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

I had heard about it on the news and then some people at work were trying to have it done through our insurance. Initially, I was skeptical (as I always am) and then started to see their progress.

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

Extremely difficult. When I first looked into it, the company I had chosen through work did not cover it and during the next year, the insurance companies were excluding it from their policies. I wrote many letters and spoke to as many people as I could to get it as a covered benefit; this year it was finally covered. Even though I submitted my paperwork January 2, 2007, they managed to lose my paperwork 6 times, kept adding more and more stipulations to meet, and had me spending an inordinate amount of time tracking down their incompetence. My advice is to document everything from the moment you begin the process; keep a food, exercise, and weight, diary; keep copies of any and all diet programs you have been in; keep a record of what you did when with the paperwork; every time you call the insurance company, get the person's name and extension to whom you are speaking; tell the insurance company staff what is going on with you, this keeps the grievance process alive. You may only be speaking to an administrative assistant or customer service rep but get him or her on your side; DON"T SHOOT THE MESSENGER. The person I found, found it hard to believe that the company that she chose to work for could or would lose paperwork 4 or 5 times; she ended up being my greatest ally at the insurance company.

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

I had already done a copious amount of research on the procedure and had my heart set on a particular doctor. That doctor could not see me so the office staff asked me to just meet this surgeon. I was skeptical of the younger, less experienced surgeon but her knowledge and ease with talking about those very issues made me feel in good hands. Don't be afraid to ask any and all questions about the doctor and their experience. Write down your questions and write down the answers. If someone can go with you, that is another pair of ears and more questions get generated.

What made you finally decide to have the surgery?

Wanting to be healthy and felling I was in very good hands with the surgeons. My internal medicine doc and I had long discussions about the surgery and she was very positive in her approach as it is probably the only way I was going to get and stay healthy.

How did you decide which proceedure to have?

Research, research, research. I had RNY because it is the GOLD standard. I know me, and I did not want a lapband where it would be so much easier for me to cheat and have the consequences be no weight loss and even gain; dumping, frankly, scares the hell out of me.

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 spent much more time dwelling on my early death from the complications from obesity. I did have a living will and had a durable power of attorney in case something happened but I had the positive attitude that this was going to be the best thing for me and I was not going to have any complications. I was not afraid the morning of surgery, just calm but excited. I feel as though I made this happen for me and if things did not work out, I would deal with that, too.

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 was surprised by my mother's reaction, in that she was supportive. We talked about her perceptions of my always eating what everyone else ate but my being overweight most of my life. My brother was not supportive and believes I could have done "it on your own." (At 56, if I have not been able to do something about it by now....) My neices were great, they wanted to know what I needed them to do. Friends were a mixed bag; some were concerned about the possible complications, they strict vitamin regimen, etc. and others were "WOW, tell me all about it and what can I do to help you."

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

My supervisors are my friends and have been my support people. I work in a maximum security psychiatric hospital that has a tight knit support system within our teams and administration. I told them the truth and will return to work after two weeks but cannot have any client contact for three more weeks to make sure I am not hit and have completely healed.

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 two full days and part of another. The hospital was fantastic. Because of having sleep apnea, they kept me in a step down unit overnight and then moved me to a regular room the next day. I brought too much stuff with me. I brought a book and cross stitch and barely touched the book. They encouraged my getting up and walking as much as possible as well as resting so I could heal. The only problem I had with the hospital was that I am vegetarian and they kept sending me beef and chicken broth; bring your our packets or small boxes of broth if you are vegetarian. You might even want to bring a couple of clear protein drinks.

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

I did not have any.

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 felt excited; I had no anxiety. I meditate regularly and with the fight I put up to get the surgery approved, I felt proud that I had done something that many others have been able to do.

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

That you will feel tired but that it is your body trying to heal tself after major surgery. Rest when you need to and walk as often as as much as you can. Coughing and sneezing are hard so have a pillow nearby to hold over your abdomen. Drink, drink, drink, drink! There are some new bodily sensations you will need to get used to. Any questions, call the doctor's office, nurse, nutritionist, etc.

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

The hospital and doctor's office are in the town in which I live. Living 5 miles from the hospital and no more than 10 miles from many of my friends did not affect my aftercare at all, in fact it made it easier.

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 kept to clear fluids the first two weeks and experienced no hunger; a first for me. I kept the protein drinks cold but sometimes they just did not taste very good. After the two weeks I could go to soy milk based drinks but they seemed very heavy on my pouch so I tried rice milk which was a little better. The soft diet was going well until I found myself not being able to tolerate foods I had been eating. At my one month doctor's vist, I had thrown up the night before. We found my gall bladder had lots of stones and maybe the cause but we are checking other things. I have since reintroduced those foods, so far without problem. I have followed the nutritionist's and doctor's guidelines for adding foods on a weekly basis, and have done fairly well with most foods. I still am experiencing some nausea and vomiting from time to time.

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

I started walking the halls in the hospital and when I got home, I walked up and down my street at least four times a day for the first two weeks. I increased the number of times I walked and the number of times I went up and down the street at each walk. When I was able to go back to work after two weeks, I took the stairs and walked the quarter of a mile to my office. At first you cannot pick up anything heavier than 1-2 pounds but as time goes on, you can start to pick up heavier loads. I have two dogs that are 8-10 pounds each and they stayed with friends for two weeks because I did not want them jumping on my incisions and I could not pick them up. Bending down was not that easy either.

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

All from Bariatric Advantage: Multi, B complex, B-12, Calcium I take a prescription Iron and vitamin C.

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 had none immediately after surgery but one monthe after surgery, I became nauseous and vomited on food I had been eating for a while. I still, occassionally am nauseous and vomit and it may be due to my gall bladder which may need to come out. I have had no hair loss, in fact, my hair loss has decreased since I have been on the higher protein diet. I sleep better without the CPAP machine. I have not had any dumping because I have not had any sugar.

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

The fighting and waiting to get it done; nothing to do with the surgery itself.

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

There are Support groups that meet twice a month in town and have run from being very helpful to only so-so. I began going to them prior to surgery to inform myself of issues for post-op people. They were very supportive of me in my battles and the encouargement others get is fantastic. Just the general knowledge from their own experience has helped those of us just starting or who have been on the road a while.

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

I have six small scars from having my surgery done laproscopically. They used surgical glue to close them so there is no extra scarring and pain from staples.

Please describe any plateau experiences you have had since surgery.

I have had weeks when the scale did not move. I kept my exercise routine and tried to keep my intake the same. It seemed that when I was having the problems with the nausea and vomiting that I did not lose weight. Once I was feeling better (added Prilosec) and eating what I needed to eat, the weight started to come off again. I have the expectation that I will plateau from time to time but that I need to keep my head in the right place and keep the plan going.

Do you notice people treating you any differently now?

Yes. While I feel better due to the weight loss and my clothes are falling off, people are either super surprised or curious about how I have changed. People tell me I appear more confident and this appears to put some people off. Some of my male co-workers are looking at me more as if they have never seen me before.