Into the Woods and Out of the Woods and Home Before Dark!

I'd like to start out this edition by announcing the birth of Quartz Rollo James Landaker, new son of my dear, dear friend Andrea (ne: Meibos) and her wonderful husband Wes Landaker. He was born September 1, 2004 at 6:08 PM in Alberquerque, NM, weights 8 lbs, 16 oz. and is 20 inches long. I've been friends with Andrea longer than anyone. She has been my best friend, my defender, my confidant and supporter for many years and I love her and wish her the best. I've claimed Quartz as my nephew (since we are blood-sister and all) so I wanted to share my love for them with you all too.

So I thought I'd spend a little time talking about my journey up to now and then in my next posting I'll detail the actual surgery procedure.

I decided to do the surgery once and for all in May of 2003. I was doing a production of "Oliver!" (yes, again) and acting as Prop's manager, Asst. Stage Manager and actor (somehow that always seems to happen to me! Anyway...). The director's husband came one night to take pictures and, after seeing them, I was horrified at how bloody awful I looked. I was wearing a blue dress and, well, remember the girl in 'Charlie and the Chocolate Factory' who turns into a blueberry? Yeah. Besides that, I was having far more than the usual amount of difficulty getting prepared for the show. Tech. work isn't easy but this time was accompanied by the melodious notes of the ever increasing sounds of stressed breathing, groaning and joint popping. The pictures were the last straw and so I went to my doctor.

I won't repeat the story of what happened with my first doctor, Dr. Kalkstei... I mean Dr. Doorknob. I told it in the last edition. After that thrilling meeting, I switched doctors and began seeing Dr. Walker. Dr. Walker was one of my father's doctors and I felt that since he knew about my family history, he would be more likely to grant my request. (His being head of the hospital didn't hurt my chances with the insurance company either.) The only problem was that he had never refered someone for Bariatric Surgery before so we got off to a slow start while we tried to figure out exactly which forms needed to be filled out, etc. I was sent to get a Sleep Apnea test which, after a really horrible night of sleep, turned out to be negative anyway.

After requesting approval of a referral the first time, we received a letter from the insurance company saying that to be considered for the surgery, I needed to meet the following requirements:
1) My BMI had to be at least 30 with medical problems or 40+ without.
2) Be at least 100 lbs. overweight.
3) Have had an apt. with a Dietatician and a 30 day follow-up apt.
resulting in the Dietatician's recommendation for the procedure.
4) Have tried at least one weight loss program with a counselor.
5) Have tried at least one formal exercise program.
6) Have an EKG test.
7) Get blood tests.
8) Have the recommendation of a psychiatrist


Luckily, I had already done most of these things. My BMI was 57. No problem there at all. I was a good 150 - 175 lbs. overweight. I've done Jenny Craig twice and Curves once, among numerous other fad diets. So all I needed was a meeting with a dietatician (whom I'd seen once already about 2 month previously), blood tests, a meeting with a shrink and an EKG.

The lab tests were requested by someone other than my regular doctor, which would provide further complications down the line. The EKG was easy. You're in and out in a matter of minutes. The Dietatician was more complicated. When I met with her for the second time, we noticed the clause about the follow-up having to be within 30 days of the first apt. so scheduling a third apt. took us all the way into December. I knew it would be a lengthy process but the dragging was already starting to kill me. I also needed to get a letter from Jenny Craig and Curves testifying to my valient attempts to lose weight using their programs. Luckily, my Jenny Craig counselor was also my best friend Brian. (HI BRIAN!!!) So even though I'd stopped going months before, it was simple to get a letter from him. Curves was pretty easy too since, at the time, I was still going. The letter from the owners was quickly obtained. However, near the end of December, I became very ill and ended up in the emergency room with the flu, complicated by both and asthma attack and an anxiety attack (hey, you try to stop breathing without getting stessed out). The doctor took another EKG which, due to the stress and axiety, showed up abnormal. I'd have to get another normal EKG in order to meet that qualification. (Of course, I had a relapse in February, so I had to put off the third EKG until May.) I saw the shrink somewhere in there too and he wrote a letter of recommendation for me after less than half an hour.

So I finally had jumped through those set of hoops and was referred to UCSF for surgery. I was starting to get excited until I got the letter. The 20 page packet provided me with a phone number to call to set up my screening apt. with the surgeon. I had to call and leave a message which wasn't returned for a week. When it was returned, the woman told me to call back in 6 months to see where I was on the list for appointment scheduling! I'd also been hearing some not so great things from a co-worker about UCSF and so felt no disloyalty about calling up my insurance company and asking them to switch referrals. This co-worker of mine was getting ready to have surgery with a company in Pleasanton called Valley Care Health Systems. She said that they were only just beginning to take insurance referrals so the waiting list wasn't long at all (waiting lists at both UCSF and UC Davis were at least 2 years). In fact, she was getting ready to have her surgery done in the following month or two! (Which I'm happy to say she did.) I requested referral to the same group and was soon setting up screening appointments with them.

