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

I've been watching with interest ever since Carney Wilson had hers. I've read about it, researched it, rejected it because I should be strong enough to do this by myself, and finally given in to the fact that I'm not. I need help, and the TOOL will be to me like antibuse is to an alcoholic.

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

As I said, I researched this procedure for a LONG time before I even went to a live seminar on it. The doctor brought several people from his practice who had had the surgery, and I spoke with them to get their feelings. One of them had the same insurance I did, and warned me that they would require me to jump through some substantial hoops in order to be approved. So, even before I had my first appointment with the surgeon, I got the information from my insurance company about what needed to happen, and I began to make it so. I needed to do a minimum 3 month physician supervised weight loss program with my PCP, seeing a registered dietician at the same time, there needed to be documentation each month of my weight, my exercise activities, my behavioral modification program (support groups I was already attending), my labs, my diet, etc. I made sure that the documentation was thorough, and I logged every bite that went into my mouth. I also got on SparkPeople.com, and used that website to log my exercise, to log my nutritional intake, to learn new exercises, to journal what I was feeling, and to connect with special interest groups who were an online support for me. I also got online with other bariatric support groups and special bariatric product sites, and purchased sample kits of products. I also read a book my surgeon recommended called "Before and After" by Susan Maria Leach, and got a workbook recommended by my dietician, called "Healing the Hungry Self"

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

I prepared myself with a list of questions and concerns... like the fact that gum surgery made it impossible for me to eat ice chips... I wanted to know how soon I could return to work, I wanted to know what the extended support network was, and how to prepare. Luckily for me, he was very impressed with the preparation I had already done. I was already following his eating plan (only on a grander scale because I hadn't had the surgery yet - but I'd still lost 20 pounds already)... and I was well informed about the different procedures (lap-band versus RNY), and I had already decided which procedure I thought was best for me, and he concurred. It's vital to go and see your surgeon armed with WRITTEN notes and questions.... and also VITAL to write down his/her answers.

What made you finally decide to have the surgery?

I want to get out from under the back, leg and knee pain. I want to be able to walk without huffing and puffing and having to stop every 5 minutes. I want to be able to attend to my toilet needs without having to pull my belly out of the way. I want to be able to put on underwear without having my "fat apron" fall out the bottom. I want to be able to walk up and down stairs normally, not one leg at a time. I want to be able to play with my grandchildren without pain. I want to live longer and not have high blood pressure or the propensity for Type 2 Diabetes. I want to get my cholesteral and triglycerides down. And, I want to FEEL GOOD ABOUT MYSELF!!

How did you decide which proceedure to have?

I want to lose as much weight as I can, as fast as I can. I chose the RNY because I don't want to have to keep messing with the fills and "un-fills" required by the lapband. I also wanted the threat of suffering "dumping syndrome" if I ate the wrong things, because I understand it makes you REALLY sick for several hours....and I will do anything to avoid being sick, including policing my eating habits so as NOT to get "dumping syndrome".

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 am now 5 months post-op, and the following is what I wrote before surgery. It still holds true right now. "I have not yet had the surgery. My surgery date is a little more than a week away. I am not afraid of complications or dying. My hospital is a Bariatric Center of Excellence, and my surgeon has performed well over 2,500 of these surgeries. His practice includes support groups, mandatory nutrition classes, mandatory post-op appointments, a 12 week behavioral modification course.... and he is an amazing person who insists that his patients be educated about their procedures and make all the preparations necessary before having them. You even get a notebook at your pre-surgical nutrition class that has 10 different tabs in it... from a slidshow about the procedure, to the expectations of the surgeon for YOUR performance, to the pre-surgical preparations, to the hospitalization, to the post-surgical diet, to a grocery list (including first aid items you'll need at home for wound care), to frequently asked questions, to warning signs, to articles and other research on the various procedures. I would recommend that you look for all this in YOUR surgeon... and if you don't find it, you look for another surgeon!

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 nothing BUT supportive. My partner would rather I'd had the LapBand procedure because it can be reversed if need be...but she respected my decision and supported me fully both before and after the procedure. This has been difficult for her emotionally because she, too, has a weight problem, but she is determined to lose weight the "healthy" way, through proper diet and exercise. Problem is, she buys what she wants and needs for her "healthy diet", but then doesn't spend the time to prepare the food so that she can conveniently take it to work with her or grab it for dinner. So, she is suffering from depression, much of it related to her self-image. I want to help her so much, I would like to encourage her to have the WLS, but it is something she can't even hear right now. Maybe when she sees the results of my journey, she might understand that her physical and emotional health are more important than her "perceived" RIGHT way to lose weight.

