RavenClaw779

Having anxiety has led to a number of "cardiac" incidents over the years i.e., palpatations. Coupled with a family history of heart disease, I've had echocardiograms, stress tests, Holter monitering and other than some trivial valve issues and a slightly irregular heartbeat, every cardiologist I've seen has told me I have nothing to worry about. Last Friday's pre-surgical clearance with my doc had my BP at 110/74. Today - after the BiPap fitting, I drove an hour to meet with the pulmonlogist - for 15 minutes. When I got there my BP was 138/84 and he expressed concern. Nevertheless, my pulmonary function tests were fine - lung capacity and oxygenation well within a normal healthy range. The pulmonologist didn't even feel that my SA issues were that severe that if the BiPap didn't work for me, it wouldn't be a big deal...but the Resp Therapist told me my poor sleep quality and oxygen levels could lead to a heart attack or stroke. Apparently I shouldn't sleep on my back either. Okay - except that I have arthritis in my neck and any other position is uncomfortable, coupled the carpal tunnel which make my hands go numb when I lay on my side. I still have to wonder about the accuracy of the sleep study, when none of these issues are addressed. Beyond dealing with my weight, I have to say getting older sucks as it seems it's a juggling act of trying to balance life's responsibilities with managing health issues.

I have to admit that I was wrong - while my "Sleep Apnea" quiz indicated I wasn't likely to have SA, the actual test yielded some surprising results. I probably would've grasped the reality better if my pulmonologist had called me with the results of the initial test(2/18). Instead, I got the full picture today(plus copies of both test results) from the Lincare respitory therapist. I only had one incident of obstructive apnea, but 161 hypopneas(shallow breathing) resulting in a drop in my blood oxygen level which means that even though I get a full night's sleep, my oxygen level dips too low, so I'm not sleeping as deeply as I could. So, I've got the BiPap and I wore it today while reading. It was okay - we'll see what happens tonight.

I have to admit that I was wrong - while my "Sleep Apnea" quiz indicated I wasn't likely to have SA, the actual test yielded some surprising results. I probably would've grasped the reality better if my pulmonologist had called me with the results of the initial test(2/18). Instead, I got the full picture today(plus copies of both test results) from the Lincare respitory therapist. I only had one incident of obstructive apnea, but 161 hypopneas(shallow breathing) resulting in a drop in my blood oxygen level which means that even though I get a full night's sleep, my oxygen level dips too low, so I'm not sleeping as deeply as I could. So, I've got the BiPap and I wore it today while reading. It was okay - we'll see what happens tonight.

My blog pretty much says it all, but here's my stats: I'm going through the Ellis Hospital Bariatric Care Center. *Orientation - 11/14/09 *Original Initial Appt - 12/14/09 (got the flu and was re-scheduled to 1/14/2010 *1/14/10 - Met with surgeon's PA; told I needed to lose 10%(27 pounds prior to surgery); blood drawn for lab work *1/28/10 - Pulmonary Consult *1/29/10 - Psych Evaluation(Scheduled by me) *2/1/10 - First meeting with surgeon - Dr. Malene Ingram; Projected Surgery date 3/10/10. Had lost 10lbs on own, but required to begin MediFast Program(thru their office) - 4 shakes a day and one lean & green meal *2/15/10 - Upper GI, Ultrasound & Chest Xray,EKG, Blood Gases *2/16/10 - Cardiac Consult *2/18/10 - Nuclear stress test and echocardiogram, sleep study *2/19/10 - Nutritionist *2/25/10 - CPAP sleep study(utter failure) *2/26/10 - PAT's; pre-surgical meeting with Dr. Ingram. lost 25 pounds. Cleared for surgery on 3/9. *3/1/10 - Pre-surgical clearance with PCP *3/4/10 - CPAP fitting; Follow Up with Pulmonologist *3/9/10 - Surgery at 7:45am - Insurance - BCBS of MA(PPO) - approved in 3 days. After deductible, plan pays 90%. - Sort of numb at this point as it's all moved so fast. It's going to be a shock when all the pre-prep is done. Using these last couple of days to stock up on eats for my husband, ensure all the bills are paid, the house is clean,etc.

I'm being banded on 3/9 - Welcome to the club!

Drowsydad makes a good point about possible positives. Following the last adventure at the (No) Sleep Lab I did some research on CPAP and found out a number of interesting points: 1) Your nose and face are supposed to be measured...nostril type/width, nasal depth, length, eye to nose ratio. Masks come in different sizes based on gender and even age - there's even equipment for kids. No one at Jurassic Sleep Lab measured me for fit. 2) Feelings of confinement are quite common even for people without recognized "claustrophobia" present in other situations. 3) Compliance beyond 3 months is poor. Perhaps that's why the machines and masks are so expensive. 4) There are BiPap machines available which drop the level of "push" on exhalation so it doesn't feel like the machine is trying to breath for you. 5) There are alternatives to the full face mask and the nasal octopus:laugh: - like the nasal prong... I'll try to keep an open mind.

