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

I had heard of stomach stapling years ago but had a very negative view. It seemed so drastic and I have a real hatred of doctors and hospitals that has developed over the years. Then I read about Carnie Wilson's surgery and the new laporascopy procedure. That spurred me to start researching. I spent four months researching the various procedures, surgeons, and I spent a lot of time on WLS.com and ObesityHelp.com. I realized how the surgery had advanced and the potential for losing weight. I wasn't going to lose 300 lbs. eating grapefruit and lettuce.

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

I had no trouble getting approval for the Rouen Y. However, I wanted the duodenal switch. My insurance company considers it experimental. I do not regret the Rouen Y, but if you really want the duodenal switch, give yourself months to fight for approval.

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

My surgeon, Dr. Daniel Herron, was very patient and personable. He obviously has the sensitivity to work with obese patients. I had a prepared list of questions that I had been compiling over several weeks. Some of the questions he answered innitially. He explained the procedures of the various surgeries. He answered all of my questions and didn't think any of them were stupid. People must be prepared when they meet the surgeon. Besides being busy, they do this several times a week with various patients. They will not know your individual questions. Take a written list and don't hesitate to ask.

What made you finally decide to have the surgery?

Lack of options. I tried all the diets, commercial, underground, bizarre, whatever. I did fasting. I did exercise. I did behavior therapy. My life was no longer a life, but merely an existence. I had no choice if I wanted to get by life back and I wasn't ready to die.

How did you decide which proceedure to have?

My insurance company ultimately decided. I originally picked the duodenal switch for two reasons -- it had greater stomach capacity long term and a higher percentage of weight loss.

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 had fears of dying more than anything else. Because of my size (475), I was afraid of stroke or heart attack. I had not had surgery for thirty years. I confronted my fears. I updated my will. I made a list of financial things such as bank accounts, insurance policies, mortgage company. I left instructions with my friend how to close my business and take care of my affairs. I even talked about my funeral with her and expressed my wishes. Then I told myself that if I died, it was okay because I wasn't living anyway. I was willing to take the risk. When facing your fears, consider the alternative. Are you happy with your life without the surgery. If you are, don't do it.

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 discussed the surgery with three groups -- my family, my friends, and my therapist. Initially, my friends were supportive. My family was skeptical and thought it might be too drastic. They were concerned about the long terms nutritional deficits, surgical risks, and could I adjust. My therapist was opposed. She thought it was too drastic and it artificially altered the way nature inteded our body to function. I sent everyone pages of materials I had downloaded from the various internet sites, including the National Institute of Health. I sent all of the articles to my family and therapist. After reading the articles, they all came to support my decision. My family was with me at the hospital. (I live in Texas, the surgery was in New York) My therapist came around and now has another patient who had the surgery. I still see her every couple of months during the post-op adjustment. I think she looks at the surgery in an entirely different light. After seeing he weight loss and change in attitude and energy, everyone is supportive. I am constantly being asked about the surgery by people who are looking for a remedy.

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

I am self-employed so I didn't need anyone's permission. I did have to arrange my law practice so I could be out so long. I have a great staff and professional friends who covered for me and reset court hearings. The judges were great and did not force me to trial. I was out about six weeks, inclusive of surgery. I went in for a few hours a day the last couple of weeks. I also did some paperwork at home.

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

Overall I have a positive view of the hospital stay. Since my surgeon was affiliated with the hospital, I would have thought the hospital staff would have been more sensitive to my size, however. The majority of the nurses were aloof, lazy, and unconcerned. There were a couple that were great. The food was okay but what can you do to jello and mashed potatoes. I was in the hospital five days. I had a lot of trouble keeping food down. I threw up a lot. Daytime tv is terrible, so bring reading materials. I couldn't sleep well in the bed, so I spent many hours in the recliner. Make sure you have a room with some type of chair. Because you are stitched up like a Thanksgiving turkey, you can't sleep on your stomach. Bring your own hospital gowns. I went through them with the throwing up and diarrhea and large gowns seem to be a rarity. I also had a diary, but I didn't write as much as I wanted because I was tired so much of the time. I was suppose to walk the halls. I wish I had done it more than I did because it took me a while to walk any distance. A major deprivation was no shower. It would have been nice to have some kind of dry shampoo and body wipes.

