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

I was aware of it for a long time but didn't consider it for myself until the last few years. I had gotten to the point of no return and needed help. I was leery at first. After educating myself, talking to various people who had the surgery and to physicians about their opinions (which weren't all positive), I decided this was the route I wanted to go.

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

I had tried to have the surgery a few years ago, but my insurance at the time (United Healthcare) denied it. They did not cover the surgery under any circumstances. This year 1/2000, we switched to BlueCross/Blue Shield of MN. They were great. Yes, there were requirements: 100lbs overweight, 3 month supervised diet (I saw a dietician), pysch eval, primary doctor referral. But all in all, they were great. They continued to be supportive post op when I got a bill from the hospital that I was not responsible for.

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

I met with Dr. Howell in May 2000, approx 5 months after starting the whole process. I had been provided with alot of information and educational materials prior to the first appointment, so I knew the questions I needed answered. He was very thorough and explained the risks and benefits. I think you can get the most out of the first meeting by really reading the material they give you, and then write down a list of questions that you want answers to. That way you don't forget to ask the questions that are important to you. Compile this list over a week or month. Just be sure you get the answers! If you don't understand something, ask again, or have them clarify it until you do understand. That's there job. When you sign the surgical consent on the day of surgery, you are saying that you understand the risks and the goals. Now is the time to get that understanding!

What made you finally decide to have the surgery?

I was sick of being heavy. Sick of being tired. Sick of being sick. I wanted to feel good again and be able to live life. I wanted to walk up a flight of stairs without panting. I have tried so many diets and nothing worked. I needed help and finally came to the conclusion that surgery was the answer.

How did you decide which proceedure to have?

The RNY was what Dr. Howell recommends and feels gets the best results. I read a little about the other procedures, but felt if this was what he is most comfortable with, so am I. I also talked to people who had this procedure, as well as a friends' mother who had her "stomach stapled" 25 years ago by Dr. Howell. She actually has still kept her weight off all these years! So I looked at different procedures and decided to go with the surgeon's recommendation. An anesthesiologist I know also told me what good results (minimal complications) Dr. Howell has with this procedure. That was a strong recommendation to me.

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?

When they explain risks, they are required to give you all the details - worse case scenario - so naturally it is scary. Any surgery carries a degree of risk. But so does life. And I was really at the end of my rope. I've had surgery before and am always a little nervous. A friend who is a nurse explained that you are probably safer in the OR than you are at home in bed because you have so many people monitoring your vital signs! I was given Versed just prior to surgery which was great because I was getting a little nervous. Find out what kind of drugs are offered, and use them if the need arises.

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?

I have heard people say they had negative reactions from family and friends. My whole family has been extremely supportive. My mother and sister came 350 miles to see me in the hospital. My husband and children have always loved me no matter what - even when I haven't exactly loved myself. My husband has been a great asset through the whole process. My son hates it when I throw-up. So do I! But I just reassure him it will get better with time.

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

Even though I work in the healthcare field, the emphasis was always on getting back to work. "How long are you going to be off?" My supervisor has always been like that, so it wasn't a surprise. You would just think that since she works in healthcare, she'd be more understanding than say, a banker. But no. Her supervisor, my big boss, was much more understanding, but I don't work directly with her. Since surgery, they've been supportive. I took 6 weeks off. They let me work 1/2 days for 2 weeks. I really felt I needed that much time, even though I was more tired than in pain. And luckily, I had accumulated more than enough leave. You're learning a whole new eating pattern, so the time off was well used!

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

I was in the hospital 5 days. I had surgery on Monday morning and was discharged Friday afternoon. The hospital stay was a little disappointing. The nurse's were practically non-existant. No one came unless you put on your light. I also had one nurse who wanted me to drink a pitcher of water on the 3rd day when I was on a fluid restriction! This is when the things you learn pre-op come in handy. I also was served food that was not on the diet on the 4th day. I did question this and talked to the dietician when she made rounds. I didn't think the pain was that bad. I had a PCA machine where you self-dose yourself with narcotics. I used it the first 2 days, and after that I had Toradol. This is not a narcotic, and was the best drug for pain relief for me. I did have a bad case of the blues on Wednesday. No one told me about this pre-op. But almost everyone I talked to afterwards said they had a day where they were sad. Kind of like baby blues. I bawled my eyes out for about 1/2 an hour. Then I was fine! It's a stressful time, so roll with it! The only things that were important to me were my toothbrush, toothpaste, that kind of thing. I didn't feel like reading, or doing crossword puzzles or even watching tv. I just wanted to rest. And that's basically all I did. They did have us get up and walk up and down the halls. That's great for you to do. Maybe bring a favorite pillow or blanket to be more comfortable. A friend brought her walkman. I'd advise bringing the things you can't live without, because you probably won't be interested in much. On discharge, the nurse told me not to follow Dr. Howell's written orders of cleansing the incision with hydrogen peroxide. She said to use soap and water. I used the hydrogen peroxide. At this point, I know there is some education happening on that floor for staff, as I did tell the Dr about these "problems".

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

No. Things went very well.

