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

My pcp told me about the possibility of surgery. She did the research for me. When I found that Medicare would cover it, I was at least open to exploring it. I had been so depressed, I had gotten to the point of telling my pcp that if I could not get some kind of help, there was no point in going on. I could not physically live this way. I was so miserable, and helpless, and I was prepared to end my own life if there was rationally nothing anyone could do. I did not want to die like my mother, and I did not want this narrow, strangling life holding onto crazy, ineffectual notions that "God will help if you pray enough" or end up in some grouphome because I couldn't walk any more. I wanted a reality based on my ability to control my life. I couldn't do it on my own. Surgery as an option was definitely an eye opener. I had never considered it. I knew it existed. I wasn't stupid like some people who think it's "the easy way out". I knew there was more to it than that. So, I started researching it at the library. There isn't a whole lot at the library. So I got on the net. The more I researched it, the more I realized that this was what I needed to do. I had lived with doing it "au naturel" for 40 years. I knew my limits. I also knew that I was at that magic age to start getting the family curses-heart disease, diabetes, and lung disease. The only way people got skinny in my family was when they got sick and then shrivelled up and died.

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

Medicare. I was lucky. BMI of 69, and co-morbidities of apnea, hyperinsulinemia, high cholesterol, osteoarthritis, incontinence, lymphedema. The things I would advise anyone considering this surgery is this: get your ducks in a row-1. Document your weight and health problems with current test results, and if a problem shows up, such as a heart problem, take care of it. Keep a copy of all of your tests. The usual tests for the surgery varies with insurance and doctors, but usually include basic blood work, heart tests, and a sleep apnea test. 2. See a counselor. Not only will this be good for any pre-surgery tests you may need because a counselor could write a referral explaining you understand and can follow post-op requirements of the surgery, it will give you an opportunity to work on issues you have with self esteem, past traumas, and your own maturity. Pick a counselor according to who your insurance will accept and who you feel will support you in your goal of surgery. 3. If your insurance requires recent proof of an official diet program, either through a hospital program, your doctor, or an organization like Jenny Craig or Weight Watchers, start it now. Usually you have to be on the program 6 months. I think this is bogus of insurance companies, because I can lose weight-I just can't keep it off. Some people do the program, and fake it-purposely work at not losing weight, but I have a problem with that. It's up to each person to decide what to do. I would see if I could change insurance to one who would fairly cover the surgery. 4. Start checking out wls surgeons and hospital programs you know your insurance has covered services for. This web-site is a good one to find out about insurances if you don't want to alert the insurance company that you're researching the surgery. Many surgeons have long waiting lists, and if one doctor you like a lot has one, get on it. It's always good to start interviewing asap, even if you have to pay out of pocket-it's kind of like buying a car-you sometimes have to put out some bucks to get the deal you want. 5. Finally, keep track of all of your costs, and match them to insurance payments. In this day and age of computers, it's easy to get double charged, or charged for something that was never done. When you get your surgery, have your significant other help you keep track of what was done and when, and when you get the bill, check it carefully. If you have a lot of questions about it, make an appointment with the billing department to go over it with you.

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

My first visit with Dr. Richard Thirlby at Virginia Mason Hospital in Seattle was in July 2003. He trains people in this surgery, and even though I was an hour early, my family and I were ushered right in to see the resident. He was a very nice and thorough young man. Dr. T. came in, and I knew right away he was serious about this surgery, and he questioned me carefully about my understanding of some of the side effects and possible complications. He wanted to make sure I didn't have unrealistic expectations, and that it would require my compliance to the aftercare for this surgery to be successful. My family kept him answering questions (they remembered stuff I had forgotten). I wish I'd had longer, but he did geve us a long time.

What made you finally decide to have the surgery?

The fact I'd tried everything else, and that I was deteriorating healthwise. I'd hit the magic age in my family of 40, and I have high cholesterol, lipids, first signs of diabetes, lymphedema...and at the rate I was going, I wasn't going to see 50. Knowing myself as I do, and understanding I was going to need help, wls was the best choice I had. Not perfect, the best.

How did you decide which proceedure to have?

Because I already have a problem with anemia, it seemed rny was the way to go. It's also the only wls my surgeon performs. He's done 1000's of them. Also, the rny will alleviate my GERD, whereas DS seems to cause it.

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?

One should be afraid. Especially if they haven't had surgery before. The risks of dying are similar to other abdominal surgeries. I used to work at a hospital...I knew of people who had died of simple gallbladder surgery, people who were healthy. People have stroked out giving birth. All procedures have a risk. One has to really weigh the benefits vs. the risks-is living my life the way it is acceptable to me to avoid that small but very real risk? For some people it is, and bless them. For those who chose to go through this surgery, it will have benefits you can't imagine. I encourage anyone considering any life changing choice to consider every angle of all of one's choices, and from one's center. Make the choice for yourself and not based on what other's opinions are and that includes spouses, parents, and children. Anyone "selling" a viewpoint needs a quick boot out of one's space, too-the choice must come from one's wisest self without interference and the best info one can get. And no matter which way you go-you GO! You live life the best you can!

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 and friends have been very supportive, except for a few blurps. Even the blurps have come around when they become more educated as to what's involved.

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

Noy employed.

