It's a date.

So, I have a date. I am scheduled to get banded on Wednesday, November 17th. Just about 12 weeks away. I have a weight check on 9/21 then pre-op on 11/2. On 11/3 I will begin the official pre-op diet.

Here's the thing. I'm thrilled with the date. It's within my insurance coverage/approval period and it's far enough out that it still gives me plenty of time to prepare mentally and physically. I'll have a few extra days of recuperation built in because my office is closed on Thanksgiving and the day after Thanksgiving. But this does put me at Day 8 post-op on Thanksgiving Day. No stuffing muffins for Kiki this year.

That's not even the problem. The problem is that I'm not so sure I will be able to follow through with my plan to not tell my family. Hmmm.... what to do, what to do.

Don't get me wrong. I love my family. I really do and I have no doubt that they would be supportive. My mother actually had gastric bypass in 2002 and has successfully managed to lose (and keep off) about 150 pounds. I just worry that they will end up being too supportive. They will worry about me too much, ask too many questions, become the food police, be watching me too closely and just end up making me uncomfortable and angry. I know it would be out of a place of love, but sometimes I just need to be left alone. I'm not a big fan of being the center of attention, positive or negative. This will be something of an attention getter. I can feign illness for the day. But I may just have to come to terms with the fact that I have to tell my family and I have to be able to ask for space and trust that they can give it to me.

What did you all do about telling people about your surgery? Did you shout it from the rooftop, did you keep this to yourself? Did you only tell certain people? How did people react?

It's not my intention to pull a Star Jones. I don't intend to deny it. I'm not ashamed of having this surgery. I'm ashamed of needing it. My husband knows of course and I have 2 close friends who know. Only because I know they don't and won't judge me. At work they know I'll be out for a week or so for surgery... but they don't know and don't have to know what kind of surgery. I work with a bunch of men, if there's even the slightest whiff that the surgery is for female issues they won't ask about it!

Down the road I'm sure I'll get "have you lost weight?" questions, but it's not unusual for me to go up and down in size. I've gained and lost a lot of weight in my 12 years at the company! My immediate family also knows of my eating disordered past so they're pretty good about not mentioning my weight around me. My extended family... well, not so much.

The good news is this definitely gets me out of spending any turkey time with my in-laws. I will give a great big thanks for that!

Already?

I've felt lucky in that I've never really worried about insurance approval in this process. My current plan with Harvard Pilgrim covers the surgery with medical necessity. My BMI is about 47 and I have comorbidities up the ying. Seriously, if I don't qualify there is something wrong with the process. Once I got the green light with the psych eval I wasn't concerned at all about insurance holding up the works.

Anyway... I'd been playing phone and email tag with my PCP for a couple of weeks trying to get a "letter of medical necessity". I knew the surgeon would need it and I need it to get some of my related expenses reimbursed through my flexible spending account.

I got a call from my PCP's nurse on Thursday saying that she had written the letter and sent it to me. Great. I stalked my mailbox. Didn't come Friday. Didn't come Saturday. My husband called me Monday to tell me that I had received something from the dr's office in the mail. I knew that was it.

Just for shits and giggles I logged on to my account with Harvard Pilgrim. Apparently I have already been approved for the surgery. Huh? I hadn't even sent my dr's note to the surgeon's office yet. So I'm not sure if my PCP made the request herself on behalf of the hospital (her practice is affiliated with the hospital) or she sent the letter to the surgeon and they already submitted the request or what. But it looks to me like I'm approved. It says "approved" three times on the page.

I'm not going to lie. When I saw that on the screen, I got butterflies in my stomach. This might actually happen. Yikes!

So now I have to get in touch with the surgeon's office to confirm all this and see when they can give me an actual date. Of course the billing coordinator was out today so I will try again tomorrow. Timing is everything because I'm going to lose this insurance plan on November 30th.

It's a long story, but my husband was laid off in May 2009 and our COBRA coverage ends in November. I can get insurance through work, but my company's plan is just awful. We are actually spending less money paying the COBRA premiums than we would getting insurance through my company and paying the higher co-pays, coinsurance, deductibles and pharmacy. Plus, it covers to nothing. Certainly not Lap-Band! There's a chance that my husband will be offered a full time job in October at the company he his temping for. But that's not guaranteed at this point.

