Just starting out -First visit details

[CariC 12]

So I had my first meeting yesterday and I thought I would write out what happened and what my timeline looks like for those looking at what to expect. This is my experience of course and will, I am sure, vary depending on your doctor and insurance.

My Stats:

Name: Cari

Age: 32

BMI: 54

Doctor: Alan Schuricht , Pennsylvania Hospital, Penn Metabolic and Bariatric Surgery Program

Insurance: Amerihealth NJ PPO

I went to the information session on Sat 6/18/2016 at Penn Presbyterian Hospital. The following Monday I called the bariatric center and asked for an appointment with Dr. Schuricht (my SIL had her surgery with him so I decided to use him)

My first appointment was Tuesday 6/21/2016

The intake nurse:

Took my Blood Pressure (147/77)

Height 5'9"

Weight 369.9

Last Menstrual cycle date

asked about any current conditions, medication, pain etc (no conditions)

I was then moved to the exam room where I met a nurse practitioner.

She took:

A detailed family medical history

A detailed personal medical history

Explained who my team was and what they would all do for me

Then she gave me a print out of all the appointments I would have to make and explained what each were and what the requirements were for my insurance (however she wasn't 100% sure and the coordinator would later explain it to me more clearly)

Then the Surgeon came in

I met with Dr. Schuricht

He asked:

What surgery I wanted and why

He agreed that he thought I was a good candidate for sleeve

He then talked to me about how I should expect things to go and what the expectations were for my efforts.

He told me he could only help me and I had to want it and said the key to success was follow through and follow ups.

Then the nutritionist came in

She took

A detailed dietary history (what i'd done to loose weight and how successful I was)

She asked me about my medical history again and dietary restrictions (i'm a vegetarian)

She went over what I was expected to do over the 3 months of managed weight loss (I don't have to loose but I can't gain)

She explained how I could start preparing my body for after surgery:

Get into the habit of eating several small meals a day

Get more Water

We set some goals for our next visit

10 mins of walking a day

3 meals a day at least

Smaller portions

Then I met with the coordinator and she scheduled my visits and explained my insurance requirements including 3 nut visits (this one counted as the first then 2 more 30 days apart), a a Psych eval, 1 support group meeting. She also explained their requirements as a surgical center.

My dates are as follows:

July 22nd

7:45am Upper GI contrast scan

10:00 2nd nutritionist visit

August 5th

10am Psych evaluation

1pm Cardiac Clearance

August 19th

9:30am 3rd and final nutritionist visit

10:45am Respiratory and pulmonary clearance.

Then somewhere in there I have to go to one support group meeting and a nutrition class 2 weeks before the surgery once I have that date.

So there you have it a snap shot at a first visit and the reqs through amerihealth.

[gottadosumthin 19]

Hey CariC,

You're about a month ahead of me. I did my orientation with him at the end of July. We have the same insurance and everything! I'm hoping for a surgery date in December. Seems like your visit was a bit more thorough than mine.

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[Nana1222 159]

Thank you for taking the time to share this with us! Very helpful and informative!

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[CariC 12]

No problem glad it was helpful. Here is some more on the process for me so far.

July 22nd

Upper GI test:

This was not fun for me as I have trouble swallowing thick or goopy things.

First I swallowed some crystals, about a teaspoon full , with about as much Water. They feel kind of like pop rocks and taste like the powder on sour candies but without the bite. Then I stood in front of an upright xray bed and was handed a cup of the contrast Fluid. I stood and swallowed big gulps while they moved the x-ray thing around taking video/x-rays of my upper give at work. The liquid is white tastes kinda like Mylanta and is the consistency of a melted milkshake mixed with pudding. Once I finished the cup they took a few more pictures then they tilted the bed back to a laying position. I laid down and the technician instructed me on how to turn this way and that sometimes on my side sometimes on my back and sometimes face down. So they could take images of my stomach as it was coated by the company trade Fluid from different angles. Next I laid on my stomach and was given another cup of contrast with a straw which I had to sip while they did more images. Once that was done they sent me to another room where they took my two chest xrays. I was instructed to eat and drink normally and to drink extra fluids to get the contrast stuff moving out. The techs were all very nice and the test was not too bad.

