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

Being a nurse I heard about stomach stapling surgeries many years ago. I had been warned by co-workers that "it was a dangerous procedure - Don't do it." Well this past spring 99, when my asthma and obesity hit an all time high - I needed to do something, because I was no longer living. I could not walk from the hospital parking lot to my office without stopping at least twice to catch my breath - I sweat all the time. I couldn't enjoy an afternoon of shopping with my daughters. I started by surfing the net and learned about the many procedures available. I read profiles and asked peers and surgeons, as well as my own doctor what they thought. I wanted the best surgeon, with the best outcome. I found him with my many questions, his bedside manner was not good, but his success rate in the operating room was superb - so after insurance ok. and 5 months of waiting - I took the plunge - it is still scarey - I had rough moments - but I feel it is the best thing I could have done for me.

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

Write your own letter - of why you want surgery. List the programs that have not been successful in your battle and list where you hope the future will go for you. My personal physician, OB/GYN, and surgeon wrote letters of support for the surgery to my insurance company and included my letter. It worked and was totally paid. It's frustrating that they have such control of your life - but keep perservering don't take No for an answer. Appeal the No - and hopefully it will go through for you.

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

4 minutes of nothing. Being a nurse I know the type of person my surgeon was - but his reputation in the OR overran his attitude. He poked my tummy and said "you're caring all your weight here!" My 20 year old daughter's response was "Thank you Dr. obvious!!" He did not discuss the procedure looked at my letter and said "Now we need to get this ok'd by your insurance." That was it - Thank God I had read up on the procedures and knew what I was up against - but I was frustrated that I waited 2 1/2 months to see this guy to have 4 minutes of silence and his poking. It was a let down, but I was able to get support from my family and actually my surgeons secretary who sent me info - and referred me to a young local surgeon, who had trained under my surgeon and the local young surgeon, was my godsend for post - op care and teaching. I developed a post - op infection and he helped with that too. He taught me everything that the "old" one didn't and was very personable. I go to occasional checks with the original surgeon - but I love his young residents better. Make your needs known and pick the surgeon that is known for quality workmanship - find a person, who is knowledgable for questions too.(this may or may not be your surgeon)

What made you finally decide to have the surgery?

Not being able to breath and be a part of my families life. Weighing in at 410 # and knowing I would not live much longer if I didn't do something.

How did you decide which proceedure to have?

I wanted the best nutritional support - being a nurse I new I needed to have the nutritional support to survive and not have complications. The RNY gave me that. I learned most from the internet investigation.

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?

Pick a good Doctor. Know your own post-op care - you need to be your own advocate. I had terrible post - op care. I knew with my history of asthma - I needed to move right away and I did. I went home 4 days after surgery for sanity and safety. I wanted a recliner to rest in. I asked losts of questions and kept asking until I got answers. My families and friends care was the best and I moved. Get a strong support system. It is necessary. Talk about your fears with the physician and nursing staff. Even the smallest surgery has dangers. Be your own advocate - and make sure you do just what you need to do. You have to be positive for you.

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 had tremendous support - my friends and family wanted me alive - they had seen my physical decline and knew I had to to something - they all supported me - My co-workers supported me. I work at a nonprofit organization and my peers were so supportive. I talked about the procedure and what I was planning on doing and I met NO negative responses. My friends, that were Doctors, warned me about what to watch out for, and were very supportive too. They all knew as I did - I had to do something. My husband took off 3 weeks post - op to care for me. He slept on the floor -so that he could help me in those early days when I needed to get up or needed help in the bathroom - he went beyond marital vows - He has been my strongest supporter. I knew he loved me at my large weight and I know he knew I needed to get healthier so we could grow old together. My friends, baked and cooked and brought me magazines and flowers. They were wonderful too. Many said "you've given so much in your life - now it's your turn." When I got down 2 weeks after surgery and felt "What have I done!!!! my aunt especially - through me back into reality - saying " you had to do it Mary, you could not go on the way you were - it was not living." This was my help. This is my continued strong support. It is definitely needed.

