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March 2007

GERD Update

After having set off all the red flags at Medco, and them faxing all my doctors about the drug interaction between Symlin and Reglan, I got an email from my endo suggesting that I half the Symlin.

I did tonight. 

I did really well Monday night and Tuesday night but had a really bad reflux night last night. 

Patient Gripe - Bariatric Surgery Suggestions

If you haven't figured it out already, I'm "morbidly obese".  As a result, medical professionals feel the need to suggest Bariatric surgery.

Okay, they don't suggest it.  They practically demand I do it and do it now.  And they won't take a polite: "Yes, I've researched it, and it is not the answer right now."  Often once I disagree with that treatment plan, I am immediately treated as a noncompliant patient.

Here's the deal.  I've met with a surgeon and I didn't like him.  Yes, there are other surgeons but I've looked at my insurance and I don't like the amount of money that will have to come out of my pocket. And that's if it is successful.  I also don't like what my body will probably look like when I'm done, and I'm talking about the sagging skin.  I also don't like the idea of opening the door to more surgery.

I don't like the mortality rate.

I don't like the complication rate, NOR am I really thrilled with the known complications.

Much less the rarer, little know complications.

I am also a very good candidate for becoming an addicted person in another way.  Yeah, food addiction is probably a problem for me, but at the current time it is much more socially acceptable (much less job acceptable), than drug, alcohol, or even shopping addiction. 

I've had long conversations with several people over several different conversations who have had bariatric surgery in various forms.  While they are happy with it, at the end of the conversation, we walk away agree I'm not ready yet.

The point of this?  My doctors, especially my primary care physician know that I am a highly educated individual, know just about every facet of the diseases I'm am dealing with and know that I research everything.  Though I will admit I often take drugs on their word alone and get to figure out the diabetic side effects 3 days later.

As a patient, I'll respect you infinitely more if you find a polite way to work it into the conversation, and then drop it when I respond intelligently in the negative.

Funny, but that works with just about every treatment plan.  Not just bariatric surgery.

What is even worse though, is when the physician who suggests it weighs about 10 pounds more than he did the last time you saw him, and he is steadily gaining weight over the years. 

Recap of Signing up For Fitness4Diabetics

Unfortunately the initial contact can be difficult.  Be patient, leave phone messages and email messages.  They will eventually get you and get your credit card information.

After your credit card information clears, they will send you your initial paper work.  It's quite a bit, but does help them get you started.

The next step is clearing everything with your doctor.  I haven't seen that form, but it did take mine about a week to process.

So after all that is done -- and it's about a two week process, you are ready to go.

I was sent a food log, an activity / blood sugar type log, and a goals setting sheet.  Since this is all personalized AND virtual, don't expect a full blown set of things for you to do -- I sort of did because I've participated in programs in the past that would hand you something that sort of fit you and then they customized it as they went.

So far, everyone appears very cordial, and very ready to work with you.

I am working with a fitness coach, a nuitrion coach AND a wellness coach that is supposed to round out everything.

Not bad for the price!


I've started fitness4diabetics in earnest now.  Their Wellness coach and I had a good telephone conversation this evening.

I've got a food log started -- though I think I'm going to make a few changes to it.

I've also got a good bs log going, but no really good exercise log, so we need to get going on that.

All in all I'm placed -- the first week is all about all of us getting to know each other and getting a working relationship going.

fitness4diabetics documents

I got my first set of information from fitness4diabetics.  I got an acivity / blood sugar log, a food log + blood sugar log, and a form about change habits.  And a sheet of directions.

Lots of logging but then I'm used to that.  I also made some requests of my own towards exercise, etc. 

Of course, this morning WOULD be the day that the nuitrition class (we called it home ec in my day) made taco salad and brought some by this morning.

The taco salad was very good, but I ended up doing a wild ass guess for the carbs.

Gastro Medication regimem

She's keeping me on Protonix, 40 mg twice a day.

She added Reglan, 15 minutes before meals and Carafate 1gm at night.  Reglan is to aid stomach mobility.  The Carafate is in case it is bile acid and not stomach acid.  According to the drug information on the web it's also for healing ulcers.

I get a sonagram of my gall bladded a week from Friday and get scoped the Monday after.