Tuesday, February 23, 2010

Sometimes you just gotta take the bad with the good…

Today is my 1 month “surgiversary.”  Yes, it’s been an entire month (4 whole weeks) since my surgery.  I am very happy with my progress to this point and look forward to what the future still has in store for me.  That’s the good part of today.

Then there is the insurance issue.  I’ve been on COBRA since quitting my job in September, 2008.  I had a maximum of 18 months coverage, which means my current policy expires March 11, 2010.  So earlier this month I went online and worked up a quote through a National insurance carrier – the same one my COBRA policy is through.  The quote was within reason (actually a bit less than what I’m paying currently) so I filled out the application and submitted it.  The application was incredibly thorough asking not only for doctors I’d seen but medications I’ve taken and am currently taking, who prescribed them, dates I’d taken them… and surgeries.  Naturally I listed the WLS procedure I had last month.  I figured the fact that I noted it was a “self pay” would be a good thing.

Yesterday I receive a large envelope from them.  I figure this is good news, just like when you get the large envelope from a college or university you’ve applied to.  It was partly good.  Yes, they could offer me a policy, but at their highest tier (4).  The premium per month is roughly 4 times that of the quoted monthly premium.  Their reason for the tier was that my “weight is elevated for height.”  So I fumed.  All I could think was how did they overlook that I just had surgery to help with the weight?  So I spoke to my mom last night as she’s had far more dealings with insurance companies (and once upon a time actually worked for this one) and she suggested I call them even though I couldn’t file an official appeal over the phone (and I don’t really have time to appeal either).

Earlier I spoke to a very nice underwriter named Mary who pulled up my file and reviewed it while we were on the phone.  I asked her if the fact that I’d had gastric bypass last month, and that I’ve already lost over 30 pounds was taken into consideration at all.  She said the fact that I’d had the surgery last month was why I’d been put into tier 4!  I was flabbergasted.  Apparently I’d have to be 3 years post-op in order to be considered for a higher tier!  Insanity!  I thanked her for her time and called my mom with the news.

Am I happy with the outcome?  Hell no.  Is there anything I can immediately do about it?  No.  I can’t be without insurance and there is no more time to apply to another company.  So I will bite the bullet and pay this horrific premium until I become employed and qualify for insurance through a group plan.

However this does bring serious issues to mind.  In my opinion having a surgery for weight loss may cost $X up front, but in the long run it costs the insurance companies less for other co-morbidities that the patients would have.  That would make the insurance companies’ pay out for claims for WLS patients less over time.  Consider all the co-morbidities that my insurance might have needed to pay if I’d not had the surgery:  hypertension, diabetes, sleep apnea supplies and/or surgery, knee and/or hip replacement, etc…  Now my chances of all those are drastically reduced.  This is just another example of how the US healthcare system needs an overhaul.  I’m actually trying to figure out where to send a letter/email to those working on the healthcare issue so they have even further evidence of how the insurance companies are treating the insureds.

If I could still drink I would most likely have a glass of wine.  But as alcohol is off limits for another 11 months, I think I’ll just enjoy some water.  Or a nice protein drink.  Regardless, I’m relaxing the rest of tonight.

Tuesday, February 16, 2010

Woo hoo!

Today is 3 weeks after surgery, and 3.5 weeks from my final pre-op doctor's appointment... and I've lost 29 pounds!  I'm excited about this as well as a NSV (non-scale victory) I had last night.  Years ago I was given a birthstone ring by my mom.  I've only ever been able to wear it on my right hand ring finger - it's a size 7.5.  Well yesterday I noticed it was fitting a bit loose so I started playing with it, and just for giggles put it on my left hand ring finger... and it fit!  I have noticed some of my clothes fitting a bit more loosely than before, but others not so much.  I know it's a matter of time so I'm not discouraged in the least.  I can honestly say I am very pleased with my progress thus far.

Last night I made a yummy cheese quiche.  Lots of protein in a 2 oz serving.  Next time I'll precook some broccoli or spinach to put in it as well.  Regarding the protein, some days I have very little trouble hitting or getting close to the 85g I'm supposed to get, but others it is an absolute struggle.  The same goes for my liquid intake (64 oz), but I know that is partly due to restraints on how I can drink.  I'd love to be able to chug a bottle of water at times, but it's not possible.  Well, I could try but I'd probably end up very uncomfortable and burping for hours.  Not pleasant.

I think it's nearly time for me to do my first load of laundry since surgery.  My wardrobe has been pretty limited to pajamas and lounge wear since surgery, so the supply of those is getting low... not to mention under garments.  LOL  Sadly laundry is always a necessary evil (just like dishes... which need to be done again too...)

