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

My best friend was researching surgery and I was gung ho to help her and support her in any way I could, but I didn't think that I would be interested in "giving up food" because even though I was unhappy, I liked to eat. It was the only thing that I had to rely on, so I thought.

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

Know your insurance. I had Tricare Prime, and on the East Coast, I had no problems because it was all done "in house". When I had to come back to Missouri, my PCP was less than forthcoming with a referal to my surgeon, even though he didn't know the requirements to qualify for the surgery. After several appointments of trying to prove my worth for a referral, he finally gave me one, telling me that I would die if I went through with the surgery, and that he would not look forward to treating me when I had complications. Once I had the referall, my surgeon's office took care of everything and I had no more problems.

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

The very first visit is done with the informational seminar. My surgeon came across as a very knowledgeable, very concerned person. I came to this meeting having already been researching for almost 3 years, so I had lots of questions comparing him to my previous choice of surgeon. I also wanted to know about the facility, and his staff. Research is the key!

What made you finally decide to have the surgery?

After my best friend was about a year out and could eat "normal" food again, I decided that small portions of normal food were better than looking and feeling like I did. And I was jealous of her! She didn't hurt any more, and so many other of her health issues had healed themselves with her loss of weight.

How did you decide which proceedure to have?

My insurance only covered the bypass, but even if I'd had the choice, I wouldn't have chose the band...it only restricts portions, not types of foods, and I needed that control to help me learn the better choices.

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?

My fears stemmed from concern over malnutrition and vitamin deficiencies. The statistics showed that the surgery itself was relatively safe....after surgery, I am reminded on a regular basis to take my vitamins and eat right. I'm a nurse, so I see some of the people who don't follow the rules and the problems they can have because of those choices.

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 parents and sister were less than supportive about my decision. I think it was a lot of jealousy along with concern for the unknown. I answered their questions, offered them invitations to support group meetings, and showed them research to help, but eventually they just quit trying to talk me out of it. Now, 4 years later, it's funny to still be under the microscope at family get togethers, but they no longer question my decision!

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

My employer at the time was very supportive. I worked 2 weekend nights per week so I only took one weekend off work. When I went back, I couldn't lift for a couple more weeks, but my coworkers were very helpful! I was also a full time student, so I had surgery over spring break. I missed a coupld of classes, but my teachers knew what was going on, so they were very helpful too....all in all, it was easier than I could have ever imagined!

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

My hospital stay was pretty uneventful. Everyone says to bring this whole list of stuff, but I didn't use most of what I brought...my glasses were most important, so I could see when I wanted to. My comfy socks and robe were nice when I had to venture out and walk around the nurses station. Shampoo, conditioner, hair dryer, that kind of stuff for my 2nd day before I left. I didn't read any books or magazines, I used my PCA pump and slept most of the time. Oh, and my cell phone & charger, just in case I wanted to call out. And a pillow to splint my stomach on the way home...that was a lifesaver!

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

No complications! Yeah!!!

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

It was very surreal...I had been waiting for so long, and had heard no so many times, I didn't think this was a very funny joke...but it was real, and the dr.s office and my insurance were great about answering questions. I kept a notebook for questions and answers so I could refer back to it. And I was constantly on the internet looking for people in my same situation or people who had already had surgery. My best friend and I were on the phone constantly, and I paid for her plane ticket to come home so she could be here the day before and a few days after.

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

Emotional upheaval! Learning how to cope with mental hunger is a huge challenge...I wasn't physically hungry, but if I couldve ate cardboard, I probably would've. I just wanted to chew some real food! Once I got it through my head that I didn't need food, it was a whole lot easier, but I sent my daughter to my mom's house for meals a lot because I just couldn't cope with cooking for just her and me drinking my meals, or having soupy mashed potatoes. This is when a serious support is necessary...just like AA when you want t drink so you call your sponsor instead. When you want to eat something you aren't supposed to, call your sponsor. It really does help! And you eventually begin to realize how many food triggers there are, and what to do to cure the addiction.

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

I live in the same area, so I only had to go about 12 miles.

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.

