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

I saw several programs on television that spoke about weight-management surgery. My initial impression was that the people seeking these services simply did not have the will power to lose weight the "right" way. They were simply seeking a way out of their self-created, self-inflicted hell; they were just doing it the "wrong" way. I viewed the doctors who performed these surgeries as vultures who were in it to make an increasingly embarassing amount of money, and I believe that their antics only gave people additional reasons to not take responsibility for their own unhealthy ways.

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

By the time I considered getting the surgery, I had worked with the insurance industry for several years, so I knew the process in and out. The approval process with my medical group and insurance company was fairly straight forward. I met the qualifications to be considered for the surgery (e.g. substantial BMI). I spoke with my primary care doctor about it, and she started the process. A few weeks later, I got a call setting up an appointment to give me more information about the surgery. After that class, I saw a therapist to ensure that I was initially fit to be considered for the surgery. On August 21, 2006, I got my approval letter. That also was my birthday.

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

My surgeon was Dr. Li. The first thing that struck me odd was that he seemed very young, perhaps in his early 30s. Of course, we all want someone experienced to handle our care! However, he proved to be professional and caring throughout the entire appointment. I had questions, and he had cogent answers for me, so that put my concerns to rest. The best suggestion for meeting with your surgeon is to pepper him or her with as many relevant questions as possible. He or she will be the person with your life in his or her hands, so you have a right to know everything you need to know before a knife (or laser) is put in your stomach.

What made you finally decide to have the surgery?

I decided to have the surgery when I looked in the mirror and noticed how much weight I had gained. I was appalled at my appearance and knew that some type of change had to be effected, or it was likely that I would not have lived to see my 40th birthday. From there, it all took off.

How did you decide which proceedure to have?

I decided that I wanted to go with the procedure that would net me the best results and would help me mitigate gaining the weight back. For me, that was the laproscopic Roux-en-Y procedure. Downtime would be minimal, and the chances of someone's gaining weight after this procedure is significantly lower than other procedures that were available at the time.

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?

My fear was dying in the middle of surgery. I have never had a major operation, so there was fear in the unknown, which is natural. I wanted to ensure that I lived to see my partner get old. I wanted to live to have children. Other than that fear, I didn't have any others that I could think of. To maintain the level of fear in my life, I made sure that I did enough research to know what I was getting into. Again, most people fear what they do not know. Thus, the more education that one has, the less amount of fear one will have in his or her life.

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 partner was initially skeptical of my getting the surgery. He was not against my having it, but he had the mentality that I could lose the weight the "right" way. I told him that this was the right decision for me, and I also educated him that having the surgery was simply a tool, albeit a dramatic one, to help me get to where I needed to be health wise. He came around and is no one of my biggest supporters. My family and friends generally took the tone that the surgery was unnecessary and that I could lose the weight normally. As a rule, none of them has come around, but this journey is not about them; it's about me.

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

My employer was supportive in allowing me to take the time off needed for the surgery even though I had recently started with the company. They recognized that my having the surgery would have a greater impact to their bottom line through better attendance and such.

What was it like attending your first information seminar on weight loss surgery? Were you glad you attended? if so, why?

I was truly excited to go, because I was interested in the information that they were going to share. How were they going to approach me with weight loss? What new information were they going to share that I didn't already research? And after having attended the meeting, I walked away with a mound of information and expectations that I keep with me even to this day.

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

Previously, I had an antipathy toward hospitals, but I must admit that my hospital stay was positive. At every step of the process, the staff provided me with information so I was never confused about anything. I packed lightly for my hospital stay. I had a few change of clothes, toiletries, some reading material, and my cell phone (of course!) It really depends on how long your stay will be. If there are complications, your stay could be several days. You'll need something to keep you company. I did get anxious after my surgery and was a bit more fastidious than other patients perhaps. Really, I just wanted to go home and rest there, not in such a clinical setting. So after 23 hours, they discharged me.

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

I had no complications whatsoever after my surgery. In fact, I had expected to be in a lot of pain, but I didn't experience any perceptible pain at all during or after the surgery. I never even had to take pain medication after discharge. I am told that this not normal, though. My suggestion to anyone else is to prepare for a moderate amount of pain at least.

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

It was a bittersweet victory for me. It was bitter because I knew that my old eating habits would go away and for good. Keep in mind that I was on a weight-management plan already through my nutritionist, so I was already losing weight. However, the surgery made it more of a permanent staple in my life. I wouldn't have the ability to overeat or to eat all types of food. That made me sad, since overeating was an ever-present vice for me. It was sweet, too, because my medical group would not set a date until I had lost a certain amount of weight. I wasn't entirely confident that I could lose the weight, but I did. So to get the surgery date really showed me that I could be successful in this weight-management affair after all.

