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

Actually, this type of surgery has been around a long time. I used to be a RN working on a surgical floor in the late 1960 onward. These surgeries and others similar to them were done frequently to control stomach ulcers. They were also done for other reasons of course, but they were still done fairly often. Most people then (late 1960's-1970's +)did well after surgery. Weight loss was one of the side effects of the surgeries. It later became used for that reason. Those surgeries, I think were done more radically, because they were done for a different reason. They were not done because you were bleeding to death but battling obesity. I think a lot of doctors went overboard in the extent of the surgeries they did and caused a lot of unnecessary problems. Those being some of the horror stories you hear about today describing the many complications people endured and continue to do so. I think that today the procedures are more refined, precise and controlled as to the extent of restriction. They give a more predictable result. I still do not think they should be used unless other things are tried first. BUT I DO NOT THINK PEOPLE SHOULD HAVE TO WAIT UNTIL THEY ARE SO FAR ADVANCED IN OBESITY THAT CONTROL IS HARDER TO ACCOMPLISH! I am 51 years old. I have been considering this surgery for several years. It is becoming more common now and fewer restrictions by insurance companies. I am less afraid of it now than I was many years ago. Right now, I consider it a godsend.

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

Similar to a lot of others, A lot of run-around. Me thinking the insurance co had what they needed, they saying they did not have it. Saying my case was before a committee for evaluation, My case not being before a committee, not even there!! Having to get my Union company rep. get on the case. many e-mails and lots of waiting. finally SUCCESS. Have everything you can think of prepared, write a long letter yourself telling how you feel, how you are affected by obesity, that sort of think and fax or certified deliver the stuff to a particular person or committee. Talk to the same representative and keep track of what is going on in writing. Don't give up.

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

It was really clinical. I had visited my family doctor, my gastroenterologist and had done some on-line research. My doctor agreed with my requests and after several questions, it was agreed to pursue the surgery. I was rather surprised it was so quick. I thought I would have to beg and plead, the usual, but I didn't. I think probably be as prepared as possible and not go into the meeting blind, not knowing anything about the surgery or what outcome you want.

What made you finally decide to have the surgery?

I couldn't get up out my chair without effort. I didn't want to get out of my house. The effort to get ready was too great. I was loosing all interest in things previously enjoyed because of not being able to physically participate. I had had enough of dieting and had just about given up hope of ever being any different.

How did you decide which proceedure to have?

Sounded the safest, easiest, best results with the fewest side effects. My MD only does open RNY, but if I had wanted another procedure, I could and would have gone somewhere else. We just happened to agree.

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?

Scared out of my wits. Mostly my fears had to do with breathing. I have asthma, controlled, but not controlled. . . it can be scary...like drowning. I have postpolio syndrome also and it makes breathing after anesthesia horrible....needless to say I did have problems and they were almost as bad as I feared. BUT, and this is a big BUT, I have post polio, not many other people would have this problem. very few in my opinion. All circumstances are NOT ALIKE. and one shouldn't presume to think they are. If you have fears you need to address the fears YOU have, not the fears of someone else!... As to dying from the surgery, the thought crossed my mind several times. I prepared my will, etc. and talked with my husband and kids and my God....what else could one do? I was in a good hospital with a good doctor, I just did what I had to do too-my best to get well.

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 told only my immediate family and a couple of friends. I did not tell my parents and one handicapped brother. My brother because he would tell my parents and them because they are elderly. My mother is the one I was especially concerned about. My dad would understand, be worried and be OK. My mother-that is another story. She is post breast cancer (radical mastectomy) 3+years. She is on lots of medication for various conditions and her mind comes and goes. I could not physically and emotionally deal with her prior and post surgery. Some times she wouldn't even know who I was...No way could she cope with major surgery on her daughter. Soooooooo....I have told her I am on a diet and have been following it closely (which I have) and I hope she never finds out. She even spent the night with me 3 days after I got home. I told her I had a bad viral infection and was not over it, which was the truth and I just moved slowly. I don't think she was the wiser. If they do find out, I will fess us, but until then, I don't plan on telling them a thing. To my family and friends, If they don't know why I am having this done, then they haven't been paying much attention over the years in how desperately I have wanted something to help me with my weight. I have mentioned it enough. So far post surgery...everyone has been over and above what I could have hoped for. I feel so pampered and treated like I matter. I think I thought I didn't for a long time prior to 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 to employer, but I do volunteer at a nonprofit agency and I think this will get me more in the thick of things again.

