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

After one particular peak in all my numbers (diabetes) my PCP send me to see an endocrinologist, who is also a diabetes specialist. A small man from India, the first thing he said, (after the initial consulatation) was "Have you looked into Bariatric Surgery?" I said that I had thought about it, but my previous PCP's had always downplayed it. They were of the mind that I was just 'a big guy' and "not to worry about it'. He was extremely irritated with that attitude, and he nailed me on my family history, size, and diatary attempts. He said he would push for surgery, if that is what I wanted, I did, he has, and here I am, looking into it, and possibly going in for WLS in Oct. 2003. I still think it is a radical procedure, but absoluty nothing else has worked in the last 40+ years.

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

So far, we have not had any problems..yet...I am gathering the letters from previous specialists and PCP's , and am working on composing my letter to the insurance company. They have been very supportive -over the phone - but time will tell in the long run. Just go slow, be patient, and document...document...document...and remember the folks pushing the papers are just that...they're trying to do the best they can. It's the folks in the big offices who have the final say. Don't be too hard on the desk workers/assistants. But be determined.

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

My first visit with Dr. Skendaris was very professional and slightly informal. He asked a lot of questions, and I gave him a lot of answers. He detailed the different types of procedures, the risks involved and what would be expected of me in return, and that this was going to be a lifelong commitment. We talked about the complications and what diabetes has done, and what WLS would and would not do. Then it was my turn to ask, and he spent quite a bit of time answering all my questins. I left the office that day feeling like I may have a chance at this, and felt pretty good. Just remember, WLS is a tool. You will never eat the same again, ...or your body will let you know about it...if you do. I wish that I had found this forum before my first meeting, I could possibly have had a few more questions, but they have been answered by forum members in the meantime.

What made you finally decide to have the surgery?

My body tells me, 'do something now, or pay for it later". The compounding effects of weight and diabetes are piling up, and I'm not going to get any younger. A significant loss in overall body weight would negate nearly 100% of my diabetes complications (according to my endocrinologist), and I have been sticking to a diabetic food lifestyle for 3 years noy, and although I feel much better, stronger and healthier than ever before, I know that this weight will kill me eventually.

How did you decide which proceedure to have?

The Dr. pretty much decided for me. Based on my physical activity, weight, height, size, etc. He said that Laprascopy was not the best for me because of the buildup around my main trunk section. He was also very honest and said that an 'open' procedure would be the easiest and most convinient for he and his team. I work out a lot and ride a bicycle everyday, so recovery would not be as difficult (in the long run). Based on my diatary and exercise regimes already in place he suggested an open RNY.

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?

Surgery is surgery, a small blood clot could do you in, whether it was WLS, heart, lung, appexdix. The risks you take in life are that...risks. I look at what I have done so far, and am pleased with what I have done. I want to do more, and will...but I don't 'worry' about the risks or complications. We have some of the finest medical facilities in the world, and if you are prepared (mentally and physically) for this procedure, then you roll the dice and keep on going.

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 wife is understandably "cautiously negative" about this surgery. I am the same person she met 25 years ago, and a drastic change such as this is difficult to comprehend or contemplate. You entire life changes after this (I am told), and we enjoy a good meal at a nice resturant, but I told her, all this means is that I get to take home more leftovers than her in the longrun. I'll get 3-4 meals out of mine, where she will get just 1 (smile). Most of my other friends are all for it, as long as it is what I want.

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

Initially my 'boss'boss was concerned that my WLS would interfere with her vaction plans. Ain't compassion in the workplace grand? But my immediate supervisor said "Go for it". I have enough sick leave accrued to take 4 weeks totally off of work. When it came up in a discussion between boss/supervisor/myself, my 'super' supervisor said..."well, if you can take three weeks off to take a cruise, I think he can take 4 weeks off to save his life"...and my 'boss' hasn't said a word since. Gotta love that supervisor!!

