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

I have known people who have had "stomach stapling" surgery for 30 years. Frankly, most of them had been successful - some for many years - before gradually (or not so gradually) regaining their weight. I had resisted WLS, thinking it was "the easy way out" until I began to have some early symptoms of diabetic retinopathy and neuropathy. Then I began doing some research on the Internet and talking to people who had had gastric bypass. My primary care physician brought the subject up at one of my regular check-ups and I told her that I wouldn't have it because of my looks, but that I had read about diabetics whose symptoms improved greatly after having the surgery. Her response was something along the lines of "obesity and lack of exercise brought on the diabetes in your case. If you lose the weight and get the exercise, your diabetes will be improved - maybe even cured."

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

My insurance company required a recommendation from my physician, the surgeon, a dietician, and a psychologist, as well as a letter from me stating why I wanted the surgery. I think these are pretty common requirements for most insurance carriers. I took a lot of time writing my letter and revising it. I listed every diet program I have tried and the disappointing results I had. I also listed my own private diet strategies and their results. My advice for others would be to be very honest with yourself and to really work on that letter, making it honest and detailed.

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

My first visit with my surgeon was wonderful. His nurse asked me to fill out a detailed survey before he came into the exam room and when he came in, we discussed my answers. He took his time and answered all of my questions thoroughly. He also was careful to tell me about possible complications and the risk of unreasonable expectaions. (I think he may have been afraid that at 50, I was expecting to look like one of the Sports Illustrated swimsuit models after surgery!) He made me feel very comfortable with him as a person and I was already very confident about his skills as a surgeon. People need to be open and forthright with their surgeon and they need to be sure that there is a strong one-to-one connection with him or her before putting their life and their future in that person's hands - literally!

What made you finally decide to have the surgery?

The complications I begain having with my diabetes. At 50 I was afraid that I would lose my sight and my job and my hobbies require that I be able to see.

How did you decide which proceedure to have?

Locally, only the RNY procedure is available. I really didn't want to go elsewhere for it since that would have meant driving at least 2 hours for exams, surgery, follow-up, etc. At the time I had my consultation, only the open procedure was done in my town, but by the time the preliminary exams and reports were finished and the insurance approval came through, the laparoscopic procedure was available. Since that had always been my first choice (I'm pretty impatient about things like recovery) I opted to have it done that way.

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?

My fears and concerns were what I believe are normal for anyone facing major surgery. I had read about complications in this specific surgery and ultimately, the individuals who had had the complications were glad they had gone through with the surgery afterward. As far as death, I figured that if I kept going as I was with the Diabetes and high blood pressure, I would die early from one or both. And I wouldn't enjoy my life much until then. I took my fears seriously and I wrote both a will and a living will and gave copies to the clinic, the hospital, and the administrator of my will. Then I prayed for God's protection and for a successful outcome. My advice to others would be to acknowledge and confront any fears and concerns and to make your peace with them before having the surgery. It IS a big deal and I think you need to be realistic about all of the possible outcomes.

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?

Surprisingly, my mother, was encouraging. Her attitude was that if she had had my weight problems when she was younger, she would have opted for the surgery herself. I expected her to be totally against it. My sister on the other hand, was honest about her feelings that it was too risky and that I shouldn't do it. But, she said "I'll support you" if you decide to go ahead with it. I told friends and colleagues the truth about what I was doing (since I figured they'd figure it out anyway) and most were encouraging. It's been 9 months since the surgery and now people are very happy for me. For them, it's mostly about looks and they are delighted that I'm so slim.

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

I was also honest with my employe about the surgery. I told him that I needed to have the surgery and that I felt I couldn't wait until summer (9 months away) because of my vision. He was supportive and my plan was to be out of work for up to 5 weeks. Due to the complications I had, I missed more like 20 weeks during the course of the school year. And my supervisor is still writing a letter of recommendation for me to begin a graduate program and to take a year of sabbatical leave. What a guy!

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 longer than expected. Since I opted for laparoscopic surgery I expected to be home in three or four days. Instead I was there for 10 days. Because of an allergic reaction to the antibiotic I was given during surgery, I lost most of my white blood cells - they were below 1, which is lower than what usually occurs with chemo patients. After injections, they finally came back to near normal and I got to go home. Mostly my hospital stay was good - not pleasant, but as good as could be expected. My main problem was that I got my period they day after surgery. I hadn't been warned that this happens to about 90% of female wls patients, so I was unprepared. So it's important to bring supplies with you, unless you want to use what they have in maternity. I would advise bringing pads rather than tampons since mostly I did not want to bend that far that soon after surgery. The other important thing I neglected to bring was my Carmex, so my lips got uncomfortably dry until my sister brought some to me.

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

Three months after surgery I developed a fistula. My gallbladder had attached itself to my intestine and it had to be removed. I had to have an open surgery for that one and it went well EXCEPT I got a staph infection in the incision. Not really that rare I understand. The infection kept me in the hospital for 31 days over Christmas and New Years and I got very weak from lack of activity. Once I got home it took about a month before I felt comfortable climbing up into my 4-wheel drive pickup and driving - not to mention shopping, vacuuming, laundry,etc. Mostly I just laid on the couch and watched TV as I slowly increased my daily activity.