As for the rest of today, I think I'm just going to relax.  I have a bit of a sinus headache and it's making me want to curl up and nap with the kitties.  Sounds like a good idea...

Tuesday, February 9, 2010

Call me a slacker...

I haven't exactly been on top of my blog lately.  It's most likely the adjustment to being home and my "new" life.  My emotions have been a bit crazy the past week and that seems to be taking a lot out of me.  Yesterday all I wanted to do was sleep... and today I was somewhat active, but now I feel as if I could sleep through the night (and it's only 6:21).

I'm following both the doctor and nutritionist's orders, although I'm still not walking as much as I would like.  Hey, there are only so many times you can walk through a cluttered house before you want to scream.  Perhaps if Mother Nature could see fit to stop dumping snow on us every few days I could get out and enjoy some fresh air and walk on the road (which right now is treacherous).  And have I mentioned it is snowing.  Again.

The last storm, which some have dubbed the snowcalypse or snowmaggedon, dumped another two feet in my area and left tons of people without power.  I was without for nearly 26 hours, and I've heard that people in my town are still without.  Now the next storm front has started and it's expected to give us another 7-14 inches.  My neighbors (bless them!) have brought wood up to the house for me since I'm still on lifting restrictions, and have warned me they expect another outage.  Please, Mother Nature can you give us a break?

Weight-wise I'm doing well.  I'm seeing a steady decrease each week on the scale.  I still am not feeling it much in my clothes, but I know that will come in time.  I'm in the "soft/mushy" phase now, and it is honestly nice to have something besides liquids.  The first thing I ate was cottage cheese - my very first craving after leaving the hospital, and it tasted good.  I'm carefully measuring all my portions and taking all my vitamins, the only real "work" is getting in all my protein and liquids each day.  I'm usually very close with the liquids, but have only been close (within .5-1g) on the protein twice.  I think once I get some more protein powders that I like it will be easier to get the liquid protein in me.

Speaking of liquid protein... time to go mix up a batch...

Monday, February 1, 2010

Catching up!

I realize I have been lax with my blog since the surgery, but since returning home I’ve found it difficult to focus on any one thing for a long period of time.  My mom says it is most likely an effect of the anesthesia.  I’ll take her word for it.  So let’s get caught up:

Tuesday, January 26:
We arrived at the hospital an hour early!  I never would have expected traffic to be that light, but both Manda and I agreed that it was better to be early than late.  I was taken back to have my blood type/screening done and then it was off to the surgical suite.  I must admit that when we walked through the doors and headed towards the desk I felt my first twinges of nerves.  That was the first and only time I felt nervous, and it passed very quickly.  I was taken into a small room and asked to change into an every so lovely hospital gown.  I then made myself as comfy as possible on the gurney.  There was a TV in the room but as I don’t watch it at home I didn’t see much point in turning it on.  Dr Mahtemework was the first of the surgeons to see me.  He would be assisting Dr Tran.  The anesthesiologist came in and began my IV.  I’ve never had an IV, so it was odd having this long needle in the back of my hand.  It didn’t hurt but I had all sorts of visions of moving my hand the wrong way and doing damage.  Dr Tran came in and spoke to me about the procedure and let me know we’d be getting underway in about 20 minutes, and then Dr Halmi came by.  I felt pretty lucky to see three of them the morning of my surgery.  I remember Manda wishing me well as they wheeled me into surgery… and the CRNA telling me about giving me something  to sedate me…

The next thing  I remember was being semi awake.  It felt like a dream, and I actually thought for some time after fully waking up that I had been dreaming during the anesthesia.  I remember the nurse telling me to put my legs on the other bed (I believe there were nurses to help guide me, but I was really still quite out of it) and then telling me to use my legs to pull myself over to the bed.  Seriously???  I had just come out of major surgery!  Then she asked what my level of pain was on a scale of 1-10.  I thought about it and told her a 5.  She said I’d already been given some morphine and then handed me the “button” to my PCA (Patient-Controlled Analgesia) and told me to push it.  I think she then told me how often it could be used and to use it if I needed it.  Of course the nurse on the floor that night might have told me too.  That part is still a bit cloudy.  They then handed me my bear.  Let me explain about the bear.  Apparently this bear was designed specifically for people who’ve had major surgery to their chest, stomach and abdominal areas.  His purpose is to be held against your body to help absorb the shock from things such as coughing, sneezing and bumps in the road (literally).  She told me to hold onto him since they were moving me and it could be a little painful. 