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

While Va. Beach Sentara Hospital is a nice hospital, they are not really set up for bariatric surgery per se. The nursing staff is very professional, but I constantly had to press the call button for them to put down the side rails so I could get up and get around. I asked them to not put all the rails up, and the call cords contantly came off the hooks at the top of the bed, meaning there were periods of time when I saw no one. Granted, I was not in such a serious condition as other parients, but if they would have done as I had asked, I would have been able to at least sit up and put my legs over the side of the bed myself. I found the night staffs to be much more friendly, and once they discovered that all i wanted to do was get up and walk, they were more than glad to accomodate me. Went in for surgery on a monday and had to fight to let them release me on a friday. The last meal in the hospital was a joke. Pre-op I did not eat sugar or caffiene, and I saw the dr. mark in large red letters across my chart. no sugar - no caffiene - no solids. So what was my last meal? A large glass of iced tea with sugar packats, a bowl of steaming cream of broccoli soup, 2 slices of white bread, a cup of black coffee, chocolate pudding with whipped cream, vanilla ice cream and some type of brownie. Not exactly what the dr. ordered, was it? I brought that to thier attention and they just shrugged thier shoulders and left. I was informed that I had to try to eat this before they would let me leave, so I tried a spoonfull of soup, and gagged, and a sip of tea, and scooped out portions of the others and threw them in the garbage can and covered it with trash. It was the only way to get out of there. Later I told the doc this and he was pretty peeved. I packed rather lightly, but the most important items I had with me and used regularly was my robe and chap stick and slippers. Everything else was provided by the hospital. Also I brought and used regularly a small clip-on electric fan, made the warm rooms feel so much better!

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

No complications what-so-ever!

In the weeks after you got your surgery date, how did you feel? How did you cope with any anxiety you might have felt?

The first week after surgery was touch and go, even though each day felt better than the day before. Broth and jello get real old real quick, but I stuck to it. I tried to stay with the doc's schedule, but found that I needed clear liquids for a week and a half. I am at 7 weeks out, and the small portions are easy enough to deal with, but I get full so easily, even though I make my meals last 20-30 minutes. But no real complaining. I just need to go slower than most folks. At 7 weeks the energy level went through the roof. I always feel 'almost' nauseous after a meal of anything solid. Yogurts and such are fine, but anything solid seems to set for a while, but that's understandable. Tried chili and eggs, and barfed on them all. So I am using soy products in the form of burgers or chicken patties. I can only manage to take in less than a 1/4 of each at a meal. I think my system is having to get used to to processing solid foods of any sort, and it just takes a while. Morning breakfast is history for now, it used to be I had to wait till 11 in the morning to eat anything, but everyday it goes back down by a few minutes, and now it is at around 9:30-10:00. Yogurt usually does well, or a small portion of milk and cereal. Some anxiety post-op when the nights were darkest and the thoughts of nausea filled my head, but I remember seeing the before and after photos and reading the daily posts, that brought me out of my 'oh-poor-me' attitude.

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

Week after surgery was a maze of fuzzy recollections and some rememberance of pain, but not too much. The main thing is the thirst! I know I would have made myself sick, but I felt like drinking gallons of water, but knew I couldn't. The pain meds prescribed by the hospital gave me the freakiest nightmares, so I switched to liquid tylenol and crushed up a tylenol pm and added that to the liquid mixture right before I went to sleep, the result was just 'strange' dreams, not the freaky things that would have kept Stephen King in writing material for years. Sleeping was problematic for a week or so, I think it was a week and a half after surgery that I actually slept all the night through, (12-6), and with each passing day the good feelings kept piling up, and after 2 weeks the idea of regretting having this surgery never entered my mind again. Just keep yourself busy, boredom will just make any doubts and fears increase way beyond proportion. I worked on my rug loom, watched old movies, listend to books on tape and ventured forth in walking further each day. Keep busy, or suffer the consequences!

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

We live about a mile and a half from the hospital and the dr.s office, so this was a moot point.