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

My only complicaton was an infection in my incision. It developed about two weeks post-op. I went to a local surgeon who treated it. He opened up about half of the incision and it drained for weeks. I think it took ove two months to heal. I had to pack it in medicated gauze for a couple of months. It was nasty, but not painful.

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 didn't have a lot of time to dwell on my surgery. Since I am self-employed, I had to get things lined up. I travelled from Texas to New York City, so I was making plane reservations, hotel reservations, etc. I was doing a lot of pre-op and nagging the local doctors to get the results to NY in time. I probably should have scheduled my surgery a little farther off in time. I scheduled it about six weeks from my initial consultation and that was a short timeframe considering all I had to do.

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

I laid around the house. I stayed in NY four days after surgery. Then I had to walk through the airport and fly home. I didn't have much strength to carry my bag and walk to the gates. I took it real slow. My mother stayed with me for a week after I returned home. She made meals, oatmeal and mashed potatoes and waited on me. I never had much pain. I had a feeling of pressure on my stomach, like an elephant sitting on me who won't get off. I walked around holding my guts in, as if they were going to fall out. I slept a lot. I was not sleeping at night because I sleep on my stomacb which was not possible. So, I spent many sleepless nights sitting in my overstuffed chair watching late night tv. This meany I catnapped all day long. I got bored. I walked around my house, but I should have walked more. Even if you walk to the corner and back, you should walk and build up energy.

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

I travelled over a thousand miles -- Dallas to New York City. I returned to NY for my one month checkup. This was a little difficult because I still had not recovered my energy so it was an exhausting trip. I had already lined up my gp in Dallas for any followup care. When I got my incision infection, he referred me to a surgeon. He did my aftercare which was not a problem. I did my three month in New York. This was a fun trip because it was Christmas which is a great time to visit New York. I made the appointement late in the day and made my flight arrangements so I could get there on time. I had enought energy to do Radio City Music Hall and Broadway. In March I did my six month locally in Dallas. It was getting expensive the travel to NY every three months. My local doctor did the blood work and check me out generally. There was no problem. He faxed the blood test results to NY. The only thing that has come up, is that my tests showed that my parathyroid is overworking and he did not know if that was normal or not. So, I am waiting to hear from NY to see if there is a problem. I can email my doctor and he always responds. Going to NY every three months would be ideal, but doing aftercare locally has not been a problem.

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 am now one year post-op. Nothing is really off-limits, but there are foods I have trouble tolerating. Food rich in fat and sugar causes abdominal cramping and diarrhea. I can eat cookies, but I have just about given up candy and ice cream. It doesn't really taste too good any more. I have trouble digesting steak. It seems to sit in my stomach and hang around a long time. I also have trouble with rice. It seems to swell up inside the stomach so I have overeaten without realizing it. I stay away from fried foods. A lot of my dietary restriction is a matter of choice. I can only eat so much so I have to choose so things like bread, dessert, potatoes, and salad get left off.

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

In the days immediately following surgery I did very little activity. I had no energy or stamina. I forced myself to walk around the house. Part of the problem was my inability to get a good night's sleep because of the staples in my incision and my incision became infected. I returned to work after four weeks but it was six weeks before I really had much energy to do the walking. I started working out with a trainer at around four months.

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

Calcium, Iron, ADEK, a multi-vitamin, protein drinks and bars

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?

Immediately after the surgery, I was nauseated and puked my guts out for 2-3 days. I also had constant diarrhea. I even got the dry heaves because I had nothing to throw up. I couldn't sleep because of the staples in the incision and constant nausea. The diarrhea and vomiting lasted for about a week. The diarrhea lasted longer than vomiting. I still have diarrhea when I eat the wrong things. The hospital gave me some anti-nausea medication but I don't think it did much. I just toughed it out. I had no choice.

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

None. I like in Texas and had my surgery in NY.

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

It is approximately six inches long with track marks. It is also dimpled about half way up from the bottom. I thought it would be lower than it is. It is not as dark as I expected.

Please describe any plateau experiences you have had since surgery.

The major plateau is the slow down in weight loss. I lost 75 lbs. at four months and have only lost 50 more in the last eight months. It is discouraging but I am hoping for better things.

Do you notice people treating you any differently now?

Not really. Of course I am still at 350. My professional colleagues have been really great. They comment on how well I look and how much weight I have lost. One friend is taking phots every month or so so I can see my weight loss especially since I have been discouraged on the slow down.