Barenaked Ladies

In an off topic post: This weekend I got to see Barenaked Ladies! It was a free concert, and we hung out all day (and therefore were front row)! We videotaped the concert, and here's some of the videos my husband shot:

The Big Bang Theory:

My husband and I are huge fans of The Big Bang Theory TV Show, so we were very excited for this song.

Pinch Me:

 Classic BNL

One Week:

The BNL song everyone loves.

Falling For The First Time:

I love when Ed looks at the camera!

As a special gem, I got to meet and talk to Ed before the show!

There are more videos posted and being uploaded of the concert on my youtube channel.

The best part of the day was that even though I was sitting in an area surrounded by festival food vendors, I still managed to stay on track calorie wise! The scale actually was down a bit the next morning!

Bariatric Appointments

This post is a conglomeration of a few months of appointments, so it will be very informative. 

So, last we left off, I hadn't been seen at the Bariatric Surgery Center (BSC) yet. I am happy to say that I have now been there three times.

The first time I went to the BSC was a group informational, and it was pretty much useless. It was located in the giant lobby of the building the BSC shares with other offices. I have to say, it was very weird being in a giant room with a couple hundred morbidly obese people. Though, the chairs were soft, wide, and awesome... so that’s a plus.

They went over types of surgery available, outlined the pre and post-op diets, discussed the risks (and their center's history of very few complications), the benefits, and so much more. I'm sure they answered a lot of people's questions, but if you're like me: you research your choices so much that you learned all the information on your own already. I was already sick and tired of hearing the same information over and over… but alas, it will never end.

The real purpose (for me) was the paperwork. I received a folder with anything and everything I need. Including a giant stack of paperwork (remember, I said need not want). I was instructed to fill out the paperwork, include a non-refundable check for $150, and mail it back to the center to officially enroll in the program. The $150 required is a program fee not covered by insurance. This covers the cost of support group meetings specifically for bariatric patients (I'm required to attend 3).


After a few weeks of waiting and being disappointed by an empty mailbox, I took things into my own hands and called the center. My paperwork had been processed and I did have an appointment date on file... the paperwork just hadn't made it back to me yet. She gave me the date over the phone, and I felt like I finally made some real progress!

I was super excited but also very anxious on the day of my first true bariatric appointment. I was told that I would be there for a few hours, and boy were they not joking. Unfortunately, at least 1/3 of that was sitting around waiting for different people.

First, I was triaged by the nurse. This included taking my weight (the enormous scale was mildly amusing), going through the medical history I sent them in the mail, and more; it was basically a bunch of standard "doctor" stuff.

Next, I finally got to meet with my surgeon! My surgeon is Dr. Taewan Kim.

He was pretty awesome actually; he was laid back with great "bedside" manner, but he was also very clear and informative. We went through more stuff I have already heard (they really pound a lot of stuff into your head to make sure you really get that you need to change your lifestyle). We also talked about and chose what type of surgery I prefer.

We decided on the typical (and most prevalent) surgery that is

Roux-en-Y:

(Creates a separate small pouch, and bypasses the most absorbtive part of the intestine)

(The rest of the stomach is left for the digestive juices)

The other choices are:

Gastric Sleeve

(reduces stomach size, but does not limit absorption)

and

Gastric Banding

(adjustable band is placed around the stomach to create a small pouch that restricts food intake)

(this was specifically discouraged by my surgeon for multiple reasons)

We discussed all the things I have to do before surgery; many of which I have already completed. Though, I still need to get a psych evaluation, and go to the group meetings.

The last thing that is required before surgery is to lose 5% of my weight on my own. For me, this translates to 16 pounds.

Finally, I had to meet with a nutritionist. She took notes about my current eating habits, and gave me info sheets that are tailored to people like me (on the run (fast food habit), eating in the evening, etc.). She again went over what the post-op diet is like. We talked a little bit about the food pyramid, and then we were done.

One cool thing I must mention: their office is covered in bulletin boards with before/after pictures and thank you notes. It was very inspirational.

