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

Newspaper ads, TV ads. First thoughts were that I'd never get that overweight....

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

The company my husband works for has an exclusion clause in its HMO Plan, so I had to pay for my surgery. It's Aetna HMO and the clause states that there is no coverage for any weight loss surgery for any reason, even medically necessary surgery. This seems odd to me, because they willingly covered my sleep study, CPAP, appointments with the sleep apnea doctors and respiratory therapists, TWO knee replacements which required multiple appointments with my surgeon and many prescriptions post op, various cholesterol lowering statin drugs, and all the lab tests associated with these conditions, all of which were weight related. My weight loss so far has eliminated the need for CPAP, my cholesterol is normal, I'm far more active and eat a healthy diet every day--which are the very things that healthcare plans are all aiming for!! Maybe a cost effectiveness study should be done. If insurance companies want us to be healthier, why deny us the resources that help us GET healthy! My advice is to appeal to your insurance company for as many times as necessary to get approval, even if they require you to "jump thru hoops" before the surgery.

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

Wonderful! Dr. Kuhn answered all my questions, and as a nurse, I had lots of them. Talk to peaple who have had the procedure you're most interested in. Go to seminars (I went to 2, one for the lap-band, the other for the Lap Band AND the Laproscopic Roux en Y Gastrip Bypass, which is what I had). It was led by Dr. Barnes, an associate of Dr. Kuhn. Get all the information you can before your vist, then make a list of questions you want answered. Bring someone with you because they may remember something you miss during the seminar. I brought my husband (cheerleader-in-chief)who is the most important person in my support system.

What made you finally decide to have the surgery?

My Primary Care doctor said I needed to go to the seminar at the hospital he's affiliated with because of my health issues.

How did you decide which proceedure to have?

Recommendation by my surgeon based on my medical history, age, amount of weight needed to lose and maintain.

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?

No fears, having had several previous surgeries--C Sections, Abdominal hysterectomy, 2 knee replacements.

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 husband went with me to the seminar, which was crucial since he needed to understand WHY I needed this surgery and WHAT was required both before and after the surgery. Everyone was VERY supportive. I always communicated the medical necessity of my surgery, probably because I felt that was the only legitimate reason to have weightloss surgery. I now know medical necessity isn't the only reason someone has for having the surgery.

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

N/A

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

My stay was considered Day Surgery, but I stayed overnight after having surgery in the early morning. I was in the hospital less than 24 hours. Bring (or wear)loose fitting clothes to wear on the trip home, along with warm socks, comforable shoes, personal care items (like tootbrush/toothbrush etc.) Your support person can be with you PreOp and I was groggy PostOp, so I didn't need the book I brought!

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

None! I'm a very compliant patient and am fortunate to have a very stable stomach, so have not had any problems with on-going nausea or vomiting. Have only felt nausea twice, when I ate one bite too many at a meal. Only threw up twice, within the first month after starting solid food postop.

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

A little nervous because I'd never had laproscopic surgery before, but having faith in both God and my surgeon helped.

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

Spent the first few days in comfy PJ's, taking it easy with activities of daily living, napping after I took pain meds. My husband (nurse/cook/housekeeper)pampered me, but also encouraged me to walk (inside the house)and start to resume normal activity. It wasn't long before I was starting to do more and more, even things I hadn't done in a long time, like exercise!!

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

Less than 50 miles, which isn't far since we live in a huge metoplex.

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.

The nutritionist and Dr. Kuhn prepared wonderful materials outlining both preop and postop nutrition. There were specific foods that were recommended, those that were to be eaten occasionally, those that were to be avoided, and why each food was placed in its catagory. PostOp diet was liquids only (Protein Shakes, milk, non-carbinated sugar free drinks), until my first PostOp appointment, which I think was 2 weeks. Then I graduated to soft foods like scrambled eggs, lowfat yogurt as well as the protein shakes. After being cleared to begin solids postop, I only had a problem with a hard-boiled egg! My stomach apparently didn't like the white of the egg (the protein!) and promptly threw that up, but not the yolk! OR maybe I had just eaten that one bite too many, so my stomach rejected it. I've had hard-boiled eggs since then with no problems. I gradually added foods and have not had any problems with any food yet. I eat a regular low salt, low saturated fat, low sugar type of diet, but very small portions, 3 meals a day. I have anything I want, but I don't want fried foods, greasy foods, high calorie foods, etc. If I want to have a small serving of dessert, I have it, but that happens rarely. I'm very careful to eat my recommended amount of protein every day and as early in the day as possible. It's important to balance your recommended amount of protein with whole grains, dark green leafy vegetables, fresh fruit, legumes (all carbs), and heart healthy fats such as olive oil or cannola oil in small amounts. This kind of diet is healthy for everyone and especially for us because of the high amount of protein we need to eat. A healthy digestive system depends on a healthy diet. The nutritionist made it very clear that the pouch can be stretched by eating just a "little tiny bit" too much at meals and a diet of fried and/or high calorie food will eventually cause weight gain and/or a return to the "couch potato" routines, as well as your preop unhealthy state! It sounded very hard to do, but since I'm not hungry all the time it's very easy. I love vegetables and fruit and whole grain bread, too, so that helps a lot with getting the vitamins and minerals necessary. Hey, I've eaten the "wrong" thing on occasion, but since I can only fit a small amount in my new stomach, even cheating on the diet isn't disastrous since it happens so rarely. I had to learn that my eyes want more than my stomach can hold, so now (even at a buffet or cafeteria) I don't put anything on my plate except the good-for-you stuff. After eating that, I'm satisfied until the next meal. Amazing!

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

Very little activity besides walking around the house at first, gradually resuming and then surpassing my pre-surgery levels

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

I take Formula Four, Multi-Min, and Salmon Oil by GNLD. OTC calcium citrate, generic pepcid AM and PM, liquid sublinual vitamin B Complex, vitamin B-12 sublingual.

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?

Hair loss? I've been having hair loss since a couple of years or more before my surgery. More loss since then.

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

Can't think of a downside in my particular case other than the cost, because our insurance has an exclusion clause for WLS, even when it's medically necessary, which mine was. So now that the company is touting its Wellness Program and Plan, I want to scream, because if they really want wellness, they'd cover medically necessary procedures!

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

I get my surgeon's team's newsletter via email each week. haven't been able to go to one of their group meetings yet. I have such a supportive husband, family, and church family in addition to my surgeon and his staff! It's all very important to me.

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

I'm very fair skinned, so the 5 small scars are almost invisible after 11 months. But I'm not young (only my husband is likely to see them) and am not planning on wearing a bikini ever again! I do wear a bathing suit, however, saggy skin and all. Nobody has ever made a comment about the long scars on my knees from my knee replacements! Besides all my scars are badges celebrating how much better I feel!!!

Please describe any plateau experiences you have had since surgery.

I've been on so many plateaus during my years of dieting that I just don't worry about it. I DO take stock of what I've been eating and how active I've been and make adjustments if needed. Going to a shake as a meal replacement once a day for a few days and moving more gets me back on track. I'm not on a sprint here, more like a marathon. Slow and steady (weight loss) wins the race (good health for life). I'm just not in a hurry, but have lost 65 lbs. not quite 11 months. (I needed to lose 100-105 pre-surgery.)

Do you notice people treating you any differently now?

People I know compliment me on how well I'm doing and how nice I look. People I don't know--don't know I'm any different. I've always been kind, courteous, funny, friendly, and smiling to everyone pre-as well as post-surgery, so wasn't treated badly before. But as I said, I'm not young either, and I was normal weight until about age 47.