A New Beginning

Well, I did it. I’ve made the calls and shared the news with all my folks. I’ve started sharing with colleagues and began planning how to make work work while I am away. More calls, more plans, more arrangements are in store before it can happen. It feels a little surreal. I’m finally at the crossroads and ready to take the plunge into bariatric surgery.

I’ve never thought much about bariatric surgery before. But about 18 months ago I became quite ill — easily the sickest I’ve ever been — headaches, fatigue, and excruciating pain in my lower back and groin. It took months to form a diagnosis of chronic prostatitis, only after an MRI, sleep study, EKG, cardiac stress test, trips to the neurologist and endocrinologist, and blood work — lots and lots and LOTS of blood work. After all those tests the answer seemed quite simple: the prostate was infected (not enlarged), which inhibited testosterone production, which caused then the pituitary gland to underfunction, and thus cause the headaches. Further, the infection spread to my pelvis and created significant pain in my lower back and hips. I’ve discovered first-hand the wisdom of my urologist: prostatitis is an insidious infection, extremely difficult to effectively treat, and has a high likelihood of recurrence. I’ve been on antibiotics more days than not in these past 18 months (Levaquin, Doxycycline, and Bactrim), to only moderate relief. The tipping point came this past fall when my really, really good general practice doctor and I began talking about my health, generally. My weight and type II diabetes weren’t the cause of my infection, but they were certainly factors inhibiting overcoming the infection.

With Molly’s blessing, I made the phone call to Missouri Bariatric Services. I watched their online video and took the virtual quiz and made the appointment with Dr. Richardson. Missouri Bariatric Services require a sleep study and a cardiac stress test — fortunately I’d recently had both. They also require consultation with a psychiatrist, so I made that appointment, too. In November, I began nutritional supplementation, per doctor’s orders. In addition to a quality multivitamin (I currently use GNC’s ”mega-man” formula which includes additional thiamine/B-1), I take 1000mg of calcium, 1000mg of sublingual B-12, and 4000mg of vitamin D. I was off and rolling.

That was the fall of 2010. In the past couple days, the final piece came into play — I’ve been approved by my health insurance carrier for surgery. Say what you want about United HealthCare — and I can say plenty about their runaround and idiotic delay tactics (they wanted five years of clinic notes and weight history — and when they initially only received 4 3/4 years’ worth, they rejected approval and the process had to start from scratch) — when push came to shove they approved the surgery several other carriers won’t cover.

I’ve been approved for gastric sleeve surgery (also called sleeve gastrectomy). Until I met my surgeon, I hadn’t even heard of the surgery. Basically, the stomach is surgically modified — made radically smaller — but doesn’t require re-routing/bypassing or installing a band. In the end, to me gastric sleeve has more appeal over the far more common lap band and gastric bypass. To each his or her own — and for certain I didn’t want to be beholden to occasional adjustments (“fills,” I guess they’re called) as in lap band that I knew my insurance wasn’t going to cover. I could totally have lived with gastric bypass, but the upside of gastric sleeve surgery appealed to me most, especially the nutritional malabsorption issues common to other bariatric surgeries. (I hope to write more in the future about what I learn about gastric sleeve — in the meantime, I found this link especially helpful for its simplicity: http://www.yourbariatricsurgeryguide.com/gastric-sleeve/ .)

At the moment, my file is undergoing final evaluation at Missouri Bariatric Services, and I hope by the end of the week to be told a surgery date. A day of classes at the center awaits sometime soon, as will an appointment with the anesthesiologist. I’m told we’re talking surgery within weeks, not months — so we’ll see.