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 broth and jello were ok, but I had to use the low sodium broth packets because the reg. broth was way too salty. week 2 was supposed to be cloudy soups, but my system couldn't tolerate them. Also tried a bit of very runny grits, that was a mistake! and a very tiny amount of runny mashed potatoes, also a mistake, so I stayed on the broth for a few more days. week 2 3/4 - cloudy soups, made with milk seemed to go down and stay down, tried scrambled eggs again, still not a good idea. week 3 Soft foods will not agree with me, so it's back to soups and broths, but I feel pretty good considering. week 4 cream of wheat is a life saver! Cup of noodles soups, but just the broth are also very tasty. week 5 dry cereal and milk, well soaked tasted so good. Not brave enough to try grits or eggs again, so I will wait. Had a bit of some canned soup with very tiny pieces of ground beef, not a good idea. Never did throw up, but felt horrible for hours. week 6 Office party - soft cheese like string and havarti are doing real well. Even got brave and tried a small bite of a meatball (swedish) and the inside of a deviled egg. Went down and stayed down, but was full. Tried cream of wheat in the microwave, did not do well. I suppose it must have something to do with the cooking process and such, so it's stove top for me! Had some well cooked oatmeal, tasted wonderful, just an 1/8 cup serving, went down well, stayed down, but was filled to uncomfortableness for a day and a half. Need to stay away from grains for a while. Tuna sald seems to do ok, and very small bites of chicken and turkey are ok also. Tried a bit of beef jerky, very tiny bite, chewed it well, but spit it out, because I could feel the tightness in my throat. Beef seems to be off limits. Did try making smoothies at home, but they also fill me to the point of uncomfortableness for a long period of time, even though I drink them over the course of a few hours. Maybe too many calories and too much protein at once? week 7 have vowed to stay away from beef for a while, and am learning to like the flavor of Boca brand chicken patties and hamburger patties. Still, less than 1/4 portion of 1 pattie, and I am still full, but that's why we had the surgery, didn't we? Tomatoes seem to be too acidic for the pouch at this point, so tomato based sauces are out for a while.

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

1st week, queasiness and 'near' nausea, same for week 2 but founf that breath savers wintergreen sugar free mints helped a lot. 3rd week went to the movies by myself and was driving short distance. Week 3 and 4 I was walking anywhere from 2-4 miles per day. Week 5 went back to work, but was usually tired when I got home, but felt much better after a short nap. Week 7 the energy level has gone through the roof. Drove up north, 11 hr. trip and felt fine, same for the trip back. Used to be a 'sitter' at work, sit whenever I had the chance, now I seem to always be on the go, on my feet, doing something. I hope this level sticks around for a while.

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

sugar free chewable flintstones and sublingual B-12's

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?

All of the above (except for the hair loss) was in the first 2 weeks, sporadically, not a continuous thing. At 7 weeks out I can still feel nausea creep in if I take one more tiny bite of anything. Learning to recognize that 'inner voice' that says 'don't put that in your mouth or you'll regret it'. Quite an effective Pavlovian tool! Once again the sugar free breath savers wintergreen mints have been instrumental in keeping the nausea level down.

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

The inital 'worst' thing is the interminable waiting for office admin. folks to get the job done, letters transcripted, and mailed, but that's life, and the wait from the ins. co, is the same. While the hospital stay wa snot 'bad', the evening of surgery and the next day were probably the most uncomfortable, physically. But the way I look at it, a few days of discomfort is the price we pay to reverse a lifetime of obesity.

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

There is an insurance/Hospital sponsored support group that meets once a month, and I go to most of them. As a man, I am in the minority, but I find it useful to discuss things and as a post op to be able to lend my voice in helping others. The most valuble support group I have enjoyed being with is the online message boards through AMOS.

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

I was expecting a SCAR, but what I have is a very fine red line of about 10 inches from the bottom of the breast bone to the navel. It seems that my surgeon is also a cosmetic and vein surgeon, so he did a real nice job. I dare say that the scar will be but a mere memory in a year or so. You will feel the scar tissue under the skin, but it is hardly noticeable at all now.

Please describe any plateau experiences you have had since surgery.

The first month post op, I slowed down from 20 lbs a week to a pound a day. Not really a plateau, but a definite slowdown. I don't trust the scales anyway. 3 sets of scales and none of them say the same thing, so I just use the doc's scales monthy, and I look at the ones at home, just to see the trend, but I don't really like to rely on them. I go by how my clothes fit and my energy level.

Do you notice people treating you any differently now?

The people who knew me pre-op still treat me like I went for some strange operations, and are constantly asking question, which I don't mind, but some folks don't look at me with the 'OMG, look how fat that person is.' look. Perhaps the fact that I usually ride a motorcycle and have on shades and look like I'd chew them up on a whim helps, but as a guy, I hardly pay attention to behavior like that.