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

I had followed gastric surgery stories like Carnie Wilson's experience and then did extensive research on the internet. My cousin had the surgery performed in Texas, and she didn't have any complications and lost 120 lb.

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

I was on an HMO through HMSA and Straub Clinic. My surgery was approved with no problem. I checked with both my surgeon and the insurance company to be sure exactly what was covered. Visits to the dietician were not covered and a poriton of my psychological testing was not covered.

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

My first visit to the surgeon was very informative. My physician explained the surgery and answered all questions I had. I asked how many of these surgeries he had performed, how many deaths, the most common side effects, etc. He was very candid in his answers. I would advise people interested in getting this surgery to find a surgeon who is experienced and has performed over 100 such surgeries. The more surgeries the surgeon has performed, the better for the patient.

What made you finally decide to have the surgery?

My mother and two brother have diabetes. I had been fighting borderline diabetes for several years and was almost in the diabetic range. This was one of the main reasons I decided to go ahead with the surgery.

How did you decide which proceedure to have?

I never considered any other procedure than the RNY surgery. My surgeon only performed the open surgery, so I really had no choice between having it done laparoscopically vs. open. The reason I chose RNY vs. the band surgery is because with RNY surgeries, most diabetics were cured but this was not always the case with banding.

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?

The main thing I would tell people thinking about having the surgery is: 1) Read everything you can about the surgery; 2) learn everything you can about what to expect on the day or surgery and while in the hospital; 3) practice for 2 days eating a liquid/pureed diet before you have the surgery; 4) practice eating slowly; 5) have a positive attitude; 6) try to lose weight before surgery - the less you weigh at the time of surgery, the better 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?

My family was supportive although they had concerns. My boyfriend and co-workers were all against it. Many of my friends told me horror stories about people they knew who had almost died from the surgery or had bad experiences. One friend told me she couldn't figure out why I wanted to have the surgery. I told her, "because I want to live a normal life". My boyfriend and I almost broke up when I told him I had a surgery date. I told him, if he couldn't support me through this, then let's break up now. He then had a change of heart and kept whatever negative thoughts he had to himself. Postop, of course everyone was supportive. If I had it to do all over again, I think I would have told fewer people, but I had no idea they would react the way they did. However, after I made up my mind that surgery was the right thing to do, nothing anyone else said made any difference to me.

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 very supportive. I told them exactly what was going on. My doctor routinely keeps his patient's off work for 6 weeks. However, if I had asked him to do so, I could have returned to work two weeks postop. However, it was my decision to take off the full 6 weeks because of having to eat pureed foods. I felt it was much easier to do that at home rather than having to take pureed foods with me to work.

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

I was in the hospital for 3 days. I brought a portable fan that came in handy because for some reason I got hot in the hospital. I could have done without bringing my own gown from home because I wore the hospital gowns the entire time. I didn't really have any pain because when I woke up postop, I had an IV in my neck which was connected to a morphine pump. The only thing that really hurt was the staples in the 6 inch incision. I used the morphine pump more for comfort when I slept than for actual pain. I woke up with a tube down one nostril, the IV in my neck (for pain medication and also for hydration, blood withdrawal for lab tests, etc). I also had a urinary catheter and stockings on my feet/legs that massaged them to prevent blood clots. Every night before going to sleep, I was given an injection (alternated between each thigh and then my stomach) to prevent clots. I drank only liquids the first day and then advanced to pureed food the next two days.

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

I have never had any complications at all and I am now one year postop.

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

After I got my surgery date, most of my stress came from concerns of others about me having the surgery. One person even told me they dreamed I died on the operating table. I did feel some anxiety the day of surgery when I was waiting for the anesthesiologist to insert my IV tube before being wheeled into surgery. After that occurred, I don't remember anything else until waking up in my hospital room the afternoon of my surgery which began at 7:30 am that morning.

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

I had a pretty easy time of it. I live alone in an apartment that has two stories, and I was able to manage on my own from the very beginning. I had a friend who would drop by and help me if I needed anything. I ended up sleeping on the couch for the first 2 weeks because it was more comfortable than lying flat in my bed. This was because the staples in my incision were uncomfortable. The first 2-3 days I was home, the most difficult problem I had was getting up and down from the couch. Then, after about 3 days, the pain I had getting up and down completely disappeared. Actually, I can't believe how well and fast that I recovered.