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

Lots of attention, NO SLEEP, Medical Students 4 or more times a day. Breathing Treatments every 3 hours. Massageing plastic things on your legs. IVs that don't want to stay in my bad veins. Trying to find the dang self-administering pump button...hands too weak from polio to push the dang thing, its up too high and I can't find it without my glasses...finally get an order for the nurses to just give me the stuff, RELIEF, just push the call light (after someone told me where it was) and help came. Horrible N/G tube everyone wanted to irrigate with too much water and nearly choking me three times. Trouble breathing...bless those respiratory people... Heparin 2x a day in my abdomen-stung sometimes but not much. But what lovely bruises in some odd spots on my anatomy. Up to the bathroom to try to pee after the cath out...almost didn't make it for a few drops...oh well. Hall walking and knees knocking. Thank God for my husbands strong arms. Mine knees were weak. Eight days in hospital 3 of those in Intensive care post surg due to possible complications from post polio and from the knicked spleen. Did well after my 104 + temp broke and on antibiotics...got home to rest!!!!!! Things to bring: House shoes that cover you feet and are NOT slick Your own toothpaste forgot mine and the hospital stuff is horrid! Something to keep your hair out of your face, off your neck . Mine is long and I had a high fever and it nearly drove me nuts until I got a scrunchy to keep it up. A warm fairly long robe that you can tie at the waist. Reason...you might be walking with IVS and you cannot put your arm down those zippered ones and there is no way to keep them up without tying.... I know it sounds silly by I took mens no sleeve or neck tee shirts, The kind the real old guys wear... When they took off the bandage it kept my gowns and PJs from rubbing on the staples.. Worked good when I got home too. Other than that Some PJ bottoms or gowns that are very comfy and you don't need much of anything else. I took my crocheting, a simple project...and did maybe 3 rows. I couldn't concentrate and I could never get enough sleep. And was too tired. I did read about 2 newspapers and that was it. The rest was get well. Almost forgot SOCKS!!!!!

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

Knicked spleen. 2 units of blood. Didn't even know it happened until my husband told me. No big problem, just manual pressure and that stopped it. I do have dilated blood veins in my legs due to polio and that causes a smaller blood volumn that size or weight would give indication, therefore I am under the assumption that is the reason I received 2 units of blood. I had no complications from the transfusions, to my knowledge. bladder infection ...I was on antibiotics prior to surgery because of a history of heart murmmur...that took care of it too. Viral throat with a temp of 104 +. Acutally I didn't deal well with it at all. I don't tolerate temp elevations due to the polio. They affect me severely. I am afraid I lay drenched in sweat and don't remember much of a couple of days from burning up and bringing my temp back down.. I thought I would flow out of my bed a few times. The lymph gland swelling in my neck and sinus headaches and infection was treated with a Z-pack and finally resolved that problem. It was not fun and at times painful. The surgery itself was a breeze compaired.

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

It is 19 days after my surgery March 19, 2000. I feel pretty good at this moment. I have been on a Medrol pack to help my lungs. They have not been moving air very well. That has made me very tired since I have been home. This is my 3rd day on them and I feel much better. I still don't have the energy to do much of anything, just very light tasks...That is improving and I hope will continue to steadly get better. Anxiety wise, I feel better than prior to surgery. My outlook is upbeat, I feel this has been a good choice.

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

I felt strange, almost like a stranger in my own home. I had been gone a over a week. Things outside looked differently, spring tried to rear its head. I could see none of this in the hospital. I have been more tired than I ever thought possible, I don't feel like doing much of anything. It is a struggle to go about my daily living, but amazingly each day gets a wee bit easier. I know this will continue but it is so hard waiting. I have been from elated to depressed. Elated that it is over and I am loosing weight, depressed over some physical changes that I had not anticipated. Things don't taste the same. I love water, and it is hard to get enough down. I am bored with food! I was never bored with food. Adjusting to this new life is strange. 040400 I am having trouble with eating too fast, ergo-too much. Makes me feel very full and my heart races. I have been on RX that increases your appetite and I can't wait to get off of it. I don't like the full feeling and am feeling uncomfortable with letting myself overeat. 060600 I have been loosing hair and this has really bothered me since I had a lot of long thick hair. I hope I don't go bald (grin). I have been eating pretty much what I want. I occasionally feel like I have eaten too much and try to do better. I have so many changes in my tastes in food, it is scary at times. Things I really liked before, I don't seem to care much for. I have cravings for foods that I didn't used to eat much. It is unusual for me not to want lots of milk for instance. I get upset sometimes because, I really don't know why. I suppose just so many changes so fast. It can be upsetting. I also don't know what size of clothes I wear now. My old clothes are falling off and I don't want to get new ones yet. I look like the models in the plus size catalogues wearing baggy clothes. We all know they probably have on the smallest size the catalogues have and they are swallowed in them. I feel that way sometimes now and I enjoy having lots of extra room without buying the bigger sizes!

