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

I heard of bariatric surgery years ago, only back then it was termed stomach stapling, I had an uncle who's wife had the surgery when I was a teen but I didn't think much of it because it wasn't a problem for me at the time but over the past 5 or so years I'd been hearing about this weight loss surgery, since the big Carney Wilson break out. And as it became more and more public it attracted my interest. I thought it sounded great for those who truly needed it. By the time the Dateline program showed Al Roker's story, I was convinced this might be the answer for me because again after being diagnosed with hyperthyroidism and taking medications for about a 1 1/2yrs my levels had gone back to normal and I was off medicine for a 1yr I thought why am I still not able to get any real weight off, I discussed this with my doctor that maybe my metabolism was effected by this and I needed help, he prescribed Xenical which was supposed to be the number 1 in success at the time. Well I started the prescription, joined a gym, joined Xenicare the support group, mapped out a 1500/day calorie diet and followed instructions to the tee. the support session was a 12wk recommendation and at the end you could start-up again. Well at the end of my 12 weeks, I only lost 7lbs before constipation set in with all the instructions being followed, 8-10 glasses of water a day, and lots of other fluids, eating right and on time daily, working out 3, sometimes 4 days a week to end up with this problem with the medicine. Most people got diarrhea from this prescription I was told and that was never the case for me, so my doctor became concerned and stopped the prescription, I felt like a failure back to square one and of course the 7lbs and them some came back. I started researching doctors and facilities for myself for the surgery. But first, I met someone who joined the new phenomon CURVES so I said what do I have to loose but try and see if this works for me, well to no avail and $149 less I lost not 1lb in 3 or 4 months, not 1, I was disgusted.

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

Well, I guess on this subject, I must say the insurance approval process was smooth for me. As long as I met the criteria of being 100 lbs. over my ideal body weight I was approved. My insurance carrier is Qualcare PPO. My doctor's Coordinator processed and submitted all necessary forms to my insurance company and the next couple of weeks I received a letter saying I was approved. I know that might not be the case for everyone, but I would say if this is truly a decision you have made and want it bad enough then do whatever it takes to fight and get approved. I'm told there's a law that supports the surgery and insurance companies have to offer because of the National problems with Obesity and Morbid obesity. So if your medical doctor diagnoses you one of the two terms then provide whatever health info to the insurance company to back up your request and find out what your entitled too in your plan, make sure you understand your services, which a lot of people enroll in their employers plan and most are contributory and do not even know what is covered for themselves and their family memebers. Read your plan's hand book, call their customer service and ask questions directly until you get the answers you need. A lot of people think that when they take the benefits package with their employer that the Human Resources Dept. is responsible for making sure they are benefiting from all they are covered for and that's not totally true. Yes, initially Human Resources is who you enroll through and should be giving you detailed benefits summaries to explain the entire package -medical, dental, eye exams, etc. At that time is when you can ask questions and they are available throughtout your employment history for that purpose, however they only act as the liason for the employees with the Insurance carrier. That company you work for has purchased a plan from the Insurance company that best suits there budget to include the number of staff they have to offer benefits. And they have to explain and share as much as detail as possible about your plan. But the insurance company is the one who facilitates the plan that was purchased by your employer and if and when your HR Dept does not fully satify your needs, then contact them directly that is what you are paying for.

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

Well, my first contact with a surgeon was back in January of 2003 at Hackensack Medical Center and the process was, you needed to attend one of the surgeon's seminars before you schedule a consultation. I signed up for the next available seminar. Which was an auditorium of people interested in the surgery, people who already had the surgery and the surgeon and some of his staff. He showed a film explaining the Bariatric Surgery from A-Z, the types, the risks, the statistics the whole bit. Then he opened the floor for questions and anwers and the biggest concern in the audience was how many surgeries he had done and how many did not make it. From what I remembered was that he gave a number of approx surgeries scheduled per week but some how danced around the fatalities. He kept highlighting the Medical Center as a whole and how many surgeons total that do it and how many are done total a month by all physicians and I don't ever recall and exact number or approx which raised my eyebrows, I won't mention the particular name of the doctor, not to discredit him, this is only my opinion. Anyway, I decided to still schedule the consultation and have a one on one with him and then I could probe a little more on that topic and questions of my own that I didn't get to ask, like recovery time and support groups and things he may had not touched on already. I went for my consultation 2 wks after that seminar and we met, I wasn't totally confident in his presentation of himself and experience or maybe not that he wasn't qualified but his personality was too mild manored or something or perhaps it was my own fears, this is major surgery we are talking about with a lot of possible risks, like any surgery but this to me was ultimate in decision making and you want to feel safe. To get the most out of the meeting beforehand right down your questions and don't be afraid to asks lots of questions even the silliest, it may make the difference. In the end I was convinced nonetheless and I scheduled my surgery for February 18, 2003

What made you finally decide to have the surgery?

