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

My first exposure to bariatric surgery was a television commercial advising of the availability of surgery for the treatment of obesity. I was excited, I called and got an informational packet but never followed through because my husband strongly disapproved of any surgery. I began reading and searching for information on the internet about the various types of surgery available and sought to find out if they were really as dangerous and horrible as he said they were. ( His mother had gastroplasty unsuccessfully and he felt all surgeries were pointless as a result.) Never one to take someone elses opinion totally at face value, I continued reading and researching and found that great strides have been made in bariatric surgery, yielding far better results with much less risk than methods originally recommended for surgical weight reduction. After a lot of contemplation I decided that I would like to have RNY Gastric Bypass Surgery. I then set out to find a surgeon that offered what I had read was necessary for the most likelihood of success - structured aftercare - including nutrition, psychological counseling and scheduled Dr visits. I visited several surgeons and found Dr Joseph Afram, at Columbia Hospital for Women in Washington DC. I found him immediately easy to communicate with, friendly and his staff was warm and professional. My decision was made, it was then time to gain approval from insurance and get the ball rolling.

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

My approval process was relatively quick and painless. All the details were handled quickly and professionally by Velma Spriggs. She is a godsend and is wonderful at her job. Still when you are waiting for anything you really want, a day can seem like an eternity. All I suggest is making yourself available to run errands or get information from physicians or others if your insurance person isnt as "on the ball" as Velma... and practice patience, though it may seem like a long wait at the time, its worth it and once it has been approved, it becomes a whirlwind.. spinning you right into surgery!!! If your insurance is more difficult and you dont get approved at first, dont despair! There are appeals and other processes that you can go through to get your surgery.... DONT GIVE UP!!

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

My first meeting with Dr Afram was excellent. I was made to feel very comfortable and his professionalism and attention to detail made me feel immediately secure and safe entrusting my care to his skill. He was very thorough and provided a complete explanation of the procedure, the recovery, possible risks and contraindications. He treated me with kindness respect and friendliness, a welcome change from many physicians who view the obese as weak or flawed people. I would suggest that people approach their first visit by being prepared with questions and educating themselves about the process they are asking the surgeon to perform. Important as well, is introspectively evaluating what your expectations are for the surgery and making sure that you are having surgery for realistic and healthy reasons. Appearance is important, but health and over all well being far outweigh looks as a reason to have surgery. Be sure to address any and all concerns with your surgeon, and be sure to pick a surgeon that is experienced and focuses on obesity surgery as a major part of their practice. I wouldnt want a dentist performing my hysterectomy and I certainly dont want someone that doesnt do obesity surgery working on my stomach and intestines!!!

What made you finally decide to have the surgery?

I was worried about my future help. My mother was diagnosed with Diabetes, my grandmother had breast cancer, and I know that with the additional weight and risks it causes that I am at an even HIGHER risk for complications and comorbidities as my life progresses. I decided that I needed to act before something happened that would permanently alter my life forever and perhaps preclude me from having surgery. I wanted to improve my quality of life and make myself a healthier happier person.

How did you decide which proceedure to have?

Various procedures and success rates are available over the net. I did a lot of reading, talked to nearly a hundred successful WLS patients and found that over all, RNY patients seem to have very high success rates, low occurrences of complications and long term health risks are low. I felt that an open procedure was superior to a laparascopic procedure as the surgeon has greater freedom of movement, is able to handle and properly view the organs and structures of the digestive tract and abdomen and only one incision is made as opposed to 5 with a lap procedure. Recovery time is not significantly greater with open vs lap, and given the additional benefits it offered in terms of my security, I felt much more confident with open RNY than with Lap.

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?

Because I attemped to educate myself fully before deciding to proceed with surgery, I had few fears or trepidations. As with any surgery, being obese is always an additional risk, and I was concerned that my weight could cause potential complications, such as blood clots or heart attack as a result of my obesity. My fears were totally unfounded as my doctor ordered a full battery of tests and procedures prior to my approval and release for surgery. His thorough examination and testing made me secure that nothing was going to happen to me. Certainly he wouldnt want to do surgery on me if there was any extra risk that I would die or have complications, so I was very secure by the time I was being admitted for surgery that everything was going to be fine.

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 was concerned and some members were very negative. My best friend was very supportive as was my fiancee and my grandparents. My mom who is also obese was a surprise because she was not supportive in the beginning. She has since become a great support and an advocate that is unflappable. Everyone was concerned, I addressed their fears, allowed them their opinions, and respected them, but I had made the decision. I would not express anything any differently than I did in the beginning, and most people have become very supportive since the surgery. Those who are negative or unsupportive, I choose not to associate with.