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

I only traveled from Ashland, KY to Huntington, WVa apx a 40 minute drive with good traffic. About, 35 miles or so. Not far, considered a local commute in this area. It doesn't really. Lots of people in this area go to Huntington for personal health care.

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 have not found anything that I cannot eat so far. Everything that I have been allowed has worked. I have had more of a problem with my medications than anything. Some do not want to either go in or stay in my pouch. 4 weeks. I have been eating pretty much whatever I want except fresh vegetables and fresh firm fruits. I ate a one ounce piece of steak yesterday. I chewed till I thought my jaws would drop off, then spit it out, I was afraid to swallow it. I really crave veggies now. I want fresh ones. I want to eat my orages and crisp apples with the skins on...I will see in two days what I can add. 060600 It has been a little over 3 months since my open RNY. I can now eat just about anything I want. Chicken seems to stick easily and not empty out well. I actually have more luck with beef, fish, and pork. I have some lactose intolerance which I didn't have prior to surgery. I still drink sixteen oz. of skim milk a day. This is throughout the day. I have always done so and would put up with occasional diarrhea than pop a pill for calcium. I can use very small amounts of sugar, perhaps a teaspoon full on occasion with cereal. I do this infrequently though. Usually use Equal and one other brand that you can use in hot foods. I got diarrhea from too much Equal at first, but it doesn't seem to bother me anymore. I have had a lot of trouble with beans. I have tried different ways to prepare them and find refried (lite) works best. I really like them but they give me gas and cause my stomach to swell up...not empty well. I can now eat some fresh fruits, apples chewed very well with the skins on, oranges (same with chewing well), I love strawberries!!!!, blueberries, bananas, etc. Fresh salad I can eat some but I have to chew VERY WELL. I did crave it for about a month and couldn't eat it. Now that I can eat it a bit, I don't want it as much. Go figure! All canned veggies I can eat. Fresh-need to cook most of them a bit. I do well on stir-fry just a bit more done than usual. Meat: Well cooked all kinds. Fried meat I get an upset stomach and diarrhea. Deli meats in moderation as I get a reaction to the fat if they have much in them. Poultry: I don't seem to digest it well, it doesn't empty well. I have eaten little of it or turkey. I probably will try again this month. Fish: love it and it loves me! Eggs: used to eat a lot of them, Now I have to force myself to eat one. Great protein, just don't want them anymore. They cause no gastric problems. Water: Still can't get enough!!! Have always loved lots of good water and couldn't drink much for about two months post op. I just couldn't drink enough to satisfy. Finally, I can drink all I want and not feel like I am in the desert with no oasis in site. September 21, 2000 As of this writing i am able to eat anything I want except milk which causes some dumping and indigestion, bloating etc. I do fair on skim milk but cannot drink it like I used to. I also used to crave it, now I don't. I still don't care for eggs much and I used to love them. The same for bologna and chicken. I can eat them but I don't "want" them. I seem to prefer more meats and most vegetables. I am able to eat small amouts of sweet things like cereals and other things with sugar, but not much. I usually just taste and that is more than enough. I use artificial sweetner for any add ons. I have also stopped craving carbohydrate foods such as pasta. I nearly lived on them for a month or so. I still enjoy them but don't crave them as before. I do not drink sodas, I enjoy crystal lite and decaf coffee on occasion, usually sticking with lots of water.