Well, again my physical condition was such unbearable that my everyday life was a struggle. The desire for life as I once knew it was gone and I am only 37yrs old which is too young to end up miserable and bigger and bigger. Certain numbers in my head I would tell myself that I would never allow myself to get to and then I did and so I would increase the number and this last number of 300lbs scared the life out of me and so at 320 approaching 350 I couldn't take it anymore, I was walking around with the weight of two people. After scheduling my surgery date, I was told his office would handle all of the paperwork and that the hospital will contact me for pre-admission testing. I waited, and again in couple of weeks I got the approval letter and was all set somewhere around 2wks before I was scheduled for pre-admission testing and then the bomb hit. I received a call a week before pre-admission testing from the doctor's office, the coordinator telling me that this doctor has relocated and left the practice and a new surgeon will be coming in from Florida to replace him and would be able to do my surgery on the same date scheduled. I panicked, I thought this was odd and too, I never met this new doctor, knew nothing about him, it was already that I knew little about the origional doctor. She said I could come in and meet him beforehand and that's when I put a halt to everything and said I would rescheduled for a later time instead. My next consultation was for the end of July with this new doctor who had been in the practice for two years is all she knew about him at the time. I started talking to people an discussing this experience and almost wanted to reconsider. But I now was at the point that now I am approved and when I shared all this with my insurance company I was told my approval was still in effect and once I found a new doctor just contact them and update my records. The research began, I came across obesityhelp.com and found a lot of good info. and insight. I then met someone through my field of work who I happened to be interviewing for a job and she shared she had just done the surgery 6 mos prior and after we finished the professional part we talked and she referred me to some surgeons that she had already researched and had even done an assignment in college on Obesity that she shared with me too. One of the doctors on her list was the surgeon I ended up using, his name came up again through another collegeau who's boss had the surgery done by, so I decided to set up an appointment to meet him in May/2003 and it was the best decistion I ever made because, he turned my whole first experience into a new and more competent experience. This man named Michael Nusbaumm, South Mountain Advanced Surgical Assoc. was sent to me from GOD I believe. He was so thorough in his process step by step, very detailed, very reassuring, confident as well as competent and that's not to down play the other physician, but he has this booklet that he gives out at his consultations that he goes through with you front to back with pictures, he makes drawings in the book to show you an image of your personal outlook with the surgery. I can go on and on and immediately I signed up along with the other great recommendations I was sold. Lastly, his pre-admission process was somewhat different then at the other facility. He requested a series of test before the pre-admission testing even, I told him I hadn't done any of that before. I had an Endscopy, EKG, Pulmonary Function, Stress Test, Venous Doppler, General blood work and then because my iron was low I was sent for a Colonoscopy. All these test is why I am able to sit here and share my success story. Even though we started out in May/2003 and it took a couple of change in dates up until the final date of September 26, 2003, it was worth the wait because had I gone for surgery with some risks or conditions that needed attention to miminimize all possible risks I may not be here today and with that I have my Higher Power who I continually prayed to for guidance in every decision before and now after the surgery and Dr. Nusbaum

How did you decide which proceedure to have?

After discussing all the options, the rouxen Y seemed most appropriate based on success rate and risks of complication.

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 biggest fear was leakage, which is the #1 complication that leads to death, I was most afraid that what if the staples do not cover every space of the incisions and then my doctor once again reassured me by being the only surgeon known to take extra steps to prevent leakeage. He in addition to the stapling, hand stiches the wound also as a 2nd safety, I was relieved to hear that he does that because it helps him sleep better knowing he took every possible precaution to assure a successful surgery. No one is perfect and even with that, things could go wrong so what I would share with others is to think this through, make sure all your questions and concerns have been addressed about the procedure and once you feel confident in the professional you are working with, the rest is up to you and your Higher Power. Pray about it and then turn it over. It may be easier said then done because I was a nervous wreck the closer I got to my date but I knew this was the right decision and I knew even with some of the dates being rescheduled that things happen for a reason and that GOD was in charge and once I gave it to HIM then I had to just trust. And for those who may not believe in GOD then you can make anything your Higher Power as long as you believe something Greater than yourself is capable.

