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

I had known for years about this surgery, but because of the crowd I was involved with a group that admired large men, their attitude was pervasive. Most of the people of this group thought that this type of surgery is 'mutilation'. Their being very vocal about their attitudes, I was influenced to not consider this as a viable alternative.

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

When I finally decided that I needed to have the surgery, my lover left me. My best friend helped me through. In talking with the doctor about surgery, he was courteous and supportive. The insurance nightmare was basically they never came out and told me all that was needed at the front. After the first initial contact with my surgeon, the insurance company approved the procedure. A week later, they 'postponed' their approval because I needed to go through a nutrition class. Then they approved it. Then they again 'postponed' it because they needed a psych approval. Then they needed another psych approval, then another thing, then another, etc. etc. etc. I got final approval and had the surgery date set. It took almost a year from first approach to the insurance company to surgery date. What I would say might have made things easier would be if both the insurance company and myself had set down and ALL of the needed opinions / referrals / documents were mentioned up front. At least I would have known what to fully expect. I had searched through the Web to get what I thought to be the needed support, but it was not the specifics of what my insurance wanted. I needed to have been more proactive in what they wanted and how to get it in a timely fashion.

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

My first visit with my surgeon, I was very nervous. This is a procedure that I had not readably accepted for years. In deciding to have this surgery, I had lost my lover, lost support from most of my 'friends', but I realized that unless I had this surgery, I would not live more than a year, if that. The surgeon was very thorough about the physical and mental problems and associated risks of the surgery. I had searched the Web and did go to the first meeting with him where I handed to him a 2 week eating chart to prove to him that I was serious about this. He was impressed that I had already done what normally, for him, was his first request. That was probably one of the biggest assets that I brought with me. I had shown to him that I had taken the initiative to look through the Web, to do my diet chart, to see the need to have this surgery even though my lover and friends were against this.

What made you finally decide to have the surgery?

I had 2 people in the Bear community that had had the surgery. I had many long talks with them. Through their talks, their similar experiences, their compassion and understanding about what I was going through finally helped me to decide that this surgery was NOT a choice, but a necessity!

How did you decide which proceedure to have?

When I first went to the surgeon, I had researched the many different types of surgery that were available. I had narrowed it down to the Vertical Banding, preferably with an adjustable band. Both of my friends had the Vertical Banding done with a non-adjustable band. My best friend's mother had had intestinal by-pass in the late 60's. She had gone through hell and has since regained her weight. I knew that this was NOT the type of surgery for me. After the nutritionist that worked with my surgeon had consulted my diet history, the only surgery that he would perform was the Roux-en-Y procedure. It took some talking on his part, more research on my part, talking with the friends who had gone through their operations, and some serious meditation on my part, I finally realized that this was the appropriate surgery for me. In hindsight, I now know that this WAS the appropriate choice. I am very glad that I did not search out a different surgeon for the VBG.

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?

What I would like to stress for others in the need to have a valid support group (be it 1 or 20 people). My best friend Andy from Iowa came out and spent 6 weeks with me - 1 week before until 1 week after I went back to work. His support was very instrumental in my recovery. The night before surgery, I was somewhat nervous. I ended up staying up all night with friends. When I arrived at the hospital on Monday morning, the staff was very supportive. Having a medical background, I was very curious about all of the procedures and instruments around. The staff answered all of my questions quickly, thoroughly and accurately. They helped me to feel comfortable in my surroundings and with everything that was going on around me. I was not worried about dying. I have always had the feeling that when I am supposed to go that I would go no matter what I was doing, or where I was. I knew that if this were my time to go, I would do so during surgery. I could accept that. Complications? I expected them. I had none. When I awoke after surgery, Andy and the surgeon were bedside me. The first thing that I heard was the surgeon telling me that I was in the intensive care unit, that I was still intubated and therefore I could not talk, and that the surgery went very well. He then elaborated about what all he did during the surgery, including the fact that he had indeed removed my gall bladder per our pre-surgery talk. Andy also told me that the surgeon had kept him informed of my progress during the day. Andy was treated as family the entire time. I do have to admit that I only have a vague recollection of this above conversations, I did have to ask the surgeon several more times (as well as Andy) the specifics of my coming round. Andy admitted several months after the surgery that it was one of the hardest things that he had ever done to have a smile and supportive face when I woke up. He told me that I looked like 'death warmed over'. No surprise since I was catheterized, 3 IVs in my right arms, 2 IVs in my left, and a 3 lead IV in my neck, with numerous electrode leads all over the body - I probably looked more like Frankenstein than myself!

