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

a co-worker had it and was successful although she had some post op complications

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

my surgeon had a thorough checklist that had to be completed successfully before surgery could be scheduled. I feel that this assisted him in determining who actually had 'staying power'. You had to obtain 5 years of previous medical records, see a nutritionist associated with his practice twice, meet with a psychologist who specialized in eating disorders twice and have a mini-MMPI, attend two monthly group support meetings and then you could be scheduled to get an appointment with him. (The first meeting at his office was with is nurse who explained the process). He would then come in and talk with me for about 20 minutes before he did an actual physical exam. Once that was completed, he then told me that he would do my surgery if I still wanted it. Once I received insurance approval, it took about three weeks to get on the surgery schedule. It has been wonderful from there. His office staff took care of the application to the insurance company. The company first 'lost' the application and I had to call and demand that they search for it and sent it certified mail a second time. That seemed to take care of the 'lost' application part. After that, they wanted a couple of documents from my primary care doctor and the surgeon's office handled that. Finally we obtained the approval! I feel like the 'lost' application could have been a stall technique but it did not work.

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

go prepared with questions. research everything you can before the visit in order to make the most of the time you have with the surgeon. If you do not have a 'good feeling' about the surgeon.....walk away! I went to another surgeon first before I found the one who actually did my surgery. The first surgeon only did group introduction classes and refused to answer my questions about post op morbidity and mortality. It was later discovered that he had been billing insurance companies for one procedure (RNY) but actually doing a shortcut version with a higher morbidity rate. He was stripped of his medical license. I cannot stress enough.....you MUST TRUST your surgeon!!

What made you finally decide to have the surgery?

I found a surgeon that I trusted, had a good reputation in the health care community, and who took his time to answer all my questions without making me feel rushed through the visit.

How did you decide which proceedure to have?

My surgeon only did the RNY at the time so the only choice was open or lap. We chose lap.

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 fell like any questions I had were addressed and I had no fears about the technical part of the procedure. I was only afraid of the needles! I had already researched complications and was confident that my surgeon could handle anything that came up. My primary care physician was also aware of the surgery date and was available in the event of any issues with my asthma.

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 friends were supportive. My family was less supportive. My father insisted that I stay at his house post op (I was there for 3 days). My estranged husband felt that it was going to be one more failure for me that I would not be able to keep up. I don't know how I could have told them any differently. It was my choice and there was really nothing they could do about it (my family). Since the surgery, my now ex-husband has just said 'I hope you can keep it up' meaning that he hopes I can keep the weight I have lost off. My father is very proud and has actually used me to speak to a couple of his friends who were considering the surgery. My baby sister is grossly overweight and would probably like to have the surgery but she is a very poor candidate medically at this time due to diabetes and heart issues. My middle sister occasionally says that she would rather lose weight naturally.

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 extremely supportive at the time of my surgery. I had been discussing my interest and research in the procedure for about 2 years so it really came as no surprise. I took two weeks off work but could have gone back in one. When I went back to work, I was in the office two days then flew out to attend an out of town meeting.

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

I was admitted to the day surgery at 10 AM on Thursday, in the OR at 1:30, back in my room at 5:30PM, up walking in the hall at 11 PM. On Friday AM they took my Foley catheter out at 4 (I insisted because the nurse wanted to wait until 6 because 'that's the way they did it' but I wanted it out then!!), down to X-ray at 10AM for a barium swallow to check stability of the staples and discharged by 4PM Friday. The care I received was less than ideal as the staff was short handed and the float nurse had no idea of how to treat a post op RNY patient. I am a nurse so that made it easier and I had all my written materials with me so I could say....I need to get up and walk now....I need to have a breathing treatment for my asthma, etc I recommend bringing a gown and not pajamas. You cannot wear pajamas with a Foley catheter! Bring your written materials. Have someone there with you to listen to the discharge instructions.

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

I had no complications at all!!

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 felt wonderful! The weight was falling off and I had this rush of energy that I could not believe!

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

Expect that you will get hungry differently. It is hard to explain...I drank ISOPURE post op and jello, etc but could not go 2 weeks on liquids. I started on a soft scrambled egg and soupy grits after about a week. It is hard to get used to not feeling hunger like you did before surgery.

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

local

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 started out slowly with soft scrambled eggs and soupy grits. The first solid food I really wanted was tuna salad!! I could not eat steak for about 6 months....I could eat hamburger though. No foods are off limits to me. I have little desire to eat inappropriately. My tolerance for different foods increased month by month. My surgery was 31 March and I had my first bite of lettuce in August! Protein first!!

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

My activity level increased as the weight fell off. I joined a gym and hired a personal trainer.

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

I take 2 calcium with vitamin D tablets daily, two multivitamins daily, and 1000mcg of injected Vitamin B12 monthly. I also supplement with Isopure to make certain that I get enough protein. I still find it difficult to eat 60 Gm of protein daily.

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 to go through the usual 'testing' of how much is too much but quickly learned that even licking the spoon can cause vomiting. I refer to it as the biological dollar bill changer....kind of like a vending machine that rejects the dollar bill because it is wrinkled....my body rejected the food because it was too much. It can still happen even though I am over 2 years post op. I can eat almost 2 cups of food but do not push that limit.

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

being overweight to start with....no, really....just the needles pre-operatively for me.

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

I attend a group support meeting at the eating disorder psychologist's office twice a month. I also attend the monthly large group meetings sponsored by the surgeon and the hospital. I cannot stress how IMPORTANT this is to maintaining the weight loss!

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

I have three small scars that I can barely see. I rubbed vitamin E cream in them as soon as they healed. The scars do not bother me.

Please describe any plateau experiences you have had since surgery.

The occasional plateaus have been dismal but expected. I knew to expect them because of the support group. If I had not had the support group then I can see that it might have been easy to slip back into feeling like a failure but the group has been wonderful to provide suggestions and even physical presence to help when needed.

Do you notice people treating you any differently now?

yes. When I fly, men have jumped up to help me with my suitcase. It used to bother me because I was never offered any assistance when I was fat but I have managed to get past that and ust say thank you. I like being able to fly without a seat belt extender! I have started initiating conversations with people on planes, in airports, etc where before I would never have spoken to anyone.