to be Lap Dancing. Still waiting to hear from the physician's office. I will call them once I get home. I may take tomorrow off. I have an urgent urgency to get this done. Last night I told my daughter. It was almost 3 AM, I couldn't sleep. My intention was to tell no one, just my husband. I stayed up because I am so excellerated in my hyper mental state that my normal LULL to bed is gone. She was up from coffee. We sometimes adjourn to a room by ourselves for lovely talks that can go on for several hours. I hesitated in telling her. Because I have an absolute drive for no one to know (more on that later) I am fearful the secrecy will be compromised. But after assurances that she promises not to tell, I told her. I swore her to keep it a secret, to tell no one. She understood with almost no explanation necessary. And so now I wait for the call. I wait for the OK, GO. Waiting you'd think but I know better

December 25, 2008

1

And then they said NO: Sept 6 2006

and then they said NO[06 Sep 2006|04:23pm] Everything I have done in my life has led me up to this moment. My reading of positive books, my most preferred books by Gerry Spence "How to Argue and Win Everytime", there was a Gerry in my orientation group ( a sign?) there was an orientation class happening on a Monday that I happened to have off ( a sign?) that Monday was only a few days from when I first called this center ( a sign?), my ability to deal with insurance companies after being responsible for that when the business had insurance ( past ability that come to my aid now?) being a secretary for seven years and writing business letters ( so I can deal with corporations?) and appealing a "Not covered". When I spoke to my insurance company did I expect them to tell me it wasn't covered? Of course! Who am I kidding? I need this so bad so of course it isn't covered! Does NO ever mean NOOOO? Hell NO. Not in my world. This is where stubborn comes in handy. This is where putting on the b8tch hat of determination makes for a more positive result. Knowing that this person is a human being, knowing that she is doing her job and she didn't write the rules and knowing the last thing she wants to tell a 355 pound woman is "NO" your insurance doesn't cover this procedure that will likely lengthen your life; Knowing that gives me a calm when I speak to her. Her name is Darlene and she is the next level after customer service. There are always the other levels of people that you speak to. They work at banks and they reverse bounced check fees, they are supervisors that reverse policy under special circumstances, I was shooting for the special circumstance and I believed with all my heart that when I spoke to her yesterday, I WAS the special circumstance. I did something with Darlene that I have not done since I got this heavy, I cried. The human in me escaped and I wept. I apologized. She told me it was okay, to "let it out" and I did. I told her that I had never cried about this before but that I felt like "No" was a death sentence. "He told me ten years" and then I cried some more. She told me she too had dealt with something similar, not weight loss surgery but an illness. *there are real people on the other end and they know* I think everyone has a loved one in their family, extended family or friend who is obese. They love them and they worry. They see the stories on television and in the magazines "Woman loses 200 pounds" or worse still ( 1 ton man stuck in door frame) How did they get that way? I know I know!! One pound at a time, one mouthful at a time. So they said No and I cried. Then there is the BUT. The but is called "medically necessary". ((and I'm here to tell you that medically necessary is me)) The steps to follow are that my doctor (the one who recommended gastric surgery, the one who knows I have tried, the one who has been on this journey with me) needs to contact my insurance company and follow the procedure outling why I need this. (10 years?) So I compiled a letter and I sent it by fax to him. I'll eventually post them on here. Waiting now. No? Yes? If it is no, I swear to all that I will drive to an appeals hearing and I am completely prepared to strip naked in front of all of them. I will lift my stomach and offer that they can hold it if they want to "you can even touch it, here..it's okay!". How many think they would coil with repulsion? I do. They don't know how determined I am. Waiting.

