My Weight Loss Journey

First Bariatric Appointment

Hey, friends!

Let's start! by Anya Soda on Dribbble

Let’s start with the major failure of the transportation company provided by my insurance. I called the day before the appointment to confirm my ride. The insurance company stated the transportation company confirmed my ride but I did not receive a call the day before from the driver. This is a common practice and it made me nervous to not get the call.

The next morning, I waited until my pick-up time of 8:30 am and no one showed up. So, I called the insurance company and they contacted the transportation service for status. The minute I was supposed to be picked up, I was informed that the driver went on vacation and the company failed to transfer my ride to another driver. The insurance company couldn’t arrange another ride due to the late notice and therefore, couldn’t go through with my request.

Let me tell you, I was angry.

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I made this appointment a week and a half early to ensure my ride would be secured. It takes many months to get into this doctor and I couldn’t just reschedule it. It would’ve been a much longer wait. So, started making some calls.

I filed a complaint with the insurance company and the transportation company. Pending a phone call back and hopefully an apology. The only positive thing is that they transferred my ride to gas reimbursement. So, I’ll be reimbursed for the 454 miles that we drove yesterday.

Thankfully, my dad came to the rescue and drove me.

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The drive there was nice because I got to chat it up with my dad. The weather was nice despite the rain previously in the week. The roads were clear and the sky was clear. We did have to rush it a bit to make sure we got to UNM Hospital on time. In fact, we pulled up into the parking structure ten minutes before my appointment.

My dad was a trooper because not only did he have to get up early (he sleeps until 10ish normally), he also had to sit in the hospital for hours while I was waiting to meet with Dr. Bock.

I arrived and checked in right at 2 pm. I was called back for triage and then put into a room shortly after. I would say the annoying thing was they stressed I had to be there on time for my appointment. Then, I sat in a room for 1 1/2 hours before the doctor actually came in.

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After sitting on my butt for hours in a car, I spent most of the time in the room walking around and trying to get circulation into my legs. I also read one of my books to keep me from being bored. See, I tell you, always take a book with you! Doctors never run on the timetable you think they do.

Discussion with Surgeon

When Dr. Bock finally came in, we got down to business. First, he had a lot of concerns and questions for me. Here is a list of things we discussed.

  • My May 22 ER Visit and the possibility of meeting with a surgeon later on for my hernia repair. He called Dr. Popek (my previous surgeon) to talk things over. He will review my CT scan and other things to determine the severity of the hernia and if more immediate attention is needed.
  • My liquid diet. My new dietitian does not think that I should be on a liquid diet and as long as I don’t eat too much fiber, we formulated a plan for what comes next. (I’ll discuss the plan below.)
  • Dr. Bock needs to see the CD of the CT scan performed at Mountain View. So, I will be calling next week to request that CD be mailed to his office.
  • Dr. Bock wants to perform a MRI Enterography. If you don’t know what this is…it’s a nightmare. You drink Barium (nasty chalky drink), lay in the machine on your stomach, they inject a dye and an agent to slow down the liquid from going through your system. Once the agent stops working, you spent some time in the bathroom. (Both ends!) Yuck! I hate it.
  • He wants the results of the Endoscopy I have scheduled for July 8. He requested that I ask Dr. Reinhold (My GI) to add an H-pylori text as well.
  • I was given a packet of questions to answer. I filled this out today and will be sending it to the Bariatric department at Sandoval Center in Rio Rancho. This is for the Psych-Evaluation they require before surgery.
  • He did a physical exam of my belly and said that depending on the bowel and where it is, the surgey is doable and things should go well. We have to see what the CT scan and the MRI Ent. show.
  • I will see my dietitian via telehealth in two weeks to see how the new diet is going. (see new diet below).
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Materials

I was given a booklet that has information on the procedures. I’m doing the Sleeve surgery. I did some research on the procedure, the risks, possible complications, etc. There is information in this booklet on the following:

  • Obesity and Weight loss
  • To Do list
  • Protein supplements
  • Self-care
  • Pain management
  • Taking care of incision
  • Getting back into a routine
  • Mental Health
  • Self Esteem
  • Nutrition including recipes for before and after
  • Exercise
  • Medications
  • Resources

So, basically…I have a ton of reading to do in this booklet. I don’t mind. The more I know the better prepared I’ll be.

