How did you first find out about bariatric surgery and what were your initial impressions of it?

I knew about it for a long time, but I was very scared because of the statistics in past. Then the lapband came out,and that did not seem so bad. Turns out I wasn't a candidate for it (I have connective tissue disease which is contraindicative for the lapband.) I had the RNY instead. Looking back, this was the best plan for me.

Describe your experience with getting insurance approval for surgery. What advice, if any, do you have for other people in this stage?

Insurance approval for me was the easy thing in the process. I can't believe they didn't fight me on it. My BMI was 43 (I think), and I have been big or bigger my entire life. I pointed out the 100,000's of dollars they are spending to manage my Rheumatoid Arthrits alone. I pulled my records of expenses and included those costs when I called them. With the other diseases just waiting to join it for the ride, their $25,000 surgery costs was a bargain! [I went into remission for 1.5 years after surgery, and no longer take the most expensive meds to manage my RA. I take 1/3 of the pills I did before, and they are mostly vitamins.] I advise you to add up the costs your insurance is paying year over year, and show them the reduction they'll see in expenses from you not having to manage controllable diseases because your weight will no longer be a negative factor. It is simple math and money. Insurance companies understand and care about money a lot. It is Win Win!

What was your first visit with your surgeon like? How can people get the most out of this meeting?

My first meeetign with my referred doctor was right, so I met with another doctor in that practice. We clicked perfectly. You have got to be comfortable. Hey this person will have your life in their hands, you ahd better like them at the least! I came prepared. I researched the pros and cons. I knew going in that I coudl not get the Lapband because I did my research. He did ask me "what type of surgery do I want." I answered "the kind that doesn't involve scapels or lasers." After we both laughed, I said "I want what is best for me. That is why I am hiring the best. If you are not the best, let's cut this meeting short. Time is money, and I'm not getting thinner sitting here" We got down to the facts, best case scenarios and the worst cases and his own personal expertise and patient history. I used all of that informaiton to make an INFORMED choice.

What made you finally decide to have the surgery?

I was on a very high dosage of Remicade and in pain every day from Rheumatoid arthritis (RA). Remicade is greatm but with methotrexate, there are some real nasty side-effects. I knew I could not cure the RA, but I could do something about how much of the drug I would need to control it, and that is to change my weight. It took a year of me beign scared, and listening to others who tried to scare me off. Finally my fear of the medicine's side-effects and the threat of a long nasty death outwieghed my fears about doign something about it. For me it was WLS and a plan to make it successful for me that convinced me to follow through.

How did you decide which proceedure to have?

My RA decided it for me. I could not get lapband, I had choices of what type of RNY, but I told my doctor to use his expertise to determine what is best for me. Afterall, thst is what I'm paying for.

What fears did you have about having complications or even dying from from the surgery, and what would you tell other people having the same fears now?

I got my affairs in order. No one lives forever! However, We can choose how we live the time we are allotted. I had a choice: choose my own destiny or ride out a long miserable life based on my past experiences. I could try the dieting again, (I did that 4x prior to surgery and gained more back!) or I could stop being insane and choose another path. So I would rather choose when someone woudl open me up to fix my physical problem rather than wait for a heart attack or stroke and have some onverworked ER intern rip me open later. Obviously, I had enough of relying on chance to make my choices since that had worked out "so well" for me in the past. Make a choice and choose your own destiny.

How did your family and friends react to your decision? Would you have communicated anything differently if you could now? How supportive were they after your surgery?

I had those that meant well (or did they?)who told me every horror story they come up with. Very few were positive in their initial reactions. I got the, "why don't you diet again? You have been successful before." When I point out how successful I have been and that we are having this conversation as evidence of that, I got uncomfortable silences or stares. I have a son, and he was scared, but wouldn't tell me how scared. Even if I had known at the time, I still would have done it. You have to stand firm. After surgery, they ALL became very supportive and admirable of my strength to carry through with it. I still hear horror stories! However, they are puzzled that I am NOT a horror story. So much for that! People are like that. Fear is our biggest enemy. Being strong in the face of friends and family will be very difficult.

How did your employer/supervisor react to your decision? What did you tell him/her? How long were you out of work?

My colleagues were very supportive. They know how strong willed I can be. I was out for 6 weeks. I wish I coudl say it was a greast party the whole time. It took 13 days for me to be able to think through the pain. Bad as the pain was for those 13 days, it was nothing compared to the caesarian childbirth I did with my son. A close second, LOL, but not as bad. That turned out well too. The lesson is that there are no easy pain free avenues to being a better you. You have to work hard, and be willing to work at it the rest of your life. Everyone dies someday. Some choose to die a little each day and be miserable while doing it, others choose to live life at their best until it really is their time to step aside. I know that I wish I had done this 20 years ago, but now is better than never. Which type of life do you want and are you willing to work towards it?

What was your stay in the hospital like? How long where you there? What things are most important to bring?

I had a room to myself (Nice!)I was there for 4 days because I could not keep my meds down and I could not get my bowels to move initially. Bring the bare minimum clothing and accessories that are comfortable. Have a firend/family member stay with you in your room for the first day. Nurses get busy and you ar not their only patient. The friend will make sure they take care of you until you are conscious enough to communicate clearly. You will be in pain if it is RNY, so looking "pretty" won't be high on the agenda. I kept getting cold, so ask for anything that makes you feel better.

