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

A meeting where Dr. Benotti was the speaker on the topic of bariatric surgery and where audience participation revealed emotionally penetrating and strongly determined viewpoints enabled me to decide that he was the physician of choice. The fact that while Dr. Benotti had participated in some laparoscopic surgeries, he currently offered RNY Distal as an open surgery (only) determined the specific surgery.

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

Really, take advantage of having a Sleep Apnea study done. A positive diagnosis requiring use of CPAP or BiPAP may become the cornerstone of success in major surgery. My CPAP machine being used now for over 10 years was allowed by the Doctor to be used during post recovery room and later periods of in patient stay. That in turn led to good breathing habits being attained at the earliest possible moment. (Deep breaths are not without some pain immediately after surger, but the CPAP at 15 helped exercise my body into regular, deep breaths.) The Sleep Apnea condition certainly correlates while to insurance approval for clinically morbid obese condition.

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

Don't raise insurance questions.... Just DON'T.

What made you finally decide to have the surgery?

Quality of patient experiences expressed in bimonthly open-to-public forums.

How did you decide which proceedure to have?

The doctor. Dr. Benotti only does one procedure and he only does it in the open surgery format (not laparoscopy).

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?

Even now as the hour approches, there is little fear. I have put in place the patient choice as regards NO artificial means of being kept alive and have named my wife to make a final determination if I am unable to do so. Our lives are not only for ourself to determine. In fact, little occurs from our efforts. At least 95% is the working of a higher Cause (whatever that "Cause" is named-- God, Jesus, Mohammed, Budha). We did not choose our birth country, the freedom or lack of freedom, the environment in which we were raised. My search was for a good man that knows his work and has confidence as seen through the attesting of those who are his patients.

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?

Skeptically. Some close friends, including a highly thought of RN, opposed it based upon a patient of not so long ago who had a similar operation (but different type).

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

That I was having surgery to handle my overweight condition was an immediately understood serious choice on my part. Initial plan was for a 3-week period.

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

The purpose of a stay in the hospital is... to be the recipient of the best possible level of care and patient well-being through the hospital's optimal use of human and technical systems of delivery, incorporating best practices and the latest technology available, in order to better insure the best possible professional, skilled- and non-skilled-care in the most optimum setting for delivery of such service. How quickly one gets out may be one good measurement of success. My stay was just 3 short days. The most important thing to bring is yourself in a state of mind that all is OK with the cosmos, the world, the nation, the community, your family and yourself. Certainly, none of my possessions brought with me the day of surgery (not even the clothes on my back!) were made available. With the explanation that my exit from the recovery room would be to an ICU room to which no personal belongings would be taken, all things brought either on my body or in my overnighter, were placed in a locked security locker for my wife to carry home upon her return later on the day of surgery. Indeed, once transferred to a "regular" level of care room, personal matters could at that time be delivered for my use. But that was not in the plans for at least one over-night period after surgery. Thus, one presents himself/herself on the stage and all lights are following his/her every move. Finally, the difference is not in the size of any act but of the actor. That is, there is no such thing as a small or large act just small or large actors. Every act is equally important regardless of the skill set used by the deliverer. In the ICU after exiting the Recovery Room, a highly qualified ICU nurse, Cindy, did her best to meet every imaginable need. But the Doctor had left instructions that Cindy have me sit up and "dangle my legs." Well, Cindy was very small in stature and overall size. When placing her arm under mine, she offered an assist to my gaining a seated position with my legs over the edge. At first, I declined stating that I would do better trying on my own. But I knew her determination was that I would dangle my legs. And I did with her boost. Then, she asked if I would try standing. Once gain placing her arm in a locked position with mine, I quickly said, "No!" I just did not believe it would happen. Then, Cindy asked for a very young man to give a hand. The man was really not more than in his teens. I remember asking if he had been doing any weight training. Not exactly. But the kid held out his straightened arm. I clasped his hand and away I went into a standing position. That, on the first eve of surgery, made all the difference. I knew I could handle what had been received. The next day, I moved myself into the dangling legs position and then stood without any assistance. I moved my feet in place while being very careful to use a chair back for continued balance. I was moved from ICU that afternoon (the day after the surgery) and even gained my nutritionist's agreement to see me two days later before noon or miss me as I would be out of the hospital by noon of the the third day. Be confident that a standing ovation will be received as the curtain finally closes. Indeed, one is very conscousious of the new consciousness upon exiting the hospital. The purpose of life is clearly that a new self can begin accomplishing the next act in a multi- multi- multi-act play hopefully with even a better sense of relationship of oneself to the cosmos, world, nation, community, family and self.

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

None.

