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

I did most of my early research on-line, reading sites like ObesityHelp.com. I read stories, looked at before and after photos, and researched surgeons all on-line. Carney Wilson was just starting her WLS process, so I followed her story in the news and I even tried to watch the on-line streamed video of her surgery live. . .but for some reason I couldn't get the video to play. I started going to a support group to hear more first-hand experiences, and that was amazingly helpful.

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

When I had my surgery in 2000, few insurances were covering WLS. . .at least not easily. My primary insurer at the time was Regence BC/BS of Oregon HMO, which didn't cover WLS. But luckily my secondary insurere, CHAMPUS, did. My surgeon wrote letters to both my insurance companies at the same time, knowing Regence would deny. CHAMPUS approved my for surgery the same day they received the letter.

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

My surgeon, Dr. Latham Flanagan, was the most experienced surgeon I could find anywhere nearby. I had to drive 2-hours to get to his office in Eugene, Oregon, but it was worth it. I found Dr. Flanagan to be a warm, caring, interesting man. Some of his patients I came to know thought he was cold and abrupt, but that was not my experience. He asked many good questions, and he expected you to know the answers. He had given me a pre-worksheet to fill out, so I'd be ready to answer questions about my dieting history and other such things. . .so it was easy to get through the first meeting with him. The hardest part was digging up the facts of my own history as part of my pre-meeting homework. The meeting itself was great.

What made you finally decide to have the surgery?

I began to do my research on WLS after I took one of those insurance life-expectancy quizes, and was told I would live to be only 44. . .and I was already 42. Two years earlier I had developed adult-onset diabetes, and was insulin dependent. I had two children who were in their early teen years. I wanted to be there for them as they grew up, as I knew how hard the next 5-10 years would be for them. And as I watched them both gain weight, I decided I needed to become a better role-model and not continue to lead them on the same path to obesity and poor health that I was laying down for them.

How did you decide which proceedure to have?

In 2000 there were fewer options in the types of proceedures done. I chose to have an open RNY, as it seemed the best fit for me.

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've always been an optimist, and I had been through several major surguries and two complicated pregnancies already, so I didn't really carry too many fears about the surgery. I was focused on the fact that I was 44 years old, and that by the time I was 45 I would no longer have problems with diabetes, GRD, sleep apnea, or arthritis pain. And of course, that turned out to be true. In fact, my health and my happiness improved in so many many ways, that it just confirmed my belief that there's no reason to let the fear of surgery stop you.

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?

Everyone around me was very supportive. They knew I had made my decision based on sound research, and they trusted my decision as being the best one for me. I had no thoughts of hiding my decision, even though back then the whole world of WLS was less known, and some magazine horror stories were still in some people's memory banks. Actually, I do rememer planning to NOT tell my best friend from high school, back in my home town. But only because her sister had died from complications of having her teeth wired shut and some very-early form of WLS. I was afraid my old friend would not be able to get that memory out of her mind. I did not want her to worry about me. So I only told her after I saw her again many months after my surgery and had lost a lot of weight. She was very happy for me, when she found out.

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

I was a nonprofit Executive Director, so my supervisor was a group of 12 volunteer board members. They were supportive of my decision. They allowed me to work from home and be as flexible as I needed to be throughout the process. As a director of a busy nonprofit, there's always too much work to do, but that just gave me more incentive to not sit around and do nothing for too long. I went back to the office on a regular schedule about 2-3 weeks after my surgery.

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

I was in the hospital for 3 days. I spent most of the time resting, listening to soothing music through headphones, to drown out the noises of a busy hospital. I found the chance to rest and do nothing to be a very pleasant change from my busy life. I thought of it as a mini-vacation. I just closed my eyes and pretended I was working on my tan. The only uncomfortable part was the first 12 hours while the breathing tube was in. So other than trying to get out of bed and moving, as soon as I was allowed. . .I just focused on sleeping. And soon it was time to go home.

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

They discovered I had huge gallstones blocking my gallbladder duct (or something like that). So they ended up removing my gallbladder while they had me open. The surgeon said I must have been in a lot of pain before the surgery due to the stones and related infection, but I hadn't noticed. Pain had become a normal part of my life. . .and I just thought it was part of being obese.

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 was elated, and couldn't wait. I had a close-knit group of friends in the support group, and we celebrated everyone's surgery with great anticipation and excitement. I was ready to be reborn and share the experience with my friends.

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

I was surprised to realize that I could do nothing the first week or so, except sit in a chair and plan the next liquid meal. It took me as long to get through 1 oz of Carnation Instant Breakfast with protein added . . .and then the drinking enough water before the next meal as it did following a stict diet that involved much measuring and food preparation. My whole world involved a 2-foot space around my favorite rocker-recliner, that was full of shake and protein mixes and a small cooler of low-fat milk and water. I was not in pain, but I couldn't move around much.

