Consultation

I had my consultation with the surgeon yesterday. I've met him a few times before and I really like him. He recognized me right away from a support group meeting. I had asked about his policy on caffeine.

First thing I did was fill out some additional paperwork to the very large packet I had already completed. It was just the privacy policy and all that jazz. I paid my $200 program fee and was called back. I was weighed (285.4) and measured (5' 2.5"). In the room, the medical assistant made sure that all of the paperwork was there, and were very happy that I had brought in previous medical records, including my previous ERCPs and Laparoscopic Cholecystectomy. Then the insurance person came in and went over a few things. Turns out that my insurance is fairly straightforward and my only requirements are as follows:

• BMI greater than 40 -or- BMI between 35 and 39.9 with serious medical complications.
• History of active participation in non-surgical methods of weight reduction. Must be fully documented in the medical record.
• Documentation that endocrine disorders have been ruled out.
• Psychiatrist/Psychologist consultation and clearance.
• Documentation of Nutritional Counseling
• Pre- and Post-Operative dietary evaluation and nutrition counseling.

So, I am definitely qualified. When she left, the surgeon came in and talked to me a bit. I told him that I wanted the Sleeve, and he said that is what he prefers. He did a physical exam, checked for swelling, palpated my abdomen and thyroid, listened to my heart and lungs. He said since overall I'm in good health and my insurance requirements are minimal, he is putting me on what the call the Fast Track. This means that I can have surgery in as early as six weeks. It will probably be closer to eight weeks, though, because of Christmas and he will be on vacation. So we're looking at a surgery date around the first week of January. This will work out perfect for me because I am a student and it will be in between semesters.

When he left, the medical assistant came back in. She will be scheduling my psych evaluation as well as the endoscopy. The endoscopy will either be November 10th or November 17th and I won't know until the Monday before so that will be a bit challenging. I also have orders to take to the hospital to get a chest x-ray and labwork. Specifically, they are looking at:

• CBC
• CMP/BMP
• PT/PTT/INR
• Platelet Count
• Vitamins B1, B12, A, D, E, K
  
• Lipid Profile
• LFTs
• Copper, Calcium, Phosphorus, Magnesium, Selenium, Zinc, Iron, Folic Acid
• HgA1c
• Thyroid Functions (T3, T4, TSH)
• PTH intact
• Vitamin D-25 OH Total

I will also need to go for a second sleep study with CPAP titration. I am *really* not looking forward to this. I slept so horribly on the first one, I just don't want to do it again and I'm worried that the CPAP is going to be very uncomfortable. I'm also a stomach sleeper, so not sure how that will work out. I will also get an appointment to see the nutritionist to go over the diet.

So, I guess that's it for now! I go back on December 1. I'll probably have most of my tasks completed by then. I can't believe this is happening, I'm very excited!