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 to become a new being. I rationalized that my body as I knew it had been more like a house where I was banging on the door to get out even while my comforts within the "house" were OK. So, my surgery was indeed looked upon as the real "first day of the rest of my life." Two and one-half weeks out from surgery, I attended a 3-day conference in Washington D.C. Social interactions that included active group discussions as well as banquet style food service were somewhat of a chore. But the effect of hybernation where some post op patients sense their body "closing down" and find a need to withdraw into no activity and increase their sleep time was avoided. I had ever more motivation from the increased interaction.

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

Regular morning activity was guaranteed by awaking to drive my wife to where she caught the bus to her job in NYC. There is need to be disciplined. There is nutrition to be gained along with 6 cups of liquids to be consumed. And early morning routines of preparing the nutritional supplement (like Carnation Instant Breakfast but not CIB, rather MET-Rx) for the first two feedings, got the day rolling. And then I poured myself (too many liquids?) into preparing a website, http://communities.msn.com/metnews It is so important to stay busy...

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

Englewood Hospital and Medical Center is within 20 miles of my home. So, there was no affect on my aftercare.

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.

Dietary tolerance was without any limit except my own self imposed limits. I never experienced nausea or vomiting. But the best recommendation for high protein consumption was cottage cheese, and so I ate many cottage cheese portions topped with three or four fresh strawberries. I stopped eating before sensing being too full. I used only none sugar additives to water, like Crystal Lite. I stuck to soft foods such as cottage cheese, fish and vegetarian dishes.

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

Within the day of surgery, standing in place. One-day post op: standing and walking in place. Second day post op: walking the floor of the Hospital; third day post: discharge included walking out of hospital and to the car in the parking lot (from where my wife drove us home). Fourth day, walking in community. Fifth day, walking in Church and at indoor mall (because of high outdoor temps). Sixth day: Return to office for brief visit and walking. Seventh day: 2-hour walking. Eighth day, plan to drive to first post op doctor visit, walk and talk and get elevated to soft foods and nutritional supplements. Who knows? An appearance before Congress, pressing for more funding and support of clinical morbid obese study?

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

I strongly endorse MET-Rx (www.met-rx.com) engineered foods as the total nutrition drink mix. Created and marketed for over 7 years according to the GNC store manager where I purchase it, the Founder and Chairman of MET-Rx Engineered Nutrition is A. Scott Connelly, MD. "A. Scott Connelly, MD is a critical care and metabolic specialist. He has studied medicine and nutrition for over twenty years, including studies at some of the finest medical institutions and universities in the country...." In the most frequently asked questions, one stands out, "How is MET-Rx different from a meal-replacement product or other general-purpose nutritional supplement?" One sentence of Dr. Connelly's answer states: "MET-Rx is more than just a load of dietary calories; it's a PRECISE nutritional tool we can eat with foods to ensure the body gets all the positive nutrients it needs." I used MET-Rx for four weeks before surgery and maintained an 1800 calory level or more "diet" (but well less than the 3000 calories I could eat for my weight and height (355 and 6'1") at a weight maintenance level). So, day of surgery found me weighing in at 345 pounds, down 10 pounds from my last pre-surgery visit weight of 355. The "pre-conditioning" was completely my own addition to the total plan. And MET-Rx is my newly found reference. Besides 4 daily servings being done post-op, I do take a 100 mcg B12 tablet every other day. I can only offer that a 3-day hospital stay was the best as regards shortness of in-hospital stay ever achieved during the nearly 1000 Gastric Bypass surgeries performed by Dr. Benotti. Indeed, everyone seems very impressed by my continued good performance after RNY distal with open surgery. Could "same-day" laparoscopic be far ahead?

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?

None. As at day 5 post op... And still none, at end of fourth week out from surgery.

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

The recovery room procedures upon first coming out from being under anesthesia.

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

Doctor encourages his Obesity Support Group. Fine group with opportunity to meet with the doctor.

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

Too long. Not exactly what I expected. And after nearly 8 years out of surgery, the not easily observable scar is truly less than 4 inches as was originally described by the doctor.

Please describe any plateau experiences you have had since surgery.

Too soon... Key to not experiencing plateau experiences would seem to be a recommendation of varying the calory intake. I flip a coin. On heads, I go with a daily limitation of 900 calories. On tails, I go with 1400 calories. This is on basis of only being 4 weeks out from surgery. And now at nearly 8 years out from surgery, I really do not have any indication of weight regain. From a low of 185 pounds, I have remained in the 190-205 range. I have not ever needed to restrict calory intake in order to stay within the 15-pound range. As exercise levels increase in summer, my weight normally returns to about 190. My goal weight for my height and bone build should be 185, but I have not given that too much attention.

Do you notice people treating you any differently now?

No. Not yet. And now, after nearly 8 years out of surgery, no one even remembers the "other me."