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 got mixed reviews at home and at work up until the day I left which from my life experiences I am used to the odds being against me and I guess I am so strong willed that once I make a decision for my life, it doesn't matter if I have the support or not. I have lived for others and have given of myself so many times even up until this day that if not one person in my life would have supported me I probably would have done it anyway. I am a loner for the most part, I have a small family, and friends I can count on 1 hand and at work, my personal space is my personal space and because I am sharing my experiences with you, means I welcome your opinion but it would not affect my decision. I have to go back to my spiritual relationship with GOD and once I felt secure inside after conversating with HIM over and over during the decision making I was prepared for whatever. So it wasn't until then that I even shared with anyone my plans and if it wasn't HIS will for me or if HE didn't have my back, the surgery would have never taken place. That's my belief.

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

As I stated prior my co-workers were mixed, those closet only respected and supported my decision and if they didn't particularly agree with it they kept it to themselves which is the same way I would have reacted if it were their lives, they may have asked questions and once their curiosity was satisfied then they were in my corner. And then you have those 1 or 2 negative people for the sake of being negative ( ones who find wrong in every situation) that kept questioning my decision, some mild sarcasism things like that but in the end they all showed genuine concern and wished me well. Brought in breakfast that morning and cake for dessert at lunch time, along with new pajamas and slippers and a balloon on my last day of work. So overall they supported me, some peoples fears may have been the reason for the comments but again I can't live for anyone else but me first. I have to be the most important person in my life before I can be for anyone else.

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

I went into the hospital on Friday, September 26, 2003 arrived at 12noon and was scheduled for surgery at 2pm, all I was told to bring was myself and no personal belongings, that my family could bring them later once I was placed in my room. So, although I had all my personals in the car the only thing I took for admission was my I.D. (driver's license) and then gave my pocket book to my Mom who came along with my uncle and youngest daughter, 13. I was admitted for 4 days and usually the length of stay is 2 - 3 days is what I was told origionally, in my case on Saturday my blood pressure rose up too high into Sunday and so they needed to monitor and stablize that. I had never had any previous problems with blood pressure so maybe it was a result of the surgery, I don't know but by Monday it was back to normal and then I was almost ready for discharge and then my first bowel movement had blood in it and so the doctor wanted to monitor that and make sure it wasn't continuous so I had to stay and wait for the next one to be tested and sent to the lab since the RN made the mistake of telling me to flush the first one and no sample was taken. So I had to repeat blood work to check my hemoglobin since I am also anemic which brought me into Tuesday, finally everything looked fine and I was discharged by 11am. The most important for me to bring was extra pajamas and slippers, deodorant, tooth paste, the usual over night bag. Even though I ended up wearing hospital gowns the whole weekend there. I decided to put my pajamas on when I got home.

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

I had no complications from the surgery. I was told the procedure takes anywhere from 2 - 2 1/2 hours and I was out in 2 hours. No fever, no vomitting, nothing Thank GOD!

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 couple of weeks, in fact at least for the first two months I was on a Natural High. I felt so good inside and out that I went back to work in 3 weeks, I was getting bored at home and watching T.V., all I saw was a million commercials with food advertisements, making me hungry. Eventually, that high started coming down and I began experiencing exertion, which the surgeon did say might happen. After around 3 or 4 months, I started feeling depression and the anxiety but couldn't quite understand why. Then the blood pressure began to rise again and my medical doctor said I was retaining water around the ankles so he put me on a combo of blood pressure & water pill. Then he aslo prescribed Wellbutrin SR for the depression. I could only attribute these changes to my work, that's the only place where I felt the most stressed. Even though the weight loss has been steady and consistent, emotionally I have been up and down to date. 6 months post-op.

