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I was recently asked by my area support group leader to complete a patient questionnaire that will be posted (along with before and after photos) in our area hospitals. The intent is not only to help people considering a surgery in their decision making process, but also to keep the immediate post operative patients and family members positive regarding the decisions that were made (as the first days in the hospital following surgery can often make you second guess yourself). The text of that questionnaire is below:


1.  Why did you decide to have weight loss surgery?

In November 2006 I was diagnosed with Type II Diabetes. At the time I weighed 360+ pounds. I struggled for almost a year with various weight loss attempts but to no avail. My condition worsened to the point that oral medications were not helping. Once I was threatened with being insulin dependent, I knew I had to do something more. I read about weight loss surgery and the dramatic improvement in the diabetic condition post operatively. I was convinced enough to attend Dr. Dennis Smith’s seminar. Once I attended the seminar, I knew that weight loss surgery was the answer for me.

2.  What was your biggest challenge going through surgery?

Luckily, I didn’t face any major challenges prior to surgery. My greatest concern was related to the social aspect. What would people think? What would people say? I made a conscious decision to be open and honest with everyone about my plans. I was pleasantly surprised that most of my acquaintances were extremely supportive of my choice to be healthy and improve my quality of life.

3.  What is the biggest change that surgery has made in your life?

I am far more active today than I was prior to surgery. I spend much more time playing with my children, exercising, etc. verses sitting on the couch and watching television.

4.  How has having surgery changed the way you see yourself?

I am much more confident in myself today. I feel as if I “fit in” in social situations where I may have felt uncomfortable or embarrassed before.

5. How has having surgery changed the way others see you?

I am no longer thought of as the “fat guy” in the room. I am treated as normally as anyone else, which is a great feeling. I feel that my career options have opened up as I no longer have to deal with the discrimination against obese persons.

6.  What kind of impact has having surgery had on relationships?

In general, most relationships have improved because I have become so much happier with myself. I was a miserable person before, which placed a lot of strain on personal relationships. Since that barrier has been removed, relationships have improved accordingly.

7.  What impact has having surgery had on your health?

Prior to surgery in December of 2007 I weighed 348 pounds. I suffered from hypertension, sleep apnea and diabetes. My fasting blood sugar averaged 220 - 260 on a daily basis.

Currently, I weigh 235 pounds (113 pounds lost). I no longer suffer from hypertension, sleep apnea or diabetes. My fasting blood sugar averages 85-88 on a daily basis.

8. Are there any medical conditions for which you no longer take medications as a result of the weight loss you’ve achieved?

I no longer take medication for diabetes or hypertension.

List a few things you can do now that you couldn’t do before surgery:

• Sit in a booth without holding my breath
• Walk up a flight of stairs without losing my breath
• Fit into “normal” clothes and shop anywhere

9.  What changes have you made in your:

a.  Eating habits

In the past, I was addicted to both fast food and junk food. I was not mindful of nutritional value, portions or overall caloric intake. I only drank caffeinated beverages.

Today, I focus on eating protein first and taking in “healthy” carbohydrates when possible. I drink a minimum of 80 ounces of water per day. I no longer drink carbonated sodas and avoid any caffeinated beverages. I do have bad days, where I let the “carb monster” take me off track. I choose not to get discouraged as I have far more good days than I do bad days.

b.  Exercise regimen

In the past, I broke into a sweat just thinking about exercise. A walking routine was too much to ask of me. After 5 minutes in a gym people were looking at me and asking each other if they had 911 on speed dial, as I was bound to keel over.

Today, I attempt to work out at my gym 4 to 5 days a week. I don’t always get in that many days per week, but I do exercise on a frequent basis to say the least. I perform cardio during every workout and resistance training during every other workout.

c. Daily activities

Quite simply, EVERYTHING is easier today. There is more effort involved in planning my diet and exercise, but I am no longer “held down” by the excess weight.

11.  If you could change anything or have done anything differently, what would it be?

I would have taken control of my life much sooner than I did. I waited until I contracted an incurable disease before deciding to take action.

Also, I would have purchased stock in a certain fast food chain, as I personally drove their earnings up for several years.

12.  Would you recommend this surgery to others who are in your position?

Without hesitation; I have no regrets whatsoever.

13.  What suggestions would you have for someone who wants to have this surgery?

It is extremely important that people considering this realize that weight loss surgery is not a “magic pill”. It is simply a powerful tool that helps us to implement the lifestyle changes required to get healthy. It is imperative to success that a person change their eating habits, exercise regimen and overall thought process regarding food.
I still, and always will, have an instinct to look to food as my coping mechanism for stress. It is important to find a replacement for food from an emotional perspective. It is a constant struggle that I will deal with for the rest of my life. It is important for anyone considering this surgery to realize that our problem is as much psychological as it is physical. That is a component that must be dealt with in order to succeed.

Finally, I cannot stress the importance of support. I attend support groups as regularly as possible. Seeing my peers and hearing how successful they have been keeps me motivated.