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

After I got my surgery date, I felt elated. Then I felt depressed that I couldn't lose weight by myself-like a failure. I was up and down. But this really was the decision I wanted to make and I just tried to think of how good I would feel after everything was over with. I did get anxious. We are fortunate enough to have a monthly gastric bypass support group. That was very important,informative, and supportive. People in all steps of the process are invited - those exploring the option, to those several years post-op. Also, if you are a nervous person, there are medications. Ask your doctor. Possibly this would be an option for you short term.

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

I made myself get out and walk starting the day I got home from the hospital. The first day, I only walked 2 houses down the block and back and was exhausted. Throughout the week, I worked my way down to the corner and back, and eventually I got walking quite a distance. I walked everyday the 6 weeks I was off work. Now my motivation has slipped somewhat! But basically I felt good. I was tired, so I had the luxury of sleeping when I needed too. Some days I barely got out of the chair except for my walk. And some days I sat on my deck swing most of the day. But you are healing and should expect to be tired. Rest a little, walk a little, eat a little. Moderation is the key the first weeks home. My pain was minimal. I didn't use the oral pain meds they sent me home with. I really felt the incision was ugly, but it didn't hurt much! I went home with a g-tube in place, and had to clean and empty it periodically. I was able to shower. Personal hygiene was a little tricky since it hurt to twist at all. I was able to do almost anything I wanted to, except lift things.

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

I had surgery at a local hospital 6 miles away. Didn't affect my aftercare at all.

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 first foods were liquids, then soups,puddings, yoghurt. They were tolerated fine. It wasn't until I added things that weren't so soft textured that I started having problems. I have problems with vomiting often. I try to eat slowly, chew well, and relax. But some days nothing wants to stay down. Those days can be kind of miserable. At first, I had a real problem tolerating meat of any kind. Now ground hamburger (like taco meat) works very well. Canned chicken, tuna go fine. I haven't tolerated regular chicken well. I don't know if it's just too dry or what. I've boiled, broiled, baked it and it doesn't make a difference. One day we went out to eat and I ordered steak. I ate a square about 1"x1". But it was delicious! Expensive, but delicious. After seeing the dietician last time, she told me to eat more protein. (First time anyone every told me to eat more!) I have been eating a lot of cheese. I haven't had problems at all with any kind of cheese. Eggs are fine too. I usually have cream of wheat for breakfast made with skim milk instead of water. Also, I have a latte in the morning made with skim milk. So I've been working in my protein. When I have a hard time, I go back to the softer foods, and that usually helps. The one thing that really standa out in my mind is that I couldn't stand the thought of coffee at first. And I drink quite a bit of coffee. But it took about a month before it was appealing.

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

I walked everyday the first 6 weeks after surgery, while I was off work. I had got up to walking 40 mins daily. I started out very slowly. When I was tired, I took a nap and just sat around. I didn't feel I had to do anything but heal. I might wash a load of clothes, or I might not! Just depended on how I felt. I didn't push myself - and neither did my family! They were great at pitching in and helping.

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

500mcg Vit B12, Multivitamin, 1000mg Calcium w/Vitamin D, Iron Supplement (Fergon).

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?

The vomiting has been the worse side effect for me. I hate to throw up and feel I do it alot more frequently than I'd like. Often, it's more like reflux, rather than heavy duty vomiting. I find that often it's more mucous than food. That's pretty gross, but true. I did talk to my surgeon and the dietician about the vomiting the last time I saw them, but neither seemed too concerned at that point. I haven't had nausea or sleep disturbances. I am about 3 1/2 months post op and am just starting to have signs of hair loss. So emotionally that might be a little hard, but it grows back. I want a new hair style anyway, but......11/16 Saw the Dr 3 days ago re:vomiting. He prescribed medication to relax the pouch so food can go through. Haven't had to take it yet, as I stopped vomiting the day I called for the appt. Also, since my hair was thinning, I got a haircut yesterday. Feel great!

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

Waiting for the actual surgery approval and date seemed the hardest part. But in retrospect, the whole process has been positive. The only negative has been the vomiting.

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

We have a monthly support group meeting that is really beneficial. We have people in all stages of the process that come. Some are just beginning to look at the surgery as an option, and some are several years post-op. So there is really a large range of experiences to draw on. Dr. Howell attends twice a year. He was at the last meeting and showed a very rough film of the surgery. It was made to show how he measured the intestines, so it wasn't a step by step film. But it was very interesting. The group is well attended and beneficial. I can't imagine not having that. Though this website is wonderful. My surgeon was just made aware of it and will advise his patients about it.

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

The scar is ugly. Basically it's what I expected. I don't plan on wearing a bikini anyway. It will fade. There was a girl at a support group meeting who had her scar tattooed with vines and flowers. It actually was pretty neat. Maybe not what I'd do, but it's an option!

Please describe any plateau experiences you have had since surgery.

I've been stuck at the same weight now for a couple weeks. It's kind of frustrating. But yet, I know more weight will come off. I feel like I'm losing inches and have gone down a couple pant sizes and a shirt size, so can't complain. Well, I can...but what good will it do. I also know I've kind of slacked on my exercising since it got cold out. If I pick that up it should help too. 11/13 Down another 4 lbs. Yeah.

Do you notice people treating you any differently now?

No. The people who were jerks before still are, and the people who were nice before still are. It is nice when people give you compliments though!