Mandapalooza……the person

I know there is an about me spot, but really….who actually reads those? I just wanted to give a brief (probably overly long winded) about me with so me greater detail of what this is, why I am doing it, and what is in it for anyone else.

My name is Amanda K. I am 42 years old and I am a sad , misunderstood obese woman. I call my home in Northwest Louisiana. I have been married for 19 years and I am mom to a 15 year old boy with Asperger’s and a very chaotic 4 year old boy. Yes, I know….he was definitely a surprise and I will get into that later. I do work full time for a major telecom company and I also major in Network Security with programming elective.

Was I always obese? NO.  I actually was pretty fit growing up. I played basketball and softball (summer leagues). I was never EVER over weight.  I would say around 17 I probably noticed the major changes when my period stopped. Period???? What does that have to do with being obese? Well, at that time not much. No one really could put a finger on it but honestly, no one really tried to figure it out. It was hit and miss. I would have one that lasted a month or so and then it would be gone for months. I noticed I started gaining a lot of mid-section weight. I would say from 17-20 I gained 30 pounds or so.

Fast forward  into my early 20’s it was the same issue. No physician ever really tried to figure it out. I met my husband in 1996 and we married in 1997. By this time I also had developed hirsutism  on my lower stomach and face. Still……no one thought it was abnormal except for me.

It was not until we tried to start having a family that I was finally diagnosed with polycystic ovarian syndrome.  After several months up to two years of not being able to conceive, I made an appointment for the local fertility specialist. After going over my history, he knew exactly what was wrong with me. Of course my husband was also tested and he was normal. The weight gain, hair growth, fertility issues…..all because of PCOS and low functioning thyroid. After several rounds of fertility meds (chlomid, metformin) we finally got the news that we were expecting! In 2001 I welcomed my first at 10 lbs 3 oz.  I gained 62 lbs during that pregnancy. And, just six weeks after his birth, my husband was diagnosed with testicular cancer. Surgery and radiation left us with little to what the specialists told us “close to zero” chance of having another baby.

Lets fast forward quite a bit. Over the next few years I gained more and more weight. I tried every fad diet there was from Slim Fast to Weight Watchers. Nothing at all helped. Not many doctors were educated on PCOS because it was not as widely diagnosed as it is now. It was not really a household name. In 2009 I decided to go another route and at my heavies weight (346 lbs) I had the Lapband placed.

Having the Lapband was not my best decision. Over the course of July 2009 – early 2011 I had lost 50+ lbs.  In that time frame I started having HORRIBLE issues with my band. Severe pain, constantly getting “stuck” and “sliming” (only banders will get that reference).  The pain in my side was the worst. It was debilitating. I went back and forth to my surgeons office. I was sent for ultrasounds of my gall bladder (3 total), nuclear hida scans of my gall bladder and still NOTHING. My surgeon could press on my side and I would jump from the pain. Finally after being told nothing was wrong with me I went for a second opinion. Within one week of seeing the second opinion doctor my gall bladder was removed. The surgeon said my gall bladder was filled with sludge and there was scar tissue everywhere. He said it had adhered to my liver and he had to cut that away. My pain was gone instantly. I probably should have known from that instance that my surgeon who installed my lap band was no good.  By this point, I started calorie counting. I was still getting stuck but hated going to my doctor so bad I felt it to be pointless.  I did go for a fill in my band ( 14cc band I had filled up to 10 cc from 8 on this visit), and during this visit he saw my new scars and was “offended” I went to someone else.  This was in the summer of 2011.

I started losing weight again right after the surgery to remove my gall bladder. It was in October 2011 I had planned a little get away with the girls and due to what was going to be consumed, felt the weird urge to take a pregnancy test. Mind you, I still had on again off again periods. I was technically late, but then again I could be on the no period streak. Something told me to take the test and sure enough….on October 22, 2011 I found out I was pregnant. Shocked to say the least. My OB was shocked, everyone was shocked. From October – March 2012 I lost weight at an alarming rate for a pregnant person. I got down to 262 and woke up one morning not able to keep anything down. Nothing would go through my band, not even water.  I called my lap band surgeon to be told that “Just because I am pregnant does not give me an excuse to have my band unfilled”. WHAT! I called my OB crying and he called the surgeon along with my specialist (very high risk pregnancy for several reasons…age, I was 37, weight, single vessel cord) and demanded it be unfilled. I went and had the lap band unfilled, while my doctor lectured me at the same time how it was not needed. I gained 40 lbs over the next 3 months after the band was unfilled.