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

I told my employer that I was having minor surgery on my stomach related to a hiatal hernia and that I should be back at work within a week. I actually didn't go back until I was 11 days post-op because I developed an infection around the incision site for my JP drain, and had to wait until they removed it before I could go back to work because the infection caused nasty drainage that leaked out of the dressings onto my clothing. As the weight loss began and progressed so quickly, it became obvious to my supervisor and co-workers that I'd had WLS, so I finally copped to it. No one said anything negative to my face, although I know of one co-worker who disapproves of anything like this and won't hesitate to give you her opinion (which is why I didn't tell anyone ahead of time).

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

It was exciting and extremely informational. Dr. Snyder gave a slideshow presentation, along with peer-reviews and obesity study results, and as he energetically walked back and forth across the dais, it was obvious that he really loved what he was doing. He also brought along a large number of people, some who were two or three years "out", some who were 6 months to a year out, and some who had just had their surgeries. They each got a couple of minutes to tell their stories, and then everyone stayed around for people to ask questions of afterwards. It was very inspiring to hear and see them. I am VERY glad I attended.

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

I was there from Monday Morning until Wednesday Morning. The nurses were mostly wonderful, but pretty busy. At night I had to wait for a little while until someone could come and disconnect me from all the tubes and pressure "stockings" so that I could get up to the bathroom. I also set off the pulse oxygen monitor a few times and no one ever came to check on it. Lucky for me, I have a medical background and knew to take slow deep breaths to make the beeping stop.

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

I did not have complications in the hospital. I did develop an infection at the incision site for my JP drain after I got home. My surgeon is one who believes that antibiotics are way too freely prescribed these days, so he refused to order any. The infection got worse (not painful, just draining copious amounts of green pus), and it wasn't until I'd seen him 3 times that he finally ordered antibiotics. I also had a seroma where my other drain had been. It opened up after I'd been home for about a week....and my surgeon just ordered me to "pack" it with gauze. That hurt, and it was my only point of depression about the procedure. Finally, I pulled a muscle in my upper abdomen trying to turn over in bed, and that made it a little hard to take a deep breath for a while, but other than that, all was okay.

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 as far as the surgery went. I was dealing with other non-surgical pain problems that were very serious, but surgically, I was fine. The only anxiety I had was when I developed a stricture at 4 weeks out, and didn't do anything about it until 6 weeks. I threw up a lot, and stopped losing weight because my body went into starvation mode and because of the other non-surgical-related pain, I couldn't exercise, so I was in trouble. I made an appointment for a dilation procedure, and the next week I got an epidural pain shot - and was pain-free within 24 hours. I began exercising, and because I could now hold down my food, my body no longer thought it was starving, and I was keeping my metabolic rate up, so I began to lose weight again.

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

I think I'm an exception. Several weeks prior to surgery, I ordered a protein product sample package from bariatriceating.com, and then picked and ordered my favorite protein products for when I came home from the hospital. I went to Vitamin Cottage and bought plenty of the IsoPure RTD 20 ounce bottles and some of the Vanilla Oh Yeah ready to drink shakes. I prepared something like 30 or 40 one-ounce containers of fat-free-sugar-free pudding and jello with protein powder mixed in for myself the day before surgery. I also had smooth yogurts on hand, and fat-free cottage cheese. It was a challenge to eat ever 2 - 3 hours, and then to keep drinking the protein drinks, but I did it...at least until the stricture popped up. One thing to look for is having your food get "stuck". You'll definitely be able to tell the feeling. If it happens more than just a few times, get yourself checked for a stricture right away.

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

Not even 5 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.

I actually have been able to eat most of what I could eat before, avoiding of course, anything with too much sugar or fat. I've found that I'm not as fond of red-meat as I was, and that with dense protein like chicken, turkey or fish, I have to limit myself to about 2 ounces or it gets "stuck" - unless I puree it, which is and has been an option all along. I still eat off of a sandwich plate, and I use a baby spoon to help make sure that I don't take big bites. A typical food day for me is an EggBeaters "scramble" with one slice of Great Value Fat Free Sliced Turkey Breast (from WalMart) diced up, and 15 grams of Weight Watchers Reduced Fat 4-Cheese Mexican shreds, and 1/4 cup of chopped mushrooms. I also have half of a small banana and 1/2 cup of sliced fresh strawberries with a packet of Splenda sprinkled over them. A midmorning snack might be a couple of pieces of the fat free turkey rolled up around two tablespoons of Cedar's low fat Garlic Lover's Hommus. Lunch is usually a small piece of chicken or fish with 2 ounces of cottage cheese, or a serving of the Starkist Tuna or Salmon Creations in the pouch with a little bit of fruit (like the strawberries). I usually skip the afternoon snack, and dinner is usually more chicken or fish, or finely chopped sushi salmon with lemon bits and fat free cream cheese, and scallops with cilantro (no rice or seaweed, just the raw meat). I have not made ANY food entirely off limits except for white bread, potatoes and pasta, and that's not because I can't tolerate them, it's because I want to adhere to the rules of the tool provided by my surgeon and nutritionist. If someone has something sweet that I really like, like peanut butter cheesecake or a jello parfait or a piece of cake, I will ask for just a tiny taste of it. A half a teaspoon will satisfy me. I almost always have a late evening snack of OIKOS Fat Free Greek Yogurt with a teaspoon of vanilla extract and 2 packets of Splenda, and mix it with 2 tablespoons of sugar-free smuckers strawberry preserves. Truth be told, I could live off this all day long. My mouth waters for it. And the OIKOS is waaaaay high in protein. Higher even that FAGE. I still sometimes have a problem with my dinner getting "stuck" and will vomit it up....thereby not getting in my required daily protein, so on those days I will have an Inspire Peanut Butter Cookie or Chocolate Peanut Butter Fudge shake.