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

My employer was supportive - I told them right away. I was off work 4 weeks. I filled them in on everything. It took a long time (5 months) for the final date setting and all the paper/insurance work to go through - but they have been very understanding. I did not have disability so I took the time off - not paid. I also job-shared with another nurse so she picked up my off hours -so I could do this for myself. I approached them and explained I would be a more valuable person -with the weight off and they supported my decision. Because I have MORE energy.

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

HELL! I'm a nurse. I stayed as short of stay as possible. I was never turned post op - I was not helped and they were told of my dissatisfaction. I was my own advocate and got out in 4 days. The residents and medical students were my support. I came home with a six inch line of bedsores on my back - they had no recliners or foot rests so I built up with fluid. The nursing staff knew little about the diet and liquids. I learned what I needed to from the visit from my nutritionist. That is why I am sharing all of this -you need to be your own advocate. You need to move and it is not and easy procedure or change in you life -but you have to want it really badly. Bring everything - a journal - a fan - lotion - soap - toothbrush - chapstick -mouthwash- deoderant- comfy clothes and pillows - especially for the ride home.

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

My worst complication happened last week, 7 week post op - I developed an abcess under my incision line - having a high pain tolerance and not knowing what to expect - I kept asking about the hardness in my incision and was told it was scar tissue -but last week even my stretch marks were stretching and the area became warm to touch - I had a fever -which I didn't feel because - I'm always hot - but they cut open the incision in a few places, but the worse was this midline area - its been a week and I've got packing inthere still and see the local surgeon for changes every few days. My incision healed beautifully but healed on the outside and had this pocket inside that festered. Now it is healing and I'm on antibiotics. I have been told that this is probably weakened the site and I may end up with a vertical hernia - but now I know what to expect. It has improved my sleeping to have all of the fluid removed and to have it still draining. Now my weight loss has also hit my middle abs. Update - 12/1/00 Had a small ventrical hernia to the right of my pouch - had surgery outpatient and recovering now - all is well.

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

As addressed previously, my friends and family were my stronghold. They have helped me continue to perserver. The change in eating has been the worst to deal with. We used to eat out and go out with friends allot. I still can't handle "real food" too well so we go to more movies and play games etc. Food is no longer a priority. So you have to make your social side in other places - I am told the eating out will improve but so far - I prefer to eat at home - just incase I get nauseated or have the wonder "dumping" feeling. 12/1/00 Eating is much improved I know my limits and get that full feeling and know when I need to stop eating.

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

You really go through a post partum depression. You ask yourself - Did I make the right choice? That is were strong supports come in and journalling. I reread my preop writings - I reread my list of what I wanted to do when the weight started coming off. I remember the first time I was able to buckle my car seatbelt with out the 'extender' I was thrilled - even in my husbands little car - you begin to move and feel better. You find out which foods work better for you. Gradually it seems ok - but that self - doubt can crop up - but you just begin to see changes and that is wonderful.

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

70 miles. I forgot about the drive home post op - it was not easy. Take a pain pill before you leave and bring many pillows, a bucket, and water(or cool liquids). I was able to follow up post operatively with a local surgeon, who had trained under my surgeon in Madison, Wi which is 70 miles away, as I said before being younger and local - he really did help me and explained allot of things. You will feel every bump and bounce on the drive home - that is why taking the pain meds are important - I didn't take any -thinking I'd be ok - but I really think it would have gone smoother if I had. I also took one during the next week at bedtime - it really helped me sleep.

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.

