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

I work at a hospital, and a few co-workers had gastric bypass. I didn't know much about it at the time. I first heard about Lap-band on the television. I felt like it spoke to me. The lion was walking around and roaring and then a lady started talking. She was saying the same things that I was thinking. Then the television show Big Medicine came out on TLC...that's when I started to really research on it. My weight had plummetted up, and my endocrinologist and my family doctor was really worried. She gave me my surgeons name and said look into it. I went from there.

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

It was very easy, actually. I was surprised. I am 25, really young, and relatively no medical problems besides the polycystic ovarian syndrome. I think based on my BMI of 40, the PCOS, and no real medical problems, I guess they figured I am the perfect candidate. I think they thought that if I got the surgery, I wouldn't be bothering them down the road with any more problems. I'd say, put some trust in your doctor's staff. They will know the right things to say in order for you to get approved. And all of those steps you need to go through for a few months is tough and costly, but I think that it will be worth it in the end. For me the plus was to find out that all of the test came back great and I was relatively healty!

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

The first visit was extremely long. I met with so many people who asked me so many questions. I can't even remember all of the people I met. My surgeon was very nice and he was informative and quick to the point. He explained the entire surgery in full detail, drew me a picture and told me why it was going to work for me personally. I left there knowing he was the right surgeon and I made the right choice of surgery. My advice, bring a list of questions because once you are in there, you will forget what you wanted to ask. I know I had millions of questions, but I didn't write it down. Most answers I didn't find out about until I went for my pre-op appointment.

What made you finally decide to have the surgery?

The staff really convinced me that it was going to work. Plus I had my family doctor behind me, my endocrinologist behind me, and my gastroenterologist behind me. I felt like they were all saying go for it. You are young now, why wait? So, with all of my doctors, and of course my family, all behind me, I said this must be the right choice. I thought to myself, I will only get worse if I don't have this surgery. And if I had the surgery, the worst that could happen is that I stay the same, but maybe feel more healthy. So I went for it.

How did you decide which proceedure to have?

I knew from the beginning that I didn't want the full gastric bypass. I am young, and I am not as big as most bariatric surgery patients. My doctors were all confident that lap-band was the way to go, and with all of the research that I did, I felt like that was the right procedure 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 wasn't worried at all until I saw the EMMI program that my doctors office gave me. I watched it the week before my surgery, and that's when I started to get scared. It started talking about general anethesia problems, and general operation problems that no one really mentioned in all of my appointments. But, I realized, that's probably what they say with every surgery. I just put my confidence in the surgeon, the hospital and the fact that I am young and for the most part healthy. That is my advice to others...put trust into the staff because they know what they are doing.

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?

At first I kept it a secret. I didn't want anyone to know. Especially until I was sure I was having it done and I had a surgery date. My family has been by biggest support. If it wasn't for my parents standing by me, I don't think I would have gotten the surgery. Then I told some of my really close friends, but I didn't really want to. Most of them are thin and they don't understand the struggle I have been through. Even when I told them, they automatically said "why don't you just diet and go to the gym". I felt like they were saying that I was taking the easy way out, but I wasn't. I had to really explain to them my struggle over the years that they didn't know about and that what might work for them, definitely didn't work for me. They finally came around and have defintely been very supportive now that its over. But I really don't wan't alot of people knowing. It's personal, and I don't want to be under a microscope. I don't want comments and people watching everything I eat, so I chose not to tell alot of people. Maybe once I start losing the weight, I will have to courage to say I had it done. We will see.

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

My company hasn't been the best support, unfortunately. For being a hospital, I am very surprised by that. All they were seeing was that I would be out of work for awhile. They didn't look at it in a positive way. I was told I would be allowed to go back to work withint 2-4 weeks. My employer said don't come back until you are completely healed with no restrictions. So I had to go on short-term disability. I am going to return on August 26th, 2008 if occupationl health clears me. That will be a total of 6 weeks out of work. We will see what happens.

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

I had the best hospital stay. I was there from 5 AM on surgery day until 5pm the next day. The staff was excellent. Very caring and very attentive. They definitely knew the meaning of patient care! I brought a small pillow, which came in handy for getting in and out of bed. I brought a bath robe, brush, a change of clothes to go home in, deodarant, and slippers. Everything else I needed, they gave me. The nurses were excellent. They were so encouraging. They would always tell me that I was doing so terrific and that they were proud of me. They made me feel good even though I didn't feel good. Everytime I went for a walk they would pat me on the back. It was defintely a great experience, and now that I was a patient, I know and understand what my own patients feel when they have to be admitted to my hospital.

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

I didn't have any real complications. My surgery went flawless. I did have a problem with my electrolytes the next day, so I had to get an extra bag of fluids with magnesium and other electrolytes in it. After that I went home. The only other problems I had were the IV's. Both of mine infiltrated. But if that's the worst that can happen, then I was okay with that.