When I first had surgery, it was clear liquids for 2 weeks. the first days were a medicine cup every 15 minutes, and gradually, over time, I worked up to drinking about 100 ounces of fluid per day. That took about 4 months. Back to immediate post surgery--2 weeks of full liquids: anything that could fit through a mcdonald's straw. Very runny mashed potatoes, fine oatmeal, protein shakes, jello, sherbert. After that, soft foods: scrambled eggs, shredded cheese on just about everything, mashed or baked potatoes, canned tuna or chicken, some veggies, canned green beans, peas, more protein shakes. After this six weeks were up, I could start adding "regular" food back in slowly, one thing at a time. I was eating a lot of canned chicken and tuna, a lot of mashed potatoes and baked potatoes, pudding, jello, fish. I only ate about an ounce of food at a time, probably about 3-4 times a day. I drank a lot!!! Crystal lite, flavored water, protein drinks. I didn't even want the sugary foods from before, I was actually craving healthy choices. Hamburger is still something that doesn't go down well, as is salad. I couldn't drink coffee or diet coke either one for almost 2 years. I am embarrassed to say that both go down easily now, although I don't drink very much soda, maybe one a week. Now, at almost 4 years out, I can eat just about anything in moderation. Instead of eating the whole bag, I have a few bites and that's all I want. I don't eat until I feel stuffed, I eat a small portion of whatever and stop. Then, if I'm hungry later, I'll eat another small portion. I have maintained my weight at 122 pounds, and I am very content with that!

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

I walked, walked, and walked some more! From the day after surgery until I was about 6 months out, I walked for at least one hour every day. I also worked in a factory that was not air conditioned, so I was definitely getting plenty of exercise! When the weather started cooling off and getting to the rainy season, I quit walking, but I am still very active around the house and at work, so I log about 10,000 steps every day.

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

I take 4 Opti-Source multi vitamins every day. I also get occassional B-12 shots. Right now, I am on a prescription Vitamin D supplement and Iron supplement. I'm also supplementing with a B-100. I'll have bloodwork again in 3 months to see what needs to be changed and act accordingly. Once all of my levels return to normal, I'll go back to yearly bloodwork again.

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?

The hair loss was bad, but I have very fine, thin hair anyway, so throughout the whole process, I was almost bald at one point. Thanks to a great hairdresser and some creative coloring, we made it through! Now, I keep my hair fairly short to medium, and color to keep out the gray! I can avoid dumping if I avoid the triggers, which tend to be stuff I shouldn't be eating anyway, candy, sugar, sweets. The worst of all was during pregnancy, finding foods to work with surgery and baby, but once we made baby happy, my tummy settled down a bit. And worst case scenario, I go lie down for a bit.

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

Learning that surgery was not just a physical thing. I didn't know what an emotional attachment I had to food until I couldtn't eat anymore. Working through that was hard, but once I did, I faced a lot of demons I had been hiding, and I am a better person for it today!

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

Although I am not as active now as I was the first 2 years, Dr. Hornbostel sponsors a support group in Sedalia. It is SO important to have that monthly group to go to with problems, questions, concerns, triumphs and defeats! I would not have been nearly as successful had it not been for this group.

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

I had laproscopic surgery, so my 6 incision holes are virtually unnoticeable now. I never imagined my tummy would be almost flat and no scars!

Please describe any plateau experiences you have had since surgery.

I started at about 220 pounds. When I had lost about 40 pounds, I slowed down a little, and then picked up again, not really stopping until I reached about 120. I got pregnant when I was 12 months out, and after having a healthy baby, lost 10 more pounds. I really didn't need to be that small, so I increased my intake a bit and over about 8 months, put the 10 pounds back on.

Do you notice people treating you any differently now?

yes, and it really irritates me! I remember going to Victoria's Secret before surgery once to buy perfume. I couldn't get a salesperson to help me to save my soul. Now, if I go in VS, 2 or 3 fall over themselves trying to make a sale...I don't visit there very often! Job interviews are easier now, too, people tend to make eye contact better. And I don't feel those sideways glances in public.