December 25, 2008

1

Journal , Time to Start This Journey, from Sept.3, 2006

Time to start this journey [03 Sep 2006|10:57am] [music | The first time ever I saw your face [03 Sep 2006|10:57am When did it hit me? When Chris said, "think of all the things you would have done in Alaska had you not had a mobility issue"(?) Probably. It all seem to come to synchronicity (great album BTW). Half day at school, I needed to renew my prescriptions and see the doctor about that darn rash. I went to my dentist after school let out and had that off bite drilled down since it hadn't really felt right since doing the new filling. It took but a brief five minutes and I found myself back out in my car and heading towards Main Street. Left. I think I'll get those prescriptions in person rather than waiting for the pharmacy to call them in. Five blocks away and I was parking right next to the front door. How often does that happen? I walked up to the window and signed in and sat down. "Mrs. Reeves did you have an appointment?", a new receptionist peered out from the glass partition, "No I just happened to be in New Port Richey for a dentist appointment and need to have a rash looked at" (TMI I though to myself, too much information) but it seemed to appease her and I waited. Less than ten minutes and I was walking down the hallway past the examination rooms, going, going, to the last room which I know to be my doctor's preferred examination room. Wednesday, he's not there on Wednesdays, it's his day off. "What are you here for today?". I like the older staff. I know them, they take their time and I can ask about the issue "downunda" without feeling like the PHCC grad staff is "sewgrossing" about it at lunch. I tell her all of the truth, that I have a rash down there and that I have another rash on my arm. My back is killing me ( couldn't be that extra 200 pounds could it..answer your own question Patty, YES!) The list is long. She smiles, she comforts me and takes my blood pressure. She leaves. I'm waiting for the nurse practioner to come in but I hear my doctor's familiar pitch and tone. It's Wednesday, he isn't here on Wednesdays. The door opens and my nurse has returned, "Is Dr. Sichelman here?" "yes" "he isn't here on Wednesdays it's his day off" I tell her, "Dr. Galadi is on vacation so he is covering" she tells me. (how often does that happen?) This is going to be a day for unexpected things. My doctor comes in, I show him my rash on my arm, it's not really anything what else? There is the lump on my stomach in the mass of large fat on my belly I feel a pea like object, he feels it, it's nothing. He notices the rash below my stomach. I've been treating it with ointment for how long? (should I tell him years? Should I tell him two baths a day?) "it's been there awhile" I managed. He pulls at my underpants and notices another flush of skin below that. I admitted sex hadn't been what it use to be and he tells me to go to my OBGYN, "we really don't deal with that". Before I know it the conversation has turned with the problem at the moment and he begins examining me. This is a man of medicine, a healer at heart and I never appreciate him more than this moment. I have a staph infection and then a yeast infection. Before I leave there I will end up have a stack of nine separate prescriptions. I cover myself back up and sit down on the bench. He sits down at the other end and the nurse is stationed with my chart and a pen at the desk. The greater question, the greater issue, my weight. "So when are we going to get this weight off?" It's a question, a subject that he and I have talked about for years. My doctor of 16 years. Through the phase of Phen-Fen, Meridian, Redux, 1200 calories, 1800 calories, over the counter products into last year and the diagnosis of Type I Diabetes, rehabilitation to begin some type of activity until now. It's serious. My back is giving under the pressure, I take Lasix for water retention, blood pressure medication and he switches me today to two types of medication. "I know Doctor. I don't know what to do. I've tried, I've tried for years." This is a moment of honesty, the reality that my life is on the line. He tells me I'm looking at ten years. (ten years until my body breaks a blood vessel in my brain, tens years until my heart faults, ten years of semi goodness left in my body) He goes on to tell me about another patient. "He had the same problem as you. He had the gastric surgery, came in a few months back and I hardly recognized him." *A year ago I couldn't have, wouldn't have entertained this procedure* I can do this on my own I said. But a year later and an increase in 25 pounds told me that there comes a time when one has to admit they are in over their head. I was in over my head and I knew it. "Where did he go?" I was ready. I'll take some fries with that bypass [05 Sep 2006|11:59am] I refused to go to Community Hospital. Some how my brain is in 1983 with my first pregnancy and the halting news of things that had happened in this antiquated facility. But that was then, this is now. Reconstruction, new specialists are the norm for hospitals. This one has taken on the issue of obesity with a center for Weight Loss Surgery. I called three gastric doctors before realizing that there was going to be more than just a surgery. I went online and found the center's information site and read. I read for perhaps an hour. There was gastric bypass surgery, there was another type of surgery that was invasive. There was also the type of incision. I was quickly opting for laproscopic surgery. Small incision, scope to aid the doctor to see what was inside. Less invasive, quicker recovery(...I'll take some fries with that). I phoned the center and the voice on the other end was a rich accent (Jamaica?) and gentle. She asked all the questions I anticipated. I'd been down this road with my children and their pediatric disorders. Who? What? What kind of insurance? The quicker route would be to have my doctor's office call this center because everything is a referral. Making a decision to have a procedure like this is the first step the second, step is the business of it. Is it covered by insurance? The following Monday was a holiday and as it just happened to be, she was having a seminar with a few other patients. I would attend. That weekend went fast and Monday morning I was on my way down to New Port Richey, to the hospital, to the empty parking lot (holiday) to the office of Ivy. The first thing I did was sit down OF COURSE that is what fat people do when they first enter a room! (note to self: send that joke to Louis). We made our way across the hall to the meeting room. There is something about conference rooms that put me at ease. I expect a lecture, a Power Point because the screen is down and soon we are joined by a couple. Later I would exchange email addresses with "Patti" who happened to have a favorite color too...PURPLE! She saw my "Pattypreferspurple" email address on the sign up sheet and we clicked from that moment on. She had come with her husband. Then there was Gerry. I looked at them and we all seemed to have this spiritual connection. I was past being shy about my obesity, I'm big and I know it. After a few hours I was hungry and my sugar was getting low. I asked Ivy for a banana or something to raise my sugar, FOOD? She called down to the cafeteria and ordered up a few breakfast items and coffee. What do fat people love to do when they come together? ORDER IN! What did I care that there were pastries on the tray, I was here for a procedure that wouldn't allow me to eat more than 1 oz. of food, " A shot glass" as I put it. We laughed, ate, drank and got down to the business of filling out paperwork, copying identification cards and preparing ourselves for the business of weight loss. and it occurred to me. These people were smart, well articulated and with the collective as a group, we were already breaking down the percentages of the data on the Power Point and realizing that a large % of the group did not return post the procedure in the study group. So I admit that I too have the misperception that fat people are stupid, food numbed individuals who wile the hours away in front of a television doing everything but being nutritiously sound in mind and spirit. I'm beginning to learn a lot of WRONG things that like the rest of the world, I believe to be true.

December 25, 2008

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