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

I first found out about bariatric surgery from a magazine article in a diet program office a long time ago, and I was curious about it, but wasn't ready to address my own problems via surgery. My initial impression was that it is a drastic step to take and at that time, I felt it was like killing a flea with a sledgehammer. Well, this is now the flea that ate Chicago, and is looking for New York!

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

I never did get insurance approval for surgery. I'm a self-pay. This means coming up with big bucks in advance. It was frustrating and demeaning having to deal with the medical insurance chosen by the folks at my former employer. I found out that, despite there being a measure in the Ohio State Code that coverage for obesity surgery may not be denied on the basis of medical necessity being questioned, I was denied on the basis that the coverage that my former employer agreed to at the time they placed the contract with the insurer, United Healthcare of Ohio, excluded any treatment for weight loss. ANY treatment, no matter how cost-effective. Anyone else who is facing them, beware! The employee review board were very cavalier. I could see them turning their thumbs down over the telephone! As for advice, just get another insurance company if you can! If you can't, then DOCUMENT, DOCUMENT, DOCUMENT. On every phone call, document who you spoke to and what you heard them say. Keep copies of everything you intend to send to them. Send everything in some way where you will have PROOF that the package got to the insurance company's address (Certified/Registered is one way, using an overnight service another).

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

It was a long wait in the waiting room - more than 2 hours! He had gotten very behind schedule. The surgeon's staff were wonderful, very encouraging and polite and understanding. When I finally did get to see him, it seemed like the time flew by, Dr. Needleman had a lot to say in a short time, but he covered virtually all the questions I had. The first impression he makes is of compassion, friendliness, brilliance, and a good sense of humor. I think that certainly one way of making sure you receive the most benefit from this meeting is to write down in advance all of your questions, even the stupid ones. Another thought is to take along a tape recorder, or one of those memo recorders so you can have some kind of record of what he says. And, of course, be prepared to wait as long as necessary.

How did you decide which proceedure to have?

I chose the laparoscopic Roux-en-Y procedure because it offers the best chance for compliance and success on my part. Also, the laparoscopic rny has a number of advantages. First, it will take less time to heal. Second, it is permanent. Third, there is less chance of infection. Fourth, it uses both malabsorption AND restriction to achieve the desired results. (Double protection.)

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 have few fears about complications. Dr. N is very experienced with this procedure and seems to have had few negative results. Every major operation carries with it some risk of dying. I think that you have to keep that in mind, but not obsess over it. You have to go into this process with your eyes open as to all possible outcomes, but I can say that it hasn't influenced my decision to where I would not have this procedure.

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 and friends have been more than supportive, they've been enthusiastic. I had a little apprehension about telling them before I actually did tell them, but they have been positive about my decision from Day 1, Moment 1. That says a lot about them! And it says a lot about how much they care about me.

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

I'm unemployed.

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

My stay at the OSU Medical Center was I would say an "A-." I was impressed by the kindness of all the staff and their especially helpful attitude. I had only one nurse who was a little ditzy, but the rest of the staff, including the ICU staff, were friendly, positive, and solicitous.

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

I had one stricture about 7 weeks after surgery. I wasn't able to keep foods down that I had been eating a couple of days before, so I called Dr. Needleman's office. They suggested an endoscopic dilation, which I had, and it was no problem after that.

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

Pre-op, I Had lots of feelings of excitement, fear, doubt, all mixed up at once. I Coped by focusing on the future, and relying on my wonderful support system. I also read a lot on the AMOS site. I looked at the before-&-after photos for inspiration often.

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

I traveled about 3 or 4 miles.... Tough, huh.