Winston (he came with a name: Winston the Weightloss Bear) and I arrived at my room.  I remember a nurse asking if any family was waiting for me.  I knew Manda would have already left by then.  What I don’t know is how much time passed between her asking and Amanda and Dani coming in the room.  I gotta tell ya, anesthesia sure screws with how alert you are!  LOL  I did perk up with them in the room, and Amanda even said I was more alert than Gena had been post-op.  That made me feel good.  She and Dani dug my cell phone out of my bag so I’d have it handy, and Amanda even plugged in the charger in case I needed it.  They stayed for a bit which was nice.

I have to say the thing that made me feel really great that first night was all the calls and texts I received.  I am certainly blessed to have so many wonderful people in my life, and hearing the voices of my angels (Gloria, Ashlee and Francesco) on the phone gave me more determination to do everything the medical staff told me.  I was very thankful to be in what I considered minimal pain (that night it remained somewhere around a 3 or 2, and I used the PCA very little), but I’m sure I still sounded somewhat out of it on the phone. 

During the night my back began to ache profusely.  I knew it was from lying down for more than 12 hours – I remember the feeling from when I’d get the migraines and be bedridden for so long.  I called for the nurse to see if she could help me get more comfortable and she did what she could.  She said she would check my orders to see when I was allowed to get out of bed.  At 4:00a when she came to check my vitals she told me she’d be in at 6:00a to get me up and moving before the shift change.  When she came in at 6:00a and asked if I still wanted up part of me wanted to leap from the bed!  Naturally I didn’t, but that was how much I wanted out of that bed.

Getting up the first time was a bit painful but nothing I couldn’t tolerate.  She told me to do some walking in the halls as it was very empty out there at that time.  I did 5 laps of the area before 7:00a.  I felt quite accomplished, and my back felt immensely better!

Wednesday, January 27:
“My” nurse for the day, Carolyn came in a little after 7:00a to introduce herself and see how I was doing.  She was quite pleased to find me sitting up and alert.  She took my vitals and such and told me that someone would be coming to get me for my Upper GI that morning.  (It’s required to make sure there are no leaks.)  One of the other nurses came in after her with hot wet washcloths, soap, and waterless washcloths (they have everything built into them – like a really think wipe) so I could clean up a bit.  She also brought me a fresh gown.  Getting the gowns on and off around my telemetry unit was a bit tricky but I managed, and it felt good to clean up a bit.  I hadn’t been done with that for more than a few minutes when they came to take me down for my test.

This Upper GI was far more “pleasant” than the pre-op version.  And as expected, everything looked fine.  At some point that day Dr Tran came by to check on me and look at my incisions.  He said that everything looked good and I’d probably go home Thursday or Friday at the latest.  I was determined that I would go home Thursday.  I was also given the clear for the initial liquid diet.  I had just loads of choices… not.  I got some chicken broth, sugar free jello, herbal tea and a bottle of water.  I ordered as much as I did solely because I didn’t know what I would and wouldn’t be able to tolerate.  I managed most of the broth (a whopping 4 oz) and a few bites of jello.  I kept the tea bag as the water had gone cold (it’s actually still in the bag I had at the hospital) and the bottle of water to sip on.  Gena, Pat and Heather came in while I was sitting with the tray in front of me (although I was done eating by then).  They brought me some lovely flowers (Gena & Heather) and a nice melon scented candle (Pat).  We chatted for about an hour before they headed out.  They could tell I was tired.

A couple hours later I got really bad gas cramps (a side effect of laparoscopic procedures) to the point of nausea.  Carolyn was fantastic and put two medications into my IV to help with the nausea and said one might help the cramps a bit too.  Not only did they help, but they helped me sleep for an hour or so.  I desperately needed that sleep because I was feeling exhausted.  I had a bit more broth for dinner, and there was a never-ending supply of ice chips and water.  I just had to be careful how much I ingested at any one time.

I actually watched a bit of TV simply out of boredom.  I couldn’t concentrate on anything long enough to do a Sudoku or any of the other brain games I had on my DS.  I finally gave up on TV and tried to sleep.  I slept fitfully for several hours and then became incredibly uncomfortable again.  One time after I got up to use the bathroom I went to sit in the chair because I just couldn’t bear getting back into the bed.  After the nurse came to check my vitals at 4:00a another one popped her head in to check on me.  She was concerned that I was in pain and wasn’t using the PCA.  I told her that it was gas pain and I didn’t see how Dilauded would help.  She said that it might and I should use it.  So I did.  She also told me she didn’t want me getting up on my own to go back to bed due to the nature of narcotics.  That wasn’t an issue though because I fell asleep in the chair.  I did eventually go back to the bed… I think it was around 6:00a when the IV machine started beeping (the battery was running low since I hadn’t plugged it in).  I called the nurse at that time and she made sure I got over to the bed ok. 