My third appointment was a month later. I only met with the nurse practitioner this time. Basically, it was just a checkup. They checked my weight (which was indeed a bit lower), and talked about how the month went. It was short and simple.

My next checkup appointment is on August 9th, and I'm super excited. If things go well *crosses fingers* they will schedule my surgery then.

I have made weight loss progress, but I'll save that for another post because you probably have something else to be doing (now stop procrastinating and go do it).

... but before that, I just want to let you know: I know many of you may have questions for me. I am taking questions from my readers, and I will answer them in a follow up post. This can be from anything on the blog, not just this post. All you have to do is leave a comment with your question!

Photos retrieved from the Syracuse BSC website.

Sleep Studies #2 and #3

To recap: The first sleep study showed that I have Sleep Apnea which required me to return to the to the sleep center.


My first night with the mask (referred to as both study #2 and night 2) on did not go well. I was in the lab tossing and turning from 9 pm to 4 am. The scheduled release time was at 5am, but the respiratory tech was kind, and didn't force me to stay any longer. I slept for a grand total of a gi-normous (note the sarcasm) 90 minutes. I spent the rest of the time trying to (unsuccessfully) get comfortable. I am a stomach sleeper, and unfortunately, the masks don't function well in that position (air leakage). The tech informed me that although I slept very little, he was pretty sure he found the correct air setting for the CPAP, and I shouldn't have to come back.

Alas, that turned out to be false.

By the third time, I pretty much knew the drill and things went smoothly. I did, however, take an opportunity to try a mask that I hadn't tried yet. On the second night, I first tried a mask that basically took up my entire face. It covered both mouth and nose, and had an extension that rested on the forehead. The piece on the forehead obstructed my vision. I hated it.

Bask in the Hideousness:

You can also see a few of the many electrodes on me. 

It didn't last that long. So, for the remainder of the evening I used a mask that only encompassed the nose; they called it a "nasal pillow". I liked the fact that it was so unobtrusive. However, I didn't like the fact that any time I opened my mouth (and I realized then I do this more than I originally thought) I felt like I was being suffocated; it was a frightening occurrence.

Therefore, on the third night I tried a third type of mask. This mask covered both mouth and nose, but had no piece extending above that. It was the best of both worlds, and I was able to fall asleep and have a relatively normal night.

After a follow-up with yet another (different) doctor, I was prescribed a CPAP machine to treat Obstructive Sleep Apnea. For those that don't understand the disorder, it is a disorder characterized by abnormally shallow breaths (hypopnea events) or complete pauses (apnea events) in breathing. Every person with Sleep Apnea is rated on the AHI (Apnea Hypopnea Index) to rate the severity of their disorder. My apnea events were averaged at 5 per hour. My hypopnea events were more numerous than my apnea events; as a result my oxygen saturation frequently plummets below the 89% threshold. After the treatment, I was assigned an AHI of 9.9 (less than 5 considered normal). This is a mild form of the disorder, but it is still important that I use the machine.

At home I've been having troubles getting used to the machine. Although it does have humidity control, the heat of the summer months makes the mask even more uncomfortable to wear. I also have had issues with feeling claustrophobic since the mask covers both means of breathing. I know rationally that I can breathe just fine (heck the machine is designed to help me breathe!). However, I still have feelings that I will get stuck in the mask and I won't be able to breathe. Oh me. I've been working on wearing my mask more often (I have to wear it a minimum of 5 hours/5 nights a week for insurance to cover it).

My home equipment:
 

There is no way not to ruin your hair putting this on:

So, the question you probably want to know is:

 Why is it important to know this information before gastric bypass surgery?

Well, I'm glad you asked.

Gastric bypass surgery obviously requires me to be anesthetized, and also to be on pain killers afterwards. Both of these things can affect lung function. It is important that they have a CPAP available while I am unconscious and under the influence of these substances because we don't want anesthesia to worsen my condition (right?). I don't think I have to spell out the ultimate worse consequence of not monitoring my breathing.

In the end, now that the doctors know about my condition, they can perfectly adjust my CPAP to reverse any effects the medications may have on my breathing.