Tumultuous times ending with good news!

The last month has been very tumultuous for me. I mentioned in my last post how I was being impatient about not having my advice yet. By November 25th I was so stressed out I would start crying out of the blue, I got extremely anxious and was very tired because I couldn't sleep. I was so stressed that I had to call in sick at work, so I called my g.p. to see if there was anything I could doand he prescribed me with Oxazepam. Because oxazepam affects your driving ability I had to stay home from work for a week. I stayed home one week and after that I went back to work mornings for a week, I am now back working fulltime.

On November 26th I received a letter that crushed me: Vitalys wrote to tell that I was not suitable for operation and I had to contact my g.p. to hear the reason. So on to the g.p. I went on the 27th. Basically the NOK thought I hadn't tried enough to lose weight and I was told to go see a dietitian and I could come back in a year. Basically their advice was the complete opposite from what they told me on the day of my multidisciplinairy screening. 

Then on December 6th my p.g. called me out of the blue: he had received a letter from the hospital. The surgeon had discussed my case in a multidisciplinary team meeting and they had changed their minds and now I was positively adviced for surgery!

I don't know which surgery I will get, I'm hoping on a gastric bypass but it might be a sleeve. The hospital doesn't do a lot of banding. I'll have to wait and see. My pre-operative screening is on January 22nd and the preliminary phase leading up to my surgery start on January 28th.

Impatiently waiting

'Patience is good only when it is the shortest way to a good end; otherwise, impatience is better'

4 Weeks ago I had my multidisciplinary screening, the dietitian at the screening told me that I would hear from Vitalys within 3 to 4 weeks whether or not I would be operated. 4 Weeks came and went and I had no news. 

Being impatient and restless and becoming more and more sure that I would be rejected, so last week I already gave the NOK a call: they said they had sent their advice to Vitalys on November 1st. Because I still hadn't heared from them, I finally decided to give Vitalys a call today. The secretary said they received the advice yesterday: November 12th. The NOK and Vitalys are located across from the street from eachother, how can it take one letter 11 days to get there??? (I know, I'm being unreasonable...)

The advice is now on the surgeons desk, the secretary said it would probably take 2 weeks before I hear anything.

Multidisciplinary Screening

October 15th I woke up quite nervous: it was D-Day again. Time for my Multidisciplinary Screening. I had to be in Hilversum at 9 am on a Monday, this meant I had to drive there in the middle of rush hour. The alarm clock woke me up quite early, I picked up mom and we arrived perfectly on time at 8.45 am.

 Overall I  think the screening went okay, but you never know what 'the experts' think. Upon arriving I had to hand over my food diary and two photos. Then I was escorted to the waiting room where I saw the other 3 people that were there for the screening that morning.

My first meeting was with a nurse/care co-ordinator who weighed me (116,8 kilos), measured my height (1.72 m, so I have not shrunk yet) and measured my waist: 118 cm (Yikes :S). On to the computer where I had to fill out two questionnaires: one on my medical history and one on my 'physcological state of mind'.

Then I saw the dietitian: she told me that research showed that for certain people dieting does not work. My 'diet-past' shows that I am one of those people. My BMI is just below 40 (39,49), but she said they would round that up to 40. We discussed my food diary. The dietitian was very friendly and within a very short time was able to determine that I'm a perfectionist and too hard on myself. Basically she told me that the operatie was my last resort. 

Next I had my meeting with the movement expert, again a very friendly lady: we talked about exercise and then I had to bike for 6 minutes: no sweat! The cycling was quite easy, I could have gone on for another 6 minutes if she had asked me to.

A meeting with the psychologist followed, this was the meeting I was dreading the most. She asked me what prompted me eating and I told her about several issues I had experienced when I was still quite young. She asked I had talked about these issues with a psychologist or psychiatrist in the past, which I haven't. She almost made me feel like I should have been very depressed. This meeting made me feel a bit awkward and insecure.

Last but not least was my meating with the p.g, probably the easiest of all. We talked about my medical past, she listened to my chest and measured my blood pressure: 105/80.

Now the waiting starts.... During the Orientation Meeting in Velp we were told that we would get the results of the Multidisciplinary Screening within 3 to 7 weeks, in Hilversum the dietitian mentioned 3 to 4 weeks. Confusion!!! So I called Velp yesterday and was told that it would take at least (!?!?!) 7 weeks and that once the results were in, they would send me a letter. If results are negative I have to call my p.g. to hear why. If they are positive, it will contain the date for my Post Operative Screening and during this screening I would be told what surgery I would undergo.