So, there we go. I'm just a bundle of emotions at the moment... anxious, scared and excited all at the same time!

Worries and Doubts

This is a self-indulgent post for me to try to make sense of the "thought tornado" in my unmedicated mind.

I've been going along on this journey knowing full well that I can stop at any time. When my PCP first suggested that I look into it in April she told me that very thing. Until the anesthesia takes effect I can change my mind.

I'm 95% sure that Lap-Band is the right thing for me to do and that I will do it. I'm only 90% sure that I can do it. Is that normal? Am I just setting myself up for failure if I'm not 100% convinced I can do it?

I still have concerns about how successful I can be with a Lap-Band. I've ultimately failed at every other attempt to lose weight, what makes me so sure that I won't fail at this, too? Maybe I just haven't found the right method of lasting weight loss that will work for me. Maybe the Lap-Band is exactly what I need and in 2 years I will be one of the amazing success stories! I won't know if I don't try. But it's a pretty big undertaking for "maybe".

Anyway, Grace over at Grace's Fat Chance bravely wrote about something yesterday that illustrated my biggest concern/fear/worry for myself. Her post has prompted me to put this out there.

I've not been shy about the fact that I've struggled with bulimia in the past. I engaged in the behaviors at least as far back as high school but never had a name for it until after I graduated from college. I've been hospitalized for it twice. I've been in treatment for over 10 years. I haven't purged since July 2007. I can't tell you the last time I had an honest-to-goodness binge. I've been trying to not focus on numbers. I've tried to stay off the scale. I've tried not to count calories, points, fat grams, etc. Getting hung up on the numbers tends to get me into trouble. I'm an accountant by trade... over analyzing numbers is what I do. I try to leave that at the office.

Lately, though, I have been focusing on numbers... having to lose a certain amount of weight before such and such a date. Getting weighed a lot more often. Having more focus on my food selections. Once I'm banded, I will most definitely need to pay strict attention to what I'm eating. My fear is that all this focus will turn into obsession again and bring me back to where I was. Or send the pendulum swinging the entire other way. I could just as easily see me turning to restriction, becoming an obsessive exerciser or not know when to stop losing weight.

I know this is something I need to bring up with my therapist. I've just been afraid that if the doctors know I'm having these thoughts they'll flat out say I can't have the surgery. I don't want to lie. But I don't want to blow a chance at lasting success. Especially if I'm just being silly.

Intellectually I know I am in a good position to be successful. I know what I'm getting into. I know what I need to do to be successful. I have a good support system. I have a medical team that I trust and respect. I have a husband who loves me like I can't even believe. I have a family who loves me and has the best of intentions, even if their execution is sometimes hit or miss. I am in a much better place than I was 10, 5 or even 3 years ago. I've come a long way. I owe it to myself to try, right?

Okay, I feel better getting this off my chest. I'm up to about 93% sure on the confidence meter. Thank you!

Slowly... but surely

Okay, so after my meltdown after my nutrition appointment, I "buckled down". I knew there was no way on earth I'd lose the 11 lbs I needed to in order to reach 50% of my surgeon's pre-op weight loss goal for me in time for my next visit with him. Even before I found out that I had actually gained weight I knew I would be hard pressed to lose that amount in 4 weeks. For those of you with PCOS, you know how painfully slow the weight comes off even under the best of circumstances. (I hate using terms like "being good").

Anyway... I was quite nervous about my check-in. I just didn't want Dr. R to think I wasn't trying.... to give me that "disappointed look". (The same look my piano teacher would give me when she knew damn well I hadn't practiced all week!)

The appointment went surprisingly well. I ended up being down another 5 lbs for a total of 10 lbs lost since I first saw him in June (9 weeks). Then he surprised me... he told me that he thought he could put me on the schedule. He's booking 2-3 months out so he figures he can put me on the schedule and I can continue losing to meet my pre-op goal. He cautioned that if I were to gain weight in the meantime, they'd have to postpone. Fair enough. So, I will call his assistant tomorrow to make sure they have all the insurance nonsense they need.

Once I have an actual date I can figure out what to do about work, insurance and whatnot.

Thanks, everyone, for the comments. I love reading everyone's blogs. They are such a great source of inspiration, hope and knowledge. It's helping me feel not so alone in this.