Daydra

Wow... this is the first time I've heard of someone that is functional "failing" the psych eval. That sounds like complete bs to me. Is your depression diagnosis major depressive disorder or something more like dysthymia (chronic depression)? Not that it really matters, but if you're functional, capable, are a good candidate, have a good support system, and understand what you are getting into, there really isn't any reason not to approve you. As far as meds go... I've been diagnosed with dysthymia for years (my my MD). I've been on and off meds because I never really felt like they were that helpful and I never really felt like I had a horrible life situation. I always wondered if I actually did have depression or if it was just life stresses (primarily weight) that essentially gave me the symptoms of depression. I feel like I have a good life, I'm intelligent, I have friends and family that love me, a great career, a nice house, a good marriage, so I never really understood why I felt so crappy because I never felt like my life was crap. I started seeing a therapist recently because of some stress with my aging parents and after talking about this for a little bit, she said it sounded more like anxiety than depression. So all along, we may have been trying to treat depression when it might be anxiety instead. Anyway, just to make a long story longer, I'd been on Prozac, didn't feel it was effective, didn't like the sexual side effects of Celexa, Zoloft didn't seem very effective, Wellbutrin added to Zoloft still didn't seem very effective. My doc said that since I'd "failed" 2 of the cheaper antidepressants, that would qualify me for some other, more expensive options. I've been on Pristiq for several months now, and I feel pretty decent on it. It apparently works both on serotonin and dopamine. Anyway, that is just to let you know there are options other than the standard players... I would recommend, though, that you look into whether getting a second opinion is possible. Your insurance may not cover it, but if a second opinion will be acceptable for approval it might be worth the out of pocket cost. Unless you are having major upheaval in your condition or are having major life changes and stressors, I really don't see any reason to make you wait an additional 6 months. But, I'm certainly no professional. If you get a second opinion and they say the same thing, at least you might be more confident that the initial assessment is valid... Good luck. I'm really sorry you got delayed.

