Emergency Self-Pay Surgery in just 20 days...with a BMI of 54?!!!

Hi, folks! Long story explaining my current situation and seeking advice...thank you for bearing with me! 

I am a 40 year old female who has struggled with food addiction, depression and some health complications after two very difficult pregnancies in the past 4 years...now have a staggering 359 pounds on a 5'8 frame. 

Husband's insurance switched last year to a different health insurance company...with a TOTAL EXCLUSION for bariatric surgery, regardless of medical need. 

I've been researching bariatric surgery for over a decade and almost had an RNY about 10 years ago, but chickened out at the last minute...worst mistake of my life! 

Now, I've come to my breaking point this week. I took my 2.5 and almost 4 year old out to the nature center for a walk...after months of spending most of my time on the sofa due to knee, back, and foot pain when walking...and they both RAN AWAY. I was talking to another mom, turned my back for a couple minutes...they disappeared! Ran down a nature trail towards a very busy four lane highway with nothing but a sidewalk to keep them from the trucks and cars whizzing by. 

I literally COULD NOT run more than a half a block, when they ran back up toward the nature center's paths and woods and I was panicking...for the life of me, I could not find them! I was calling out and other mothers came running to help find them..THEY finally found them down at the bottom of the hill behind trees. At this point I was too weak to go down the hill myself. Other mothers had to bring them up to me. It was humiliating, to say the least. 

This was my breaking point. My nadir. My children could have DIED because of my obesity. I've been 'talking' about doing the self-pay surgery for months despite almost NO support from my husband, with whom I have a very rocky and unhappy marriage. The same day my kids ran away I contacted the surgeon in Florida I had been talking with about self-pay gastric sleeve surgery and scheduled my surgery with a tentative date of September 26. I will need to follow a liquid diet for a minimum of 2 weeks to shrink my liver before laparascopic surgery. 

I do not have a lot of friends anymore...lost them as I sank into a depression and then gained about 125 pounds in the space of a year and a half...on top of the 250 or so I ALREADY weighed! So I was too humiliated to see my old friends. I have an elderly mother with many severe health and mobility problems...and her health is fading fast. So my support system right now is frayed. 

I have a mother in law who can watch my very challenging 2.5 year old but ONLY for a brief period as she is going to be caring for my sister in law's newborn. Currently the SIL's own mother is visiting from out of the country but can only stay for less than a month. My own mother is very weak but she can watch my rambunctious almost 4 year old, despite the fact that she has a severe hip problem which impedes her mobility and her own obesity problems at age 73. 

So, despite everything, I have a SMALL WINDOW in which I can get my surgery. I had my 'food funeral' yesterday with a bunch of cookies for breakfast and lunch and a steak dinner takeout because I am too embarrassed at my size to go in public restaurants. 

Today, I started my protein shake diet. I'm terrified that I will get very hungry as I'm used to eating whatever I want in large amounts. 


Questions: I have diabetes, high blood pressure, and gastritis. I stopped taking the gastritis medicine months ago because it was causing an itchy, allergic rash. Do you think 2 weeks on a new medication will be enough to prepare for surgery? 

I have had a few EKGs in the past months and years and they all showed normal, even though in recent months I noticed a weird 'palpitation' feeling in my chest from time to time..but that might be from anxiety. 

Finally, my PCP has prescribed Phentermine in the past to help me stick to a diet. It works for a while but then my body gets used to it and it doesn't work anymore. (One 32 milligram tablet per day) I'm wondering if I could take it during the pre-surgery liquid diet protein shake phase so I won't cheat. 

Thank you for any and all advice! 

Hi and welcome to OH. I'm sorry about that experience you had with your kids. I remember once my kids were young and riding their bikes and I was walking- they took off far ahead of me. I tried catching up with them but couldn't- other jogger on the path offered to catch up with them for me. it didn't dawn on me then that my weight is what kept me from catching up with them-- I just wrote it off to kids on bikes are faster than adults on foot (denial at its best). I'm glad they are safe.