Did you have any complications from the surgery? If so, how did you deal with them?

I had horrible gas that would not move out. That hurt worst than the surgery itself. I had a problem with my muscles spasming and not allowing me to stand up straight so that I could walk. I had to go to the emergency room for that. They gave me muscle relaxers and I coudl stand up straight afterwards. I did stop breathing once in the recovery room after someone gave me benedryl for the itching I had. I always have problems with anesthesia. be sure your Dr. and friends know of any past histories with surgeries so they can watch out for you.

In the weeks after you got your surgery date, how did you feel? How did you cope with any anxiety you might have felt?

I wanted to grab the scapel and get going with it. It was like looking forward to being released from jail. I have never been in a prison system, but being fat is like prison I imagine. I got all my affairs in order in case the worst happened, but I planned for the best. I made up my recovery room downstairs and cleaned everything perfectly so I would not have to try doing it post surgery.

Describe your first few weeks home from the hospital. What should people expect from this period?

I vomited a lot and could not stand the sight of food. I had to tune the TV to stations that did not have all of those food commercials. There are lot of them! I was not too worried except for the vomiting. I walked around the house a lot to prevent the blood clots. I had to rig a carrier for my j-drain so I could use both hands to wash my body. Get some good protein sources (Profect protein tubes and Unjury protein powder were very helpful for me) and a reliable driver to take you where you need to go (Dr.'s visits, etc.)

How far did you travel to have your surgery? (If far, how did this affect your aftercare?)

Across town, 10-15 miles max. No it did not affect my aftercare.

Please describe in detail what things you could and couldn't eat in the weeks and months following surgery. What foods have been off limits? Please explain how your dietary tolerance changed week-by-week, and then month-by-month since surgery.

I had to relearn what to eat. Clear liquids for 3 weeks minimum, then thicker liquids. I found that the denser the food, the easier it made me sick. As time went by, I learned that I can eat pasta and rice, but steak or anything dense got caught in my chest. I can't eat salads because it makes me sick, but I can eat lots of different soups. I am a sugar dumper, and dumping is horrible. I eat more of a diabetic like diet, except I can have breads. I stay away from them because I get a lot of protein in my daily diet. I do 1 Profect protein tube a day (25 g/ serbving) and 1 Zone Perfect bar a day, the remaining protein is from food itself. I eat a handful of peanuts a day. I can eat almost anything without sugar that I want now, but I choose not to eat certain foods because they are not enough protein or too much fat, etc.

What was your actvity level in the days and weeks after surgery?

I walked around inside the house every hour that I was awake. I was so scared of blood clots. I hurt like crazy the first week, but got better over time. I used my breathing machine too to keep my lungs clear of pneumonia Eventually, I started moving my arms in circles and twisting my feet back and forth just to move around. I was ready to get outside and walk my dog.

What vitamins and/or dietary supplements have you taken since your surgery?

Calcium Citrate, B12, Ferrous Gluconate, Folic acid, Adult multi-vitamin without iron. The calcium pills are monsters, and they are really hard to swallow in the first 4 - 6 weeks post surgery. I tried breaking them up, but that made it worse. For me, it was better to swallow them whole with as little water as possible to not fill up my pouch. Two years post-op, this is not an issue. I'm back to normal in being able to swallow pills and food like I never had surgery.

What side effects (nausea, vomiting, sleep disturbace, dumping, hair loss etc.) were worse for you? For how long after surgery did they persist? How did you cope with them?

The vomiting is the worse for me. I had no hari loss because I keep up on my protien levels. I no longer vomit much because I won't eat foods that I knwo will make me sick. I have a lot of gas everyday from eating the protein drinks and the soy milk. It can be unpleasant, but I do have to manage it a lot more than I like. I rarely dump because I watch what I eat. Some things look so innocent and sugar free. I consider all to be sugar laden until proven otherwise now. Live and learn.

What was the worst part about the entire bariatric surgery process?

The 13 days of the intense pain immediatly post-op. Don't resist taking your pain medicines. I waited too long out of fear of getting hooked and suffered more pain than I should have, Knowing what I know now, I would not hesitate to go through it again.

What aftercare support group/program do you have? How helpful/important is this?

I did not go to th support groups like many people do. I'm not the group person. I prefer being around my family and friends rather than strangers. However, I did do several online communities. I like those best. Also, I mentor anyone who asks me about the surgery. I get great satisfaction doing one-on-one converstions with those who are interested in the experience.

What is your scar like? Is this what you expected?

I have a 5 inche scar right down my middle. It is my badge of bravery. I expected it to be smaller, but I can live with it.

Please describe any plateau experiences you have had since surgery.

I plateued many times, but they were brief. I set up my weight lose in groups of 10 lbs. I always would say to myself "ok you made it to XXX, now let's go for XXX - 10 by next week. Breaking the losses into 10's with nice milestones worked perfectly. Then on sundays, it was try on smaller clothes day, and setting goals for dropping another size by a particular day.

Do you notice people treating you any differently now?

Yes. It is true that people will judge you by appearances. Sad, but true. This is not so with people I love, but strangers and acquaintences do react differently. I still think people are waiting for me to revert back to my old ways. They watch what I eat and question me about it all the time. This is especially true from family who have weight issues. I love them, but they are trying to find a way to justify not doing something about their weight in hoping that I fail somehow. That make me more determined that ever to NEVER fail.