Thursday, January 28:
I hate to admit this, but this was probably the worst of my days in the hospital.  It had nothing to do with the medical staff because they were great.  It had everything to do with the fact that I was utterly exhausted and wanted nothing more than to be home in my own bed.  I was told early on that I’d be able to take a shower, which made me happy.  They had disconnected the PCA very early – probably around 7:00a and said the rest of the IV would be disconnected a bit later that morning.  The nurses kept trying to get me up to walk, but I was so miserably exhausted that I wouldn’t.  I finally managed to order breakfast (I was moved up to a “full” liquid diet) but I had no appetite.  I managed a few small bites of cream of wheat.

I finally told the nurse I was ready to take a shower and she got everything together for me.  It felt really good to feel the hot water against my skin and to be able to bathe a bit more normally than the previous day.  But the shower took a lot out of me and I had to lie down for a bit.  Dr. Mahtemework came in to see me and said I would be going home that afternoon.  Naturally that made me immensely happy!  The nurse said she’d start getting the papers together so I wouldn’t have to wait on her once Gena was there to get me.  I asked when I would be able to put on “my” clothes and she said anytime.  So I began changing, which took a bit of doing but I managed it all on my own.  I then began to slowly gather all my things together in one central location so we wouldn’t forget anything.  All of that took a lot out of me, but I felt good that I’d been able to do it.

Gena had gone to my house to get my Jeep for the ride home from the hospital.  We both figured it would be more comfortable.  She was very surprised how little the bumps and such on the road bothered me.  I think I only made audible sounds of pain twice – perhaps three times the entire trip.  We stopped by the pharmacy to fill my prescriptions (Dilauded for pain and something else for gas build-up in the stomach), and that became a fiasco.  Long story short:  due to the incompetency of this particular pharmacy I waited close to 1.5 hours for two prescriptions because they couldn’t tell us from the beginning that they didn’t have the Dilauded in stock.  Gena felt horrible that I’d been waiting in the car all that time, plus she wasn’t feeling 100% herself.  She managed to get me home and into bed, and I told her that I didn’t need her to stay.  I probably fell asleep somewhere around 7:00p and didn’t get up until about 1:15a when I used the bathroom.  I decided to spend the rest of the night in the recliner, and ended up sleeping until a little after 6:00a.  I was awake for about an hour before I dozed back off… and woke up just before noon!  I guess I was a bit tired.  LOL

Friday, January 29:
Gena came over for a bit late in the day.  I managed rather well on my own.  The only thing I hadn’t been able to do was feed the kitties so she did that for me.  Plus I didn’t want to shower without someone in the house, at least not the first time after coming home.  It went well and felt amazing to actually be in my own shower with my own shampoo and soap.

Saturday, January 30:
It snowed all day!  And I received a beautiful purple bouquet from my Angel.  I couldn’t think of anything better than being curled up with the kitties.  They seem a bit intrigued by my odd schedule and things I’m “eating.”  But they’ve both been really good about not walking on my incisions and that is the important thing.

Sunday, January 31:
Mina was quite intrigued by the yogurt I had for breakfast.  I told her it was not hers.  (It didn’t stop her little nose from sniffing the air wildly.)  I found my mobility was getting better which made me very happy.  I managed to shower without anyone else in the house.  I also determined which of the protein drinks (of those I’ve already tried) will be the easiest for me to ingest.  But this is all about learning how to create a new way of eating for my new life.

Monday, February 1:
Wow!  February is here.  It doesn’t seem possible.  Today I’ve found that my mobility is much better.  I have far less “pulling” on my left side (where the biggest incisions are, and also where everything is “pulled” to during the procedure) when I get up or turn over in bed.  I’m also sleeping longer in my bed before waking up and coming into the living room.  Now if I could just get the furrballs to understand that when I need to get up from bed they need to move!  LOL

Alicia (my neighbor) called me this morning to see if I needed anything from town.  I swear she and her family are just the sweetest.  Her husband, George fixed the hall toilet while I was in the hospital, as well as cleaning the filters in my HVAC and sealing a hole under it with steel wool (he thinks that’s where the beasties are getting in at).  Plus Alicia cleaned up my kitchen a bit more so it was easier for me to prepare my soup and all.  I truly couldn’t ask for better neighbors.

My cousin called me earlier to see how I’m doing.  It was really great to hear from her as she’s been on my mind a lot lately.  Gena called and we discussed her ongoing situation at work.  I just hope they don’t let her go.  She really doesn’t need that sort of stress right now.

Right now I’m reminding myself that I should have started drinking water or a protein drink at least 45 minutes ago… but I got carried away typing this.  I guess I should go get that now…