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

I was at the hospital from Thursday afternoon to Sunday afternoon. It seemed only a certain amount of the staff were very familiar with WLS patients, and I was lucky to have the same nurses every day until Sunday. The bed was awful-typical hospital bed. I asked for a fan, and was provided with one. I brought some personal things, and except for my contact lenses stuff, really didn't need to. Everything was provided. The biggest frustration was that when I needed a nurse, I wasn't able to get one right away on day shift. I waited 45 minutes in pain until I even got an aide on the second day. Night shift was much more responsive.

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

The epidural came out during surgery, and I woke up in horrible, awful pain. It had to be put back in the post-op, and I was put back out until it took effect. Also, I was started on a lighter dose of fentanyl than I needed and I was in awful pain on day 2. The nurse who handled that didn't understand why but she fixed it.

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 on an awful rollercoaster of emotions, and I had great anxiety about dying during the surgery. I knew how serious the procedure was because my mother almost died trying to get the procedure done (under anesthesia, her heart had stopped, and the priority was get her breathing-the doc did so, and sewed her back up). During the three months until my surgery, I, for the first time in my life, lost weight due to the worry and stress-21 lbs. I did breathing exercises and stretching, walking as much as I could, just to get in better shape for the surgery. Sometimes, I meditated. Sometimes, I just drove around.

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

My pain control problems in the hospital weren't set-backs-because I was walking right after I got to my room. The catheter was out the next early afternoon, and I felt pretty good. At home, my care network fell apart, but because I was getting around so well, I decided to just take care of myself, and use those friends and family already lined up to do chores for me to help with things like take out the garbage and recycle. The first week was a challenge when I tried to do as the dietition advised, and it was difficult getting all of my water in and aiming for enough protein. I just reminded myself that I was nutritionally enhanced and I was going to have a learning curve in sticking to a meal schedule. At 12 days, I got the schedule working for me. The first week home, I did well-took pain killers as needed and using just ibuprofen after 3 days. I weakened easily, so I rested a lot, but made sure I walked and stretched regularly. Every day, I improved by leaps and bounds. 12 days after surgery, I had lots of energy, was off of pain meds, and was ready to climb the walls. I felt stronger at less than two weeks post-op than I did before surgery.

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

84 Miles, one way. It was not easy, because I had to have my niece drive me for my pre-surgery appts., and to surgery. Afterwards, I planned on using the bus, which cost me more money than I could afford as I'm on Social Security, and a very limited income.

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.

I have tolerated everything well, and could handle dairy much better than before surgery. The biggest change was in my sense of smell-almost anything odorifous made me nauseous. One thing in the beginning that was my biggest nono-SUGAR. Instant dumping, and stronger than before the surgery.

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

First ten days, I was weak but improved steadily day by day. By Day 12 I was in good shape. I felt I had more energy than I did before the surgery. At first, I was able to get myself food, go to the bathroom, make my bed-the most immediate concerns. As I got stronger around day 6, I started in on a few chores-do dishes, put laundry away, sweep up-it was do a bit, rest a bit, but I did it. To do a shower at this point took an hour and a half, and naptime. But with speedy healing, I was doing loads of laundry, shopping, and going out with friends and feeling vey energetic by day 12. But I think I'm a fairly rare case.

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

Children's fortified chewables, B-complex, calcium chewables, and a multi for hair and nails to forestall hairloss.

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?

Any sleep disturbance was due to the incision-ITCHY. I slept as well or better for a couple of weeks as before the surgery. No vomiting or nausea. One episode of dumping, but it was no worse than before the surgery.

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

The not knowing exactly what to expect until it happened. I had never had abdominal surgery, so I worried excessively. The worst part for me was getting the epidural in-it was weird and the sensation was unpleasant. Kind of creepy.

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

The Bellingham WLS Support Group was my emotional support as well as the ObesityHelp website. I had one post surgery visit with my surgeon to get the staples out, and three with the dietition. It was pretty bare-no long term classes or visits, but I felt I had enough info and support from peers and family to do it myself.

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

I am two months out, and I got the scar I expected-a long thick rope and a keloid at one end. I was hoping I would scar this way-but that's what usually happens for me. I am hoping the further out I get, the flatter it will become. If not, I will look into laser surgery. (At one year out)The scar is still red and ropey, though one end has flattened out. I'm very hesitant about reconstructive surgery because of this experience, yet the excess needs to be dealt with.

Please describe any plateau experiences you have had since surgery.

The plateaus starting 7 months past my surgery. My weight would fluctuate 10 pounds or so, and scare me, yet my body kept shrinking. During one plateau, about 9 and a half months out, I didn't lose weight, but I did lose a size and a half in clothes. The weight loss goes something like this now (and has for the lat couple of months-I'm one year out)-no weight loss for a couple of weeks, and then a sudden drop of 5 or 6 pounds in a week. It's very frustrating. Especially as I had lost so quickly in the first six months.

Do you notice people treating you any differently now?

People don't call me as much. They are uncomfortable about the fact I can't eat and keep pushing me to eat. I am surprised and disappointed. Also, one friend's comments on my weight are getting ruder and I am not sure how to handle this. My family, on the other hand, have been great. (One year out)I don't notice much difference now. Friends have gotten used to the changes, and now old aquaintances are commenting continually on the loss, which can be irritating, as I have so far to go.