At the very least, I can use it to scare the dog!

I make no secret about being claustrophobic and it's no secret that many people with claustrophobia have other anxiety issues. My first ever anxiety attack was five years ago when I was juggling a 70 hr a week job, and coordinating a 1,000 mile move for my husband and I. It happened at night - my husband was away on business. I was sitting on the couch and suddenly felt my heart pounding and like I just wanted to run...out of the house and into the dark. It passed but several days later I was working at my desk(at home - I telecommute) and it happened again. I took my BP - 150/120! I called my doctor thinking I was having a heart attack. An EKG and blood test were fine so the doctor gave me a couple of RX anti-anxiety meds and I slept for two days. The anxiety only manifests itself now when faced with closed spaces like MRI's. It tweeks me a bit for things like CT scans and really pinched for the whole CPAP event. I had a minor "attack" last night while watching TV and it's almost embarassing to recount. A Taco Bell commercial came on and I thought to myself, "I'll never be able to eat a burrito again let again a whole one..." This segued into thoughts of blockage, of no solid food, of the foreign object in my body. No, it wasn't a full blown attack - I can usually distract myself from that, but it sucks how weak willed it makes me feel. Like I haven't got my sh-- together.

Drowsydad makes a good point about possible positives. Following the last adventure at the (No) Sleep Lab I did some research on CPAP and found out a number of interesting points: 1) Your nose and face are supposed to be measured...nostril type/width, nasal depth, length, eye to nose ratio. Masks come in different sizes based on gender and even age - there's even equipment for kids. No one at Jurassic Sleep Lab measured me for fit. 2) Feelings of confinement are quite common even for people without recognized "claustrophobia" present in other situations. 3) Compliance beyond 3 months is poor. Perhaps that's why the machines and masks are so expensive. 4) There are BiPap machines available which drop the level of "push" on exhalation so it doesn't feel like the machine is trying to breath for you. 5) There are alternatives to the full face mask and the nasal octopus:laugh: - like the nasal prong... I'll try to keep an open mind.

I make no secret about being claustrophobic and it's no secret that many people with claustrophobia have other anxiety issues. My first ever anxiety attack was five years ago when I was juggling a 70 hr a week job, and coordinating a 1,000 mile move for my husband and I. It happened at night - my husband was away on business. I was sitting on the couch and suddenly felt my heart pounding and like I just wanted to run...out of the house and into the dark. It passed but several days later I was working at my desk(at home - I telecommute) and it happened again. I took my BP - 150/120! I called my doctor thinking I was having a heart attack. An EKG and blood test were fine so the doctor gave me a couple of RX anti-anxiety meds and I slept for two days. The anxiety only manifests itself now when faced with closed spaces like MRI's. It tweeks me a bit for things like CT scans and really pinched for the whole CPAP event. I had a minor "attack" last night while watching TV and it's almost embarassing to recount. A Taco Bell commercial came on and I thought to myself, "I'll never be able to eat a burrito again let again a whole one..." This segued into thoughts of blockage, of no solid food, of the foreign object in my body. No, it wasn't a full blown attack - I can usually distract myself from that, but it sucks how weak willed it makes me feel. Like I haven't got my sh-- together.

Ditto darkangel. Did you have to see a Cardiologist as part of your pre-surgical clearance? If everything's okay it probably is anxiety. If it continues after surgery I'd check in with your doctor. I had heart palpitations(flutters) several years ago - turned out to be my thyroid and a slightly irregular heartbeat. Both addressed by medication.

Instructions from the surgeon's office, "Take 2 Tablespoons of Milk of Magnesia and a Fleet Enema at 7pm the day before surgery". Beyond the concept of giving myself an enema:crying:, isn't the MOM suppose to send it out the door and the Fleet to sweep the remnants away? Figuring that these two events weren't going to happen immediately and knowing my body, I did a test run this weekend - of the MOM not the Fleet. It took 4 hours for the MOM to kick in and then I was in the bathroom 11 times over the next 7 hours. I checked with my PCP - thankfully he told me to back up the MOM dosage and wait until I was "all clear" before part two.

Instructions from the surgeon's office, "Take 2 Tablespoons of Milk of Magnesia and a Fleet Enema at 7pm the day before surgery". Beyond the concept of giving myself an enema:crying:, isn't the MOM suppose to send it out the door and the Fleet to sweep the remnants away? Figuring that these two events weren't going to happen immediately and knowing my body, I did a test run this weekend - of the MOM not the Fleet. It took 4 hours for the MOM to kick in and then I was in the bathroom 11 times over the next 7 hours. I checked with my PCP - thankfully he told me to back up the MOM dosage and wait until I was "all clear" before part two.