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

During the month I waited for my surgery I coped with my anxiety by trying to prepare myself for the worst - you know, expect the worst and hope for the best. I wrote a will and a living will, asked people to be the administrators, explained what the surgery was all about, collected support from family and friends, and worked on shrugging off those who were not supportive.

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

I felt surprisingly well when I got home from the hospital and I found that I felt stronger and had more energy each day. I went from struggling to get off the couch or out of bed to go to the bathroom or answer the door to taking walks outside in about two weeks. I still depended on others for rides to the clinic, picking up groceries and prescriptions and other errands for a couple of weeks, but improved pretty rapidly. The surprising thing was that though I felt better and better all along, I wasn't 100% for about 2 months. I did go back to work and resumed my normal routine, but it wore me out so that I was in bed by 9:00 every night.

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

Luckily, I was able to have the surgery locally, so I only traveled about 3 miles. It made it much easier for aftercare since it was so close.

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.

For the first 2 weeks after surgery I was on a clear liquid diet consisting of broth, sugar-free Jello and popsicles, apple juice, and decaf tea. After that I cooked cereals (thinned) strained soups, skim milk, plain yogurt, tomato, orange, and V-8 juice, sugar-free pudding. The next week brought pureed vegetables and fruits and cooked meats (I used baby food) , poached eggs, and toast or crackers softed in the milk or soup. A couple of weeks later I added lowfat cheese slices, baked fish, canned peaches and pears, soft vegetables, baked potatoes w/out skin, rice, macaroni, corn and rice cereal, and soft bread/saltines. Gradually I was able to add meats which were ground after cooking, minced tuna and salmon, and chopped lettuce. About 2 months after surgery I got the go-ahead to gradually add regular table foods. I was pretty cautious when I started experimenting with regular foods and lucky for me, it went really well. I ate a little over 800 calories a day and I only had problems if I ate too much or tried to take too big a bite. I've learned to eat much more slowly than I used to. I tolerate almost all foods very well. I have the most difficulty with ground beef. Even a little bit leaves me feeling uncomfortable full for a couple of hours after eating. Needless to say, I don't eat many hamburgers anymore!

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

The first days after surgery my activity level was pretty low - walking in the hall at the hospital wore me out - ditto taking a shower and brushing my teeth! When I got home, my strength and energy gradually improved I was able to walk farther and do more of my normal activities each day. It took a couple of months before I could sleep a full 8 hours at once and do most of what I had done before. Of course, now after 9 months, I have way more energy and stamina than I did before and I'm enjoying exercising - walking every day, swimming 3 times each week, and doing some strength conditioning. I did develop a large hernia, so I can't do much lifting until I get that repaired and I'm putting off the repair until a year from now so as not to interfere with my vacation plans this summer.

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

I took childrens chewable vitamins for the first few months (2 tabs instead of one) and now I take an adult multi-vitamin every 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?

Sleep disturbance was the worst side effect for me. After being in the hospital, I woke up every hour or two for the first month and after that I sort of plateaued at 5 or 6 hours at a time until a little over 2 months when I started sleeping 7 or 8 hours at night. I didn't have much nausea or vomiting, but I did lose about half of my hair. It started growing back at around 4 or 5 months and surprise! it grew back less gray and it's curly! It looked pretty bad for awhile, but now I like it so it was worth it.

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

The worst part of the whol process was the "swallow tests" where you drink some stuff and they x-ray it as it goes through the intestines. I had 3 or 4 of them over the course of my hospitalizations and the worst part was that it was quite soon after surgery and I was still weak - and the radiologist didn't seem to understand that I was unable to drink a large glass of liquid in large swallows.

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

Our local hospital and bariatric surgeons offer a support group which is for both pre- and post-op patients. We meet monthly and I find it great for helping to keep motivated and for sharing with others who are deciding whether to have the surgery.

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

I have small scars from my laparoscopic surgery - but a large one from the open surgery for a fistula which developed about 3 months out. The first are smaller than expected, the second larger since I developed an infection and it took awhile to heal the incision.

Please describe any plateau experiences you have had since surgery.

I haven't really had any yet. I have been battling with an overactive thyroid so I have had more trouble eating enough than trying to maintain a weight loss at this point. I did have some radioactive therapy last week and I'm sure the whole thing will turn around soon. But anyway, I'm more comfortable trying to lose/maintain weight than trying to gain it!

Do you notice people treating you any differently now?

Yes! People actually look at me when I talk to them now. When I was MO, their eyes really didn't meet mine - except for my true friends. Many people who are only acquaintances, now strike up conversations - usually so that they can get to the question "How much weight have you lost?" Why is it that people will never ask you how much you have gained recently, but everyone feels free to ask how much you've lost? I feel like my boss treats me with more respect and pays more attention to what I say. He's more supportive and responds more quickly to emails. Sad to say, it seems that like many people, he likes me more now than he did 10 months ago.