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

I suffer from Lumbar Spinal Stenosis, severe Facet Arthritis, and a forward-tipped vertebrae. The more I tried to exercise, the worse the pain got. Finally, I was using a handicapped cart to do my grocery shopping, and using a walker to get back and forth from the bedroom to the bathroom at night as I would not make it in time without it. Exercise was out of the question, and it showed on my weight loss chart. I saw 3 back doctors who were real jerks, the last one was on the same day as my 6 week checkup, just prior to my appointment with my surgeon. I walked into his office sobbing with pain and hopelessness. He immediately got me the name of a neurosurgeon he worked with, and had me make an appointment as soon as I could get in. She laid out a plan of action for me that included an epidural pain shot series, physical therapy, and a wait-and-see attitude to evaluate how the weight loss would affect the pain level after 6 - 8 months. Well, I got the pain shot on May 1st, and within 24 hours I was pain-free. I even began exercising with my daughter at a 24 Hour Fitness, and did so well that I came back here and bought my own membership. I've been exercising for about 2.5 hours most days (that includes an hour of cardio on the treadmill and the stationary bike and the elliptical machine; and then about 45 minutes of strength or weight training, and then about 45 minutes of my physical therapy exercises. I'm full of energy and actually happy! The pain is slowly returning to my lower back, though, so I'm not sure how long this will last.

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

I no longer take High Blood Pressure Meds, nor the Statin drugs for high cholesteral and triglycerides. My only prescriptions now are my thyroid medication, and my Valproic Acid (prescribed for Bipolar Type II - the diagnosis is something I disagree with - but my surgeon didn't want me to discontinue this drug for at least one year after surgery), and Clonazapam (prescribed for anxiety and panic attacks). Otherwise, I just take Bariatric Advantage Multi-Vitamins, Twinlab Calcium Citrate Chewables, Extra Vitamin D (5,000 IU), Sub-lingual B12, extra Vitamin K, and lots of Biotin to help keep my hair from falling out.

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?

Muscle soreness made it a little hard to sleep, but not for long. Hair loss seems to have just begun (5 months out). I was not troubled with any other disturbances. I am updating this at 1 year out. I am no longer having significant problems with hair loss, but I am keeping my protein intake well above 100g per day, along with continuing to take my Biotin and use the Nioxin hair products recommended by my hairdresser. I still have trouble eating red meat, and so I don't often have it. So far, I have not dumped, and I have to admit that I've eaten chocolates (way too many at a time), and other things that I would have thought would make me dump, but didn't. However, I don't tempt fate all that often, and when I do, I try to eat the least I can get away with of the "offending" food.

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

Dealing with the infection around my JP drain site - no pain, just yucky dressing changes every time I turned around.

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

We have monthly support groups, and a nutrition class we can pay to attend. We also have a life coaching class that is designed to help us with creating a new focus to go along with our new lives post-op.

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

I have 5 small incisions, and they are still fairly red and purplish looking, but once they fade to the silver of a regular scar, you'll barely be able to see them.

Please describe any plateau experiences you have had since surgery.

I had a plateau from week 4 to week 7, due to a stricture that had formed and being unable to exercise. My body went into starvation mode and held on to all the weight it could. I was still losing, just very SLOWLY. At 5 months out, I am losing very slowly again...don't know why, as I'm exercising and keeping my carbs waaaaay below 120, and my fats below 25, and my protein between 80-100g. But still, at 5 months, I have lost 71 pounds. Total weight lost since beginning the pre-surgical diet is 97 pounds. Update: One year out - I am at my surgeon's goal weight for me (170 pounds), but I am trying to lose another 10 pounds to get to my own goal weight of 160.

Do you notice people treating you any differently now?

Yes, they are amazed to see me, they tell me how wonderful I look, how good my color is, and how relaxed and happy I seem. Update: 1 year out....people don't even recognize me now. It's funny....they look at me like they SHOULD know me, but they just can't come up with a name. These are people I've worked with for 14 years!! People who've known me forever! It's a real kick when that happens!