I no longer post on OH but visit often. I suspect this is the norm for most. It seems the further out I get the less questions I have. I do still visit the site regularly and read the posts on the message board. I do chime in when I feel I can help.

As far a progress goes, I've lost about 100 pounds since December of 2007, 90 pounds since my surgery on 12/27/2007. I exercise like there is no tomorrow. Unfortunately, my triathlon venture will wait until next year, as I am just not ready yet from a conditioning perspective. Regardless, I will get there no matter what...

I would say to anyone considering this operation that my success thus far can be attributed to hard work and focus. I've certainly had my share of slip ups, but in no way do I behave like the "old me". Do not consider this a magic pill, as it will take hard work and perserverance in order to succeed.

Today is the two month anniversary of my surgery date. I have lost 51 pounds since surgery (62 overall including pre-surgery weight loss). I no longer take medication for diabetes as my fasting blood glucose level averages between 87 and 93 on a daily basis. 

I couldn't be happier, but I have to admit I often wonder when this wonderful journey will end. I hope to reach my goals before my weight loss shuts down. 

I am training for a "sprint triathalon" in July of this year. This consists of (on average as different competitions vary) a 750 m (0.5 mi) swim, a 20 km (12.4 mi) bike , and a 5 K  (3.1 mi) run. This is certainly a stretch goal but I will measure success by 1) being in good enough shape to enter the competition and 2) being able to finish the race (even if I crawl to the end).  If I don't make it this year I will no doubt be in the competition next year.

I had the vertical sleeve gastrectomy on 12/27/2007. I had a one night hospital stay and was home by 4:00 PM the follwoing day. My surgeon's team did an excellent job preparing me beforehand and nothing happened that was unexpected. Luckily, the whole hospital stay was uneventful.

Since being home, I've been focused on water first (difficult the first day or so) and then small meals with protein. I have a lofty protein intake goal of 100g per day which I haven't met yet. I am up to 50 - 55 grams of supplement per day in addition to any I get in the six small meals per day that I eat/drink. 

I had my week one post op appointment today and was down 16 lbs. All in all. I can say that this week has been pretty easy thanks to some good friends I have met through this process as well as everyone that responds so quickly to the posts on the VSG forum. 

I had my pre op appointment with my surgeon today. All of the education and consent forms have caused reality to set in. A little overwhlemed right now but not looking back regardless. I've met too many people that have inspired me so much. Thanks to them, I'm going to succeed!!!

I was told today that my insurance company approved my request for surgery. I now have a surgery date scheduled for December 27, 2007. I barely made it under the wire... now for the hard part.....

I was recommended to my surgeon by my PCP about a month ago. I attended my surgeon's educational seminar early in October and was sold. This is what I was going to do. I completed the application packet and submitted it to my surgeon hoping that I would be accepted as a candidate. 

As part of the application process, I had to contact my insurance company to see what is, if anything, covered under the scope of bariatric surgery. I found out that VSG was covered in 2007, but a $10,000 lifetime cap on any bariatric surgery would be in place beginning in 2008. This means that any surgery that would be completely covered in 2007 would only be covered up to $10,000 in 2008 and beyond. I realized that I needed to expedite this process if at all possible. 

I was accepted as a candidate by my surgeon, and met with him on 10/29. He is very meticulous and requires extensive testing prior to surgery (no matter what the insurance requirements are). I knew I had to find a way to compress what could have been months worth of testing into a small window of time. Luckily, the surgeon was aware of the insurance issues, and made an exception by allowing me to get my preliminary labwork done prior to my first meeting with him.  

I had already discussed this with my employer, and he was fully supportive and gave me the go ahead to "do what I needed to do". I met with my PCP on 10/31 to discuss what items I needed in regards to tests. On the spot, he gave me an overall physical as well as an EKG. He also said that he would begin getting the letter of recommendation together. Luckily, my PCP works in a group that is a one stop shop of sorts (they have diagnostics, specialists, etc.) I was able to walk out on 10/31 with all of the following items scheduled to be done during the week  of 11/5:

- Upper Endoscopy
- Gall Bladder Ultrasound
- Chest X-Ray
- Pulmonologist Consult

By the end of the day on 10/31 I had also scheduled my Nutritional / Dietician consult for 11/9. I also found a psycholgist (that was recommended by my surgeon) that was willing to meet with me on 11/10 (a Saturday). 

Never in a million years did I expect to get all of these things done in one week. I'll stay on top of them afterwards to ensure the information gets back to my surgeon's office promptly so that they can put together the insurance submission.

I'm not getting my hopes up because no matter how quickly we can get this to the insurance provider, there is no guarantee of approval. I do know that if I had not been investigating this for more than a year that I would not be pushing so hard. I'm not good at rushing into things from an uneducated standpont. 

Regardless, I've done all I can do for now and I'm trying to drop some weight as well. So I'll remain positive and hope for the best.