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

I had heard about it and read about it, in the health care field. At first, I thought it was a pretty risky, dangerous surgery that only the most obese, ill people should undertake, who had no other options. But when they started doing it by laparoscopy and it became more well-known and safer, it really perked up my interest. Then I started to have many patients who had it done, and I was impressed with how good they looked and how good they felt, and all the health problems and medications they had gotten rid of!

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

It was really not an issue for me -my BMI was in the range that my insurance company approved. The only thing I had to deal with was that they make you do a 6-month program, talking to a dietician on the phone monthly and meeting several goals towards weight-loss, before they would approve it. It was a little frustrating that when I had finally decided to do it, I still had to wait 6 months to be approved. But I think that was a good thing, because I went to workshops, support groups, met w/ dieticians and nurses, and really learned a lot and got motivated and very well-prepared!

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

I hear very good things about him. He's a little quick -I know he's busy, but he did answer all my questions and even though he always seems to be in a hurry, he always did take the time to amswer every question. I feel very comfortable with him, becuase of his reputation, and his staff is really great. I think the important thing is to do your reading and research ahead of time and make a list of the questions you want answered. I also think it's very important to do everything you're told to do to get ready -alot of it is a pain, but it's all there for scientifically-based reasons and it's important for you to do well and have the best outcome.

What made you finally decide to have the surgery?

My internist was after me to lose wt. due to my blood pressure being up (and being on 3 meds) and the likelihood of becoming diabetic (I had gestational diabetes with my last pregnancy). And my orthopedist kept after me due to my arthritic knees. But I think the main reason was to look better, feel better, have more energy, live longer and healthier, and be happy and proud of who I am!

How did you decide which proceedure to have?

The band didn't appeal to me, because it has the least weight loss, and you have to keep going in for fills (and I work fulltime) and a colleague who had it done talked about "retching and retching" after eating corn -I HATE throwing up!! I was going to do the Roux-En-Y, but I discovered that they ban all NSAIDS forever, and with my arthritis, that would be very difficult. Also I liked the idea of the sleeve, because it disrupted the normal anatomy less, and you can still have ibuprofen afterwards if you need it. (which I'm hoping I don't need as much afterwards, when there is less weight on my knees!)

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?

Being in healthcare, I realized that there is always a risk to any surgery, but I knew it's very small. I am trying to think positively and think that I am meant to do this and that everything will be OK. It's important to be aware of the statistics and how safe the surgery is now, and have faith in your surgical team. You never know what will happen in life -you could get hit by a car unexpectedly, so you have to have faith that if you're meant to survive and do well and it's not your time yet, that everthing will turn out OK.

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 has been very supportive of my decision. I was afraid to tell my mother, because I thought she might be critical of my decision and try to talk me out of it, or try to get me to try another type of diet or something. She's also a real worrier, and I didn't want to upset her and have be scared for me or worry herself sick over it. But she was very supportive too, and told me that she is very proud of me and the decision I've made to be healthier.

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

All of my co-workers and supervisor have been very supportive as well, except that the head of our group called me in 2 weeks after my FMLA leave was approved to tell me that there were serious budget shortfalls and some positions were being eliminated and mine was one of them. He said I would still be employed for another 90 days, but he wanted me to know before I went out on medical leave. (I wasn't planning to be looking for another job while I was recovering, but I guess I will be!) Even though it was a shock and very upsetting, I knew it was a possibility, as several other co-workers had also been informed their positions were being eliminated as well in the past 6 months, and I'd had a feeling that I was on the short list, due to my status, age, salary, and position in the group. But I am going to concentrate on my recovery, and I will be a healthier, happier, more fit person when I go for job interviews! (In fact, I already have one for after the surgery!) I am planning to take 3 weeks off from work, then return for 1/2 days for two more weeks, as my job is fulltime and quite demanding and stressful, and then be back to fulltime by 6 weeks. (Then I work for 2 months and then my job ends...)

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

I was very motivated and excited. I would have signed up and had the surgery the next day if I could have! I was fortunate that my surgeon was the speaker, so I got to "check him out" ahead of time and hear his take on everything. I really felt like this was what I'm meant to do, and the amazing stories of how well people do was so exciting -being off their diabetic drugs even when they leave the hospital, and the rapid wt. loss and relative safety of the newer procedures really made me comfortable with my decision.

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

Had my surgery 3/7/12 -it's over and done! I was there for 2 days, which is what I expected. I'm glad I brought reading materials (magazines) because they were easy to read, a little at a time, since I kept falling asleep due to the pain meds! I brought make-up and my curling iron, thinking I might want to fix myself up, but I didn't feel like bothering, and it didn't seem to matter anyway. I expected to be puffy and bloated in my belly (which I was) but I didn't expect my face and neck to be swollen! I was kept quite comfortable in the hospital, and the nurses were so kind and helpful. I also didn't expect to have such an extremely dry mouth the day after, because I wasn't allowed to have anything to drink for 24 hours, and the anesthesia and oxygen dried out my mouth so much! It was hard to talk due to how dry I was, and my throat was a little sore. I loved having the little sponge sticks that you can put in water and put in your mouth to moisten it. I found that soaking them in ice water seemed to moisten my mouth better than room temperature water (although I couldn't have ice chips -I felt like I could have drank a whole container of ice water at the time, although it no doubt would have made me sick!) I wasn't allowed anything to drink until the next day, after I had a X-ray swallow to make sure the staples weren't leaking -I never thought little medicine cups of room-temperature water would taste so good!