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

My activity level has been (due to post polio) very low. I have a very low tolerance to physical exertion. Therefore, I have had to struggle with anything I do. I walk in my home, do manual things as fold laundry. I do my personal care, with some minor help from my husband. I am so anxious for my energy level to increase. 040400 I feel much better. I have been on prednisone for my anesthesia irritated lungs (asthma) for two weeks. I am anxious to get off of it because of side effects. But, I can breath and walk a bit without feeling so drained. 060600 I have not had a lot of energy lately and found out my thyroid was out of adjustment again. I am hoping that will clear up soon. September 21, 2000 My energy level is much improved. I am able to work in my home and do just about anything I want to. I still cannot lift very heavy things without getting sore stomach muscles and back aches. I hope that improves. I can walk for a longer distance without getting out of breath and without my legs hurting. As I am post-polio, I am really enjoying this, but I have to be careful and not overdo as I might loss this ability. I am sleeping better and for shorter periods of time. I am not able to sit for long periods of time as I have found out I have a tailbone, which gets sore "grin".

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

Centrum Liquid Vitamins 1 tbsp. a day Vitamin B12 tabs 1000mcg 2x a day I am going to swithch to Vitamin B12 "dots" when they arrive from my pharmacy. I also drink a Slim Fast Ultra once a day for the vitamins, etc. and fiber content. 040400 I have changed to Centrum A-Z oral vitamins instead of the liquid. 060600 I continue on the Centrum A-Z oral, Vit. B-12 "dots" sublingual. My blood work shows that I am doing OK During month 4 I lost over half of my hair and as suggested by people on the net, I started taking Calcium, Zinc and Magnesium along with the Centrum and Vit B12. It is now in month 6 and the hair loss is now minimal. Whether from the vitamins or just "time". I don't know but my husband thinks it was the vitamins. Needless to say getting the hair off of the floor and everywhere else was a real trial in patience.

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?

I am having probems with the extra feeling of fullness in my upper midsection. I know it is where my stomach is stapled, but it feels like it takes up so much room. I cannot get a deep breath at times and I feel it has a bit to do with it. 040400 I have lost a total of 39# and my stomach does not feel as "full" as it did a few weeks ago. I can bend over without choking and feeling like I had a belt under my ribs. I still do not sleep as well as I wish, actually I am sleeping less, which may be a good thing in the long run. 060600 Well, for the past two weeks (especially this past week) one would think I was on Chemo therapy with the amount of hair that I have lost. I still have lots left as I was blessed with MORE than the average person has (according to my hairdresser-daughter-in-law). I still have lots of long still somewhat thick hair. BUT, it this continues, I may need wig! Seriously, I hope it doesn't get to that extreme a state!!! I am not coping really well, I am tired of cleaning the tub drain 3-4 times during a shower because of all of my wet hair pluggin it up. I don't enjoy waking up with it in my mouth and certainly don't like eating it (neither does my husband). Thank God for the Vac. or my floor would look like a hairball! Sleeping continues to be a problem, Can't sleep when I should and sleep when I shouldn't. I still wake up a lot, but I don't seem to need quite as much sleep as I did prior to surgery. September 21, 2000 No nausea, one episode of my stomach not emptying with much discomfort, causing me to induce vomiting with relief. I don't vomit easily, not prior to surgery and not post op either.. I am now sleeping well, I also don't require as much sleep as I did. Hair loss started at about month 4 and for over a month, I lost over half of my hair. As I have very long, very thick strait hair, IT WAS A MESS. I had hair on my pillow, in the floor on all my furniture. I couldn't cook anything without getting it everywhere and in everything!!!... I pinned, ponytailed wore headbands, I shed worse than my long-haired cat!...I looked here for advise and started taking CALCIUM, MAGNESIUM AND ZINC. That seemed to help. It is now month 6 and the hair loss seems to be just down to what one would normally loose. I am glad, and believe it or not, I like the hair better. Less of it and easier to handle. It seems to be trying to grow back though.

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

Not always having personnel who were familiar with the surgery and my personal physical problmes. Some would want to irrigate my N/G tube with too much solution, causing it to go up into my throat. This was despite my telling them that my pouch only held an ounce or two. They felt that they knew more. Other than a few incidents as that, the procedure, I felt was no more invasive, or problematic than any other major intra-abdominal surgery.

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

None that I know of at this time, although it is rumored that there are some trying to form in this area. I feel for a time it would be helpful, to exchange info, recipes, and general information exchange not to mention the pat on the back!! September 21, 2000 Still no outside help. I got pictures back taken while I was in hospital....I couldn't believe it was me. I look at them frequently and listen to the compliments of my family to spur me along. I still slip back to old ways occasionally, but soon snap out of it. It is scary to loose so much so fast. It is really hard to adjust. I am having a hard time getting rid of old clothes, afraid I will still "need" them if I fail...I guess everyone feels this way...I try to work on those feelings.