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 no familial contact whatsoever, so I have 'extended' families. The extended families were extremely supportive both before and after. Friends? I lost my lover and many of my so-called friends when I decided to have the surgery. I knew that there was this risk when I first started to talk about it and they would refer to the surgery as being mutilation, to all of the negative things that will go wrong. In hindsight, I now realize that this group of 'friends' really was control freaks and needed me to stay at my size because they could exert 'control' over me.

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

My employer was very supportive about this decision. When I told my supervisor, he was very concerned and took the initiative to help out with all of the needed paperwork to get me onto short-term disability. He also got authorization to get temp personnel into my position a week before so that I could train him in my duties while I was gone. I was very surprised when my supervisor and his supervisor showed up at the hospital on the day after surgery to visit me (still in intensive care) and also to bring me a plant and card. My coworkers basically were very understanding. There were some that did not understand the need for the surgery. And there is one that still to this day (a year after) that still thinks that this was an optional surgery that I did not need to go through with it. When I got back to work, I did talk with everyone about the surgery and the diet that I could have - we often would have snacks, meals, surprises brought in. I wished to continue to participate in these events. Most coworkers understood and when they do bring something, they try to keep in mind my dietary needs. However, the same person as above keeps telling me that I don't need to follow the diet plan I need and that I need to participate in all of the group events and eat what everyone else eats. This has been a source of conflict with us. Basically, though, my employer did all that they could to help me out throughout this process.

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

My experience in the hospital was supportive and educational. The nurses and doctors (a teaching hospital, so I had contact with student doctors) were very professional. I had one episode with an aide. The first time I went to take a shower, I needed to hold on to her so that I would not fall. She put me into the shower (down the hall) and left me alone. When she came back, she refused to assist me except to let me lean on her for support back to the room. I did talk with the nurses and surgeon about her. I did not see her again. I went in for surgery on Monday morning and left Saturday Noon. Andy had taken my entire belongings home on Monday. I did have my CPAP machine with me after I had the tube pulled. The first night in intensive care (I spent 2 days there), I requested a fan - I was used to having a fan blow over me while I slept. Plus I was very hot. The attending nurse took my temp, but I did not have a fever. He did get maintenance to bring a fan, but I still felt hot. A friend who was visiting had a suggestion. Being big himself and having been in the hospital for cellulitis several times, he had found this solution: He went into the bathroom, wet down all of the towels in cool water, wrung them out, and placed them on my feet, in my groin, and under my arms. The relief was immediate. The surgeon and nurses were amused to say the least, but I was no longer hot. It almost became a joke for a time because I would ring the nurse for 're-wet the towels'. I am sure that they were very glad when I could get up on my own and do this for myself. While I have to proof for the following statement, I am sure that there is something to it. My surgeon was very surprised that I did not have ANY fever or infection during my stay in the hospital (and I did not have one afterwards, which surprised him even more!) I attribute this to the wet cool towels I used.

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

I had no complications directly related to the surgery. However, about 3 months after, my mental state at work one day went 'wacko'. I went from being nice to paranoid, verbally loud and obnoxious. I called my doctor, went in and found out that my medications I was had made me toxic (Zoloft and Buspar - both for depression). My meds were reduced (to half) and 3 days later I was back to normal.

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

Getting home, I felt very relieved. While I had had a good stay at the hospital, they are not my favortie place to stay. The surgeon had originally planned on having me stay thru Sunday, but talking with him, he agreed that my being home would be better - a familiar environment, my own bed, etc. I had already had a bowel movement so he knew that that requirement was fulfilled. He knew that Andy would be there 24/7, that he cared enough to call if anything should go wrong. Going home on Saturday was the best thing for me. In the weeks following, talking with Andy, other friends, the doctors in followup visits helped me cope with the thoughts I was going through. Their constant support and inquisitiveness helped me to cope with any anxieties I had. Most people who know me know that I have a need to talk about what is going on in my life and know that by talking (or as needed just time of solitude to regroup my thoughts) is the best way for me deal with what is going on.

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

Coming home, it took me 20 minutes to get down the stairs of my apartment - I lived in a basement one. Andy was there to help when needed, but also to tell me to do it on my own. (As he is fully disabled because of back injuries, he related very well to needing help, but also to make me do as much as I could myself.) Andy also made me get out each and every day - I feel that this in itself contributed a very great deal to my recovery. We would go to the store, go to the park, drive around, and every where we would go, he made me walk as far as I could, never pushing me to go fast, but as far as I could each and every time. I had been told things would be painful at first, and they were. However, I did not even finish the oral pain meds given me. I never really felt all that much pain, just some discomfort in those first days.

