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

A few family members had had weight loss surgery years ago. I remembered that and started researcing for myself. I was very afraid of what I would find, remember what it was like for them. One lost the weight (and still maintains), but eating is not enjoyable for him at all. Another defeated his surgery and regained alot of his weight. The third had hers reversed because of eating issues and vomiting. I was desparate though and continued to research. One day while I was at work I overheard two coworkers discussing a surgery I had never heard of, the duodenal switch. When I asked more questions and researched it, I KNEW this is what I was needing. I just had to figure out if it was possible.

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

The insurance approval was an apprehensive time for me. After the letter of medical necessity was mailed, I found out I had the wrong insurance and that they wouldn't pay. I work in an organization that offers different levels of insurance and one was paying for it, the other wasn't. I thought long and hard about what to do. I wanted the surgery as quickly as possible, but that would mean fighting the insurance people for approval and that could take forever. The other option open to me was to change insurances during open enrollment in October. That would also mean waiting until January for it to take affect, but it was an almost certainty that I would be approved. What to do? I decided to switch and wait it out. The information was sent to my new insurance company on January 2, 2003. I was approved for my DS 13 days later. About three weeks after that, I had my surgery. I was one of the lucky ones that did not have to jump through insurance hoops for approval.

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

The first one was very nervous for me. At the time they had an info session every Thursday for prospective patients. The surgeon I had chosen was eight hours from me at the time, as there were no DS surgeons in my area. I got up VERY early one morning and drove through three states to go this session. We filled out paper work, were weighed and measured, making sure our BMIs matched criteria and then we were shown a video. It helped alot to explain the different procedures and Dr. Kim was available for any questions afterward. Then each of us was taken into an examing room where he talked to us a bit about our history and given a quick exam. He discussed which surgery you had chosen and gave his point of view and answered any more questions you might have had. I would suggest having a list of questions written down to ask him as you will not remember hardly anything once you're there. Do your research thoroughly before you go, it is imperative you know what you are getting in to. I am now seven years out and have 'fired' my surgeon. I love Dr. Kim, don't get me wrong, but living in Texas and trying to get in touch with him through his office is just horrible. They do not appreciate the committment that he made to his patients before moving to his office in Florida. I cannot tell you how many phone calls and emails I've made. I even made an appointment, flew to Florida and had all the expenses that a trip entails, and when I got to the office I was told he was out for the day. Really? On my last ditch effort to get in touch with him I used a business envelope from my employer (a hospital) and sent him a letter explaining how much I still needed his advice (my labs were out of control). I gave him four or five email address, my phone number, my work number, my husband's number and my MOM's number to get in touch with me. It's been over two years and I have yet to hear from him. It's very sad when one's office staff can dictate which patients will be seen and talked to. Luckily, I have a great endocrinologist, PCP and GI doc that are working with me to keep me on track. It's not an optimal situation, but it's working for me.

What made you finally decide to have the surgery?

I decided to have surgery when I just had reached the end of my rope. Every time I saw my PCP she brought up the weight. Now, this is her job, to take care of me, I know this, but I resented it. I could never lose anything and keep it off. I had gone the whole summer eating nothing but salads and Lean Quisines and didn't lose a pound. Every time I lost some weight, it would come back and bring friends. Friends that wouldn't leave. I knew my health was getting worse and worse by the year. I could see myself developing diabetes and that scared the hell out of me. Something had to be done and it had to be done quickly.

How did you decide which proceedure to have?

I researched on the internet, joined some discussion groups and talked to people that had had different surgeries. For some people they have a hard time deciding which surgery to try for, for me it was a no brainer. For my eating habits and life style, the DS was the surgery I needed.

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 think that most everyone has the fear of not waking up from surgery. I know I did. I think that was my greatest fear, of leaving behind my children, family and friends. I also knew that if I didn't have the sugery, I would be leaving them sooner because my comorbidities were going to kill me. You have to weigh the risks and see where you personally stand. Do you want to risk anesthesia and surgery maybe never coming out of it, but have the opportunity of added life? Or do you want to continue down the path you are on now, getting worse every year, spiraling down, knowing that you will one day, sooner than you need to, die of one of these comorbidities? It was an easy choice for me, I chose surgery. To be honest, I didn't really pay much attention to the complication factor. After all, that happened to other people, not me, right? Wrong! I am not happy to report that I am a card carrying member of the complication from surgery club. Mine was a very serious and potentially fatal one, it took a long time to get over, but it is now behind me and I am well. I would tell people it is very healthy and normal to have fears when facing this or any surgery. It's scary as hell. But you have to make your decision and stand firm. Be fearful, but rest assured you are working towards a healthier you. You're worth it. Don't let anybody talk you out of it, don't deny yourself.

