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

A friend and I went to an informational gathering at what was then mmpc Medical Weight Loss Group, now Grand Health Partners. Dr. Kemmeter gave the presentation, and I asked questions and was told that RNY would have the most positive effect on my diabetes. Then I had to submit paperwork and get approval.

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

I met the requirements physically for my insurance coverage. My BMI was greater than 35, and I had more than 2 comorbidities. But since my BMI was a couple of tenths less than 40, I was required to go through a 6 month medical weight loss program, and show a 10% weight loss on it. I wasn't crazy about the idea of paying over $1000 out of pocket for 800 calories a day of powdered food, and I always maintained the idea that you cannot take a "pathological eater", severely restrict their caloric intake, then expect them to have the discipline to maintain that. I appealed twice to my insurance company, because I was afraid of failing and then losing my chance for surgery. I was denied the first time, then granted a meeting in front of a panel the second time. I told them of my failed attempts at Weight Watchers and using prescription diet drugs. I told them that I knew without a doubt that if I suffered a stroke or heart attack or needed an amputation d/t my diabetes, that they would pay for it and all the subsequent rehab without batting an eye. But here I was askinf for an $18,000 preventive surgery without all the bull and they were giving me a hard time. They finally ended up saying I still had to go through the medical program but they would waive the 10% weight loss requirement. I went through it and called the insurance company on my way to my car on the last day of the program, and she said "OK, we'll get you approved for surgery". No problem, once I jumped through their hoops. At one point during my appeal process, an insurance rep actually told me "If you gain another 20-30 lb. you'll be able to have the surgery without the program first." Wow. Really?

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

Dr. Foote and the staff all were very supportive, I only had one medical program doc that told me she thought I wasn't trying hard enough because I wanted the surgery. Other than her (she is no longer a part of that group), everyone has been wonderful and positive. Think of questions ahead of time and don't be afraid to ask anything. You are changing your body and your life. Ask questions, and be comfortable with your decision.

What made you finally decide to have the surgery?

Taking care of a patient about my size and age, who was in horrible health. Listening to co workers saying it was her own doing that got her in that condition. I did not want anyone to have to take care of me in that condition and be looked at that way for not taking care of myself. I was already sure I was going to die a horrible death at some time and didn't know what else to do to stop it.

How did you decide which proceedure to have?

In speaking with one of the doctors ahead of time, I told him I was a diabetic and he explained malabsorption vs. restriction and that malabsorption would be a better option to improve my blood sugar and in his opinion my BMI was not high enough for DS, which he referred to a a "big gun" surgery.

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?

To be perfectly honest, I was not afraid in the least. I was confident in my decision and excited to get started. As I said before, I'm an ICU nurse, so surgery never scared me.

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?

Everyone was supportive and positive. My husband said he would go along with whatever I decided to do, even if it was nothing. He said, "Just make sure you're doing it for you and not for me, because I love you no matter what." that's all I needed to hear. By the time I got approved for surgery, I had 2 coworkers that had the surgery and had been a part of the OH community for quite some time and felt informed and supported.

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

Once I got approval, I had a surgery date almost immediately. My manager said, "Oh, there's no way you're big enough for that. Seriously?" He tried to get me to postpone it, but I ended up losing my temper and crying to him that he had no idea what I was going through and how badly I needed this. He ended up approving my time off. My surgeon said there were really no physical restrictions because I had a laparoscopic procedure, but I took 3 weeks off just to get my ducks in a row and figure out how to eat and drink.

What was it like attending your first information seminar on weight loss surgery? Were you glad you attended? if so, why?

Yes, it's important to gather all the information you can to be able to make a sound decision. If a seminar doesn't answer your questions, make a one on one appointment.

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

My surgery was at 11 am and I was discharged at 2 the next afternoon. The nurses were wonderful. Out of the big lists I see online and all the stuff I brought, I used: chap stick, maxi pads/tampons, my cpap mask, and my own pillows. I didn't read, I mostly slept and walked.

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

None at all. They asked me to bring my cpap mask along and I used that overnight with just a little supplemental oxygen. The surgeon had me remove my insulin pump because he was convinced that I wouldn't need it any more. During the night when my blood sugar got up to 200, I put it back on and was fine.

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 was excited!!

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

When you hear, "sip, sip, sip" that is exactly it. I was not prepared for not even wanting a mouthful of water. I was fortunate enough to not have much discomfort or any dehydration issues. Don't push it and try to eat something that's not on your list. After a short time of eating nothing but protein supplements, it is amazing how wonderful a taste of something can be!

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

The surgeon's office and hospital were about a 45 minute drive from my home. Very fortunate.

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.

It surprises me how different post op instructions are from office to office. My instructions were nothing but protein and liquid for the first two weeks. Personally, it was at least 6 months before I could tolerate chicken and nearly a year before I could tolerate steak. I suffered many "stuckages" and episodes of chest pain after eating too quickly. I have learned not to let myself get ravenously hungry, so I don't eat too fast. I don't tolerate milk, except in a latte where I'm sipping it over an hour or so. Just yesterday, I tried cereal w/ milk and spent the next 3 hours curled up in bed with pointy gas bubbles. Yuck.

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

Walk, walk, walk....sip, sip, sip. The surgeon said to get up off the couch every hour and walk around the house. My husband took me to Meijer Gardens the first weekend to walk.

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

I take more pills now than I ever have, they're just all vitamins! Calcium 3 times a day, two different iron supplements with vit C twice a day. Also, magnesium, potassium (prescription), bariatric MVI, biotin, Vit D3.

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

I am on OH daily, read blogs by Eggface, Melting Mama and Weightloss Surgery Vitagarten. I belong to the Bariatric Bad Girls Club on FB and have lots of WLS friends on FB. I plan on going to the OH event in Cincy this month. It is an immense help; no one understands unless they've been through it.

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

I have 6 little laparoscopic sites, some are almost entirely faded. I already have a big C section scar and a big scar from having my gallbladder out.

Please describe any plateau experiences you have had since surgery.

I hit a plateau one year postop and have pretty much stayed there. At one year, I weighed 156, now I am 149-151. My original goal was 140, but if I am done where I am now, I consider myself a success. I have gone from a size 22 to a size 10.

Do you notice people treating you any differently now?

Not really, I don't think I was mistreated before. I get a kick out of showing my "before" picture to people that didn't know me back then. It still amazes me when I look at pictures now, and I just look normal.