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

I was only 10 minutes from the hospital. Aftercare was not really affected in any way because of this.

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.

Getting home, I was at least able to eat non-hospital food! EECH! Hospital food! I was a cook for 10 years so I have always kept quality food around, especially in the ingredients - like bouillon. I have always liked broths, so eating at first, I ate (or drank) at lot of broth. I also ate sugar-free pudding, yogurt, and jello. Within a week, I had tried successfully toppings of a pizza (VERY carefully chewing), a bit of toast, crackers. The doctor released me to soft solid foods 10 days after surgery - when the staples (53 of them) came out. I immediately had fish - and lost all of it! It turns out that while I chewed it well enough, it was just to dry. To this day, I still have problems with fish and white poultry. As things progressed, I expanded the foods. I found out that fruit was good (did not try grapes for at least 9 months). During the summer months, I ate a LOT of watermelon - it was good, went down easily, filled me quickly and filled my sweet tooth need. I have found through the months that I have gone through stages where I find one thing that I like and eat well, and will stay with that food for a while. Items include - baked potatoes, thick soups, biscuits and gravy, salads - this surprised me - I thought that salads would pose a problem for me - being basically raw vegetables, but it turns out that if chewed well enough, salad is very good, filling and appropriate. Another food that I have found that I cannot tolerate is pasta - but only hot. I have tried a variety of pastas hot and each and every time I have tried it causes me problems. However, when it is cold - as in left over lasagna, pasta salad, I have no problem. Go fig. One thing that I have found out that I can tolerate and I have been doing now since about 3 months after surgery is I do drink a 'protein' shake a couple of times a week. I look for a protein powder that contains NO sugar (or any type of sugar derivative), mix it with milk. Sometimes I add a diet soda (root beer is my favorite) and treat it as a 'malt'. I have found them to be very good, tasty, and I believe beneficial. I have not told my surgeon about this, but have talked with the nutritionist and she agrees that once in a while this is fine. I should add that my surgeon is very set against anything other than water - no diet soda, no coffee, tea, milk etc, only water. Sorry folks, while I do drink water, I do have a mental need for the others as well.

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

For the first week I was home, my level was pretty low - Andy made me get out of the apartment every day, helped me when I requested help and it was needed, made me conscious of chewing! He would tell me over and over to chew, chew, and then chew some more. That helped me to remember to chew until everything was almost liquid - or at least as far as possible. Starting the 2nd week, we were still going out, but now to the store shopping. Before surgery I could barely make 15 minutes in the store until I was ready to leave. 2 weeks post op, I was going in for 30 minutes, using the cart for support, but walking for that amount of time. As time progressed and the weight left, I have found walking easier and easier. My joints still hurt at times, and at times very much so. I still take ibuprofen 800mg a couple of times a week to ease joint pain, but I expected that - with a history of gout (and probably arthritis in the birth family). 3 weeks after surgery I took a road trip to a scenic place in Colorado - the Royal Gorge. About 3 hours down, 4 hours back and at least 3 hours wandering around the grounds and sights. It was wonderful. It was exhausting. I remember that I slept very well that night.

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

I try to take on a daily basis a good multi vitamin. Other than my meds, I do drink a protein (non-sugared) drink a couple of time a week.