I'd recently gotten hired for a new job in Contra Costa County which was both a promotion and involved moving to a new department. I'd be on a 6 month probation due to the promotion so taking time off was something not to be taken lightly. I made a huge exception for my first two appointments with Valley Care, but stratigically scheduled my appointments with the Nurse, the Dietatician and the Surgeon all on the same day. It was here that I was first introduced to the procedure. First, I've have to loose 10% of my excess body weight which amounted to 16 - 17 lbs. to be lost before the actual surgery date. I'd also have to attend a series of Nutrition and New Lifestyle Management classes provided by Valley Care (but sadly, not covered by my insurance). I was informed that a meeting would take place that coming Friday, where the three interviewees would discuss my case and decided wether or not they would accept me as a patient. (Eeeeekkkkk!!!!!) Next I met with the Nurse who went over a few of the basics. What I could and could not do before and after surgery (I'll save the details for next time). Finally, I met with My Surgeon, and I was so thrilled to be there I could hear Barbra Striesand singing 'Don't Rain on My Parade' loudly in my ear.

However, the first thing Dr. Nguyen (pronounced WHEN) told me was that he might be leaving the group to start his own practice. But not to worry, he would still be happy to preform my surgery or I could stay with Valley Care and have another surgeon do the procedure. This was not a reassuring way to being the meeting but I was so nervous that they'd refuse to do the surgery that I just smiled and nodded and tried to keep my mind focused on what he was saying. He went over all the different types of surgeries with me and basically decided I'd be doing the Roux-En-Y procedure, which usually results in an average of 70% excess weight loss, plus it's safer. (There was another procedure that averaged a 90% excess weight loss, but was accompanied by particularly foul gas, so that was out.)

I was to expect a letter within a week, and sure enough, it came shortly thereafter. I was to lose the 16-17 lbs., attend 8 Nutrition and 8 New Lifestyle Management classes, plus attend ANOTHER psychiatric review since the first guy was not associated with their organization and therefore didn't ask all the necessary questions. The also wanted some more blood work, since the substitute doctor I had seen hadn't requested all the right tests.

So, I took my blood work referral and, since I work at the same hospital I go to, I went to the lab on my morning break to get them done fast. Of course, I hadn't factored in the other patients, so the crowd in the waiting room surprised me. The nurse told me the wait time was 2 hours. I explained to her that I was supposed to fast before the test and I couldn't wait till the afternoon to eat (I'd get very sick). I also happened to mention that I was an employee at the hospital and wasn't really free to come to the lab at an earlier time the next day. She looked around her and went and talked to her supervisor. She came back and pointed to the door that was down a hallway alongside of the lab. I was quickly led from there to a chair inside where I only needed to wait for her to type up my draw request and my blood was taken in enough time for me to get back to work by the time my 20 minute break had ended!

Next, I called Valley Care and expressed my concern about seeing their psychiatrist since I didn't really want to pay $300.00 dollars to see her. They said I could see someone else covered by my insurance as long as they contacted them and followed the required list of questions. They wouldn't be redoing my evaluation, I had been approved, but they needed more info. So I called my insurance company and was referred to a Dr. Kara Winter in Pleasant Hill.

Meanwhile, I began walking for 30 minutes, 5 times a week. This turned out to be easier than I though it would be. I started parking my car at the High School up the street from the hosptial, which results in a 5 minute walk to work and then 5 minutes back afterwards. Then I'd walk for 20 minutes on my morning break and that's that! I also began eating better and soon the weight began to come off. I decided that I'd do the first half of my classes by phone which, although more expensive, allowed me to only take off from work an hour early and do two classes a day instead of one without having to drive anywhere except to my own home.

A phone call from Valley Care informed me that some more information was needed. Besides the other stuff they'd requested, they also wanted a copy of my sleep study results and the results from my last pap smear. I made an appointment with Dr. Walker and he was able to provide me with those. Next came my appointment with Dr. Kara Walker, who made me very nervous. I was afraid I'd make a bad impression and she'd tell Valley Care that I was crazy and by no means should be put under the knife. All my fears, of course, proved to be unfounded. She was very nice and was happy to provide me with another recommendation for surgery. She even rekindled my interest in attending therpy again as another outlet of support and to work even further on myself as I go through this process.

At last, the weight was half gone and the classes half done. I made another apointment to see the staff at Valley Care, get weighted and turn in all my paperwork. At this point, I would be reviewed for approval for a surgery date and I could hardly wait. When I got there, I was weighted, and ushered into the office of the Dietitrician to review my file. It was discovered that they had not yet received my review from Dr. Winter and that the copy of the sleep study was missing the summary page, so back I was sent to get those final thing sent through so I could get a surgery date.

I called Dr. Winter and reminded her to fax the info to Valley Care. Then I called my insurace company and asked them to send my sleep study results. They referred my to the records office who tried to tell me that they could only respond to a doctors request to which I asked if, as it was my own record, if they couldn't just send the information so that I could get on with it? My request was granted and, via yet another phone call to Valley Care, was finally told that everything was ready and would be submitted for review. One of my test levels had come back a little high and might require further work to get it down but they were confident that, pending the reading of my sleep study results, that everything would be submitted to my health plan for approval and that I should hear from someone to schedule a date within the next...few...weeks....

And here I wait. Patiently. Like a spider. Waiting to snare and elusive fly. I should hear from them any day now.... And when I do, I will finally be able to set a date for my surgery. All of this work will finally have paid off. Whoever said that this was the easy way out is absolutely insane!