The screening has only happened one week ago and I'm becoming more nervous and insecure by the minute. I 'm becoming more and more doubtful on whether or not I'll get a positive reaction. And the longer I think about it, the more ridiciulous it feels to me that I have to wait so long for one person to make up his mind about a possible surgery for me.

Preparation for the multidisciplinary screening

Two more nights before my multidisciplinary screening at the NOK in Hilversum. I received a confirmation on 9 October, saying they invited e for the screening on Monday 15 October 2012 at 9.00 am in Hilversum.

In approximately four hours I will talk to several disciplines (care co-ordinator, p.g., dietitian, psychologist and movement expert). Objective of the screening to determine which treatment would be most effective for me by means of analysis, questionnaires and personal conversations. All conversations will be in private. After the screening the NOK will write up a letter of recommendation.

I was adviced to bring:

1. a food journal provided to me by the NOK in which I had to write down everything I ate and drank for a week, the times at which I ate and drank, where and why I ate and drank and I much I exercised. If I don't bring my food journal, I risk my meeting being cancelled and being fined € 50,00. I started filling out the diary last Saturday, so I can check this off my list.

2. Two recent photos, I had new pictures taken yesterday and can check this off the list too.

3. A recent list of medication or my medication. Since already carry all my medicine aroud in my purse, this also gets checked off the list.

4. Documents that show my attempts to lose weight in the past. I only have a letter of referral from my pg to my dietitian about four years ago, so check!

I guess I'm ready for my screening as far as the checklist is concerned. Let's hope I sleep better tonight and tomorrow night than I did this week. I've slept a lot, but the quality of sleep has been poor due to my cold.

Feeling Exhausted

Exhausted is exactly how Friday's orientation meeting has made me feel. I felt emotionally drained and my back hurt the entire Saturday, Sunday I had a hormonal migraine that hapilly came back this morning and also I now have a sore throat and I'm coughing. My body is acting up!

Apparently the meeting has unearthed emotions that I wasn't fully aware off and magnified other feelings. Today I called the NOK and asked them if it was possible to reschedule the meeting to an earlier date. My mom will be on holiday on November 1st and I would really love to have her present at the multidisciplinary screening. Ofcourse I know I have to talk to the specialists on my own, but it's comforting to know that I'll be able to talk to her on the breaks between the meetings. Now my multidisciplinary meeting is planned for October 15th.

On to the next step

Did you know that out of 100 percent of the people that want to lose weight 99 percent try this through dieting? And out of these 99 percent that diet, 95 percent will have gained the lost weight (and then some) back within two years? Just one of the things I learnt today.

Today's orientation meeting was quite informative, we were informed about the process that will take us towards the endresult: a change in behaviour resulting in permanent weight loss, aided by a weight loss surgery. I will write more about this process in another blogpost.

At the end a date was set for us for the next step: the multidisciplinary screening. This screening will take half a day: the first hour will consist of filling out forms and getting weighed. During the other three hours I'll have individual meeting with a gp, a dietitian, a motion expert and a psychologist. They will advice the bariatric surgeon on whether or not they think a treatment by the NOK is suitable for me, the surgeon will decide if I should undergo bariatric surgeray and which surgery would be most suitable for me. I should be notified on this decision within about seven weeks after my appointment. 

My multidisciplinairy screening will take place on the afternoon of November 1st. Till then I have some homework to do: I have to fill out a food diary for seven consecutive days and take it with me tot the screening. If I don't have it on my, I will be sent home with a fine of € 50,- and have to make a new appointment for the screening. So I figured I might as well start writing my food diary tomorrow, in that case I won't forget to fill it out!

Paperwork and Nerves

The NOK sent me some forms to fill out:

1. Referral Form that I had to fill out with my pg: this was all about my personal information (name, date of birth, health insurance), medical information (like if I am morbidly obese, have hypertension, diabetes mellitus, dyslipidemia, e.g.), biometrics (weight, height, blood pressure) lab work (glucose, cholesterol, e.g.), medication I'm taking, complaints I have and other relevant information.

2. Treatment Agreement: this basically is an agreement that states the arrangements, duties of both NOK and me an when/why the agreement can be cancelled.

3. Consent Form: where I declare that I don't object to the NOK requesting medical information from my pg and other practitioners.

