Visit three of four mandated sessions

 I met with a PA named Andy, who ironically is married to the  nice lady I had for my psych exam. My weigh in showed I'm at 225, so I'm staying under the 229 where I started and must not exceed.  I really felt I'd be much higher after three days with my granddaughter and her husband.  We ate out a lot!

I went over the following questions with him:

Am I in danger of developing gall stones after this surgery.  Yes.  They provide medications for the first month to counteract this.  

What about my low dose aspirin that I take as a preventative measure? He suggested I stop the low dose aspirin unless it's needed as this can irritate the stomach.  After the surgery I will not be able to take any NSAIDS and will only take Tylenol.

Can they fix my umbilical hernia during the surgery.  Yes they can, no they won't.  He explained that you only want to do this once and it's best to wait until I reach my goal weight.

Is there a danger of eating too much protein?  No 

Should I get a different prescription for my venlafaxine as it's an extended release?  No. There isn't any immediate release of that drug. I can take it just as it is in the capsule but I might not absorb as much of it. Wonderful. The first month when all those hormones are released into my system and I can go a bit crazy this might not be as powerful. 

How many days of liquid diet prior to the surgery?  Generally it's a two week liquid diet, but since you can drop 10-15 pounds doing this and I have to stay above 205 (BMI of 34.5) they may adjust this to one week to be sure I'm not disqualified.

We went over the vitamins I've chosen from Bariatric Pal.  I will be required to take a multivitamin with a minimum of 45mg of iron and 3,000 IU of vitamin D3 every day.  It must be chewable for the first 30 days after surgery.  He approved of my choice of ProCare Health Bariatric Complete Multivitamin with 45 mg of iron.  It's only once a day and he warned it will make me nauseous. 

I will be required to take 1,500 mg of calcium citrate each day and it needs to be spread out in three doses as the body can only absorb about 500 mg at a time. This cannot be taken at the same time as the multivitamin because it will compete with iron for absorption.  I'm going with the Bariatric Advantage Calcium Citrate Chewable.  

He did say that these were excellent choices but on the expensive side.  I figure this is my health and I will take whatever is the best for me.

It's going to be interesting to work out a time table for when I can take which vitamins as well as the requirement to not drink 30 minutes before, during or after eating.  I'm sure it will take a while to fit all this into a regime but hopefully it becomes second nature later.

My last question was when everything happened.  I need one more visit mandated by insurance and one nutritional visit mandated by my clinic.  Both of these are scheduled for in March.

I am to make an appointment to see my primary care provider early in April to have him prepare the letter of necessity and get all the lab tests needed prior to surgery.  Set up right away.  Then this is all sent to Medicare and my supplemental insurance for approval, which can take a couple of weeks.

Once it's all approved I'll get on the surgery schedule and he figures it will be sometime early May. They recommend staying close by for four to six weeks to make sure everything is going well.  You don't want  to have something go wrong and need to get back in.

It's getting closer!