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

I only had to travel 15 miles from my home. My friend took me to and from the hospital with no problem. I was able to drive myself to my 2 week appointment with my surgeon for removal of my staples.

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 ate pureed foods for 6 weeks, lots of cottage cheese and poached eggs. Since I could only eat small amounts of food, almost everything I ate was a protein. I also drank a protein drink throughout the day. Immediately postop, many things tasted really sweet and I didn't want them anymore. Even some of the protein drinks I had used prior to my surgery tasted different and I had to switch to other brands. At week 6, I went to the dietician and was allowed to start solid foods (except for salad which was allowed after week 7. I had been eating low carb before the surgery, and continued to do so afterwards. I never had any problems with any foods or milk. Only one time did I throw up, and that was from eating chicken that was too dry and felt like it was "stuck". Other than that, I have had no problems. I can eat any meats as long as they are tender. I am now one year postop and still eat low carb but I have introduced some higher carb foods into my diet on occasion. Occasionally I eat 1 1/2 slices of pizza, or whole wheat bread, and am able to eat 3/4 of an apple (usually with peanut butter on it). Strawberries and cottage cheese are my routine breakfast. At one year postop, I can now eat 3/4 of a ham & cheese omelet and 1 slice of whole wheat toast with no problem. I don't eat sweets except for low carb candy bars (only eat one a day) or 1/2 cup of low carb ice cream. I have never had dumping syndrome because I don't eat sugary sweets.

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

I walked almost every day. After 6-8 weeks, I started exercising to an aerobic exercise tape and then added muscle strengthening exercises. I have always had lots of energy.

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

I take 1500 mg of calcium a day (in 500 mg increments throughout the day); 1000 mcg of B12 (taken under the tongue) once a week; multivitamin/mineral (in the form of a powder) twice a day; COQ10 daily; extra potassium, extra magnesium, chromium daily. I also take zinc and biotin daily (started after my hair started falling out about 3 months postop).

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?

My hair started falling out at about 2-3 months postop and it was frightening to see how much hair would be in my hands after I washed my hair. I read up on the internet about what I could do and found that taking zinc and biotin helped some patients, so I started that and it did help. Since I was getting over and above the amount of daily protein I needed, I knew that was not what was causing the hair loss. Other than the hair loss, I never had any other side effects. However, during the time of the hair loss, some of my co-workers told me that I looked pale and tired (although I felt fine). At the 6 month point, my hair stopped falling out and color returned to my face. Now at one year postop and 100 lb. lighter, I do have some sagging skin on my thighs, stomach, arms, breasts, and slightly under my chin. However, the sagging is not as bad as other people I have seen who have lost the same amount of weight. So, for now, I don't plan to do anything about it, especially if I continue to lose more weight.

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

Waiting to get an appointment with my surgeon (it took over 6 months) and then waiting another 6 months before the surgery. Then, the last week prior to the surgery goes by so SLOWLY!

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

I have not been able to find any support group in Honolulu. I wish I could because it would be very helpful to me and others in this area.

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

My scar has healed really nicely and now is just a "stripe". I expected it to be uglier than it is, but it is smooth and not raised at all.

Please describe any plateau experiences you have had since surgery.

I have always felt that my weight loss was slower than some other people, but I never let it get me down. It took me a year to lose 100 lb which averages 2.08 lb a week or 8.33 lb a month. Also, I came out of the hospital weighing 12 POUNDS MORE than when I went in for the surgery. This was due to the IV fluids I received in the hospital, but it took me a full 2 weeks to lose those 12 pounds. At the one year point, I have lost about 1.5 lb over the last 2 months so my loss has really slowed down. However, I am almost at goal weight, so I just take every day at a time.

Do you notice people treating you any differently now?

Strangers definitely treat me differently. They look at me and I look at them. When I was obese, I never made eye contact and neither did they. People talk to me all the time now, hold the door open for me, smile at me. My co-workers don't actually treat me differently other than to keep telling me how great I look.