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

Just minor. I had diarrhea the second day, I think from the strong antibiotics in the IV, which was pretty annoying. (Esp. trying to get up and go in a hurry when I had an IV in each arm and was attached to 9 different lines and tubes!) My asthma also flared up that night -I think due to the swelling in my face and neck and the extra IV fluids they were pumping into me to make me urinate. But these problems were short-lived and were gone in a few days, and overall, this was one of the most easy surgeries I've had (I've had about 7 or 8, including 3 C-sections.)

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 very excited about having the surgery and getting on with my new life, ( I was counting the days!), so that helped outweigh the anxiety. I also knew, being in the medical field, that the risks were low for me, and that it was a more minor surgery than others I've had. Of course, being in the medical field, I knew about the possible complications, but I also knew they were rare. I was also in the middle of losing my job, hunting for a new job, becoming a grandmother, and my youngest graduating from college in May, so I was too busy to have time for much anxiety! I was more worried that my first grandchild, who was due about 2 weeks after my surgery date, would come early when I was still in the hospital myself! But happily, she waited until 10 days after my surgery to make her appearance, so I was able to be at her birth and welcome my very first beautiful granddaughter in person! What an incredible experience! And I'm so glad I'm healthier to take care of Naomi Cecilia and be there for her (and future other grandchildren) as she grows up.

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

I seemed to have it easier than some. The first 5 days were the worst, due to the swelling, bloating, and puffiness -feeling as though I was 9 months pregnant and just had Thanksgiving dinner (which was what I felt like when my youngest was born 3 days after Thanksgiving in 1989!) I had very little pain, which was great -the biggest problems for me were just the bloating and having diarrhea for about two weeks. Some of it was due to the IV antibiotics (which has happened to me in the past) and some due to an only-liquid diet (as my surgeon said "Liquids in, liquids out".) They had me add a fiber supplement (Benefiber) to some of my drinks, which helped, and as promised, once I started eating more solids, it did get better. But I felt really good -I drove myself to a doctor's appt. 5 days after surgery, and was out and about in a week, and back at work in 3 weeks. I attributed a lot of it to following orders pretty closely, and making a string effort to keep up my allotted amount of fluids and protein every day, but I was grateful and lucky not to have much nausea or any vomiting.

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

About 40 minutes. which is not bad at all! (Part of the reason I chose this hospital is convienence, as well as their reputation.) This turned out to be good, since I counted about 20 appointments before the surgery (including workshops, etc.) and so far, 3 post-ops and counting. This definitely made it easier on me, since I'm working fulltime and didn't have much time to take off from work.

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.

At first it was liquids and "mushies" of course -lots of yogurt, soups, jello, popsicles, protein shakes, etc. I didn't mind it the first week, but by the second I really wanted to chew and crunch! (So much so, that I chewed a potato chip just for the crunch and then spit it out -didn't really help the craving, though!) I was so excited to have my first "real" food -hamburger and mashed potato and green beans -yum! Of course, I could only eat about 3 or 4 tablespoons of it! (That meal is still comfort food for me, because it was the first real meal I had!) I tried moist lunchmeat, as recommended, but the roast beef didn't go down too well -I guess it was too fibrous or something -I couldn't seem to swallow it and it didn't taste good and I ended up spitting it out, because I felt like I was going to be sick. (That was about 3 weeks out -I've had it since then with no problems.) Tuna was good (packed in water) and I was so excited to have some saltines with it! (Crunchy!) I got pretty sick of tomato soup -I once tried putting plain Greek yougurt in it with a little melted grated cheese on top, because I was craving pizza, but it didn't quite do the trick! It was pretty tasty, but I still wanted pizza! I ate/drank a lot of chicken broth the first few weeks (esp. at night, when I was cold.) I also craved salty things and that helped. All the vitamins and supplements were sweet (artifcially) and the yogurt/jello/popsicles, etc., so what I really wanted was salty! I also mixed my protein supplements with vanilla soy milk (or sometimes chocolate) which added an extra 7 gm of protein and made them taste much better. The only thing I have not tried again yet (now that it's been 3 months) is steak -I am looking forward to it, but want to make sure it's tender and juicy and not too fibrous. (I'm thinking filet mignon would be good!) I also have not had a bagel yet -it's just too much bread/carbs -I used to eat 1/2 every morning for breakfast. Now I have a protein shake, which gets me through the morning. Of course, I have not had any alcohol, but I wasn't much of a drinker anyway, so I don't really miss it. I still love chocolate and sweets, but a tiny bit satisfies me now.