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

It is not my employers business. I advised them I was having "female surgery". I am a female.. it is surgery.. end of story!!!:)

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

The hospital visit wasnt bad at all, some of the nurses were a bit unattentive, but my boyfriend stayed at the hospital with me ( private room ) and made sure that all my needs were met and that I was kept comfortable. He helped me in and out of bed, to the bathroom, made sure that my covers were adjusted, that I had water and ice chips the first days when I couldnt take anything in. It was pretty great to wake up and have someone "able bodied" right there. The only things I would suggest bringing are a robe that is open the whole way down the front, warm slippers, a little lotion if dry skin bothers you and chapstick for your lips. Also some toothpaste deodorant and a toothbrush because after surgery and a day in bed you really want to feel fresher. Books magazines and other stuff like that are pointless, you just want to relax and sleep.. and when you arent doing that you need to be up walking and getting your strength built back up!!!

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

I had perfectly wonderful non problematic side effect free surgery.

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 better when I woke up from surgery than I had previous to going under. My anxiety over the process had lifted and I felt that I was on the road to recovery.. moving forward. I knew this was the worst I was going to feel, I would only get better from this point forward, and that was a tremendous release for me. I coped with my anxiety prior to surgery by doing lots of reading and research at sites like this, and also by talking to lots of friendly post ops that shared their experiences with me and made me feel much more secure. Anyone that would like to talk or ask questions is more than welcome to drop me a line. Sometimes it takes me a while to respond but I am always glad to share any information I have that may help someone else that is in the process of preparing for surgery.

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

Upon returning home from the hospital, I felt elated. Finally home in my own domain. I live in a second story apartment and was apprehensive about the stairs but they proved to be of little problem. I found that little things made me extremely tired, and that I needed a lot of rest between activities. As an example, showering or bathing nearly exhausted me, I tried taking a shower by myself several days after returning home and by the time I was done I was dizzy, faint and nauseated from the exertion. I felt better and stronger nearly every day but there was an improvement in my energy. By taking it easy but trying a little something more each day, before too long I was better than before surgery!

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

I travel approximately 150 miles to see my surgeon. So far this has not affected my aftercare, as my doctor has a variety of hours and is very flexible in seeing me at times that meet my schedule. I am very glad I selected Dr Afram, even though he isnt the closest to me. Our aftercare support groups are available evenings and days so it facilitates being able to attend regularly - whereas if it were only one or the other it may not be so easy. The worst part was the trip home after surgery, because I felt every bump and hump in the road. Luckily my doctor provided me with good pain management medication and I was not very uncomfortable during the roadtrip and was quickly settled in when I returned to my house.

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.

In the week following surgery my surgeon and nutritionist prescribed a dietary program of clear liquids including Jello and broths. This was the worst because I was bored and watching tv and the commercials for all the food really bothered me. After the first seven days pureed foods began and at that time I began to introduce soft foods as well. By the end of the two weeks of purees I was easily tolerating soft foods such as well cooked chicken, turkey, fish, potatoes, greenbeans, anything that could be cooked to a very soft tender consistency was very palatable and digestable. From three weeks on I have slowly began to introduce foods back into my diet, and have found only a few that do not agree with me.... such as uncooked vegetables, (broccoli and cauliflower specifically) and I dont like greasy foods, they make me nauseated. I can eat pretty much anything, but like all other things since I have had surgery, this varies from day to day, what settles well one day, may not the next. I have only gotten sick from something I ate once, and that was spaghetti!!! I ate three bites, some vegetables and knew that it wasnt going to work. I am currently 12 weeks post op and there is virtually nothing that I cant eat, just portions are MUCH smaller than before!

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

I was up and walking the day after surgery. Once my catheter and the nasogastric tube were removed, my surgeon suggested that I get up and walk. At first it was uncomfortable but experimentation helped me find better ways to do things, like go to the bathroom, that were much more comfortable. Upon returning home I would walk around the apartment several times an hour, and after several days progressed to going outside and walking around the house. I did find that little things made me more tired than before, I always had a relatively high activity level - especially for a person of my weight. At two weeks after the removal of the gastrostomy tube, I was able to walk around the block two times and now, at 11 weeks I walk approximately 2-4 miles about four times a week. I am in the process of looking for a health club to join, as I dont want to give up my fitness activities in the cold winter months that are coming.

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

I take trinsicon which is an iron, vitamin b complex, and gastric intrinsic factor supplement. It has to be taken daily for the rest of my life, because I no longer use the portion of my stomach where intrinsic factor is produced ( the duodenum ) and without it my body cannot absorb vitamin b... and I will develop b vitamin deficiencies. I also take a multi vitamin daily as well as protein supplements. I use a cherry flavored liquid protein which you can purchase at GNC or Vitamin World stores which when mixed with juice or crystal light is very palatable and gives me the extra protein I need.

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?

My worst problem has been learning what I can and cant eat... and when. Next to that.. has been losing hair.. but it will grow back. Really I dont have a lot of negative things to say. I waited a long time to make the decision to have this surgery and was pretty much prepared for everything that has happened so far.. hair loss - nausea - dumping... and even for some things that havent happened! I am still losing hair. I cope by knowing it will grow back... and by realizing that all better than it was before. I am getting healthier!

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

Waiting for insurance approval!!!!!!