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

I had serious health problems that prompted me to look into the surgery. I have degenerative disk disease and arthritis in my spinal joints. I also had serious problems with my knees. I was at a point where I had a handicapped tag and could not walk more than a few feet at a time. I was taking multiple pain-killers and having steriods injected into my disks and spinal joints. I was told by my orthopedic specialist that I would become wheelchair bound soon and suggested that I check into bariatric surgery. He felt that I was at a point where this was my only option. I was fortunate that my internist, who has since retired, had five patients that had the surgery and were doing well. He referred me to OSU's bariatric program. I was terrified of taking such extreme measures, however, I knew it was my last resort. If I did not do this, my children would end up caring for an invalid mother and I would probably die young and in pain.

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

I have United Health Care and had no trouble with approval. I was ready for a fight and didn't get one. My orthopedic specialist and internist sent letters outlining why they felt I should have the surgery and I sent them a copy of my application for surgery at OSU which contained my medical and weight loss history. I actually had to reapply for benefits since my 90 day window to have the surgery expired before I got through the OSU pre-op program.

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

Dr. Needleman was very helpful. He did not sugar coat anything. He explained all the risks and told me this is a tool, not a miracle cure. (Although at this point in my progress, I would beg to differ with him.) He told me that he did not feel I was a candidate for Lap Band surgery due to my history and other conditions. He said Rouen Y was my best option and thoroughly explained the surgery to me, even drawing diagrams on the back of my chart. He said he would do his best to do the surgery laparoscopically, but could not guarantee this since I have a large scar due to gall bladder surgery. My advice would be to read up all you can on all the options and have the surgeon explain which one he feels is the best option and why. Ask about what he considers successful surgery. Also ask about aftercare. This is very important since there are many complications that can come up. Also ask about diet post surgery. OSU has done probably many thousands of these surgeries. The recommend liquids for two weeks post surgery and blended or baby foods starting in the third week through the 6th week. After that, just like babies and toddlers, one new soft food is added at a time as you can tolerate. I have heard of people on liquid diets for 8 or more weeks post surgery.

What made you finally decide to have the surgery?

Degenerative disk disease, spinal arthritis and problems with my knees. I was taking multiple pain killers and could barely walk. I actually had a handicapped tag and could not walk more than a few feet without a cane. If I did not have the surgery, I would be wheelchair bound eventually.

How did you decide which proceedure to have?

After consulting with my surgeon, Dr. Bradley Needleman, he felt I would do better with a RNY due to my history and the amount of weight I needed to lose. He is an excellent surgeon and I trusted his opinion.

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?

Any surgery has a possibility of serious complications and even death. I had had three previous surgeries for other problems, so I had butterflies, but not any serious apprehension. If you have a good surgeon with a good success record, it helps tremendously. You have to decide whether this is worth the risk. I was tired of feeling bad and living with extreme pain. Anything that could happen was better than what I was living with.

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?

They were very supportive. I am fortunate to have family and friends who were there for me all the way. Of course they were concerned about how I would do after the surgery, but they felt this was my best option to finally get my health and my life back.

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

They were not thrilled. I even had one person in our HR department (who happens to be obese herself)try to talk me out of the surgery. She told me that she had a friend who had the surgery who was still eating baby food a year later, had I tried Weight Watchers, etc. I ignored them and proceeded with the surgery. Nothing they could do would keep me from doing this. I watched my performance and attendance to keep them from having an excuse to fire me before the surgery.

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

The worst part was not sleeping in my own bed. The beds at OSU are meant to be comfortable, but when you are hooked up to IV's it is hard to be comfortable and sleep. I also had a roommate that was a bit loud and stayed up all night, which did not help. The hospital staff can't really do much about that. I was in the hospital for about three days. I think the most important thing to bring is a pair of slippers, comfortable clothes to leave in, deodorant, a hairbrush, and a toothbrush and toothpaste. I brought things to read and crossword puzzles to do, but you won't feel up to doing much of anything but sleep. If they do not provide things to wash with, bring that, too. By the second or third day, you will feel a little grubby and want to wash up a bit. You won't care enough about how you look to bring make-up.