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

First week I laid low, but I didn't stay in bed or on the couch. I either sat in my comfy chair in front of the TV (and often drifted off to sleep, due to the pain meds!) or I sat at the table and went on my computer or read the paper. I took a short walk every day, just out to the mailbox or around the yard. The next week I graduated to walking our little 8-lb Silky Terrier around the yard or a short walk in the immediate neighborhood. I started driving after 5 days -my surgeon said I could drive when I was off narcotics, which I was by then -just on Tylenol. I was off work for 3 weeks -I could have been back in two, but my granddaughter came 10 days after my surgery, so I was glad I had the extra week to be with my son and daughter-in-law and the baby! I was also still having diarrhea (sometimes unexpectedly) and still trying to figure out what I could and couldn't eat, so even though I physically could have been at work in 2 weeks (very little pain and good energy), I was glad I had the extra time to stay near the bathroom and figure out my new diet! By 3 weeks I was back at Zumba, but took it slow (luckily my sister is the instructor and everyone in the class knew I'd had the surgery, so I didn't feel funny about not doing all the moves and not being quite as energetic as usual.) By 4-6 weeks, I felt "fine" and physically felt like myself, but even better, since I was down 20 lbs! I had great energy (better than before!) and just fell asleep in my chair in front of the evening news a little faster at the end of the day.

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

Again, I have been very faithful/compulsive about following the rules laid out for me by the surgeons and the dieticians, because I know there's a good reason for everything. I chew 1500 mg of calcium a day, sublinguingal B12 once a day, Prilosec once a day, a multivitamin (I found a Women's One-A-Day which came in a smaller size which is easier to swallow, but has a lot more calcium than most), and a chewable Vitamin D (1000 units.) I also chew two Fiber Choice chewable wafers, which have fiber along with calcium and Vitamin D, which I feel helps keep my digestive tract on a more even keel.

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 haven't really had any of those side effects. I was really worried about the hair loss, because I have thin/thinning hair already. I have heard that getting plenty of protein helps avoid hair loss, so I've been diligent about that. Also, I think because I had VSG, I've lost weight a little more slowly than some with RNY, and I think that may also be why I haven't had much hair loss. I've felt really well the whole time (no vomiting, dumping, etc.) but I've also been careful to avoid the things that I've been told can cause those problems. The worst part for me is the feeling of almost like having a big pill or big piece of food stuck in my throat that I want to wash down with a lot of water, but if I do, that makes it even worse. That happens when I eat too much and/or eat too fast -I have come to recognize the early sign of that feeling and know to stop eating then (not even one more bite!) Otherwise I feel really uncomfortable for about 15 minutes until it goes down and a couple times I have had to spit the food out if it hasn't gone down yet.

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

Worst part in the hospital was the extremely dry mouth the next day! It sounds minor, but it was so annoying! The pain was much less than I expected, so that was good. Also my asthma flared up in the hospital, probably due to the extra fluid from the IV's and the swelling/bloating. After the first couple of days, all of that was gone and I felt really good!

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

Support groups once a month, and visits with the doctor's office and the dietician once a month or so. I think it's very helpful and supportive. I look forward to seeing some of the other people from my support group afterwards to see how everyone's experience has been. I feel almost like it's when I went to prepared childbirth classes -we are all in the same boat, preparing for the same thing, and excited and nervous all at once. Then we meet afterwards and tell each other about our experiences about our new life with our (baby) or (body, now!) I think these meetings are important, to keep us in line with what we should be doing, and giving us good advice and keeping us motivated.

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

I have 5 little scars, not bad at all. I have more bruising than I expected, probably due to getting heparin in the hospital to prevent blood clots.

Please describe any plateau experiences you have had since surgery.

I seem to lose 1-2 lbs in a week (sometimes 3) and then I won't lose any for days, then all of a sudden, I lose 2-3 overnight. It's not at all even -it's kind of in bursts. But as long as it keeps going down, it's the right direction! I suspect I'm also not "dieting" as much as I should be -I feel good and I can eat anything now (except for very small amounts) and I still have a healthy appetite, at least in my head! (I have a major case of eyes bigger than stomach now -I end up putting away a lot of leftovers that I couldn't finish!) I suppose if I ate very little and avoided all carbs and fats and "bad things", I would probably lose faster. But life is too short and I feel too good, and I'm OK with the weight loss being slow, as long as it keeps going! I guess if it stops, then I will know I need to cut back and go back to the original "diet" I followed in the early weeks, to jumpstart my weight loss again.

Do you notice people treating you any differently now?

Not really, yet, since I'm only down 30 lbs so far. It's interesting to me that people don't really seem to notice yet -I'm wondering how much I have to lose before people will comment spontaneously that I looked like I've lost a lot of weight? I suppose if I see someone I haven't seen in a long time, they might notice? My sister (who sees me every day) says I look like I'm melting before her eyes, like a helium balloon deflating! And when we look at pictures from "before" we can all see a big difference. I do feel better about myself and feel more confident and less like I need to "hide" my weight or myself, so that must come across in how I act around other people. I do notice that people are very interested in what I eat and how much I eat. It's a little uncomfortable, esp. when eating out, to be aware that you are being watched (and sometime judged) so carefully, but I just do what I'm supposed to do and not worry about what they think! After all, I did this for me, not for anyone else, so the only opinion that truly matters is my own!