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'm now in the 5th week post surgery. I can't eat anything not soft and/or pureed. Hamburger, a pre-op favorite, doesn't taste good after about 10 chews. Cheese is OUT - too rich. Can't eat anything chunky. Bread gives me heartburn, even toasted. I'm still eating baby meats and veg, cottage cheese, yogurt, fresh fish cut into tiny shreds, mashed potato (even after it's been baked), applesauce, protein drink, protein bars (tiny bites well chewed), and that's about it. At 11 weeks out, am eating cottage cheese, cold cereal, mashed fruits, canned fruits and veg, fish and chicken and extremely tender beef. I can eat Wendy's chili. Still have problems with bread in any form. Protein drinks and protein bars taste pretty grim these days, can't stomach them. Have to watch how fast I eat. This is my biggest problem by far. The amount is still small, and hopefully will remain so. I try everything but bread and sweets, but usually can't eat more than about 4-5 oz. at a time. Eating about 4x daily. At 7 months out, I can eat almost anything, except for bread, sweets, anything fried, hamburger, and spareribs. I eat about 6 oz. at a time, approx. 4x daily - although not every day. At 10 months out, I eat almost anything, except for bread, sweets, hamburger - Amounts still small, trying to monitor that everything I eat has a good reason.At 1 year out, I still cannot eat much in the way of bread, but it's no great loss. I eat pretty much anything I want, but not very much of it, I estimate I'm eating about 1/3 of what I ate pre-op at a sitting. Fatty meats are out, including hamburgers. Fish, chicken, pot roast, lamb, pork, tender beef, are in. Most vegs are in. Carbos, including a lot of whole grains, are mostly out. Not much fruit (gives me the runs). Hi-fat dairy is out. Lo-fat dairy, particularly cottage cheese, is in. One protein bar snack per day. How I eat is key. I take small bites and CHEW CHEW CHEW. I take my time. At 1 year out, I still cannot eat much in the way of bread, but it's no great loss. I eat pretty much anything I want, but not very much of it, I estimate I'm eating about 1/3 of what I ate pre-op at a sitting. Fatty meats are out, including hamburgers. Fish, chicken, pot roast, lamb, pork, tender beef, are in. Most vegs are in. Carbos, including a lot of whole grains, are mostly out. Not much fruit (gives me the runs). Hi-fat dairy is out. Lo-fat dairy, particularly cottage cheese, is in. One protein bar snack per day. How I eat is key. I take small bites and CHEW CHEW CHEW. I take my time. At 18 months out, not much change from a year out. Nothing new, except I can eat a little bread, but not much and not daily.

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

Activity level is still pretty low. I don't have much energy at 4 weeks out. At nearly 3 months out, I'm doing much better, and am going to the athletic club on a regular basis. At 1 year out, I'm doing still better. I walk every day. I'm looking for a yoga class.

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

I took liquid vitamins, but I'm having trouble with the taste, so I'm trying pre-natal chewables. I also take a sublingual B-12. At 1 year, I'm still taking the same chewable pre-natal vitamin and B-12. I also take biotin and silica for my hair and nails. At 1.5 years, I'm taking a non-prescription adult chewable vitamin, and sublingual B-12, biotin and silica, and have added a calcium supplement.

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?

Dumping is the worst feeling, but the vomiting is the most frequent for me. I did have some hair loss from about 3 months out until about 7 months out, but with the help of my hairdresser, the effects were minimized. At 10 months, I still dump after eating something made with sugar and/or fatty, and still vomit if I haven't chewed something really well. As to dealing with the side effects, you deal with them the best way you can. If it's dumping, I have to find some place to lie down and I usually sleep. If it's vomiting, I either go to a toilet quickly, or if I'm at home, I make sure there's a plastic bag nearby. At 1 year out, I dump - but less often, and that's mostly because I'm at home with my choices, and rarely choose things that would make me dump. As to the vomiting, I still have to take small bites and chew everything very carefully. I avoid bread because I still cannot seem to make my stomach come to terms with it, but it's no great loss.

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

The insurance company prejudice about bariatric surgery. Morbid obesity is not a matter of willpower, it is a disease!!! Employers need to be made aware that, no matter what they have been told, weight loss surgery for the truly morbidly obese is as much as a necessity as a heart bypass is for the morbidly cardiac.

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

OSU Comprehensive Weight Management Program. I think it's important to have a formal support program in place. You then have a resource to turn to if you have questions or need a little extra to lean on. Also, it's great to have people who are true peers, who have been going through or have gone through exactly what I am.

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

I have six little scars - my surgery was laparoscopic. And Yup, that's what I expected.

Please describe any plateau experiences you have had since surgery.

2/9/02 - so far, no plateaus of any length. 3/15/02 - Little plateaus of 3 to 4 days. I'm annoyed, and thinking what can I do to break it. 7/22/02 - Or trying to think how can I improve whatever behavior is fostering the plateau. Usually, it's needing to drink more water or move my body more. 9/7/02 - Had a long plateau (about 6 weeks), thinking my body remembered that weight and liked it, but it finally broke the other day! I'm not finished losing weight yet! WHOOPEE!

Do you notice people treating you any differently now?

People are more likely to look me in the eye when they talk to me. I don't get the brush-off or that contemptuous sneer at the supermarket checkout. A lady at a department store make-up counter said, "Looking at you, I didn't think you qualified for our 15% discount for 55+ people!" I'm 57! (She had to look at my driver's license for ID.)