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

Practicing nurse for 14 years. Aware of surgery but unsure if this was the path for me until I finally realized it would be my only way to take off the weight.

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

My experience was not that great at first. I went through 5 denials, 2 peer appeals and an independent consult with a third party bariatric surgeon before I was able to be approved. Each denial was on different grounds and when the issues in the denial(s) were addressed and found to be inconcrete, there was a new letter changing the reasoning for denial. I must say, however, I have a self funded insurance and the contract wording is VERY generalized, giving them ample room for interpretation in their favor.

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

Initial meeting was at an information seminar hosted by the physician. Meeting was very informative but I also did my own extensive research outside of information supplied. I believe the best avenue to pursue is to be as prepared as possible with as many aspects of the surgery as possible so that you may be able to ask specific questions about things you are uncertain of. I point blank asked my surgeon about his PERSONAL success rate with the surgery and his mortality rate in comparison with the national rates for complications, etc. I also asked him point blank if he had ever been sued for his part of a bariatric surgery performed by him. There are also websites that can inform you of litigations against physicians and settlement amounts. Included in these sites are info on whether or not it was settled out of court or proceeded to litigation.

What made you finally decide to have the surgery?

Realizing I was in my 40's and unable to get the weight off without surgical intervention. My strong family history of early death from heart disease and diabetes was the main contributing factor in my decision to go ahead with the surgery.

How did you decide which proceedure to have?

I wanted the Roux en Y because of the possible negative reinforcements if I felt the urge to "cheat" hoping that it would deter me from making poor choices based on the dumping syndrome. I felt like having this negative reinforcement would help me stay in line until my new eating patterns became a routine.

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?

I really didn't have any irrational fears about dying or complications. I had done an extensive amount of research, felt like I was as best prepared as I could be and I had all the confidence in my surgeon's capabilities. I also prayed that God would keep his hand on me and my surgeon to guide his hands for my best interest. I believe my faith allowed me to feel a sense of calmness and peace. I only had momentary fear just before going into surgery and I believe that was purely do to the uncertainty of whether or not I would be able to eat and follow the guidelines.

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 pretty much had full support of my family and friends except for my oldest son who expressed doubts about me making such a huge change with my eating habits. We talked about it and after he understood better why I felt the need to do the surgery, he stood behind my decision because he realized that I was the only one that could make that kind of decision that ultimately affected only me.

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

I am currently unemployed so this did not apply to me. I will be entering back into the work force as soon as I am able.

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

Be prepared to be your own best caretaker. It is great to take someone along that can be with you at all times to help you when the staff are too busy to accomodate you in a reasonable amount of time. You sleep a lot so my main suggestions for taking to the hospital are a robe, slippers and a friend that can help you if need be.

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

I was very fortunate to have no complications whatsoever after the surgery. I progressed to each stage per the textbook patient. I went home with no drain or any other type of devices. The worst part about the surgery to me was the gas pains you have from the CO2 that they inflate the abdominal area with. Walking does help this tremendously.

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 had completed all of my testing prior to receiving a date so it was simply a matter of time waiting for the day to arrive. I continued my research on the procedure and did everything I could to mentally and physically prepare for what would happen after the surgery.

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

Expect that you will have a lot of gas initially. I had an extreme amount of fatigue and suffered with this for about 4 weeks. I also had emotional swings because of the changes that you cannot prepare for until you are experiencing it for yourself. There are a LOT of emotional issues that you have to deal with after the surgery concerning food and the changes you must make in order for your tool to work. This was probably the hardest part for me. The emotional adjustment is nothing you can prepare for.. you just have to roll with the punches and seek out your support system.

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

My surgeon and his hospital of choice were about 75 miles from my home. It wasn't really a big deal for me because my hubby was with me most of the time while I was in the hospital and since I have been most fortunate to have suffered no complications, travel time has been an insignificant factor for me.

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.

Thankfully, I have been tolerant of everything I have progressed to eat so far. My only problem was in the very initial stages immediately after surgery, I could not stand the taste of plain water. It left a metal taste in my mouth and it took me about 4 weeks before I could tolerate plain water again.

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

My activity level has been poor unfortunately. I have extremely arthritic knees and after stopping the NSAIDS prior to surgery, my knees have been extremely sore and uncooperative. There have been times I have had to use a walker in order to ambulate. Aside from my knees however, I have had no problems with activity related to the surgery unless you count the fatigue I dealt with initially.

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

I take two multi-vitamins (Centrum Chewables) daily and I supplement them with B-12 injections monthly. I also take 1200 mg. of Calcium Citrate daily and will be on a regimen of Actigall for a period of 5 months post op. I also take Biotin daily hoping to ward off any large amounts of hair loss. Any other adjustments will only be made according to lab results. I am not currently on any iron supplements even though I am still a menstruating female.

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 had low levels of nausea for about 4 weeks. This heightened my sense of smell and strong odors made me feel nauseated. I fortunately however, have not had any dumping. I went to get my hair cut and my hairdresser tells me that my hair is definitely thinner even though I cannot tell a difference at this point. I have extremely thick hair however and I have not noticed any extreme hair loss in the shower, brush or on my bed linens. It did take about 4 weeks for my sleep patterns to settle back down but I beleive that has to do with the anesthesia working its way out of my body as well as my extreme issues with fatigue following the surgery.

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

For me personally, I would say there were three things that were the hardest for me to deal with. First, getting approved. It was very hard emotionally to deal with so many denials and processes that my insurance company required of me. Secondly, the gas after the sugery was HORRIBLE. Walking helps tremendously. Thirdly, and still most importantly to me is the emotional issues that have to be dealt with regarding food. I am in counseling and I feel it will take me a great deal of time to get over my addiction to the comfort that food gave to me for many years.

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

My surgeon provides monthly support group meetings every fourth Thursday. I have only been to a few but it is encouraging to hear of other people's experiences and to see the success acheived by those that are further out than me.

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

I have 5 small scars, they are not really prominent and I know in time they will fade out. I am not concerned too much about the scarring as I healed well from the surgery.

Please describe any plateau experiences you have had since surgery.

Early on after the surgery, I went through a stall that lasted for over 2 weeks. In the earliest stages, you NEED that scale to move so that you can at least see a reward for what you have done to yourself. It can be a bit discouraging but I found that for me, I was stalling because I was still trying to "diet" while using my tool. I had to increase my calories in order to lose weight.

Do you notice people treating you any differently now?

I don't think my weight loss has been significant enough yet to notice people treating me differently. It has been exciting though, to have some people notice that you are losing weight. It certainly makes the insecurities you have dealt with prior to surgery and early out more worthwhile. It gives you a reward for your hard work as well as an ego boost. Ego boosting is extremely important to most MO people because we tend to be our own worst critics. It feels good to have someone say something positive to you about yourself.