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 very supportive of my decision. My mom was very apprehensive, but said if it was what I wanted and I would be healthy, then she was behind me 100%. My kids didn't quite understand until I had lost so much weight what to really expect. They are now so proud of me that the beam when their friends comment on how I look, and I am happy that I don't embarrass them. I can only suggest that you explain as well as you can the procdure you're choosing and back it up with research for anybody who is reluctant. Not everyone will be happy with your decision, you may even have people that are jealous. Remember that it is ultimately YOUR decision and you will be the one affected by it most. Have the strength of your convictions. After surgery most everybody was really behind me and cheering me on. Since I did have a complication and was hospitalized so long and so often, that really came in handy. You need all the support you can get in the first year or so after surgery. My mom even stayed with me for the year afer surgery to see me through the complication and recovery of getting it fixed. There are no words to explain the gratitude one feels for an act like that. If you do not have the support of family and friends, find it elsewhere. On the net, in support groups, whatever it takes. You have to have this.

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

My supervisor was not exactly thrilled about my decision. When I called to tell him of my surgery date, he asked what I was having done. I hesitated, because it was none of his business, and then he replied that he had heard I was going to have weight loss surgery. I told him that yes, that was correct. After a few comments he made one that really got on my nerves. He said, "So, it's a body image thing". I said that no, it was a health issue thing. My physician deemed it medically necessary for my health and that was all he needed to know. I told him I would be gone for about three weeks or so as that was what I planned on. Unfortunately, that turned out not to be the case as I was admiitted to my own hospital the very week I was to return to work. When it was all said and done, I did not return until a year later. My position had been filled and I was moved to another unit. I understand all of this in a clinical sort of way, but think personally he could have handled it better. I also realize I left him short staffed and he did what he had to do. I do not hold any grudges.

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

Very casual, very informative. Had a lot of opportunity to ask questions and make an informe decision as to what surgery was right for me. Was not pushed in a certain direction from anyone.

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

The stay was frustrating, just for the simple fact you couldn't move, you couldn't eat and you couldn't drink. Pretty normal stuff. I did develop pneumonia the first night out so I was in the hospital for 19 days as opposed to the usual 3-5.

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

I did develop a leak which was not found until three weeks later. I had been to the ER several times and told I had pneumonia. Well, duh, I knew that already. But I KNEW there was something else wrong. It took a visit to my PCP and her admitting me to the hospital to finally find the problem. The leak was not immediately fixed, in fact I had a JP drain attatched to me for the next nine months and went through quite a bit of trouble and pain before it was surgically fixed in December of that same year.

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 and terrified. I just kept telling myself this was the best thing to happen to me and tried not to think of everything that COULD go wrong. I tried to concentrate on getting healthier.

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

Mine was not a typical experience. I spent three weeks at home in terrible pain before finding the leak. I spent the next nine weeks in the hospital recovering from said leak. TPN, PICC lines, blood clots....it wasn't pretty.

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

I traveled eight hours to the hospital where my surgeon was. It was very near where I used to live so I had family and friends to help out a bit. I stayed with my mom's friend a few days before the surgery. My in-laws helped out by coming and helping my mom do laundry (she was there from Texas to help me out for a few weeks until I was feeling better. She ended up staying for a year!). I stayed in a hotel for two days before having enough and driving home to Florida.

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 was able to keep down everything I ate in the first seven days or so. That being said, it was mostly protein drinks and two ravioli at a time, a cracker here and there or some jello. Once my fistula started growing I couldn't keep anything down, and I didn't try because I was not hungry at all, I was hurting too much. Once my leak was fixed I had not had 'real' food in months and months. I had to start very slow and work my way into a normal pattern of eating, probably close to what a fresh post-op was like. I can tolerate anything now, but try to stay away from too many carbs.

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

Again, not very good, I was in the hospital.

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

I take over 3000mg of calcium citrate a day, four multivitamins, four prescription iron, one protonix, two probiotics, four magnesium, one prescription high potentcy vitamin D, two zinc and two copper capsules.

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?

After the leak was surgically fixed I was good to go!

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

The leak and waiting the nine months for it to be fixed.

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

In the beginning I went to a meeting every month. They grew fewer in between as interest wained from the group. I started going to one that was every other month in a city about 90 minutes away, then I moved. I haven't been to a support meeting now in over two years. They're not as essential to me as they once were, but they are still quite enjoyable.

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

My initial surgery was lap, so that part was great. You can't even see my incision sites. My repair was not so pretty, it starts from my breast bone and goes down to meet my vertical c/section scar which is below my panty line. Over the years it faded quite nicely. Recently I had to have surgery for a bowel obstruction and they used the same incision line. Having to start all over!!

Please describe any plateau experiences you have had since surgery.

I've fluctuated between 150-175 pounds, can't really say that I've plateued. My experience isn't normal, I'll say that up front. I'm now seven years out and stay around 160.

Do you notice people treating you any differently now?

Of course. It's amazing how much people SEE when you LOSE so much. Definately more attention all the way around.