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

Starts from just below breastbone straight down to navel then slants across top of navel for 4 cm. Total length about 28 cm.. Had staples which irritated. Staples were in from 02-28-00 to 03-16-00. The suture line healed without incident, rupture or infection. Yes, it looks just about what I expected. I had a side to side incision with my gall bladder surgery in 82, and it looked the same. It will eventually fade away without looking too bad, I think. 060600 Not too bad right now. Everything is slowly fading from an angry purple to a more rosey reddish-dark pink. The darn thing itches over my stomach more than lower down. That is the worse part right now. I know it does get better, I just hate the waiting process while it does. As to what I expected. It is longer and curved over top of my naval then down. Not expected at all. Also I would have much rather had sutures than staples. The staple holes never completely go away where the suture holes do. Sept. 21, 2000 Scar is fading well. A bit ridged over new stomach site with a couple of "tight" spots in stomach folds. They don't hurt and don't look too bad. I have not had any problems with it and pay little attention to it as I have had an open Gall Bladder and Hysterectomy in the past and have those scars also.

Please describe any plateau experiences you have had since surgery.

Have been on one for a few days, Lost 25# and haven't lost any more for 3 days. Expect this to start again in a day or two. It is 3 weeks since surgery. 040400 I have lost 39# and am maintaining for a few days. I have been on prednisone and it has caused my appetite to increase. I don't much care for the other side effects of edema, etc. either. I am off it the end of this week. I probably need a few days to get back in the swing of loosing again. Body adjustments... 060600 During my two month time, I hit a time of no weight loss actually gained 3#) Then near the end of that month I lost it plus more besides. I think it was 10 on the scales but really 13# altogether. Right now, I am having readjustments on my thyroid Rx and have been loosing slower. That is really OK as I didn't want to loose a lot over a short time. I would rather loose about 2 to 2 1/2 # a week. I feel I would have better muscle tone and less loose skin that way. This would also help with my post-polio as I don't have a lot of muscles anyway and I don't need to loose any more from rapid weight loss. I am in no hurry. It didn't get there overnight anyway. Sept 21, 2000 Have lost rather slowly the past couple of months. I am now at 235 with clothes on. I am loosing inches right now and not as much pounds. This is ok with me as my clothes are beginning to fit that I have recently purchased. I got them a bit small so I could be motivated a bit to stay active. I hope this works <G>.

Do you notice people treating you any differently now?

Not been around to see people that I had seen prior to surgery. Also, no one but a select few know I have had the surgery. 040400 My oldest son had not seen me since I had surgery. He visited this past weekend. He commented that I was withering away. It has been a long time since I have weighed what I do now. 275. That is a lot by anyones standards, but for me it has been at least 10+ years. Their memory fades and they assume one stays the same always. Not so, I hope. My husband seems more relaxed around me, I don't feel as touchy and depressed as I did. I can see the light at the end of the tunnel....all of the cliches.....I am happier, therefore it seems to be rubbing off on him. He is also trying to loose a few pounds making our private life more active. My grandaughter asks frequently why I had surgery. She is only 5 but seems to accept that I want to be smaller so that I can move about better, then I can play more with her as she grows. My parents don't have a clue, they are elderly and just know I have been ill (which I really was with asthma), I just hope I haven't been away too long (ONE MONTH) for them to remember.... 060600 I saw a friend I hadn't seen for quite a while and she kept asking me what I had done and I looked so good (keep in mind I am at 258#) right now. She just kept talking about it and it really made me uncomfortable. What must I have looked like previously???? I never thought much about it before, I do now. My husband has been paying more attention to me lately and actually listening more. Perhaps, I don't complain as much? Sept. 21, 2000 Some relatives I hadn't seen since prior to surgery walked right by my husband and I in a restaurant. They didn't recognize me...I wonder who they thought he was out with? "GRIN" My own daughter in law didn't recognize me as I was walking toward her in a parking lot. Thank goodness my granddaughter still knows me. I find this both amusing and sad at the same time. People do treat you differently. They seem more polite. They don't stare. Although I am still very large 235#, I am still smaller than a lot of people I meet in public places and I seem to blend in better. I don't feel as out of place.