Well - I'm 8 weeks and counting - I've lost 65#. My favorite foods are small curd cottage cheese and mashed potatoes. I still can't tolerate meats much. I can have some fish, but with full liquid type soups. I always drank liquids(cold) when I ate and not combining the liquids and solids is still hard for me - because I get thirty. I hate the "dumping feeling" I've worked with our local nutritionist and found other ways in adding protein to my diet. 1/23/00 - 4months and counting - eating mushy stuff - mashed potatoes, baked potatoes, cook veggies, crackers, cheese, pretzels, fruit - canned mostly, small bites of apple and some others. Eat new stuff in privacy of my home - so that if it does'n sit well I am close to my bathroom. never try anything new - if I have to go somewhere soon - try new stuff when I have time - eat about 5-6 small meals a day approx 1200 -1500 calories and vitamin. OJ at least once a day for electrolye balance

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

my activity has increased each week. I did develop an abcess in week 7 so that did hold me down a bit until it heals. I can breath much easier. I have more energy - its only been 8 weeks. 01/23/00 - great - do feel tired at night - never been a morning person - but actually have much more energy. Before surgery could not do grocery shopping without sweating and being exhausted - now can shop and shop and shop and still make dinner and do things at home - its wonderful and no more sweating (unless of course its hot in the store) Each day gets better and I feel better too. I can walk and talk at the same time - I don't have to take rest periods as often.

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

I take a daily centrum vitamin. I did not start that until I was well healed approx week 6. I have had electrolyte labs done and am doing fine. I eat approx. 900 cal a day but need to increase that to 1200. I do drink at least 1 glass of OJ everyday - it just makes me feel better. Thats it - but I'm only at week 8 - I've lost close to 70#. 1/23/00 still the same try to eat balance food.

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'm only 8 weeks into surgery postop - I still have nausea and dumping. Only vomit when I eat too fast or have meat - ie. chicken/beef etc. I am taking it very slowly. I drink milk and have cottage cheese. My sleep has always been bad - I had worked 20 years as a nurse rotating shifts and mostly working 2nd and 3rd shift - so I'm an insomniac at times. I just deal with it and surf on the net when I'm up late. 1/23/00 - I still have times when I have nausea and vomiting - especially if I'm trying something new or eat too fast or too much at one time. Protein - beef,chicken etc - still makes me vomit - even when I eat in small amount - I can tolerate it in thickened soups - but not alot. cheese, cottage cheese and soft cooked eggs are my best. 8/7/00 What can I say. I am 170# lighter all the side effects in the world were worth this feeling of hope. I still have some problems with bread, hair loss and had a IV iron infusion in July for anemia. But I feel WONDERFUL. BP 116/60, can breath and walk and talk at the same time. I feel a part of life again. Only rare nausea/vomiting if I eat something too fast or to much. No problem in coping.

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

My hospital stay and the fact that lots of people talked of the preliminary and post - late outcomes(great weight loss) but rarely did people discuss their struggles with dumping and adjusting to the food - eating change. I find that the most difficult. I miss my steaks and baked potatoes - not enough to change my mind, but I would just love to have a salad with ranch dressing one more time. It is hard and I'm only beginning. I've had to ask myself what do I want more. 1/23/00 - have my baked potatoes still no steak - but thats ok - our whole family is eating better. and our food bill has gone down too.

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

None - you. I have friends and family, but there are no support groups to be had. I surf and talk with others and read up on profiles. It is important to have people who have struggled, tried and conquered. Who have gone through the same hell. I too am keeping a journal and may publish it. 1/23/00 this website has been helpful I have chatted and hope to have a support group starting in the area soon. 8/7/00 I have been asked to start a support group at our local hospital - I have lost 170#. I feel great and think morbidly obese people need empowerment in whatever weighloss program they choose. 8/7/00 I have taught prenatal, infant and babysitting classes at our local hospital. My boss asked me to facilitate a weight loss support group starting this fall - I am - No weigh ins - just empowerment. She was able to obtain a grant from a pharmacutical company. I know it will be a success. This has been my success. Helps me stay on tract. 12/1/00 Started a weighloss support group for all people who wanted empowerment and support in November. Have 30 members - do not weigh in just have support. The 1st meeting of the month is a speaker - this month is a dietician talking about "making it through the holidays". It has been a great support for me. You know after a year some of the easiest things that sit well in your tummy after a RNY is chips, crackers, cookies - so I still need to work on the habit breaking techniques and have the support to keep up my weigh loss and eat healthy- I've lost 197# since Sept. 14, 1999 and have wonderful electrolytes and am doing well - I feel great!!!!! 5/10/01 Had a weighloss support group, but found it hard to stay positive over my decision to have a RNY because most of the participants thought it was an easy way out. They had not had a life of morbid obesity like myself. I chose to give it up and am looking into starting a support group for those people in the Fox Valley who have had gastric bypass surgery. That will be in the future next fall - I will update this website to time and place.

