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

I had the same uninformed impressions that you hear everywhere. Then I heard about Roseanne's TV program on the Fobi pouch and began researching wls. I learned that it could be an answer for someone like me, and that it was much improved from earlier horror stories.

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

I had an unusual case in that after being denied the first time by United Health Care PPO, my employer intervened for me. We are a self-funded plan and the employer has ultimate control over the payment of such claims. I talked with our Personnel people and basically asked them if they wanted to intervene now or if they wanted me to get legal help and go through an appeal process with United. The Personnel director was very helpful and said that I would probably win an appeal but why waste all that time and effort. My employers contacted United immediately and directed them to pay for the surgery "out of contract". I encourage people in self-funded plans to approach their employers if they can't get satisfaction with the insurance company.

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

I was overwhelmed by her knowledge, her compassion, the amount of time she spent with me and her instant grasp of my situation. It was such a positive experience that I didn't have to ask the 49,000 questions I had -- she answered them before I asked. In case you don't have Dr. Rose Marie Jones: research all the surgeries ahead of time and go prepared!

What made you finally decide to have the surgery?

I had decided, immediately upon discovering the possibility of surgery and learning a little about it, that nothing was going to keep me from doing this. I can't wait to get in that hospital and get going!

How did you decide which proceedure to have?

My surgeon suggested the RNY after learning of my heartburn/GERD problems.

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've had several major abdominal surgeries. I don't think I have any fears!

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 husband is still unconvinced that this is a good idea, but he is willing to support me -- like he always has. I'm still pre-op; I'll write more after surgery. OK, I'm now 6 months postop. I don't think I would have/could have done anything differently because I had no idea what this would be like. I have lost my weight so rapidly that nothing could have prepared me. I did not tell anyone but my immediate family and still have not done so. I have told people that my surgery "corrected a gastric problem of long standing duration and it required me to change my eating habits drastically." All true!

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

See above for what I told people publically. I did tell the Personnal director at work so that my company could intervene for me with insurance. That was a positive experience and I had immediate assistance from my company. I was out of work for 2.5 weeks after my open RNY.

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

I was in the hospital 5 days for an open RNY. My surgeon has RNY patients spend the first night in ICU, then the next day go to a regular room. I do not remember being in the recovery room at all - I woke up in ICU. Help was there immediately to get my pain pump working. After a couple of hours a nurse helped me out of bed for a walk. This occurred three more times in ICU. In my regular room the next day I still got good attention and assistance. The one thing I believe I did wrong was not walk enough. The day my pain pump was removed and I went to pills for pain, I was very uncomfortable and did not walk much. I think that is why I ended up with pneumonia. This added a day to my stay in the hospital: I could have gone home the 4th day if I had not had pneumonia.

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

The pneumonia delayed my dismissal from the hospital by a day. On that last day I was taking walks and puffing on the lung machine like crazy in order to clear my lungs to go home. I am sure that if I had done that more conscientiously earlier on, I wouldn't have gotten pneumonia. I took antibiotics after coming home; I think my energy was down lower than it should have been in my early recovery at home. Twice in the 2 months following surgery I had to have an endoscopy to open up my esophagus. This was pretty common, I understand, and no big deal.

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 happy and excited. I had to wait a long time (3 months -- it felt like a long time, anyway!) until my surgery date and that was hard. I had very little anxiety about the surgery itself; I just couldn't wait to get going on it!

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

Only about 40 minutes away. No impact on care.

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.

*week 1 at home: sf jello, sf pudding, egg drop soup, Carnation Instant Breakfast, sf (hated it). *week 2 at home: Pure Pro, all of the above, cream soups, sf popsicles, cottage cheese, plain yogurt *After that: soft and pureed foods *after week 6: protein and cooked veggies, chewed to nothing *after week 8: added salad! oboy!

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

At first I was not very active; probably due to the pneumonia. I just took little walks. After about four weeks I started walking on the treadmill for 10 minutes, 3 times a day. Now (6 months postop) I work out at the gym with weights 3x a week and either use my treadmill at home or go to Jazzercise 3x a week.

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

*One-a-day Essentials (they are small and easy to swallow) *1500 milligrams of calcium citrate with magnesium and Vitamin D *1 sublingual B-12 a day *I continue to use protein supplements to control hunger and keep my protein grams up

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?

I still have nausea and vomiting if I eat ribs (too fatty I guess) or Chinese food. This is after more than 2 years postop! I do not eat much rice, bread or pasta because it fills me up too quickly and I can't get my protein in. I can eat small amounts of sugar but very much of it makes me feel crummy. I have had a small amount of hair loss but it is not evident except in my hairbrush!

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

Having to wait 3 months for my surgery.

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

I am in some online support groups that are very helpful. I also attend a monthly support group at my bariatric center. This was helpful but the more important is the fact that several of us get together ahead of time for "dinner" and that support is the best of all. (Later reflections) Now, at almost 4 years postop, I still share in a few online groups but no longer attend the support meetings at the bariatric center. They want us long-term postops to come, but the sessions are focused on pre-op and early postop issues, and are not relevant to the rest of us. We have tried getting together on our own as FOPOs (far-out postops) but no one really has the time or energy to organize it. We are all too busy living!

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

It's very small (3" long for an open RNY) and is fading nicely. The 2 scars from the drains are more pronounced. I didn't expect that. But on the whole it is very minimal for what was done! Dr. Jones does not use staples or external stitiches so it is just a thin line.

Please describe any plateau experiences you have had since surgery.

I had a brief plateau at 3 weeks postop. Then I stopped losing at 5 months postop with 95 pounds gone. I stayed there for 1 month! Then lost 5 pounds in a weekend. That restarted my weight loss and I went on to lose a total of 135 pounds.

Do you notice people treating you any differently now?

Oh yeah. My family is happier and so am I. Everyone at church and work comment all the time about my weight loss. In fact I'm starting to wish they would all just shut up about it. Probably when they do I'll miss the compliments! I get more attention from the opposite sex and that is nice. But I am also more outgoing so it may not only be the weight loss.