Today I got a phone call at work from "Lincare" calling to set up an appt to fit me with a "BiPap". The first opening was 3/17! I explained that I'm only doing this as a condition for surgery which is scheduled for 3/9. Magically, they're able to see me on 3/4 and even more incredible - they already have my insurance info and plan # - excuse me, isn't that my private info to disclose? Hopefully I can lease rather than buy something I doubt I'll use beyond my surgery date.

Today I got a phone call at work from "Lincare" calling to set up an appt to fit me with a "BiPap". The first opening was 3/17! I explained that I'm only doing this as a condition for surgery which is scheduled for 3/9. Magically, they're able to see me on 3/4 and even more incredible - they already have my insurance info and plan # - excuse me, isn't that my private info to disclose? Hopefully I can lease rather than buy something I doubt I'll use beyond my surgery date.

Ditto the comments from SAKirby. My weight is something that's very apparent and often strangers feel at liberty to comment so it's not like my issues with food are a big secret. I'm not running around like alot of the folks in my support group whose whole life(scary) has become talking about their WLS, how much they've lost, how their procedure is better than yours, and what I find the creepiest - bragging about how losing weight has helped them to become more "selfish" and how I have to become "selfish" to really make it work for me... That said - it does come up for various reasons; like having to take a pass on a habitat project coming up during the time when I'm recovering and I'm quite open about it. I'm becoming less surprised when whoever I'm talking to says to me, "Oh - my sister or friend or spouse had that done and they are doing great! Good for you!" I think most people support others who are trying to do something positive for their health. Let me put it out there from a different angle. I had breast cancer and lost all my hair(10 years ago). For a long time, whenever I'd see a women obviously going through chemo I'd smile and give a friendly nod but thought I was being polite by holding my tongue. A couple of months ago I was finishing my volunteer work at the hospital and was heading home for the day. I stepped into the elevator with a man pushing his wife in a wheelchair. She'd just finished a round of chemo and looked wiped. I don't know why I did it, but I kneeled down by her chair and said, "Chemo?" She smiled and nodded. I said, " Me too - 10 years ago". She perked up and we chatted for a while about the whole process and how someday she'll look and feel like she did before. I like to think I made someone's day by making her feel not so alone. If some other plus size person who isn't happy with their weight needs a to not feel so alone, I'd be happy to lend an ear, a shoulder or be an example. God knows I've been blessed by the examples so many people have set for me to follow.:w00t:

Got the once over from my primary doctor; review of vitals, meds, allergies, urine screening. Together we reviewed the reports from the cardiologist(no concerns), the abdominal ultrasound, upper GI, chest x-ray - all normal. In fact after Friday's appt. with the surgeon and the diagnosis of "fatty liver" I was researching on WebMD and Mayo Clinic and getting worried, so I asked my doctor about it. He said that it's commen in obese patients, but that according to the ultrasound, and the radiologist's report, my liver was of normal size and condition - no mention of "fatty liver"?! Was also talked about the need of a CPAP and reviewed the report from the pulmonologist. My doc was stumped as to why the report states, "no indication of sleep apnea" but the pulmonologist put the sleep lab/cpap in as a recommended follow up. My doctor told me to have the surgeon call him and he would support me not having a cpap. Hope I don't end up having gone through all this for nothing.

Got the once over from my primary doctor; review of vitals, meds, allergies, urine screening. Together we reviewed the reports from the cardiologist(no concerns), the abdominal ultrasound, upper GI, chest x-ray - all normal. In fact after Friday's appt. with the surgeon and the diagnosis of "fatty liver" I was researching on WebMD and Mayo Clinic and getting worried, so I asked my doctor about it. He said that it's commen in obese patients, but that according to the ultrasound, and the radiologist's report, my liver was of normal size and condition - no mention of "fatty liver"?! Was also talked about the need of a CPAP and reviewed the report from the pulmonologist. My doc was stumped as to why the report states, "no indication of sleep apnea" but the pulmonologist put the sleep lab/cpap in as a recommended follow up. My doctor told me to have the surgeon call him and he would support me not having a cpap. Hope I don't end up having gone through all this for nothing.

Took my husband with me for the last meeting with my surgeon. She is pleased with my weight loss(21-25 lbs depending on time of day and level of dress:ohmy:), told me that all my tests came out clear but advised that I have a "fatty liver":sad:. My husband's concerns were addressed - still can't believe he thought the port was going to hang out of my body!?! What - like the tag on a stuffed animal!? PAT's were a repeat of tests done several weeks ago plus a pregnancy test. Strange to have to have that done as I've been POST MENOPAUSAL(surgical) since 2007!?! Guess this is another sign the insurance industry needs reform - test after pointless test to hedge against any kind of lawsuit. Told the surgeon about my CPAP failure and asked what happens now? She's going to have her patient case coordinator follow up with the pulmonologist but she made it pretty clear - No CPAP - No Surgery. So slap one one me in the recovery room.