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

No - I took care of patients early in their recovery. I developed an abscess and right now it is draining. I have been told I probably will have a vertical hernia develop due to weakening from this abscess. It is a major incision. It cuts through 6 layers of muscles. It is amazing and painful post op. Scar tissue formation is unusual - It is all a learning process. Nothing is unbearable. Just get a good education from your surgeon or his associates. My scar runs from just under my bra line (sternum) to my navel. I was surprised in how long and big it was. Any problems question. My abscess formed right under my nose. It festered for weeks and finally turned warm and red to touch and my tummy was taunt. I went in right away - They drained allot of infection out - my incision had healed on top, not inside. This can happen when you have such a major surgery and are obese. 1/23/00 - no problem shriveling with my weight loss. 8/7/00 - unchanged, there - no problem. with the 170# weight loss I am very, very pleased - scar no problem!!!! 12/1/00 Had a small hernia on upper part of abd. repaired they cut right into the old scar it is healing. Saw a plastic surgeon last week and may do a "tummy tuck" in Spring - just have to wait and see if I want to do it. It would shorten my scar tremendously. 5/10/01 Haven't had tummy tuck yet -- have had all ok'd by insurance but need 6 weeks off of work to have it done and can't fit it in my schedule until next spring. I feel great without it. So trying to decide if I will have it done. It would remove 70# of excess skin and fat. Trying to decide.

Please describe any plateau experiences you have had since surgery.

Now at 4 month and having lost 110# - I'm ok with my plateau - Ithink the body needs that to catch up and I feel great. I have alot more energy and I am losing in inches. I just keep watching what I eat - as the temptation of chips, crackers etc seem to get easier to eat with out "dumping" I really want to make sure I don't live on junk food. I try to balance veggies(cooked), fruit and of course take my vitamins 8/7/00 - I have had an occasional plateau - am currently on one - but have lost 170# in less than a year - I don't worry - just try to keep my food intake varied and nutritionally sound. Take vitamins and had a Dextran Iron IV infusion in July/00 for anemia. Otherwise swimming walking and feeling fine!!!!! 12/1/00 continue to have them - don't mind I feel it is my body adjusting to the tremendous weight loss - just want and feel healthier!!! Keep eating well balance and walking. 5/10/01 Plateau yes - do I mind NO. My body has lost 206# in 18months it's bound to catch up a bit and I want to stablize too. don't want to look gaunt or sunkin in my face or body. Happy with my new self and new energy.

Do you notice people treating you any differently now?

They are very supportive. My weight loss is starting to be noticable. So far not much change accept - total support. 1/23/00 2 months and not a negative comment about me - I had them daily when I was 110# heavier. continue to have much support from everyone and I feel much better. 8/7/00 - I can buy off the rack - yes - no more negative comments - Doors are held open for me - no more ridicule - It's quite wonderful. 12/1/00 some of the shock has warn off - but people still see that I've lost alot of weight. The world is much kinder to thinner people - I know I am living it. No more ridiculing remarks - no more terrible stares - I feel a "part of the human race." Part of that makes me sad that obese people are treated so terribly - I will never forget the degradation I faced!!!! Never - ever -ever. 5/10/01 Yes, I was recently named Woman of the Year for Fond du lac - It is amazing. It is for my work with young/ at risk woman, but just wonder if I had not lost the weight if I would be here today to enjoy this honor or even be eligible. Life is soooo different - can fit into booths, hardly never hear a negative comment. It is amazing.