Gastroenterologist Consultation

I arrived by cab, at 9:15 a.m., my insurance provides me with 24 round trips per year.  My appointment was for 10.  When I sat down, I was alone in the waiting room, but there were a few people on the other side of the partition who looked busy enough.

Around 9:50, I was called up and provided paperwork, which took me 15 minutes to fill out.  And at 10:15 I was put into an exam room.

At 11:00 I started getting antsy.  I had scheduled an 11:30 pick up for my 1:00 appointment across town, thinking I arrived early enough to provide plenty of time for filling out first time paperwork, and 90 minutes provided plenty of leeway.  and I went to the nurses station, where they assured me it wouldn’t be long, there  were only 3 more people ahead of me!

True to  their word, the doc got to me at 11:20.  I told him I needed an endoscopy as part of my prescreen for gastric bypass surgery.  He inquired if I had a cardiology consult.  I told him I had seen my cardiologist the day before.

“Did he do an echocardiogram, ekg, and a stress test?” the inquisition continued. I said yes, wanting to get the appointment and get out of there, but he wasn’t going to let me off easy and he repeated his question. ‘Okay, officer, I confess’.  I reluctantly told him that he hadn’t done the stress test.

“You’re going for the whole ball of wax.  If it were me, I’d want to be sure that I was getting off the table, and I’d demand a stress test. But that’s between you and me.”

He went on about all the stress my heart has been through damages the heart.  Guess he doesn’t  believe in the old adage, “what doesn’t kill you makes you stronger.”

He scheduled the procedure for early next week. “I want to see cardiology clearance when you walk in the door.  Pick it up and carry it in with you.  I will not perform the endoscopy without seeing clearance from your cardiologist.”

I rushed out, no cab.  I called the cab company, who claim not to have me scheduled to go to another appointment and they were going to take me home.  I called my insurance company, they called the cab company, and they weren’t going to be able to get me across town in time. I ended up rescheduling my next appointment.

My 11:30 pickup came for me at  2:20!

When I arrived home, I called my cardiologist and had them fax over my clearance.  I also asked that he call me, and remind me why he felt that I didn’t need a stress test.

I then called the gastro’s office to verify they received the fax and informed them that the doctor wants to see it before my procedure next week.

Cardiology Consultation

I love my cardiologist.  He’s personable.  Wish all my doctors had a manner that allowed me to leave their comfortable with who I am.  But then, my last cardiologist also gave me a shining review of my heart, which was a few years ago, telling me that he would actually guarantee that I would not have a heart attack within the next 5 years.

After an ultrasound of my heart, my current doctor told me that I had a very good and strong heart.  I said, “like a 56 year old”, and he rebutted, “More like a 26 year old!”.   And with that he wrote up my cardiology clearance and sent me on my way with an appointment in 3 months.

Bariatric Surgeon First Consultation

I’m looking forward to having Dr. Bridge as my surgeon.  I feel comfortable talking with him and trust  him with my life.

I’m thrilled that my insurance doesn’t require the 6 month wait. I want to get started on the extreme permanent changes.

My doctor basically asked me if I had any questions for him, but at  the moment, all I was interested in was my insurance requirements.

I showed him my driver’s license picture, when I was 350 pounds, so it’s obvious that I can lose weight and I know how to restrict.  I explained it’s my consistency that I have trouble with.

I told him I had my required consult appointments all scheduled.  He tested me, naming them off and having me respond with the respective dates.

He said that he’d see me in a month.  He didn’t put me to the task of losing any more weight, I hope he’s not expecting much from me, I really want to say farewell to a few of the foods that got me this far.

Then he sent me for the following lab work:

  • CBC
  • Comprehensive metabolic panel
  • Ferritin
  • Folate
  • Hemoglobin A1c
  • Iron
  • Lipid panel
  • Selenium serum
  • Total Iron Binding Capacity (TIBC)
  • TSH
  • Vitamin A
  • Vitamin B1, Plasma
  • Vitamin B12
  • Vitamin D 25 hydroxy
  • Zinc


Primary Care Physician

I went to see my primary care physician to let him know that I’m intent on having bariatric surgery and that I’ve decided on the Roux-en-Y gastric bypass. I can’t say that he was impressed, or cared either way.

