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

I first became interested when I stopped taking Phen-Fen, and realized how dangerous that was. Taking diet pills will chemically control your appetite. I thought perhaps a more natural approach, surgery to permanently alter the digestive tract in limiting the amount of food intake and allowing more mobility with activity seemed to make more sense. I was impressed at how this procedure helped people who were in poor health or had multiple co-morbidities, improve their quality of life. I hope to achieve the same.

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

From the time I attended the WLS seminar on 02/22/03 until I received the letter of Authorization on 04/12/03, took about five weeks. I submitted my information packet on 03/05/03. One has to be patient. My primary insurance excludes any type of bariatric surgery. However, if you have co-morbidities, and you need to work with your primary care physician, where this is documented, often times the insurance will recognize bariatric surgery as "Medically Necessary". I also have secondary insurance where I am covered under my husband's insurance. This is helpful. My primary insurance carrier is Sierra Healthcare Options, Inc., POS. Secondary insurance carrier is Great West One Health Plan PPO

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

I was fortunate to meet with the surgeon the day prior to surgery at )4:30 p.m., for ten minutes. I felt this was rather rushed. However, I did get to see the surgeon again just before I went to the operating room on the day of surgery and once more on the third postoperative day. Since I live in another State, I have not seen the surgeon again or have had follow-up contact with the office. I have, however, had regular appointments with my PCP in Nevada, where I live. My physician has prescribed regular laboratory follow-up blood work, etc. This is ongoing.

What made you finally decide to have the surgery?

Having tried and exhausted all other measures of weight loss attempts and failed, i.e., diet pills, various diets, health club memberships, etc., bariatric surgery seems to be definitive in combating the problem of obesity, or at least enables one to attempt to combat obesity.

How did you decide which proceedure to have?

I thought of the Fobi Pouch procedure. With this procedure you do not use any of the original stomach, it appears the Fobi pouch is created from the duodenum. With the RNY procedure, in observing various drawings and diagrams it seems that a portion of the original stomach, the fundus is used as the new "pouch" that will become the new stomach with the jejunum re-routed. Part of the natural stomach will be used. On research it is the most "compatible" type of bariatric surgery.

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 have taken into consideration my age of 56 years, my overall general health, co-morbidities and the risk I take at remaining at my current weight of 272 pounds. I am aware of the possible complications with bariatric surgery, as there are risks with any surgery, such as blood clots, pulmonary embolism which concerns me, cardiac arrest, stroke, etc., during or soon after the surgery. If my weight problem does not improve, I am certain to suffer a worse fate. In undergoing the surgery I am hoping for a better chance to enjoy life.

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?

I have not informed my family of the surgery. I know that they would be against it and find it to be an unatural way to deal with obesity. I have told a few friends and coworkers who have mixed feelings about the surgery. They are concerned about the risks. Some are excited about it.

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

I have informed my manager of the surgery. She does not understand the entire procedure, but seems supportive in my decision. From what I understand I will be out of work for four weeks. I work for a hospital.

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

Hospital stay was what I expected. I work in a hospital and very familiar with procedures, patient care, etc. I was hospitalized for five days. Items to bring to the hospital that were helpful were; Chap Stick, shampoo, conditioner, deodarant, toothbrush and toothpaste, change of clothing. While hospitalized the hospital will provide you with what you need, basically a surgical gown and Ace Wrap for your legs.

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

I was dehydrated, therefore I was required to be on intravenous fluids for three days as well as a Foley catheter. I have a sensitivity to Morphine, so that drug was changed to Dilaudid.

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 am currently six days postop. Still having a lot of pain.

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

"Slow and Steady Wins the Race". One must be patient for the following three months after surgery. This is about the amount of time it will take before you feel like yourself again. It takes quite a while to regain your strength after major surgery. At three and one-half months postop, I am now walking two miles per day. I have improved ambulation and do not tire as easily. I can do so much more.

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

I live in Las Vegas, Nevada. The hospital was in Fountain Valley, California. The trip took about five and one-half hours and was 375 miles. This may not sound like much, but in July driving through the Mojave Desert in 115 degree heat makes a big difference. It was important to stop every 45 minutes to get out of the car and walk, even in the heat. You learn to carry a bottle of water with you at all times.

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.

The first three weeks was not difficult. All clear liquids were tolerated. What helped was ice chips, sugar free Popcicles. Week four through six, took a little getting used to. I do not care for skim milk. I can consume this in beverages such as Carnation Instant Breakfast, no sugar added, or in sugar free vanilla pudding or cottage chese, but I cannot swallow it after coming from the container to glass or cup. Week seven through nine, very experimental, a lot of trial and error. Getting used to the texture of food was challenging. I am now in the fourth phase which will last for six months. It is a 1200 calorie, low fat diet. I can tolerate most foods. I still have a problem with certian meats such as beef (unless itis ground beef), lamb, etc. I can eat deli sliced chicken and tuna fish, schrimp. What I find helpful for occasional nausea it herbal peppermint tea.

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

Grandual increased walking from walking two blocks on day 12 postop, to two miles per day currently.

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

Vitamin B12, 1000 mg, sublingual on Sunday morning. Calcium magnesium and zinc tablet one daily, Levoxyl 50 ug, one per day, two TUMS ultra daily, two Centrum Junior vitamins plus iron per day.

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?

nausea and insomnia. I still get waves of nausea occasionally. The insomnia I had prior to the surgery and sleep about four to five hours per night. I have been prescribed Ambien 10 mg, at bed time. This helps. When I take this medication I can get up to six hours sleep during the night.

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

Fatigue. Regaining strength and mobility, ambulation.

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

I communicate with the obesityhelp.com web site. I have not attended a support group yet, but plan to do so soon.

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

I was fortunate to have my procedure done laparoscopically. I have six one-half to one-inch "stab" wounds on the upper part of the abdomen or epigastric area. They are now "pink" in color. They do not give me a problem. People are impressed when I show them my incision scars.

Please describe any plateau experiences you have had since surgery.

My surgery was on 07/23/03: As of 10/15/03, I have lost a total of 65 pounds, and have stayed at this weight for three weeks. I have increased my exercise and hopefully will start to drop more weight soon. I understand that one will hit plateaus before their total weight loss is completed.

Do you notice people treating you any differently now?

Yes. There are positive and negative responses. Most are very happy and excited to see my progress. However, there are several people who appear to be stand-offish, or (I think this is a littel strong) jealous, for which I am surprised.