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

I seem to have always known about bariatric surgery. It always seemed like a last ditch attempt to lose weight. i was frightened not only because of the known risks, but also fightened by the idea that if this doesn't work, what is left for me.

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

I had no problem with insurance approval. My insurance company had a record of all my other attempts to lose weight, and I had the full support of my primary care physician. I also was willing to get about a million other tests to prove I was healthy enough to have the procedure. Sometimes Ithink some isurance companies are more willing to do this kind of surgery than others.

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

My surgeon was great. He offered me a lot of information and required me to be a part of an educational program called New Beginnings. It is a great program that offers case coordination, support group and education from a behavioralist, a nutritionist and physical trainer. Go to the surgeon with a lot of questions. If he or she won't take time with you, they are probably not the surgeon for you. Find out whether or not thtey will be available to you after the procedure.

What made you finally decide to have the surgery?

Confidence in my surgeon, the support group and most of all, my psoriatic arthritis. I was just too damn fat to get around anymore and my life was being negatively affected by my weight. Before my diagnosis, I never let my weight get in the way of my life. Suddenly it was. I had no choice.

How did you decide which proceedure to have?

My doctor only offered RNY and my reasearch tells me that it is the procedure that offers the best degree of success. I was afraid to do only restrictive surgery because I was afraid that I would not have permanent weight loss. I needed to have a procure that would require a limited diet.

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 was not really afraid. I thought since I was younger, had no co-morbidies which I considered serious. After the procedure, I can't believe how lucky I was. I don't know how to tell someone not to be afraid. They should be scared. This is a serious procedure.It kills people. You need to be aware of the risks and decide that you are willing to accept that you may die or have serious consequences from this surgery. you need to decide that your life without the surgery is not worth living. If you can make that decision, than you can go through with this operation. If you can't accept that you may not walk away from it, maybe you should try to diet again.

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?

My family and friends were cautiously optimistic. My sister, who is my life line, did not want me to do it, but she promised to support me anyway. She was and is a tremedously supportive person. I would have told them more about what was going on in my head. I think they did not realize the degree to which I was depressed and sick of being obese. I did not have the energy to live anymore, and I wish I had told them. They might have understood my choice better.

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

I have not been working due to my arthritis. But my previous employer told me on numerious occassions that she thought GB was the only answer for someone as big as i was and that she thought I should consider it. I found this attitude quite offensive. I did a great job as a Union Organizer and I never let my weight get in my way, it bothered me that she considered it a weakness.

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

I was in Virtua Memorial for 4 days after my surgery. They took great care of me. I was in no pain and I was well medicated. I brought some good luck charms and prayer books, but to tell you the truth I didn't need a thing. They do a large number of these procedures, they had comfortable gowns, beds and recliners. I was very comfortable and well taken care of. People from my support group visited every day.

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

I have had an incision problem. It did not heal for 7 months I had home care and frequent visits to my surgeon. I also went back into surgery for a revision of the incision. I was treated with a wound vac. I was also required to eat extra protein. I have been told that I am had trouble healing due to my underlying auto-immune disorder. I also developed a pulmonary embolism which has since become a calcified mass in my heart. I have no symptoms, but am followed by a cardiologisy. I had symptoms of the embolism and returned to the hospital; a conventional lung scan did not show the embolism; however a MRI uncovered it several months later. Some abnormality of my anatomy kept the PE from my lungs and saved my life.

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 felt sad, scared and depressed. I relied heavily on my support group and the wonderful people who are in it. The people had been were I was and were great. I also worked with a nurse-case coordinator. She really helped me alot.

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

I was tired and weak. I was also quite dizzy from blood sugar fluctuations. I didn't want to do anything. I was afraid to eat anything. It was a very difficult time. I was so glad to have a support group to help me through it. You really need help. It is a big procedure, be prepared to be needy.

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

1 mile, no problem

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 cannot eat sugar of any kind. I have trouble with leafy vegtables. Week one is jello, broth and crystal light and protein drinks. After the eighth week, I could eat chicken, fish, potato vegetables like green beans. I do have problems with pasta and red meat. I eating slowly seems to be the trick to good digestion. Nearly two years later, I still react badly to sugar and substitutes. I cannot eat pasta or rice, except for few bites. I struggle with emotional eating and snacking too much !

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

I was very weak at first, and this was complicated by my arthitis. The longer I was lying around the stiffer I got. After a few weeks I was able to walk and to do minimal exercize at the gym. I had a wound healing problem so I have not been as active as I wish. I became extremely active after my incision complication ended. I go to go to the gym 4-5 days a week. I use water exercise due to joint problems, but as my weight loss continues, I try different land based activities, like spinning and cardio machines.

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

I take two regular multivitamins, 1600 miligrams of calcium and zinc and vitamin c. I take isopure protein supplement I have eliminated zinc since I have healed and I take calcium citrate, not carbonate for better absorption

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?

I am losing hair. I have very thick hair so it doesn't show much. I have had some dumping, but not much. I have been really lucky.

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

The wait to get the procedure. Going to the nursing home afterward. The fear of major complication. The loss of food as a comfort.

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

I belong to a group called New Beginnings. It is a comprehesive pre- and post surgical program required by my surgeon. It has a nurse care manager, a dietitian, a behavioralist and an optional exercise component. It has been an essential life-line. Everyone needs after-care. It is as important as the surgery itself. I participated on a weekly basis for two years. I go on a monthy basis now.

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

It is very faint, and not as large as I thought it would be. It is not really a problem...The extra skin...that's a problem

Please describe any plateau experiences you have had since surgery.

I have only been losing about a pound a month for about four months now. I am about 2.5 years out. I know if I was more active I would be losing more weight. I am still about 30 lbs away from goal weight. I also feel that I need to go back to keeping a food diary, snack less, and only eat for actual hunger. Emotional eating is still a problem for me.

Do you notice people treating you any differently now?

Absolutely. People are wildly interested in this whole process and frankly I'm tired of it. I also find myself wondering what people thought of me before, because they never cease to tell me how amazing I am now. I feel like the same old me, but even I have to admit,,,I have a happier outlook than before the weight loss. I feel less defeated.