Headed to Boston

The day was finally here. September 21. My first appointment with the new program. I left my home at 6am, expecting to be early for my 8:30am appointment, but found myself slightly late. The traffic was INSANE, and I felt the panic growing inside me as I watched my arrival time on Waze slowly creep up closer to 8:30am. When I finally arrived, I zipped into the valet and left, jamming my ticket into my bag.

They were understanding, and it wasn't an issue. However, not all of my paperwork had arrived. Fortunately, I had everything saved in my Google Drive, so I could easily forward it along to them in the office as needed. Finally, they had everything, and I paid my program fee. I was ready for my first appointment.

They set me up in an exam room and informed me that I'd be on Zoom with the mental health counselor. She was apparently sick but was signing in remotely to meet with me. Had this been program 1, that appointment would have been canceled. I thanked her profusely for still meeting with me, and we chatted about my habits, past and present, my progress to date, my expectations, and we got a little deep into my binge-eating behavior. While I wouldn't medically be classified as a binge eater, I have binge-eating behavior. This was the first time anyone had ever talked with me about the difference in levels, and she explained that if I was had binge-eating disorder, she would have concerns about me moving ahead with the surgery, but she was confident that I was not at the level of the disorder. I was very honest about my behavior and habits, and I highly recommend anyone who is considering surgery be truly honest about their own behavior and habits, no matter what. Hiding anything won't contribute to your success and could actually harm you in the long run.

We talked about the type of surgery I wanted, and when I said I wanted the duodenal switch, she told me that it wouldn't likely be an option for me. Despite it being something that wasn't right, according to this program, she kept the conversation positive and informative. I never felt talked down to, chastised, or belittled. In fact, the entire session was positive, uplifting, motivating, and she made me feel like I could accomplish anything. It was such a massive change from my previous counselor at program 1. She was complimentary of my progress so far and told me that she knew that I'd be successful.

At the end of our session, we talked about when a potential surgery date might be, acknowledging that the surgeon would be the final say. She noted that no one had ever gone through the program faster than 10 weeks, but that most people get through the program between 10-12 weeks. Given my experience going through another program, she was confident that I could expect the 10-week mark. She pointed out that there's usually three more appointments that I need to have and at least one of them is in person, and it would be hard to fit that all into less than 10 weeks.

Onto the dietitian. This was the appointment that I had always expected. We reviewed my past behavior and eating habits, and we set actual goals for me for calories and protein. We talked about what was most important for me to focus on, what wasn't, what supplements I needed, what wasn't important, and what I'd need after surgery, both in the first month and after I'd progressed, I left feeling like I learned something and had actionable things to do.

Next was the nurse. She took my vitals, had me step onto a body composition scale, and talked me through the basics of surgery, not knowing what I'd have yet. We talked about the fact that I had been told by my previous program that I would have bypass, but that I wanted duodenal, however the counselor told me it would likely not be an option for me. She nodded in agreement and said she'd let the surgeon review that with me. We then went over my body composition results. She told me my muscle mass was fantastic, and to work on keeping that up. That was my main goal moving forward. And to stay hydrated.

Finally, I met with the surgeon. She was fantastic. It was clear that she had read, really read, my file. I didn't have to re-answer all the basic questions for her. We talked about surgery options, and after much discussion, settled on the sleeve. She explained that for their program, they only do the duodenal switch on patients with more than 300 pounds to lose and significant health issues. She explained more of the rationale, but essentially, I wasn't big enough or unhealthy enough to warrant it. I think that's the first time in my life I was told I was too thin for something.

She also went on to explain that of the approximately 100 surgeries a year that she does, only about 2-4 of them are bypass. She feels that bypass results in too many complications, and that if a patient is diligent in their diet and exercise, they can be just as successful with the sleeve as they can be with the bypass. And, if I don't see the results I expect to see with the sleeve after 12-18 months, we can talk about either revision surgery or medication for additional weight loss. So, we settled on the sleeve.

To my surprise, she also wanted to look at surgery dates. Since she wanted to do mine robotically, there were specific dates that she was scheduled to be on the robot. She asked if I wanted to do November 20, noting that it was Thanksgiving week. That would mean I'd be on fluids and puree food for the holidays. I accepted, enthusiastically, saying being healthy was more important than a single holiday. "You're penciled in. We'll confirm at your next appointment."

I headed downstairs to the lab to do the final test they needed me to do; they accepted all the other tests I had done with my PCP and the other program. As I was waiting, I counted the weeks until my surgery. EIGHT! Eight weeks! I was going to be a record-breaking patient if this all worked out. I texted my mom and sister. Surgery in eight weeks, fingers crossed.