May 2017: Pre-op appointments

After I finished all of my pre-surgical requirements, I let the office manager for my doctor know so she could submit to insurance. Besides the initial appointment, I had the following to complete:

1. Four appointments with my Primary Care Provider known from here out as PCP (or three appointments at JH Bayview)
2. An appointment with a Nutritionist (here I covered vitamins and here I covered food)
3. An appointment with a Psychiatrist
4. Attend a Group Support session
5. Have an EGD done
6. Have a sleep study done

I only covered one of my PCP appointments because how many times did you need to read that I went to my PCP, got weighed, talked about changing my diet to keep my body guessing as to what was coming next, and my monthly mental challenge. 

Just a few days later, I was told my surgery would be May 31. Less than a month away. I literally couldn't believe it and all the sudden everything was in motion. The office sent me a pile of papers of all of my appointments before and after surgery along with a reminder about the pre-surgical diet, and reminding me to get a pre-op with my PCP, which would include a blood draw, and a chest x-ray.

For the sake of readers who don't actually know me, my PCP does not actually have an x-ray on premises. So one day I had the afternoon off for a clinical trial I'm in (its super cool and I can't wait to share about that), I asked her to send the request in for my x-ray so I could get it while I had time off.

Chest x-ray...check

I had my visit with my PCP lined up for a few days later. She looked at the chest x-ray with me and basically gave me a physical including an EKG. It was uneventful but exciting because after months, this meant I was getting very close. After the EKG I got my blood drawn, so I was done with that step.

Finally I had to go see the surgeon for a pre-op. I asked why, and they said I had not been to the clinic hours since my initial visit in January and there was special stuff they had to give me. I went to the visit and the nurse practitioner on my surgeon's team was thrilled with all the progress I made (by this point I was teetering at 35lbs lost since January). She gave me two bottles of gatorade, special pre-surgical wipes, and a pretty blue bag. More details on all of those (including the pretty blue bag) later.

That was May 19. Next up was the big day.

I write this post because I see a lot of people online getting very nervous about their pre-op and the bottom line is, its just a physical. The doctors on your team need to know as much as they can about what's going on in your body before they put it through the incredible stress of surgery. For example, every other provider I've met claims I'm an asthmatic. I personally think I just get sick badly in my lungs for a longer period than others (something my cat Finn must have gotten from me), but the chest x-ray showed literally in black and white, something resembling asthma. Seeing as someone, namely the anesthesiologist, was going to be controlling my breathing for about four hours, this is an important detail.

Next up: May 30, 2017

January 30, 2017: Esophagogastroduodenoscopy

Yea, that's a long title.

As you may remember from when I met the surgeon, one of the items on my list was to get an esophagogastroduodenoscopy, or an EGD. I can't even say the long version of that...

This was not my first trip to the EGD rodeo. I had one in 2010 when trying to figure out why my digestive system hates me, and I got a colonoscopy done at the same time. Just before the anesthesia was started in 2010, I asked if they can take a picture of one camera with the other and they said they used the same camera, then I went to sleep. Without the colonoscopy prep, this procedure was going to be much easier.

I called the department to get the EGD done the same day as the surgical consult, and they got me in for the following Monday morning. This completely shocked me but I wasn't about to say anything.

In case you don't know what an EGD is and the whole idea of going to the hospital, being put into twilight, and having a procedure freaks you out, it's really nothing to worry about. If you want to read what the professionals have to say you can look here. This reads at a good eighth grade level, but here is what happened on that day.

First of all, you need someone to go with you, so I recruited my mom. From midnight the night before, I didn't eat or drink anything (though a small sip for medicine is usually ok, just check with the doctor). We took the drive to JH Bayview, and waited to be called back. 

Once I was back in the prep area, things moved quickly enough. I was allowed to keep my undergarments on for this procedure as it is not done in a room with the clean standards of an operating room. After I was cleared by the pregnancy test (phew!) the nurse got an IV started. 

As I hung out waiting, by this point mom was able to rejoin me, the doctor performing the scope stopped by to ask what brought me in for the test. I'm not sure if this is a Hopkins or all hospitals thing, but they like to hear in your own words why you are getting something done and what you are there for.  Then the anesthesiologist came by to make sure she had all of the right information about my medical history.

Finally they rolled me back to the room. Once again, they did what is called a time out to ask me my name, date of birth, and what procedure I was getting done. They warned me about this by telling me this was normal and "they know what they're doing". They put a special mask on me to push oxygen while also leaving an opening to put the camera into my mouth, and the rest I don't remember.

I woke up to one of the assistant anesthesiologists asking me to cough. My oxygen numbers tend to dip a little bit and a little coughing got my numbers right up. The doctor came by to see mom while I was waking up, and then came to see me. The EGD showed a tiny polyp and low level GERD, which led him to ask if I was experiencing heartburn at all, which I was not. I got a copy of the report (with pictures!) and I was wheeled down and out of the hospital. 

The recovery from the anesthesia was not bad. I felt like myself pretty early, and it was a chill half day off. 

Flash forward about a month and a half. I followed up with a few questions I had to my surgeon, and she told me that the EGD showed her that I was no longer a candidate for the sleeve and I would need to have a roux-en-y gastric bypass if I wanted to proceed. I told her that was fine by me.

If you're reading this while on your journey, just know that if you're not sure what procedure to get, and you experience heartburn and/or have been diagnosed with GERD, your decision might be made for you.