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

Well, yesterday marked my first official week from the actual surgery and I will be approaching a full week home on Tuesday, Oct. 7th. I feel great, I can't complain, see I know people are different but my experience has been amazing. If I didn't know I had surgery I wouldn't know I had surgery that's how good I feel physically. Emotionally though I am starting to experience hunger cravings which I didn't know I would from the size of your new stomach and all but for me I am struggling somewhat with that. But staying focused, following the doctors orders because I know in the back of my mind all these good feelings can become bad if I rush this process. It may take me 30 minutes or so to complete a 8oz glass of Instant Carnation Breakfast drink made with Skim Milk but then once it's digested I may feel full and then a hour or two later hungry again so I am constantly sipping on water or other clear liquids in between meals. I am at stage two of the five stages recommended by the Nutritionist when I left the hospital. A full liquid diet, anything that is no sugar added, fat free or low fat that can be sipped by a straw I can have right now for the next 2 to 3 weeks is the suggestion. Stage 1 was clear liquids only, water, apple juice, etc. The next stage is 3 pureed foods could be added to my diet and stage 4 is soft foods and then 5 normal and this is all over a 8 to 10 week process after 10 weeks or so you should be able to take in a normal diet. It varies per individual. My first follow visit with the doctor is next Wednesday, October 8th and so I will dicuss this with him and let him know how I am feeling and I will meet with the Nutrionist on that same day, their offices is in the same building, they work as a team in this surgery porocess. Good recommendation to find a nutrionist immediately after surgery which I am sure most surgeons refer.

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

I only trvaled approx 25 to 30 miles for surgery, I found a local surgeon who came highly recommended and I knew he was the one for me after my consultation with him.

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.

Initially, I was able to tolerate the Instant Carnation Breakfast drinks and then after about 2wks I could not take them, I would take 2 or 3 sipps and would immediately feel bloated and very full. Also 5 to 7wks post-op, I tried a fruit salad and again not good, too, too gassy for my afte one or two pieces of cantalope or melon. I can now eat salads with some a slice or two of deli meats and cheese, but some of the low fat dressings aren't settleling well, like Ken's lite balsamic vinegar.

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

My activity level has been pretty much the same over the past 8wks, however I do notice I can walk a little further than I used to without heavy breathing. I just signed up for the fitness center at my job a week ago but have yet to go work-out, I felt real syked and now sluggish and exertion somewhat. I went for blood work twice already and my iron is still very low, I have anemia and the doctor is concerned, I need more iron intake and then perhaps I can begin working out.

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

I have been taking Centrum's multi-vitamin daily since surgery but again since my iron is still low the surgeon suggested I take Centrum twice a day rather than just once, I also have been taking an extra 250mg of vitamin C and will be looking for an additional iron supplement that is not constipating.

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 am still only 8wks post op and I have to say I have been very fortunate with side effects, the only experience I have gone through so far is the hair loss, I went to see a dermatologist who ordered blood work and it appears my thyroid level is a little high, I was on medication for this over a year ago for about 6 to 9 months and then my levels went back to normal and the Internist to me off the medicine and I have been fine and now all of a sudden after surgery my levels are up again, he repeated the blood work to make sure, so I will see but again I have had no other side effects and I feel great. The one thing, I find troubling and that's feeling gassy a lot even when I'm not eating and only sipping on water.

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

For me anticipation, I was a nervous wreck, my date was changed 3 times and mostly due to my iron levels and then I had a bad case of bronchitis and so the waiting was making me second guess my decision but otherwise I'd have to say again I was very fortunate with no problems during paperwork, no problems during surgery or after. No complications, minimal pain, I was blessed.

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

I haven't joined a support group yet, I think it probably would be helpful and I plan to research one in the near future

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

My scar is not bad at all and yes it is what I had expected because I had laser surgery in the past when I had my gallbladder removed and so I kind of knew what to expect, it's just that they re-entered one of my previous scars and so now it's a little longer.

Please describe any plateau experiences you have had since surgery.

To date I am 5 months post-op and down 100lbs. So far I have not reached a plateau yet. I am still loosing steadily and loving it. I would like to loose no more than 40 or 50 more lbs. I joined a fitness center and that's my only gripe because I do no go regularly as I should and I am afraid of the extra skin hanging. So far it's no worse than it was 100lbs. larger, I am still young and so I guess my skin still has elasticity which is helping me look very proportionate for now but I intend to pick up on my work outs.

Do you notice people treating you any differently now?

No, not really, I'm grateful I don't have that problem, at least not for now. The only thing is my co-workers comments almost on a daily basis about my weight loss and I'm not sure if they are proud of me or jealous. You get the scarcastic comments, like I hate you, look at you, soon I will need your old clothes. Things like that.