They found I had a slight hiatal hernia and everything else was normal.

2nd Nutritionist visit

Weighed in. I lost 3 pounds we talked about what was working

What wasn't and what we could do next. We set some goals : more activity, more Protein, less carbs. I spoke to the nurse practitioner about my blood work that I had done before coming and she asked me to start taking Iron and rx strength Vitamin D since both were low.

August 5th

Psych evaluation

I met with a therapist who had me fill out a few questionnaires.

1 on my diet habits

1 on anxiety

1 on depression (if you've ever had a baby this is the same one they give you post partum to assess your risk for ppd)

Then we went into her office. We talked about:

My dieting history

My hobbies

My support system (family, friends, etc)

My husband's feelings about the surgery

She asked me to explain what I knew about the procedure, the pre-op diet, the post-op diet, the risks of surgery etc.

We also discussed why I wanted the surgery and how I would prepare for it. She gave me clearance and told me my only requirement was ro finish my nutritionist visits and she recommended I join one of the support groups (beyond the one mandatory session) I explained I'm not a people person and don't find that environment helpful and she said online support is good too (hello bariatricpal.com)

Cardiac clearance

I had a big cardiac work up 3 years ago when I was pregnant because I have a heart murmur since childhood. The cardiac doctor listened to my heart, took my BP, did an ekg, looked over the medical records from the previous clearance and cleared me for surgery. Though I don't have hypertension he did say that I have had some high measures here and there in the past and I should keep an eye on it even after surgery.

August 19th

This should have been my last nutritionist visit but my insurance is changing to AETNA on Sept 1st so I have to do one more visit because they require 4 visits. I weighed in down 2 more pounds and did the same as before. Set some new goals : smaller plates and using myfitness pal.

Respiratory clearance

Met with a sleep specialist. They took my BP, weight, did a regular exam then I answered about 100 questions about sleep habits. She told me I really have no symptoms of sleep apnea but because of my heart murmur they wanted me to do a sleep study anyways. Luckily my insurance covers the in lab study without having to do at home studies first. (Basically she said even if the home study was normal the doctor would have sent me for a lab study because of my heart so I'm glad I could skip that step). She said either way I was cleared for surgery it was just a matter of making sure that if I do have sleep apnea I would have to have a machine before and for surgery.

My sleep study is scheduled for Saturday August 27th 7:30p-6:30a.

My last nutritionist visit is set for jFriday September 16th after that they will submit to my insurance for approval.

So there's that if you should have any questions I'll gladly answer them

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[KristenLe 5,979]

@@CariC I had such a hard time drinking the barium during GI Series. It was horrible. I kept gagging and burping which then I had to do the pop rock thing again. This is the worst of everything so far and I'm absolutely dreading another one post-op (in the hospital).

[gottadosumthin 19]

The psych evaluation info is helpful especially since I'll be probably going to the same place you went. I'm scheduled to go next week.

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[CariC 12]

@@gottadosumthin They don't accept cards for the fee. Check or Cash only and the only ATM is in the hospital across the street :/. So come prepared (I was not and was lucky my husband came with and he ran and got it while I was in with the therapist.

[tholbert08 51]

The psych eval was very beneficial in that she explained the reason why people fail after the surgery! It was good to know and great to hear!

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[gottadosumthin 19]

@@CariC Thanks for letting me know this especially since we have the same insurance! I remember him saying that during orientation, but when I called AmeriHealth, they sent me a long list of providers, and I thought they'd cover it. I'm definitely not wanting to shell out that hefty fee, but thanks to you I'll be prepared. . I remember them mentioning the nutrition class once you get your date is pay out of pocket too. When do you plan on going to the support group? I'm going to go next week to the one at Pennsylvania Hospital to get it out of the way.

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