So here's the good news... far more likely than not, it will be a minor problem. I didn't recognize that I really had a problem until I started feeling really dehydrated. At that point, I called my clinic and they talked me into coming in to do a swallow test (just like the morning after surgery). The doc can get a pretty good picture of what is happening as you swallow, so can usually determine a stricture or kink. It might be able to be solved by an endoscopy exactly like we do before surgery, so it's really a minor procedure (just passing the scope through can often resolve the kink, creating immediate relief for the patient). If more is needed, like a balloon dilation, we have to wait until about week 12 to make sure that the staple line is strong enough to handle the pressure. There are other options if that doesn't work. The only anti nausea med I have is Zofran. I am starting to realize that I don't really need it much unless I am becoming more dehydrated. I find that if it doesn't seem to be that effective on any particular day, and I look back at my Fluid intake for the day or two previous, usually my fluids are low. Also, my urine output on the days it doesn't seem effective is lower than on the days it does. If I'm feeling less dehydrated, it doesn't seem like I even have any significant nausea and might only take it in the morning to get past taking my daily meds and brushing my teeth (which would frequently send me into a major gag and possible vomit reaction even before surgery...) I'm taking otc prilosec right now because when I finished my prescription at 30 days, my body wasn't really ready to come off and I woke up the next morning at 3am with a mouth full of acid (a less than pleasant experience...) I totally understand feeling discouraged, but this issue is usually temporary and fixable. I have to admit to feeling a bit miserable myself, waiting for the nausea, dehydration, constipation (that's a really fun one... I even got to experience fecal impaction. So don't recommend that one...), abdominal discomfort, fatigue, lightheadedness, weakness.... The list feels like it goes on forever right now. However, like I said... temporary and fixable. By week 12, pretty much all the swelling will have gone down and we'll have a little more capacity to get food/fluids in, and likely less nausea due to that alone. My recommendation to you would be to call your surgeon and talk about your specific symptoms. You want to make sure that there isn't something you need to investigate further. Don't be like me and wait, thinking it's "normal" or "not that bad" or "will get better". It's far better to call and ask than it is to sit home and be miserable and possibly get worse. I probably only called my surgeon when I did because I work in public health, and was able to pop over to the clinic side and ask the nurses what they thought. If I didn't have that easy resource, I might have tried to tough it out longer, and would have been worse off. At this point, what I am doing right now to combat my particular issues is: taking zofran in the morning and then deciding whether I need additional doses later in the day based on how I feel. (seems to affected by recent fluid intake) Sipping all day long the best that I can (still, my best day on fluid intake is in the 40 or so oz range) Eating higher calorie foods (dairy seems to be the thing I tolerate the best, so I frequently will have a couple oz of full fat cheese in the evening before I go to bed to bump up my calories) Fage 2% is my favorite plain yogurt (23g Protein in 8oz, though I can never eat 8oz, I'll add a few blueberries and a squeeze of sugar free pancake syrup.) Ignoring the 30 minutes per meal rule (I let it take me however long it takes me to finish a reasonable portion of whatever I'm eating. Unfortunately, this literally means I am eating all day... sometimes 20 minutes between bites) Ignoring the no drinking while eating rule. There are 2 reasons this is a rule: 1- so it doesn't wash food out of your sleeve and make you hungry too early (really not an issue if you cannot get enough calories to keep from nearly fainting...) and 2 - so you don't try to "wash down" something that seems to be "stuck". That'll just make you vomit. I would think that we would be able to identify that situation, in which case, we just need to stop and let it work through or regurgitate, or whatever needs to happen. I've stopped looking for low fat anything, really. I simply need the calories at this point. Take a colace each evening (just started this yesterday after my most recent horrifying, at least to me, episode with fecal impaction) Hoping that this can keep things evened out. All of my strategies were discussed with my surgeon and she feels that they are appropriate actions to take. The hope is that each week, it will get just a little better, a little easier to get fluid, a little easier to get calories, a little less nausea. As that happens, all of my adjustments will be revised closer to what the standard rules entail. Here's my last recommendation... If you start really struggling with fatigue, resist the urge to sleep late on the weekends, waiting to eat until whenever you get up. Keep something by your bed, get up and get something to eat then go back to bed, anything. Weekends are the worst for me. I very very nearly passed out in the shower because I did this. When we're already on a very low calorie diet because of the surgery, and then we struggle to get in enough calories, which reduces that low amount even further, and then sleep until noon or something, it is simply a recipe for disaster. It will also mean that you struggle that day to get in enough calories, so you'll feel awful the next day as well. Trust me on this one... Totally miserable experience. Good luck! I'm confident that it will be minor and you will be fine, but it's going to take some patience and endurance to get through it. Just remember that it's not permanent!

There will be a whole host of new things for people to make positive comments about! And the hair loss is temporary. (although I bet that part is more reassuring to someone that didn't spend 20 years growing out their hair...)

Glad they are being proactive and looking to see if there is an underlying problem that needs to be addressed! Good luck!

I'm sorry you are having such a hard time! Good luck! It's a struggle to find any kind of balance when it feels like things aren't going as they should. Definitely keep on top of it, and always call the doc if anything gets worse, or doesn't feel right. It never hurts to at least ask the question. If you've discontinued your anti-nausea med, you might consider taking that again for awhile. I found that it really did help for me. The feeling that I was getting in my stomach before we stretched out the kink was making me avoid drinking and eating. And of course, all that did was make the whole problem worse...