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

I had to drive 2 hours for my surgery. I had family in the city where I had surgery, so it was like my extended home-town. The hardest part was the 2-hour drive back home the day I got out of the hospital. I placed a big pillow over my tummy, which I used to hold things tight. I felt every bump in the road, and couldn't wait to get home. By the time I had to make the trip back up for my first post-op appointment, I did not have this problem. So it was just the first trip home that was hard. Making it back and forth for aftercare appointments was not a problem, since it gave me a chance to visit my extended family every month or so.

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.

As I write this, it's been 8 years since I had my surgery, and it's hard to remember exactly when I discovered I couldn't eat what. I know I tolerated milk okay at first, but then at some point I couldn't drink even the lowest-fat milk without dumping. I ate cottage cheese for a long time out, but at some point that made me uncomfortable too. I eventually accepted I couldn't eat any milk products, except low-fat cheese, unless it was just small portions cooked inoto foods. I also at some point realized I couldn't eat any ground-beef products. I could eat ground poutry, but not beef. I think it has to do with the grease. I can't tolerate many foods with a high grease content. . without getting horrible stomache cramps and some dumping. It's just not worth it. Even today, I cannot eat hamburger, hotdogs, ice-cream, milk, or eggs. I can eat food cooked with eggs, but I can't eat an egg meal. It's weird. Since surgery I can no longer handle fruit juices, due to the high-fructose content. I can, unfortunately handle small bites of chocolate and other candies and cakes and such, with no problems.

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

I remember noticing increased energy levels shortly after surgery, and that only increased as I got further out and lost more weight. I only had about 2 weeks where I felt a low level of energy, as I was recuperating and healing right after surgery.

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

I took pre-natal vitamins at first, and then eventually went to taking Centrim Silver daily. I still take them daily. I also take Calcium and Vitamin D daily. About 12 years before my WLS I had calcium-deficiency issues related to thyroid surgery. And at about 3 years post-WLS I started having trouble with calcium-absorption again. So I take calcium.

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 remember dealing with vomiting only while I was learning what I could eat and could not, and how I had to chew well and eat slowly. Once I figured that all out, I never vomited again. While the vomitting was inconvenient, it was not unpleasant. There was no acid involved, so it didn't taste bad. I realized I had some unconcious ability to know when the bite in my mouth was one too much. It seemed like my mouth and my head knew that before my tummy did. So I always found myself discreetely spitting the last bite back into my napkin. . .and pushing my plate away. I experienced some hair loss at about 6 to 10 weeks out. At first it worried me a little, but hearing others' experiences gave me some comfort. And sure, enough, the hair grew back. I had really thick hair to begin with, so the hair loss was never noticable to anyone but me anyway.

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

To me it was an adventure, with lots of new things to learn. Sometimes the learning involved some unpleasant moments, but they were so fleeting that I never developed a feeling of any part of the process as being "bad." I've always said I'd do it again in a heart-beat.

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

I received aftercare from my doctor via regular appointments at 2, 3, 6, and 12 months out. I don't remember how far out I was when I last saw my surgeon. The most helpful aftercare suport was from the friends I made in support group. I attended my support group for about 2-3 years post-op when I moved out of state. I encourage anyone considering WLS to get connected to a group, either on-line or in-person. . with the in-person being the preferred method. Even now, 8 years post-op, I am encouraged by reading on-line posts, and I am reminded of the rules of the pouch and how I can use the tool I have lose the weight I've re-gained.

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

I have a long scar from my breast-bone to my pubic-bone. Besides having an open RNY, I also had a tummy-tuck at 12-months out, and the result is a smile-shaped scar just above my pubic line and some chevron-stripped scarring pattern on tummy. This is from the stretch-mark scars that used to go up and down, now going from up on the outside to down on the inside where they meet at the incision line. It's pretty weird looking, but not as weird as the circle that was around my naval, which was kept at my request. The scars have since faded to almost being invisible.

Please describe any plateau experiences you have had since surgery.

It's been 8 years since my surgery. I stayed at my lowest weight for only about 6 months, and I only gained a few pounds the first couple of years post-op. But due to my bad habit of grazing, I have managed to regain about half of the weight I lost over the last 6 years.

Do you notice people treating you any differently now?

It was amazing to notice that when I weighed 165 pounds, some people would treat me differently than they did when I weighed 330. My position and personality always gained some respect, but sometimes that extra weight seemed to get in the way. Not so when I was thinner. The thinner I got, the more the discrimination I had endured became apparent to me. I got to where I wanted to go hug anyone who was still fat and tell them about my amazing experience, so they wouldn't have to be discriminated and be unhelathy. The biggest difference is the way people reacted to hearing that I'd lost 200 pounds. It made me feel good to get such positive feedback.