After all the forms where filled in, I made copies and sent them to the NOK on August 24th. Now the wait began: I had to wait for the NOK to process the paperwork and the I would eventually get a call from Vitalys, Vitalys is the clinic where a possible surgery will take place. Because I would leave for Spain on August 31st I decided to give the NOK a call on August 29th to make sure they had received my forms. The nice lady on the phone informed me that due to lots of application I probably wouldn't hear anything from them the next 6 weeks.

To my big surprise the NOK called me on September 19th and invited me to come in for an orientation meeting on October 5th! Which is tomorrow!! Now that it's almost time for me to go to the NOK I am a bit nervous, even when I realise that this meeting is only to inform me (and approximately 7 other people) about the whole process. After this meeting the serious part starts.... I will be evaluated and told weither or not I will be treated. I will tell you more about the evaluation later.

So, tomorrow is my third mile-stone on this journey: the orientation meeting at the NOK in Velp. In my opinion the first mile-stone was finally admitting to my doctor that I wasn't able to do this on my own and needed help. The second mile-stone to me was actually getting referred to the NOK. And tomorrow will be the third mile-stone. The NOK told me that I was allowed to bring someone with me. E. (my BF has to work tomorrow and I knew my mom would be interested in going with me, so I asked her to tag along. I'm a bit nervous and apprehensive and hope that I'll be able to get some sleep tonight.

Appointment with the pg

So, there I was… Sitting in the waiting room of my gp. IWhy does it always seem to take so long before it's your turn when you're waiting? Finally, about 20 minutes after the time my appointment was originally scheduled for, I heared my name being called through the speaker and I found my way to my gp's office.

I started by explaining why I was there: I want to lose weight, but I can't do it on my own. We talked about all the things I had tried before (I will save that list for another blogentry) and why I thought that now was the time for me to make the change. Obesity is not healthy: it is one of the leading preventable causes of death worldwide. Being obese you have a greater risk to get all e.g. diabetes mellitus type 2, high blood pressure, high blood cholesterol, osteoarthritis,obstructive sleep apnea, cancer, etcetera. And of course there's also the socal stigmatization.

I want to live long and be healthy, I want to have kids and be able to run around and play with them without being exhausted, I want to be able to climb a flight of stairs and not be out of breath, I want to be able to do so many things that I can't do now.

We talked about eating disorders (which I don't have) and then my pg showed me the website of the 'Nederlandse Obesitas Kliniek' = Dutch Obesity Clinic (a.k.a. NOK). He told me he had referred several other clients to the NOK who had great results there and asked to have a look at their website over the weekend. If and when I decided I wanted to try this, he would refer me to them.

The NOK is the biggest and most specialized independent clinic in The Netherlands (since 1993) for the treatment of people who are severely overweight. The treatment at NOK is carried out by a team of specialist, consisting of an internist, a psychologist, possibly a surgeon, a doctor, a dietitian, a motion expert and a care coordinator. With morbidly obese people the treatment is in fact a program for lifestyle change, with or without surgery. Patients will learn how to live healthy and how to adjust their life to the performed surgery. Healthy means that we will learn to move and eat normal. As result of the surgery and the healthy lifestyle the weight will reduce and medical complaints and risks will decrease and possibly even disappear. The quality of life will increase. More about the treatment will follow in another blogentry.

I studied the website meticulously and called my gp on Monday and asked him to be referred to the NOK.

The start of my journey towards a healthier, slimmer me

For at least the last ten years I have been struggling with my weight. Since about a year I've been suffering from daily back pains and heartburn and frequent migrains. Nothing seems to help, the only thing the doctor said: "You'll have to live with this, but loosing weight might help." 

Lately I've started to notice my lack of enthousiasm to go out: I feel too self conscious: if I hear people whispering, I'll assume that they're talking about me, I hesitate to order desserts because people will probably think: "Why would she order that, she's already too heavy!"

Also I've become more insecure in my relationship, my libido has reduced to almost nothing: I don't understand how my boyfriend can get aroused by the body that disgusts me most of the time. How can he like it, if I hate it?

So finally on August 9th I had plucked up enough courage to contact my GP through an E-consult, I explained to him that I had tried lots of different diets that didn't help and asked him what else I could do to loose weight, at that point  I weighed 115,9 kilos (255,52 lbs). He asked me to arrange an appointment with him, which I did for August 17th.