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

The first week was defintely the hardest. I was in alot of pain. It was hard getting in and out of bed, so my mom had to help me. It was also hard to find a comfortable position to sleep in. I ended up propping pillows all around me to try to get comfortable. That was pretty much my only anxiety. I just took one day at a time. Besides not sleeping alot, the worst problem probably was the liquid diet for two weeks. I didn't feel satisfied and I was always hungry. The cravings were the worst. After the first week was over, I finally got over the cravings and the second week was alot better.

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

The first week was the hardest, but it gets better day by day. I made sure I walked as much as I could every day. That is the key point. Walking makes you feel better and heal quicker. You should expect to feel hungry all of the time. The first two weeks of liquids are defintely not satisfying. Especially if you live with someone else who is not on your diet. It will be challenging. The second week, you will probably feel more like yourself. You will want to walk more and do some normal things that you can tolerate. By the third and fourth week, you should finally be in a routine and if you have a non-physical job, unlike me, you will probably be going back to work. That may be good for you because it will keep your mind off the pain and keep you energized.

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

I traveled about a 20 minutes to a half hour to my surgery. My surgeon and his staff has their office right in the hospital where the procedure was done, so the commute is not the best, but it is well worth it because he has a great staff.

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.

The first two weeks was liquids, which had to be no sugar or just a few grams of sugar. It was hard getting all the protein in, the fiber in, all of the vitamins/pills in, while at the same time getting enough water in. Very challenging. I was extremely happy when those weeks were over and I was able to eat pureed foods which was the second two weeks. Again, I had to watch the sugar, but it was more satisfying. You can pretty much puree anything! Those first two weeks are like a clean-out. By the time you get to puree, you don't even crave all of the bad things you used to eat, so it is a little bit easier to watch what you are eating. I haven't had any real problems with any particular foods just yet. The only issue I seem to have is drinking a half hour before and after I eat. I seem to not get enough fluids in during the day. That is going to be a challenge for me, and maybe you too. The next two weeks is the soft diet. This makes you finally feel like you are normal again. You can eat alot more during this phase as long as you chew well. For me, still, is making sure all of my fluids are in because I am always hungry since I haven't had a fill yet, and so I am not drinking a whole lot. After the soft diet is regular diet. You still have to watch what you are eating especially the sugar and carbohydrates. Here you may slip back into your old routine. I am doing my best not to do that, and so far so good.

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

I jumped back pretty quickly. Three hours after surgery, I was already up and walking around. Personally it made me feel better walking around in the hospital and not laying around in the hospital bed. I kept that mentality when I went home. I did laps around the house. I started slow, only being able to do maybe 5 minutes at a time. Now I seem to do 15-20 minutes at a time. It gets better as long as you keep moving.

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

Since the surgery, I have been on calcium citrate, ferrous sulfate, and women's one a day multivitamin. The dietician said I will be on the multivitamin and the ferrous sulfate for the rest of my life, but if I can eat/drink enough calcium in a day, then I won't have to take those pills anymore.

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?

Sleeping probably was the worst problem for me. I was restless and exhausted all at the same time. I couldn't find a comfortable position in bed, and the way I was sleeping ended up causing back pain for me. So every few hours, I would get up walk around, eat something, and then go back to bed. After the first two weeks, I was finally able to sleep about 5-6 hours without getting up and walking around. By then I was also able to sleep partially on my side, so that took the weight off my back. Now, I am doing alot better ith the sleeping.

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

The worst part for me was not being able to go back to work and do the things I was able to do before. I am not used to just laying around and resting. I am an on-the-go kind of person, and not being able to do much made me restless and more tired. After a few weeks, I was able to move around more, drive and do little things here and there. That's when I started to feel alot better.

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

I go the lap-band support group here and there which is offered at the Center for Weight and Eating Disorders in Philadelphia. It is associated with the surgeons office, and the dieiticians/nutritionists from my doctor's office are usually the speakers there. So it is easy to go because it is the same group of people that are working with you in the surgery process. It was helpful when I was considering the surgery in the beginning. But I don't go so much anymore.

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

I am still healing, but right now, it doesn't look so great. I have still some bruises. There were 6 incisions, but the biggest one (where the port is) causes the most discomfort. It catches on my shirt and seems to bump into everything. I am hoping in time they heal a little better and hopefully wont be alot of scarring in the end.

Please describe any plateau experiences you have had since surgery.

I haven't had any just yet. Maybe ask me in one year.

Do you notice people treating you any differently now?

Initially people were always asking how I was doing and sending me cards, flowers and letters to keep me going. That was really nice, and new for me. I never had so much attention from my friends before, so it is a nice change. I haven't noticed them treating me any differently now. Maybe when I go back to work I might notice those things.