Took my husband with me for the last meeting with my surgeon. She is pleased with my weight loss(21-25 lbs depending on time of day and level of dress:ohmy:), told me that all my tests came out clear but advised that I have a "fatty liver":sad:. My husband's concerns were addressed - still can't believe he thought the port was going to hang out of my body!?! What - like the tag on a stuffed animal!? PAT's were a repeat of tests done several weeks ago plus a pregnancy test. Strange to have to have that done as I've been POST MENOPAUSAL(surgical) since 2007!?! Guess this is another sign the insurance industry needs reform - test after pointless test to hedge against any kind of lawsuit. Told the surgeon about my CPAP failure and asked what happens now? She's going to have her patient case coordinator follow up with the pulmonologist but she made it pretty clear - No CPAP - No Surgery. So slap one one me in the recovery room.

I've been working on a healthier eating profile for several years - had an indirect calorimeter done so I'd know my calories needed to lose/maintain and have been food journaling forever. After my initial appt with my surgeon on 1/14/10 I cracked down on my diet by sticking to a 1200 calorie diet, so that by my first follow up I'd lost 10 pounds (2/1). Nevertheless, my surgeon uses the Medifast (4 shakes + one lean and green) from the initial follow up until surgery. Yes, I have cheated from time to time - some "cheats" have been allowed(add'l protein in the form of eggs, cheese, chicken), some have been a few mini pretzels, a slice of bread, some popcorn... Had my last meeting with the surgeon and my PAT's on Friday(2/26/10) - down 25 pounds. I am having the worst time making the four shakes a day - esp living in the North where eating cold in the cold equals cold!:biggrin:

On the lighter side... I've heard from friends who've had the procedure about how quickly they're dropping sizes. I've been a plus size for awhile and have a collection of some beautiful career clothes - clothes I'd want to wear even if I weren't size 24. I know there's only so far a good tailor can go. Clue me in - how often am I going to be downsizing? Has anybody heard anything about bariatric clothing exchanges or consignment shops. It's a happy problem to contemplate, but I can see the sweat on my husband's upper lip at the thought of the potential clothes horse I could become. Stop me before I shop again!:smile2:

Has anybody been required to go to sleep lab or be fitted for a CPAP prior to surgery? It seems to be a blanket policy at the facility I'm using. See my blog for more details. Long and short of it - I've basically been told that even though I had no markers for sleep apnea I had to go to the sleep lab(not one close to me - only their's would do) and even before the test results were in, I was scheduled for a CPAP fitting. It didn't go well - I couldn't sleep with it on. Now I'm getting the impression that no CPAP equals no surgery. I find this odd as I've had two surgeries in the past two years; one laproscopic and both fully under and in neither case did I require a CPAP or have problems coming back from anesthesia -other than having to have a "patch" for nausea. What's my recourse if they refuse to operate?

Drove 45 minutes through a driving rain/snow mix to my mandatory CPAP fitting/sleep study. Dutifully put on my PJ's at 7pm and had wires attached to my scalp with what looked like balls of lard. Add to this 2 EKG moniters, an elastic sensor belt around my chest and another on my waist, moniters on each leg and a pulse-ox moniter on my finger. Gee - don't I feel snoozy? Then put me in a too warm room(again) where the hospital's over head central heat system sounds like the runway at JFK and hook up a miniature torture device complete with a built in bubbling humidifier - the CPAP. Started out with one that covered my entire nose attached with straps around my head. It felt like an octopus was attached to my face. Not good for a claustrophobic like me. I tossed and turned for a good 2 hours before begging them to take it off. I was feeling stressed out, heart racing and panicky. A trip to the bathroom revealed a big red ring around my nose. The nurse insisted that because I was doing this for surgery I had to put it or an alternative back on. The alternative - what looked like two mini button mushrooms; one in each nostril. Again strapped to my head - this thing was pushing air up my nose to the point it felt like it was breathing for me. Attempt to open your mouth or pull it a bit away from you face to adjust it and it clamped on like an alien life form. Laid awake for another three hours before asking to get up to use the bathroom. Since it was 5am the nurse said I could just go ahead and get up - she'd unwire me. I asked her if she got what she needed and she said that she hadn't since I didn't sleep. I apologized, but I am a serious life-long light sleeper who needs a cool, dark room and quiet. I asked if this would hold up my surgery - she told me I'd have to discuss this with my doctor. Odd thing is - earlier in the evening I asked her if everyone having elective surgery has to go to sleep lab. She told me that it's pretty much standard that all bariactric patients go...Interesting, considering I have no markers for sleep apnea. Does make me question how much of this testing it just wheel spinning and profit driven.:tongue_smilie: