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

I started to hear stories of others who had WLS - Carnie Wilson was really the one that I remember the most. I didn't make a long decision, I was having my regular yearly exam and decided out of curiosity to find out if my insurance plan would cover this surgery. My PCP asked me some questions like "you do know that even with surgery it is a lot of work, don't you?" "There are serious risks to this drastic of a surgery" Over all, she was VERY supportive. She referred me that day to start the process, which took a year. At the time I hated that it took a year to get thru the process but now I realize that I needed to get my head straight about the whole process and impact it would have on my life prior to jumping onto the surgeons table.

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

I went thru the Kaiser program. They require a referral from your PCP, an orientation class, a "freedom from diets" class either 5 or 12 weeks, you are required to exercise 5x week for 30 min., and go to a support group once a month. Then you see the nutritionist and the social worker (up to 4 times) I saw them once individually and once in a group setting, I was then referred to the review committee, from there I got an appointment with the Surgeon, was given a surgery date, saw him again for follow up. I had labs done, including ultrasound, ekg. I saw the nutritionist and the physical therapist. Then I had surgery. The Nutritionist, Social worker, Case manager and Surgeon are very strict about all the pieces being in place for us to be successful in the WL process. This takes an average of 1 year from referral to surgery.

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

My first visit with Dr Moiel was much better than I had anticipated. My husband had several questions, which I had already had the answers for. I think that to get the most out of this visit, you need to do your homework and ask informed questions. If you haven't been researching the procedures then you won't know if you've been given all the information before your appointment and you won't know what questions to ask. I would say: do your homework! Read about the surgery on the internet or the library, ask questions on the obesityhelp.com website BEFORE you see the Doctor.

What made you finally decide to have the surgery?

My health and happiness. The risks of staying over 300lbs was greater than the risks of surgery. I felt like the one thing that I loved about myself (my personality) was going away, I began hating myself more and more. I was getting to be a real pain in the backside! I lost my temper more (which isn't how I had been before). The one thing that I really hoped to get from the surgery was freedom. Freedom from some of my health issues, freedom from the guilt, freedom to do what I wanted to do, freedom from others staring at me, freedom from the inferiority complex that was quickly taking over my life.

How did you decide which proceedure to have?

Open RNY was the only procedure that was being performed thru my provider / hmo.

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 was far more afraid of continuing the path of obesity. I am pretty sure that I wouldn't have lived to be an "old" woman. My quality of life was deminishing every year. I was to the point that I couldn't exercise efficiently without causing myself injury or pain. I'm not talking sore muscle pain, I'm talking severe throw your back out type of pain.

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 Daughter, my Mother, and one cousin voiced concerns. My Mother and Daughter both feared I may die and my cousin also feared me dying, she had a friend who had the procedure and died due to surgical complications. My entire family has been EXTREMELY supportive. My daughter helped care for me during my aftercare and so did my son and husband.

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

My employer and supervisor were positive and supportive. I used FMLA after getting a form signed by my surgeon. I used all my vacation and sick pay, plus some. My employer offers what they call PALSHARE this is where other co-workers can voluntarily donate some of their personal annual leave to others who are out due to medical issues. I, personally didn't choose to request this, since I had saved up $ for the two weeks that I would be off without pay. I now wish that I had at least requested it, since it would have given me up to 40 hours extra to bank for future need.

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

My stay in the hospital was short, 2 days. I think the most important thing to bring is comfortable clothing and shoes to wear home. Wear something that is loose and flowing, without a waistband. So that when you go home, you can wear the same thing and not worry about it too much. A toothbrush, hairbrush, and socks with "no slip" bottoms.

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

Other than having my surgery sight drained of fluid on the 5th day, everything went very well. I developed an incisional hernia, which I had repaired at 6.5 months out.

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. The anxiety I felt was more for the prep day. I dealt with any anxiety by having a one hour massage two days before surgery. I had an overwhelming head hunger for 2 days about a week out. I would walk into the kitchen to get my ounce of liquid every 15 minutes and open the cupboards and refrigerator to look at the other foods that were there. Good thing I didn't have any actual hunger during this period! I just couldn't stand the liquid diet very well. I managed to make it thru the liquid diet for 1.5 weeks then called the nutritionist and asked to start on soups and soft foods.

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

I was, for the most part, able to care for my own needs as long as I didn't do too much. I couldn't do things that required me to bend over as I had an open procedure, and didn't want to cause stress to my incision. I alternated between napping, walking, and sipping on liquids all the time.

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

I traveled about 13 miles. It really didn't affect my aftercare at all.

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 could eat soups, cottage cheese, cheese, chili, mac and cheese, milk, mashed potatoes, and I could tolerate beef jerky, pringles, taco shells, and nuts including peanut butter. Everything in small quantities at a time. For many many weeks I felt full after about 5-7 bites. I could NOT eat breads, lettuce, or chicken. I had a hard time eating very much meat at one time, even chewing it to a pulp. Now at 20 weeks, I can eat lettuce and most anything except I still cannot eat Chicken or very much meat unless cooked in a broth. I will not even try bread anymore, it makes me so ill. I use several protein supplements such as Atkins drinks, Unjury unflavored protein powder, balance bars, AdvantEdge drinks and bars. I look for protein and sugar content, as well as total carbs and try to keep sugar and carbs low, protein high. 5-27-04: at 11months out I can eat just about all types of food, except most breads. I can't eat very much at a time, I have learned the difference between head hunger and actual hunger!

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

Amazing! I couldn't then nor can I now believe all the things that I am able to do. My husband often reminds me to try because sometimes I will go back to my old "I can't do that" mentality; which was true then, but not now! At my 2 month mark I went for a 5 mile hike up hill to surprise my husband at camp, then I slept for 1.5 hours and hiked back down! I was very muscle sore, but so proud of my accomplishment. I actually did it again the very next weekend! It happened to a 3 day weekend, so we stayed over for two nights. We walked many miles while we were there (hunting). My muscles didn't get very sore the second time, which I was very thankful for!

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

At first I used Centrum Chewables and coral calcium. I have since added vitamins for hair, and iron. I also use a solid centrum instead of the chewable, but I do scrape the coating off before taking it. I supplement my protein with low carb- high protein drinks and bars (as noted previously). 5-27-04: I have to take two iron supplements daily in the morning, as well as centrum chewables, and msm for my hair and calcium in the evening. Though I don't think the quality in the chewables is even close to some other types of vitamins, I know that I'm not absorbing as much without chewing or grinding up the supplements. I also have a b-12 shot monthly 1000mg. I try to get my protein in by eating protein rich foods, but sometimes need to use supplements. 1-10-05: still have the need for iron supplements. I also take calcium and chewable vitamins, as well as protein supplements on occasion.

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?

Hair loss started about 3 months out and didn't stop until almost 7 months out. I still have some hairloss even being 11mo out, but there is so much new growth. I couldn't eat chicken or bread for 7 months, now I can eat chicken, but can't eat more than 1-2 bites of white bread. If I eat bread, it is the very small thin bread that you serve with appetizers (2" X 2" and about 1/4" thick) and then I can eat only one piece. I think that the hair loss and dry skin are the worst! 5-27-04 I wish that I dumped more! Sometimes I feel that I should fast in order to kickstart my weight loss again, but I know that I should really increase the protein and reduce the carbs to kick it up. It's all about practicing the knowledge I have. 1-10-05: Still experiencing hair loss, dumping, and sometimes vomiting after 18 months. Hence the protein supplements, this helps the hair to grow back.

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

Hair loss and the anxiety of not believing that I can lose as much as I need to. Fear of complications and fear of gaining any of the weight back once I go thru all of this.

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

I have a support group thru Kaiser that I try to go to every month (I've missed a few) but I keep in touch with many of the people and we go and exercise together, e-mail each other, and have long talks. I met one of my friends at the hospital, she had surgery right after I did, the same day. I didn't know it at the time but we had also been in a few other meetings together such as orientation and a group meeting with the nutritionist and social worker. Obesityhelp.com has been my biggest support and information source. It is EXTREMELY important to have the support of others who have experienced many of the same things throughout their lives and their WLS.

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

My scar is 8" long right down the middle of my stomach and is getting more and more thin everyday. I have used mederma from the start and it has helped tremendously. I expected the scar to be worse, but I had a very skilled Surgeon who didn't use staples on the outside layer of skin. 3-24-04- My scar is still just as long, it had faded on the bottom half but due to a hernia I'd had it had become very stretched (width) on the top half. Since having the hernia repair 6 weeks ago, when the part of the same incision was used, my scar looks much better and the top half is shrinking and fading just as well as the bottom half did. Thank goodness my Surgeon used the same site and removed scar tissue when he did the procedure! 5-27-04 : My scar on top is still pink, it has one very slight wide spot (approx. 1/2"wide X 3/4"long) this is at the very top of the scar. I've used lotions and creams, but no mederma on it this time; I really think it needs the mederma and I plan to start using it soon. It made my scar fade faster after the original WLS than it has after the latest hernia repair procedure. 1-10-05: scar has faded very nicely after the hernia repair, it is thin and pale except for one small section at the very top, which is still pink and a little wider than the rest.

Please describe any plateau experiences you have had since surgery.

I have not been concentrating on pounds but rather on inches, so it has been 4 weeks between my weigh in's. I am 9wks post op at the time that I typed this and have lost 42lbs. I'm happy with that, but will be upping the protein and exercise to increase my chances of reaching a personal goal of 130#. 3-24-04 I am now 9 months post op and have had many plateaus. I have still been concentrating on the inchs (clothing sizes) more than the pounds and in the last 3 months I've dropped from size 22 to between a size 16 to 20 (depending on the style and material). I think this is slower than others but I also feel it is awesome. I used to wear a size 32 and they were getting snug! 5-27-04: Plateau City. I haven't changed clothes sizes since March. I am now 11 months post op. I have lost a little more weight and the clothes that were barely fitting now are very comfortable. 1-10-05: my Plateau's have been much longer than my losing cycles. I go for months without losing and then will all of a sudden lose. In the summer of 2004 I lost 16lbs (all in 2weeks) nothing else all summer. In the fall, I lost 8lbs (in a week) then nothing. I've joined curves and in the first week I gained 3lbs! that's the first time I've weighed sooner than 3weeks - except for a few times when it felt like I might have lost weight or someone insisted I had when I didn't think it was so. I'm hoping the weight gain was from using more muscle, the time in which I'd weighed (early am to evening), and the difference in how many clothes I was wearing (first time I was wearing thin slacks and tee shirt, second time I wore thick sweats and sweater on).

Do you notice people treating you any differently now?

People who have ignored me in the past, now make eye contact and smile. So far I haven't lost so much that people are oohing or ahhing. I have lost 76lbs total since I began the whole process. It doesn't feel like it. 3-24-04 Since my highest weight I've lost 129 lbs and people who knew me at my former size do treat me different. I like to hear the comments - some of the time. It does make me uncomfortable when someone says that I'm "skinny" because I know that I'm FAR from that! I still weigh 245lbs and in the society that we live in, I would say anyone who didn't know me before this weight loss surgery sould EVER think that I'm skinny. How do you tell a person who is trying to make you feel good and pay a compliment that you don't appreciate being called skinny? Don't get me wrong, I like the attention, but I never wanted to be "skinny" and I don't think I ever will. I just want to be healthy and not fat! Waiters at restuarants have a preconceived idea of the quantity of food that I will eat and I enjoy going out and seeing their faces when I don't eat more than 1/4 of my meal. They expect people my size to be pigs! Even though even in the past when my family went out, my husband, two kids, and myself all shared 2-3 meals we've never ordered separate meals for everyone; portions are just too big in this society. I've never finished a meal at a restaurant, unless it was a higher class establishment. It's nice to share, you get a better selection that way. 5-27-04: I don't care for the way people who didn't give me the time of day to make eye contact and smile before, now think that I want to discuss how much my body has changed with them! I just grin and bear it. Usually I just smile and say thanks, but inside I'm thinking "MY WORD, do you know me? Do I know you?" I will never intrude into someones VERY personal business unless I know them really well and/or there is a mutual bond and agreement that it's okay to ask such questions (such as at a support group). Not to mention asking someones weight or how much weight they've lost. They may think it is complimentary, but how would they feel if I were to ask them the same question?