Another update: Followup appointment today. Swallow test fine, no remaining kink, unsure of torsion at this point. My sleeve appears to have a bend in it, but it doesn't appear to be restricting flow. Still probably have some swelling. Capacity is only about 1 oz. Nausea seems to be mostly resolved. It's still a full time job to get in a meager amount of calories and fluids. I am constantly eating and drinking and still not making my nutrition goals. I have a lot of fatigue. I'm finding that some of my worst eating habits pre-surgery are not what or how much I was eating, but the times I was prone not to eat, like Breakfast, particularly if I'm so fatigued that I sleep way in on the weekends. I got up way late on Saturday and then nearly passed out in the shower. Not a good time. Fortunately something I can fix simply by not being an idiot... That also meant that I had a severely reduced caloric total on Saturday, that set Sunday up as difficult as well. Also having some upper abdominal aching... discomfort/almost pain when taking a deep breath, yawning, sneezing, really any abdominal contraction/stretch. Doc thinks it might be scar tissue causing the sensation, but I'm starting to think it's the pain from being in bed too much due to fatigue. Feeling a bit like I'm in a less than desirable cycle... Lack of calories causing fatigue, fatigue making it feel impossible to get any activity in (even shopping completely wears me out right now, causes me to sleep/nap too much, making less time to consume the calories I need. Anyway, doc says I may have up to 6 more weeks of swelling, and then I should see a vast improvement. At this point, she doesn't see anything to be worried about, so I have my next followup in a month, but have a standby appointment in 10 days just in case anything gets worse. Thanks all!

I did about the same thing about the same time. I bounced around about the same weight for about 10 days or so, and then started to drop so fast, I started to worry. Now, the last couple of days, I've held pretty steady. And some of that "stall" time was during my super low calorie consumption when I thought I was dehydrated. Could have played some role, but I'm not sure of the exact effect.

Yeah, that thoroughly annoyed me... I get that the rules are intended to help prevent abuse, but for those of us that aren't a problem, all it does is make things dang inconvenient! :-)

This very well could be normal, as many posters have said, but my post op guidance was to call the clinic if I had multiple daily loose stools because it could be a reaction to the antibiotic that I was given during surgery. Doesn't hurt to call and ask...

I've experienced some constipation as well. I mentioned it during my 1mo post op and my nurse said not to worry too much unless I feel bloated, that since I have greatly reduced the amount I'm eating, it is normal not to need to go as much. However, I've had a couple episodes where it was extremely difficult to go, and one episode where I thought I was headed toward a digital removal, but a dulcolax suppository was eventually effective. I don't really like to take Miralax, even though that seems to come highly recommended, because it seems like it gets soft enough that it's difficult to expel. Usually the first thing I reach for if it's been about 3 days or more and I can feel that I could go if only things would MOVE!, is Phillips caplets. I tried Ex-lax, but just ended up with an uncomfortable cramping sensation for about 4 days... not doing that again.

My clinic called all my meds (except my narcotic) in to my pharmacy so I could have them at home already when I got home. I had an anti-nausea, anti-spasmodic, omeprazole (generic Prilosec to reduce acid), and they sent me home with a written prescription for Roxicet (liquid Percocet). They could have called that in if I had gone with the liquid Vicodin, but narcotics don't work that great on me and I usually need something stronger than they initially think. The anti-nausea and anti-spasmodic were both sublingual, the roxicet was liquid, and the omeprazole was the only capsule. I didn't have a problem taking any of them, except it took a chunk of time out of my day to get all of them plus all of my regular daily meds down.

Welcome and best of luck to you!

Agreed! I think you are doing great! Your body will get with the program. Just be patient with it.