It's good you can afford to self pay; but I'm surprised your doctor is not requiring any pre-op testing, weight loss etc. That time period usually helps you get acclimated with some of the changes that you will need to make post op. I was only about 6 weeks from consult to surgery-- but it helped working with the nutritionist to make changes I wouldn't have thought of on my own. Are you working with a nutritionist?  

I have no experience with gastritis so I can't offer any advice-- what did you doc say about restarting the meds prior to surgery? I would not take phentermine in anywhere near surgery b/c of its known effects on heart rate. White knuckle it though the liquid diet is my best  suggestion. There are many on these boards that are proof its possible to make it through (myself included). You WILL get hungry-- and be grumpy. Drink your shakes, chew gum and drink water till your sick of it and then drink some more. 

Regarding care for your kids post op-- - why not hire someone, like a mothers helper? I've used care.com with great success in the past. Regarding your non-supportive hubby-- since you describe your marriage as rocky already- I'd encourage finding a therapist to guide you though this major transition your life is about to go through. 

Peachpie,

Thanks for the support! Actually my VSG surgeon DOES require a full battery of tests before surgery...and I must be approved or my surgery will be rescheduled. Also, he requires 2 weeks liquid protein shakes diet presurgery as well. 

I would LOVE to hire a helper but my husband complains about EVERY SINGLE PENNY I ask. He's barely willing to BORROW the $10,500 for the surgery plus the about $2,000 I will need for flights and hotels down there. 

I think you cross-posted this on main board? Like I said before forget the Phentermine... you can get through the liquid diet. We all did, you will too... none of us got here because we had control over our eating. I wouldn't take anything unless the Bariatric Surgeon prescribed it.

I ma not sure what gastritis medication you are talking about but usually they put you on a PPI like omeprezole/prescription Prilosec after surgery, not before.

I understand the 'window' of help... I just had that with a recent surgery and it all came together in 2 weeks. That being said you may have been thinking about it for a decade (good) but those around you maybe a little freaked by the seemingly rash decision. So I agree, I would talk to someone along this process and keep coming back here.... you need support.

Testing should be established by the Bariatric Surgeon you are using. Talk to them. That being said I think the normal testing most insurance companies make people go through is way over the top... I had way more serious surgeries at close to 400lbs and nobody was making me do all the tests like I needed for bariatric surgery. Just my take. Most surgeries require at least an ekg, bllodwork, urine, chest x-ray- maybe...

Good Luck!

Ny mom, again, thanks so much for your support! Yesterday I did my pre-op blood tests, urine test, EKG, and chest X-ray. My PCP will have the information within two days. God willing, I will be cleared for surgery. Then, I pray all goes well and my husband doesn't start a bunch of fights to have an 'excuse' to pull out of the loan from his work and his mom to cover the surgery itself and the flights down to Florida and the hotel while I stay after surgery to make sure it's all ok. 

So sorry to hear about that experience with your kids - glad they are ok.

I just started my 2 week "liver shrinking" preop diet and had a great first day! Our protein choices need to be less than 200 calories, at least 15 grams of protein, and less than 8 grams of sugar. Here's are the 5 protein choices I had: 

Nitrotec Milk Chocolate protein shake - good!

Pure Protein Strawberry Cream shake - delish!!

Pure Protein Chocolate Salted Caramel protein bar - oh so good!

Ensure high protein milk chocolate - not so good.

One other protein bar but I can't remember the name (got it in our preop class on Tuesday) - wish I knew the name, it was good.

We can have unlimited clear liquids no more than 10 calories/serving. I had Pacific Organic Bone Broth Chicken with Lemongrass - so disappointing, very flat, no flavor. Sugar free jello, Knorr chicken bouillon - tasty comfort, Outshine no added sugar mixed berry frozen pop - good. Tulsi tea - jasmine - great for bedtime serenity. Water with True Lemon added sipped throughout the day. 

I had no hunger at all, felt satisfied throughout the day. Good luck! Hope all goes well for you!