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

My PCP talked to me about gastric bypass at 42. A combination of wanting to lose the weight on my own, fearing my kids would think surgery was the only way to not be overweight, and my employer annually changing insurance coverages discouraged me from twice seriously considering surgery as an option. The third time, I decided I needed to do this to extent my life and not worry about other factors.

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

Insurance approval came exactly as the insurance requirements stated. i had to learn the rules of engagement and play by them, no exceptions or shortcuts. I got a medical recommendation for the surgery, then I had to meet every requirement. I read the coverage and the requiremetns and took the lead for getting everything completed, submitted, and processed. Most of the time, the doctors and staff appreciated my help/efforts and sometimes I had to push to get things done in a timely manner; especially the records from previous doctors and specilaists and the ever painful 6 month medically supervised and documented diet and exercise plan.

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

An informational seminar was required before an appointment with the surgeon was permitted. I think it was a screening process for the best potential patients, the order of pateints with the most need, and those able to be insurance approved. Actually I attended two seminars because the first one got me an appointment with a surgeon that strongly pushing only the lap-band gastroplasty, which I didn't want. After deciding I wasn't going to pay for something I didn't want, I changed surgeon and was relieved and excited with the information from Dr. Hutcher and his Commonwealth staff's seminar and approach. the first appointment was even more comforting and self assuring I was making a good choice.

What made you finally decide to have the surgery?

Finding Dr. Hutcher, his philisophy toward the reason for the sugery, his technique and process for performng the procedure, and his thorough game plan for pre-op and post-op care.

How did you decide which proceedure to have?

Dr. Hutcher performs open RNY because it allows him to perform three tests to ensure there are no incision leaks whch is the leading cause of post-op complications. He also removes the gall bladder because that usually has to be done later in most WLS patients anyway. He also serves the stomach nerves and does a liver biopsy while inside. I felt it was the most band for the buck. His logic made excellent sense to 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 feared my heart malfunctioning during surgery as a potential for my not surviving surgery. I talked to my wife and kids before and why I was making this choice. I wasn't going to live long-term without this procedure. So I saw it as a choice to live. If death occurred, it was what was meant to be. If I was making the right choice, life would be the results, and hopefully much longer than it would be without the surgery. I was having stomach surgery to cure the heart problems I had brought on myself from the weight. If I had been told to cut my toes off to fix my heart problem, I would have done that instead.

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?

Because of my lifelong activity and involvment in community, church, and family and recent withdrawal from such, most everyone seemed to understand about my decision to have gastric bypass, except a few that thought I should be having heart bypass instead. I was only really concerned about the feelings and understanding of my immediate family. My wife was the hardest sell but she is also my biggest support.

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

My pre-op health was causing absences from work. My employer understood this was my effort to get better and was supportive. I also completed my assignments through the month I planned to be out on sick/medical leave before I left and completed an emergency assignment to bail-out another department before I went out. That didn't hurt my employer's attitude toward my being out for a month either. I was out of work 4 weeks rather than the recommended 6-8 weeks because I have a desk job. If I had it to do over, I'd stay out 6 weeks. Even being attentive and productive at a desk job is difficult with the physical loss of strength and stamina from the open surgery and the low caloric intake.

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

Hospital stay was an adventure. Three days was my initial stay. I went home for 5 days then back to Er and admitted for 5 more days because of complications (no fault of the surgeon; body functions were happening correctly). What to bring? An easy to clean and manage haircut, a cooperative and obediant attitude, the desire to walk post surgery, and maybe some spray deoderant.

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

Complications: During the initial three day stay, my blood pressure fell the first day and they pulled the epidural within 8 hours of the surgery, which included the planned pain medicine. Plan B wasn't nearly as effecitive in personal pain-relief. Later, we discovered I was now totally lactose intolerant, and that included the three Carnation Instant Breakfast and the milk it was mixed in I had consumed. That caused most of the bloating and gas I endured. It wasn't unitl I got home that we figured out the allergic reaction problem. After 5 days home I came back to ER and was admiited 5 more days. I was completely dehydrated with sores on my mouth and nose, my stomach and one kidney weren't working, and I had developed pnuemonia in one lung. Going back to ER was the worst. I felt like I had failed. Everything that happened was no one's fault and the discomfort was unpleasant but bearable. After the second stay, I have been doing as well as scheduled.

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 excited and pumped about getting the surgery behind me. I had a pause or two about why am I doing this, and maybe I should cancel but it was similar to cold feet before getting married; I shrugged it off as crazy and kept preparing and doing what I had been dirrected to do to be successful. When I got concerned, I'd come to OH.com and read of other's successes, especially the before and after pictures.