I'm really mad at your medical team on your behalf. You are 5'7" and weigh 391. Your resting metabolic rate is around 2475 cal/day (that's before added exercise). At your height and weight, even a brisk walk is probably burning you 12-15 cal/min. At 1000 cal/day, you should be losing about 1/2 pound a day if you are exercising. If you are getting enough Protein, you are not getting too much fat, and even so, at the level of calories we consume after surgery, we need to get fat in too. As far as carbs go, I'm in no way convinced that 75g/day is too much. Your medical team is effing with your head here. Based on where you are post surgery, I would expect that you are experiencing what many of us experience several weeks out... a period where your body is adjusting to what you are giving it. I don't believe there was any need whatsoever to reduce your calories. As far as starving... yes, we absolutely can. I hope no one tries to convince themselves that they can cut calories as low as they want and suffer no ill effect. We do have a bit more buffer time, but it's not infinite, and it doesn't even last as long as we might expect. If we don't get an adequate amount of nutrition, we will experience muscle wasting and we will experience extreme fatigue, fainting, all kinds of nastiness... and the gift that keeps on giving is the up to 40% reduction in our metabolism that will have to be rebuilt over time with a lot of effort and hard work. You are only getting maybe 20-25% of the nutrition your body is using daily. I dropped down to that level myself. (I'm only about a week further out than you and have a kink/torsion which is making it really hard to get a reasonable amount of food/fluid each day. I thought I had gotten really dehydrated due to lack of energy, dizziness, etc. but my bloodwork showed that I wasn't. When I discussed what I was able to eat with my surgeon, she said the problem was far more likely to be not getting enough food. I'm still struggling to get 600 cal/day and about 60g protein. Carbs are around 50 right now and fat is around 20. I am still experiencing light-headedness and fatigue. In fact, I got up late today, so I didn't get to eating right away and I nearly passed out in the shower. That is no exaggeration. I seriously was trying to prop myself up on the walls until I could lower myself to the edge of the tub to sit down. Anyway, don't be hard on yourself if you feel like your body isn't getting with the program. For many, it takes awhile to see consistent loss, and it doesn't mean that you are eating too much of anything. Your body just needs time to adjust. If your medical team can't accept that, I am really sorry, but you will have to let their criticism go in one ear and out the other and examine their advice carefully before following it. Best of luck. Whatever you take from this post, know that you are not at fault here. I know that you will be successful! Good luck! (sorry... apparently I only know how to write War and Peace in these things...)

I had several pills that I needed to take everyday. My doc didn't require me to crush them or anything special. The nurse told me that it might be easier to take them with something warm instead of cold. For about the first week, I remember I would take one pill with a sip of whatever and then pace until I felt like I could take the next pill. For the first several days or week, it took me 45 minutes or more to get all my pills down, but at least I was getting fluids at the same time... Good luck, it will get better pretty quickly!

I wasn't advised either way on my bc. I did have one med they had me stop a week prior to surgery, but that was it. As far as birth control in the meantime goes, as long as you are consistent and use your chosen method correctly every time, you should be fine. You could always discuss with your doctor or Planned Parenthood, or whatever, doubling methods (condom and spermicide jelly, perhaps) and what the most effective combinations might be.

Oops, accidentally deleted the quote designation...

You should really check that out, that seems like they shouldn't have billed both insurances, I'd ask them why they thought they should bill both. That's just the way billing works for those that are dual-insured. Company #1 gets billed the full amount first and pays whatever is in their contract, and then the balance gets billed to company #2 and they then pay according to their rules. More often than not, the secondary insurance picks up everything that the patient would have have been responsible for otherwise. I have insurance from my employer and have secondary coverage from Tricare Prime (hubs is military). I almost never have any out of pocket costs, whatsoever.

I lost the Stanley Cup!!! (since start of my preop) I lost a moped if I count from my high weight.

This is the first time I've seen Kitsap here! I grew up in Port Orchard and am now in Silverdale. Usually when I tell someone I'm from Kitsap (oh, like the nurse at NWWLS during my 1 mo. post op...), they ask me where that is and then say something ridiculous like "Oh, that's what's on the other side of the bridge!" or "Is that where the ferry goes? I've never been over there." Nothing to say but wow...

It sounds like you are doing all the right things. You are going to be great!

Best of luck! Sorry you have to go through this, but strictures are fixable! I'm battling a kink and twist right now (kink fixed with endoscopy, but twist still hanging on...) Even if it takes more aggressive treatment, any improvement will be a relief for you. Good luck!

I would like to add that being a good mom has nothing to do with eating birthday cake... and it's not like you can never have birthday cake ever again, you just aren't ever likely to have a large hunk of cake like we usually cut (the average person cuts cake pieces about 2-3 times bigger than a serving). You should discuss your boyfriends comments with him, however. Remind him that "reminding" you of all the things you "can't" have or do is really not helpful and only makes things harder on you. Keep reminding yourself about all the days in the park, field trips, amusement park rides, hikes in the wilderness, swims in lakes, and anything else you can think of that you have in front of you to spend really quality time with your kids. Those experiences are going to be way more important to them than a stupid piece of cake at a single birthday party! Congratulations on your work so far! You have so many great victories ahead!