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

The weeks after my surgery started a new life, and I felt every bit of it. Supported with my vigor to exercise and eat healthy, the weight really started to come off, and I noticed fairly soon after surgery that I was able to go much farther and do so much more without getting unnecessarily tired. I was really on a thrill ride. There were certainly emotional roller coasters, though. Mainly, there are times when all of us stall, no matter how much exercise or little eating you do. That's challenging, but it does pass, and you continue on with your progress.

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

My surgery was in South San Francisco, but we lived in Sacramento; that's more than 100 miles of traveling in one direction. Pre-operatively, I had several meetings and appointments to attend, so even though my co-pay for the surgery was embarrassingly low, the travel constant travel was costly. The cost wasn't a deterrent, though, either pre-operatively or post-operatively. It was an opportunity cost that simply was a fact of life.

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.

There were obvious surgery-imposed limitations on eating immediately after surgery. For the first month and a half, I ate soups, sugar-free pudding, and mashed potatoes. I had no meats whatsoever. Although I am aware that a large percentage of patients end up with an intolerance for dairy, I never developed that intolerance, although my dairy consumption did decrease dramatically, mainly from the knowledge that milk is high in calories. After two months, I was able to resume my 1,200-calorie weight-management plan offered by my nutritionist; it was was I followed before surgery. I was never able to eat up to 1,200 calories--more like 400 to 600 per day--but I did eat all the essential food groups that were listed. It was a constant struggle to eat meat, though, because it was so difficult for my stomach to process. Sugar was certainly off limits due to possible Dumping Syndrome. The first that I dumped was approximately six months after my surgery, when my partner was cooking dinner and mistakenly added sugar to one of the food items. When I ate it, within one minute, I felt intense pain on the inside, started sweating profusely, became lethargic, and ended up having to go to sleep to deal with the pain. I later identified that as dumping. Since then, I have dumped a few times, but it was also because something in my food didn't agree with me. It was never because I willfully ate something that would cause me to dump. Nearly five years out, dumping isn't as extreme as it was, but it's still uncomfortable and nauseating. At this point, I still follow my 1,200-calorie food-management plan and can, for the most part, eat 1,200 calories. There are days when I may exceed it by 300 calories, but most days, I only consume 800 to 1,000 calories per day. My dairy intake is still much lower than what it used to be, so much so that we now only buy half-gallons of milk. I have recently transitioned into being a pescetarian, which is like a vegetarian, except we do eat fish.

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

I was fairly active. I remember my surgeon telling me that simply getting exercise after surgery was not sufficient; I needed to get vigorous exercise--the heart pumping, the exhaustion, the sweating, the vigorous working out. Of course, he was not suggesting that I kill myself. He was simply suggesting that I needed to really focus on getting in shape. Currently, I study the martial arts still, though not as vigorously, since I am nearly in my mid-30s. I do exercise about five times a week and stay in good shape.

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

I don't take vitamins these days, mainly because I get all my nutrients through the foods that I eat. To ensure that there are no deficiencies, I have semi-annual lab work as well. I will occasionally drink a protein shake.

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 only side effect that I had was moderate hair loss at the front, top of my head. I keep a low cut, anyway, so it's not noticeable to most people. It's only when I allow my hair to go uncut for more than a week is when I can clearly see it. I am happy to say that I didn't have any other side effects.

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

The worst part was getting adjusted to a new way of eating, and I mean even pre-operatively. I had to follow a food-management plan that I felt was draconian and that I was not capable of following. Furthermore, I had to follow it for nine months. There were times it was difficult, but I must say that after the first two months, it became natural, and I no longer felt like I was cheating myself out of food. Five years later, it's as a part of my life as breathing. It does get better.

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

I have developed a sizable number of friends who have gone through the surgery, so we share tips with each other and cry on each other's shoulders when one of us gains two pounds. Ha! I have gone to a few post-operative groups, but I didn't find much value in them, because I heard a lot of complaining without wanting to find solutions. That's not beneficial for me.

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

My scars are almost imperceptible. Where the five incision points are darker spots. Nothing more.

Please describe any plateau experiences you have had since surgery.

I have had mounds of plateaus, too many to name here. But that's normal, you know? I would say that at five years out, I am at a plateau that I am comfortable with. My body is now used to the fact that I consume 800 calories per day and exercise so vigorously. I am at a weight where I am comfortable.

Do you notice people treating you any differently now?

What I have noticed is that people say that my self-confidence has gone through the rough. A few people have suggested that I am arrogant now. I wouldn't agree with that assessment. I would say that I know what I am capable of, and what I am incapable of. I am unashamed of what I have achieved and unapologetic about it. I know that I look good and am in the best shape of my life. I get a lot of attention from other people--that's a reality. I don't think that I am better than anyone else; I'm just happy that I am me again.