Our little June 20th baby came early on May 31, 2012.  He spent 2 weeks in the NICU but he is now a very active 4 year old.  I had gone back to my original surgeon after my son was born. I got a fill to what they said was 7cc. He was rude, he hurt me, and I have never seen him again.

Fast forward to now. I found my new bariatric surgeon in 2013.  I love my new surgeon. He actually cares about his patients. He did do a fill but only to 6cc. Apparently my old doctor did not put in what they said they had.

Currently here is where I stand.

I decided to go for a revision. I have been diagnosed with fibromyalgia and diabetes (type II). I currently am weighing between 310-305 (it fluctuates between the two.

Quick time line: I met with my surgeon around mid July. I actually went to him wanting to revise to the VSG. He listened to my concerns (Dr. Barnes really does listen and he really does care. He is NOT just  in it to make a buck and you can tell.) and he educated me on why the VSG would not be a good choice for me but the RNY gastric bypass would be a  better option for me based on several different reasons. Mainly, VSG is a restrictive surgery. Yes it removes most of your stomach including the portion that secretes the ghrelin hormone that makes you hungry. The RNY is rearranging the plumbing a bit so that you do not absorb the calories.  There is a small egg sized pouch and the small intestine is routed to this pouch. Trusting my surgeon 110%, I have decided to take his advise and make the switch.

August 12: I had my EGD scope done. There are a series of pictures and I can describe each one.

Going from top left to right:

Box 1; Just shows the opening of the esophagus to the stomach

Box 2: The same, esophagus to stomach

Box 3: The opening to the stomach

Middle row left to right:

Box 4: The inside of the stomach, the yellow is stomach contents.

Box 5: The opening from stomach to the duodenum.

Box 6: Inside the duodenum.

Last row left to right:

Box 7: Here is the scope (top blue arrow points to the scope) going through the band (I outlined it) and telescoped back up to show the scope going through the band. The second blue arrow shows the band from the inside of the stomach.  You can see the band and the lock.

Box 8: Here you can really see the scope good (top arrow) and the outline of my band.

egd-scope-blog

My scope was great. It showed no slippage of my band, no erosion and  my doctor took all the fluid out of my band.

I also was cleared for insurance by the lung doctor and I passed my psychiatric evaluation. I am 100% cleared for surgery.

I also had to have a biopsy done of my thyroid (not related to this surgery). I was advised that the mass they found is NOT cancer and is benign.

 

September:  I received two letters from my insurance.  One letter dated September 12 is a denial of “laparoscopy, surgical, gastric restrictive procedure: removal of adjustable gastric restrictive device and subcutaneous port components.  The reason for denial is:

” Here is the specific clinical reason for our decision: Your doctor plans weight loss surgery. We reviewed your doctor’s request. The notes say you are obese. We reviewed your health plan’s policy for weight loss surgery. Your plan requires imaging showing serious complication from your band. There is no imaging which shows a serious complication from your band such as a blockage. Your plan requires a prescription meal plan given to and followed by you documented in your medical record. No prescribed diet plan was documented in your medical records. For both these reasons therefore you do not meet your plan’s requirements for weight loss surgery and this surgery is not a covered benefit under the terms of your plan.”

So in a nutshell they denied it because the issues I have had since day one are not visual. I have the issues but they are not visual to the eye and therefore I can not have my band removed. As far as the prescribed diet, having the lap band IS prescribed and you have to follow a plan.

September 13 I received a second letter. Basically it is saying that they need a 5 year medical history showing a diagnosis of morbid obesity. This information has been sent in and we are waiting on the response.

 

To date:  I do plan to appeal. I will appeal and appeal and then have them do a peer to peer. I am not down yet. I will keep updating this with each step I take. I have an appointment with my primary on October 10. Hoping my numbers are good.

I know this is long winded. I wanted to document and share what this process is and how it is going. I want to share my struggle that I know others have as well. Am I sad? A little. Am I misunderstood? Ever since I can remember!!! Am I obese? Yes. Yes I am.

-Amanda K

 

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Amanda resides in Northwest Louisiana. Married for 19 years and mom of two boys. This is her journey of a LapBand revision to RNY and struggles with being obese. This is the ramblings of a sad, misunderstood obese woman.

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