Diet/Dietitian

The dietitian was not happy with my liquid diet and she has transferred me to a puree diet. Here is what I’m doing for the next two weeks. First, let’s talk about what she thinks about Dr. Gomez’s suggestions with adding MTC oil, heavy whipping cream, and olive oil to food. She said this is not helping me and I was drinking broth and such. After doing some calculations, she said I was taking in an exorbitant amount of sodium and thinks I have some water retention. So, the goal is to illuminate sodium-rich liquids.

Dr. Bock and the dietitian recommend low-fiber foods. So, no veggies, no fruits. Here is my diet for the next two weeks.

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Breakfast

2 eggs (can add spices, no salt) pureed, 1 cup decaf coffee 1tbsp coffee creamer

Snack

Green tea, 1/2 cup cottage cheese OR chobani yogurt cup

Lunch

4 oz chicken breast, thigh, or cutlet with spices (no salt) pureed

Snack

Ensure Max Protein shake 11 oz (I buy at Walmart), decaf coffee 1 cup 1tbsp creamer

Dinner

4 oz of beef with spices (no salt) pureed

Water

My goal is between 72-80 oz a day

If I can tolerate this diet and feel full, they will advance me to a liquid/solid diet. I started today and I feel so much fuller and have more energy than I’ve had in weeks. I ate eggs, chicken, and pot roast each 4 oz. I feel satisfied and I’m hoping this helps me with the diet after surgery. I feel good about it. I drank about 86 oz of water today.

To-do List

So, let’s make a list of things I’ve got to do.

  • Endoscopy (July 8)
  • Labs
  • MRI Enterography
  • Psych-Eval
  • Sleep Specialist CPAP Compliance Report
  • H-Pylori Test
  • Get cleared by ALL doctors. (Thankfully, I’ve done this already).

Thoughts/Feelings

First, I’m tired! My dad and I were so sore and tired after the long hours of driving. On the way home, we hit some heavy rain. So much, we had to slow down and it was possible to pull over due to the rain. The lightning was amazingly crazy. It sucks to have to drive 3 1/2 hours away to meet with a doctor for 1 1/2 hours. Then, drive another 3 1/2 hours home.

I’m confident in my new surgeon and feel really comfortable that he is consulting with Dr. Popek. She was an amazing doctor and performed 5 surgeries for me. I know that with them teaming up, I’m in good hands. He says my case is a little complicated due to the hernia. He’s going to get all the results back and make the best medical decision for me.

I feel confused with the diet I’ve been on and the contradicting information I’ve received. I have been meeting with Dr. Gomez for months and thought she had my best interest at heart. I trusted her and listened to her recommendations. The fact that I followed her instructions and didn’t deviate or cheat on my keto diet was frustrating. I’m questioning it all now. I didn’t lose more than 36 pounds in 8 months and gained most of it back.

Now, I am starting with a new dietitian who says that I should not have been on a liquid diet. I should not have been eating certain things. I should not have been taking metformin for insulin resistance. It turns out the blood work showed that I’m not even close to having diabetes. Dr. Gomez made it seem to me that I was at risk and insisted I follow her diet. What does that tell me? How do I know what is right? It’s confusing.

I’m going to follow this diet that this new dietitian is telling me. I am also going to receive counseling on the bariatric diet. So, I’m going to try to make informed decisions based on what is being told to me. I’m just wary of all this. It’s hard to know what is right and what is best.

I’m overwhelmed with the number of trips I have to take to Rio Rancho, NM, and Albuquerque. There is a lot to get done in terms of being cleared for surgery.

I’m fearful that the CT scan and the MRI may be an obstacle in surgery. I’ll try to keep positive, but I need to make sure that Dr. Bock has all he needs to say that I’m cleared and that he is going to perform the surgery.

So, I’ll update again later but it took me all day just to formulate this lengthy post. There was a lot of information packed into this appointment.

Until next time,

Happy 4th

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Ruth Anne

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