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

Get the protein and water in. Experiment within the doctor provided guidelines and find what works. Soft foods are coming. It helped me that I Dr. Hutcher and staff had eductated me that normal food wasn't an option for 3-4 months so don't even think about it. it works. I had no hungary and no cravings.

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

I hhd to travel about 30 miles to the surgeon's office, which is adjacent to the hospital. It takes about 45 minutes to get there because of Richmond city traffic, even on the interstate (I-95). It makes aftecare from the surgeon more of a challenge but they have good phone support and I had OH.com and its members too.

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.

Phase I diet: I learned shortly after getting home that I had become lactose intolerant. That was the biggest hurdle. I used GNC Zero Card Isopure for protein at 50 mg per serving and Boost Diabetic (Chocolate only) ordered online from Walghrens became my friends. I ate alot of ice and drink water. Popsicles and flavored drinks began to taste acidity and nasty with to days so I quit using them. Beef broth and pureed chicken and rice soup sustained me toward the end of the third week of the liquid portion of the process. Phase II was soft foods. Yogurt with protein powder mixed in sustained me. I also used sugar-free instant pudding with protein powder. Instant potatoes with lactose free milk and butter buds flavoring was good but not much protein so I'd mix in about 8 oz of fine shredded mozzarella and maybe a tsp or 2 of shredded cheddar per 2 servings of potatoes. It usually takes 30 minutes per 8 oz of food to eat or it doesn't stay down. Phase III boiled/baked/broiled white fish, checken, tuna, shrimp, and imitation crab. YAHOO!! I struggle with chicken. About 2 to 4 oz serving and it sits in my stomacjh and throat for 2 to 3 hours. That makes it hard to get my water consumed. Imitation crab goes down best but it still must be eaten slowly. Boiled egg whites also go down well.

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

I am currently 6 weeks post-op and still struggle to keep pace. I start out the week OK but fizzle as the weekend nears. I just have to pace myself and go at my own rate. I never really slept a lot as it was 4 weeks before I could sleep for longer than 4 hours at a time withnout pain medicine at night. I walk for exercise and do some upper body weight lifting with dumb-bells at home as I am not to lift over 10 lbs for 8 weeks after the open RNY. I am also reminded that because of open RNY, it will be 6 to 8 weeks before my energy level recovers from surgery and adjusting to my reduced caloric intake.

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

The game plan I was given and am adhering to includes: 1. a sugar-free multivitamin with 18 mg of iron (Flintstones) twice a day 2. 500 mg of B12 once a day 3. Vitamin A&D once a day 4. 18 mg childrens aspirin once a day 5. Zantac (or generic) 200 mg once a day at bedtime Calcium citrate supplement is to begin 3 months post-op

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?

Worse for me was the inability to sleep more than 2 hours at a time the first two weeks. It improved to 4 hours the third and fourth week. By the end of the fourth week I could sleep through the night without pain medicine. I wasn't having pain after the third week, but I did use the pain pills to sleep better. I haven't had vomiting (until eating chicken too fast), nausea or hair loss at this point. I had a dumping experience once that wasn't plesant, after eating crushed pineapple. It had too much natural sugar.

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

The pain management options provided after the ephidural was removed at the hospital those last two days of the intital three day hospital stay was bad. But the worst was getting so weak from dehydration and pain from bloating before I went back to the ER and learned my stomach and one kidney wasn't working. I was about ready to close my eyes and quit before they got me pumped back up and processing again. That was a one day experience. Three days out of 6 weeks is acceptable to me for the amount of cutting I experienced and the 71 lbs I've lost.

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

I have 2 week follow-up visitis with my surgeon for the first three months. I attend support group once a month but it is available weekly at the hospital by my surgeon's staff. I also have the support of reading OH.com and the experiences and pictures of the members. This is all extremely useful and encouraging to me.

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

I have a 6 inch vertical scar that is far less obvious than I ever imagined. By the time it heals and turns more pink than red, and my belly hair regrowths (was that too much info??), it should hardly be noticeable.

Please describe any plateau experiences you have had since surgery.

I lost 33 lbs in three weeks and 4 lbs the following two weeks. I was very concerned. I was reminded during my 2nd follow-up visit that the weight loss is not consistent from week-to-week. Stay with the diet and exercise program and the weight will go, usually in bunches at a time, then it slows down again.

Do you notice people treating you any differently now?

I haven't noticed people treating me differently but I am only down to 337; still a big guy. I have noticed, driving, I don't need the seat all the way back and the steering cloumn all the way up to drive, going from a 60 to a 54 pants, cutting additional holes in my belts to keep my pants up, my sleeves and collars in my shirts having room, and getting anew jacket for fall, a size smaller (4x to 3x) and its a little baggy. All good things.