I long for the days that John Shaw, MD, was my physician, he always made me feel like I was his most important patient.  Unfortunately, at the advent of mandatory computer charting in lieu of handwritten notes, he opted to join Doctor’s Without Boarders and have guerrilla soldiers escort him to his patients, it was easier.

In the past 2 years, I’ve never seen the physician who’s name is written as my “primary” on my insurance card, and my current “primary” at the clinic has only personally seen me once before.  He seemed pretty annoyed, thinking that I was there with the expectation that he was going to review my chart and write the letter right there in front of me, since my appointment with the bariatric surgeon was for the following day.  I assured him, that it wasn’t necessary that I have it for my first visit, it’s just to substantiate a chronic pattern of failure to conclude surgery was necessitated to appease the insurance company.

I’m pretty sure he doesn’t care for me, other than the fact that he’s paid to diagnose and prescribe a treatment plan.  I’d venture a guess that  if he saw my face on the evening news, he wouldn’t be able to place it.

Bariatric Seminar

I surrendered to the idea of going for surgery in December 2015.  I contacted Dr. Atwa’s office, calling them every week for over a month, trying to get an appointment.  Unfortunately, his office insisted that they needed to have authorization from my insurance company before they would see me.  After a month, I looked for another bariatric surgeon.

I found South Shore Surgical Specialist, and have been assigned to Dr. Bridge.  The prerequisite to a consult was to attend their seminar with Dr. Cusasatti, who explained the three types of surgeries that they do 1) Adjustable Gastric Band, 2) Roux-en-Y Gastric Bypass and 3) Vertical Sleeve Gastrectomy.

I was surprised that “dumping syndrome” is considered a benefit, as it’s actually one of the reasons I want the surgery. I haven’t been successful at eating in a healthy way and maintaining a healthy weight, left to my own devices. And, like Dr. Phil says,”How’s that workin’ for ya?”, I only have to look in the mirror to see the answer.

So, now that I’ve attended the seminar, all I have to do is have (in no particular order):

  • Psych eval, to confirm that I have reasonable expectations and am fully aware that I’ll have to eat like a gerbil or I risk becoming ill or worse yet, failing at losing weight after undergoing major surgery and several days of painful recuperation.
  • Primary care doctor write a letter detailing that even though I’m a chronic loser, I get up again (i.e. yo-yo weight loss & gain).
  • Pulmonary consult.
  • Gastroenterology consult, to verify that I have the stomach for the surgery.
  • Cardiology consult, to validate that my heart’s in it.
  • Nutritionist consult, to feed me knowledge about eating.
  • Bariatric Support Groups, at least 3 meetings.
  • Blood tests, chest x-ray, venous sonogram, and whatever else the doctor orders.
  • Oh and of course, visits with the Bariatric Surgeon.

Then, my insurance will be contacted for prior authorization and with their blessing, surgery can be scheduled!!!

It took me a few hours, the day after President’s Day, but I was able to schedule all the consults by March 7.  And so, the journey begins.


Making The Decision For Gastric Bypass Surgery

A few years ago, my ex-band, his wife and his sister all had gastric bypass surgery.  I was of the opinion that it was the lazy way to lose weight, and when I was told they had to “diet” before surgery I couldn’t understand why, after all if they were able to control their consumption in the first place surgery wouldn’t be a consideration.

Regardless of my opinion, they all dropped 100+ pounds the first year, while I insisted I can do it on my own, as I had done a few times before.

Since then, for about a year, I focused on juicing and organic eating.  I went from 310 pounds down to 245.

I was living in Bellingham, Washington, where I loved to spend hours walking through the woods in my back yard. I had free access to all the blackberries I could eat, once I cleared the tall grass and overgrowth.  I found it relaxing to collect fallen branches, propping and weaving the wild vines.

I’m not sure where I got side tracked, but I gained weight, and went back up to about 280.

I moved in with my daughter and her family.  She and I began going to a local gym together, where, to my surprise, we became avid spin cycle attendees, riding 125+ miles, to nowhere, a week.  I dropped down to the 240s again, only to allow myself to react to drama, turning up the eating and minimizing exercise, which now finds me back up in the 280s.