I fall in the category of obese, bordering on morbidly obese, and have several co-morbid conditions: obstructive sleep apnea, high blood pressure, severe osteoarthritis in my right knee and less severe in several other weight-bearing joints, and mildly elevated cholesterol. I've battled my weight my entire life (I have pictures of me as a very fat toddler); several times I've lost substantial weight, though never down to "normal" weight, and never lasting very long.
Finally, as my health is worsening, I made what for me was a scary major decision. It's time for bariatric surgery.
I can make that decision because I'm a rarity here: I have excellent insurance.
I began the process in January with an informational session. After the surgeon's office pre-screened my insurance to tell me what they'd cover, we began a round of tests:
* Blood tests and worse (ever had to gather a sample of your poo?)
* An abdominal ultrasound (wherein we learn that iriti has a 1.7 cm gallstone)
* An EKG, (wherein we learn that iriti's heart is in decent shape, thank heavens)
* An upper endoscopy (wherein we learn that NO-ONE is starting an IV in iriti's hand when
she's been fasting/no fluids for 12 hours. Oh, yeah, and I have a hiatal hernia. Also.)
* A sleep study (wherein we learn iriti has obstructive sleep apnea and must now
sleep with an octopus suctioned to her face, sounding like Darth Vader.)
Total cost to me: $35 for each of two surgeon's office visits, $0 for any of the tests. And here's where the guilt sets in. During the time I was in this investigation process, this community undertook an effort to raise money so uninsured Sara R could have much needed gallbladder surgery. To quote a commenter in that diary:
I have never been so angry because of health care in my life.
I read in diaries and comment thread after comment thread about Americans with serious illnesses who cannot afford medical care or their prescriptions, who delay treatment until the situation is critical and then are left with crushing debt. Some die because they delay care and diagnosis for life threatening illness.
As far as weight loss surgery is concerned, many Americans travel to Mexico to have it done at about 1/3 the cost of the US.
So I know how lucky I am. And strangely, knowing that makes me incredibly sad.
I'm not anywhere near rich, and I don't work for a Fortune 500 company. But my company is German owned and thus has a whole different attitude about proper care for employees. My insurance shows what's possible if we have the will. But most businesses will not make that investment in their employees unless forced to - and the unemployed & retired have a right to the same quality care as the rich. I don't believe we'll ever get there with our current for-profit model.
\ rant
Meanwhile, I had to make a decision about which surgery to have. Gastric bypass was out because I take a daily oral steroid which makes me a high risk for marginal ulcers, already a problem for many bypass patients. At first I was leaning towards the Lap Band, since no incisions were made to the stomach, but after reading about weight loss rates and complications I ruled that out as well.
Finally, I settled on Vertical Sleeve Gastrectomy. It's a major surgery, no doubt. But once you've recovered from the original surgery and the stomach has healed, the chances for long-term complications are much reduced: no bypass, so less nutritional inadequacy and no foreign device in the body to cause erosion or other complications.
Weight loss is slower than gastric bypass - it can take 2 years to lose all the weight you're going to lose and the steroids will probably slow me down - but the overall weight loss percentage is very close to the same. It won't be easy; contrary to what some believe, bariatric surgery still requires work to be successful. But the sleeve gastrectomy should provide a valuable tool to help me finally take the weight off and keep it off.
I've "met" one other Kossack who has had this particular procedure, and she's doing great.
Surgery is Monday April 18th. I'm on a low carb diet now, a liquid protein diet starting April 4th. I'll post updates if anyone is interested.