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

The only complication I developed was a stricture. The opening where my stomach empties into my intestines closed up quite a bit due to scar tissue. I was warned about this possibility. My first episode was about three weeks out from the surgery. I went into the ER since it was a weekend. When this happens, you gradually can't keep food down and then liquids even though you are doing everything right. I knew something was wrong and remembered what Dr. Needleman said about strictures and that it could happen as soon as three weeks out from surgery. The ER resident gave me a little bit of a hard time and said that it was too early after my surgery to have this problem. I told him to call Dr. Needleman, who had me admitted immediately. I had a scope done the next day and they ballooned the stricture to re-open it. I was told that I may have to do it again if it was particularly stubborn. I unfortunately have really stubborn scar tissue because I had to be ballooned two more times. I also developed a small ulcer which responded to the first treatment. That was my fault because I was not good about taking my acid reducer. The stricture is more of an annoyance, it was not painful, but I really don't like vomiting. The scope was not bad, they sedate you to do it and it doesn't hurt, but you are really sleepy when it's over and you have to take a day off work.

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 really tired and slept a lot. You aren't taking in many calories and your body is recovering from surgery, so it is trying to find calories and energy to heal. I didn't have any anxiety other than I wanted to feel better faster. I started to feel a lot better about 5 weeks out from surgery. Continue to take it easy, though. If you do too much it wears you out and it takes longer to recover your energy. I really felt good about 8 weeks post-surgery.

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

You will be very tired and sleep a lot. It is okay to do this, your body is healing and you aren't getting a lot of nutrition. I did not have a lot of pain, but I have a high tolerance for pain. Take it easy on how much you eat. When I came home, I ate a popsicle and it was too much at one time, very painful. I was able to eat very soft food after two weeks.

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

I had to travel about 40 miles to have the surgery and after care. It was not a problem for me.

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 was on all liquids for the first two weeks. The second week I could add very soft solids. I chose baby food because blending things did not work well for me as far as texture and taste. Since I had problems with a stricture, I bounced back and forth between soft solids and liquids for about three to four months. It is much like feeding a baby. You start with very soft foods, one at a time to see if you can tolerate them. I ate a lot of soups, cottage cheese and light yogurt. Watch the labels on light yogurt, sometimes they are low in fat, but too high in sugar. Wendy's chili is good to start out on meats with as well as processed low fat lunch meats. It is high in protein and low in fat. I also found that EAS Carb Control protein drink tasted very good and had 15 grams of protein. I still drink it to make sure I get all my protein in daily. I am 9 months out now and I can deal with meats as long as they are not too tough. I still cannot eat rice. I was advised that rice is one of those things you have to be careful with since it tends to expand in your stomach once you eat it. I can eat pretty much any fruits and vegetables, and soft pasta but try to stay away from things that are really fibrous, they tend to be hard to digest and cause a lot of gas.

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

I didn't do much of anything for the first two weeks. After that, I cleaned house, did laundry and other things that were not too stressful. By about six weeks I was back to my normal routine, although I found I got tired faster than I used to.

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

I take two children's chewable vitamins a day and an extra 28mg. of iron a day. I found I was getting really tired about seven months after the surgery since my periods came back to normal. The extra iron helped with the fatigue. I probably should take a calcium supplement also since I probably don't take in enough calcium in a day to prevent osteoporosis in the future.

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 really did not have problems with dumping syndrome. I did have nausea and vomiting from time to time due to a stricture. I had a little hair loss after about six months, but I upped my protein intake to 60 grams a day and that stopped it.

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

I would say not being able to eat "normally" for a long time. I also found that I thought about food more than I ever did. Eating several times a day takes some getting used to. I told somebody that I was tired of eating, since I was never hungry, but eating five to six times a day. I had to force myself to eat.

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

I am not in a support group right now. I feel I have had enough support from family and friends not to have needed one. I also go to college with a woman who had the surgery with Dr. Needleman.

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

It is much better than I expected. I had laparoscopic surgery, so I only had five small scars that actually are almost invisible now.

Please describe any plateau experiences you have had since surgery.

I am currently in a plateau stage right now having lost 142 pounds in nine months. It is winter in Ohio, but spring is right around the corner. I will be doing more walking and working in the yard, so I should lose a little more in inches as I get more exercise. I probably have about 20 or more pounds in excess skin also.

Do you notice people treating you any differently now?

Absolutely, after thinking about it, I think that this is the hardest thing to deal with after having the surgery. Some people are very shallow and it is painful that they do not feel you are worth speaking to when you are very overweight. I try to take them for what they are and try not to let it get me down. I am still the same person I was on the inside. I may be closer to fitting the "norm" now, but I haven't changed much. I will say that I am more outgoing than I was before, but I think that is because I am not in pain all the time now.