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 had some mild nausea at first, but that went away fairly quickly. The only vomiting that I have that I associate with the surgery is more of the 'spit up' variety. When I do have this type of vomiting, I try to think back on what I ate, how I ate it, did I drink anything very liquid with the meal. Every time I have had these spit ups, I realize that I ate improperly. Now when I get these feelings, I just go to the bathroom, get it over with, and proceed (and mentally tell myself not to do it again). Both of my friends who went thru the VBG have also had this same experience and their words to me still make sense - just get it over with and go on. These things happen. When I first had surgery, my CPAP was at 19. After a couple of months, I was talking with my PCP and he suggested that I try a 'poor man's sleep test' - i.e. do not use the CPAP and let my lover know why. Ed, bless his heart woke me up about an hour later and told me to put the mask back on. However, I had already proved to myself that I could fall asleep without it on (something that I had not been able to do in the past). I then proceeded to lower the pressure level until I felt comfortable and Ed would tell me that I had not been snoring in my sleep. I am now at 16. I will keep doing this until my weight levels off and I can get as low as I can. I am hoping that someday I will be able to sleep in a bed without the mask. I can already nap in an easy chair without it, so someday there may be hope. Too many people had told me before I had surgery that I would be able to do with the CPAP as soon as I came home. When questioned, most of these people had pressures under 8. This was one of the misconceptions I had before surgery. Another was that I would be able to stop all of my medications. Wrong! But lowering the dosages certainly happened. I have had no significant hair loss that I have noticed - although my surgeon thought I had. I went from a 1 - 2 inch cut to a buzz cut a week before I saw him last. He thought I had done it because of the hair loss. I had to disappoint him however. Dumping. What can I say? Yes I have had it. It is painful, shocking, almost terrifying the first time it happened. It is definitely not something that I would want to have happed on a regular basis. And it is a good tool to learn what not to eat. I have learned that everyone has a different tolerance to the foods and food/liquid ration (the time to stop drinking before and after a meal). I pity the people that I have met that can't even use mouthwash because the xylital in it will give them dumping. I have found that I can ingest a small portion of sugar - 5g the max. So during the holidays I did allow myself a very small piece of that certain something. I found that by limiting the amount I could savor the flavor, consistency, the ecstasy or that morsel and make it last. I also found it to be refreshing. This last holiday season was my first since surgery. I had not thought that I would have had a problem with all of this, but with the social pressures of office parties, gatherings at friends and neighbors, that I was beginning to have a mental problem going to these functions. I talked with friends and 'family'. I talked with strangers about it. And I talked to myself. I got thru the season relatively unscathed, but more learned from the experience. The one interesting thing that happed to me after surgery was this. I was a smoker before, although I quit about 6 months ahead of surgery - a requirement of my surgeon. I also like to smoke cigars and be around those who also smoke them. Andy is a smoker. He has always respected other people's homes and smoked outside even if they smoked inside. When I came home from the hospital, Andy told me he would go outside for a cigarette. I told him since it was cold, to just go into the other room and smoked there. I had a room air purifier running and it should not be a problem. Well, after 2 cigarettes, I had to ask him to please close the door, and open a window. I was getting nauseated from the smoke. That really sucked. And the first time I went to a bar - I lasted only a couple of minutes before we had to leave. It took about 2 months after surgery before I could tolerate smoke in any form. The effect that smoke had on me was that I tasted a very foul, metallic taste in my mouth. Odd because I have no metal in my mouth - either in the form of filings of braces. As time progressed, I found out that I could tolerate smoke again, and have once again picked up smoking and being around those who smoke. The dumping syndrome is by far the worse feeling that I have had to deal with. After that, everything else is minor.

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

For myself, I feel having to deal with the insurance companies was the worst. I hate having to fight for what I feel is the best / most appropriate option, especially when 2 doctors agree with me.

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

Unfortunately for me, I have found no aftercare support group or program in my area. I am a firm believer in this type of group. I feel that if there is one around, it is essential for someone who has gone through this procedure to get involved with it. There may be drawbacks to have non professionals dealing with others problems, however, as in the case of all of the 12 step programs out there, peer support is a valid and vital option that should be available. If I had my way, I would make this a requirement of ALL weight loss surgery programs.

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

I had 53 staples in a straight line from my xyphoid process (the bony protrusion at the center bottom of the rib cage) to about 1 cm above my belly button. The staples were removes 10 days after surgery. About 5 of them had already come loose. While showering I would gently rub them to loosen up any dried secretions around them. They also itched. Yes, they came out while I was itching on them. The areas where the staples came out early, the scar in about half again wider than the rest of the scar and have a bumpy texture to it. The surgeon on my yearly checkup is pleased with the scar and told me that in time the bumpiness will disappear. Color of the scar currently ranges from a faint pink to a darker skin tone than the surrounding area. I have a couple of ideas to help 'hide' the scar. I do not at this time have any plans to reduce the amount of skin / fat. However, I am thinking of a tattoo over and around the scar. The first one is to have the scar be the stem of a rose and use the most prominent staple marks as thorns. The other is to have all of the staple marks be the teeth of a zipper, have the zipper run from belly button to the top and then open up to the outside of the shoulders. I would then have a bear paw coming out of the opening like it is trying to come out from the inside. I know that scars do not take tattoos very well, but both of these would make use of the scar as an identifier. Also, the zipper scenario would also make me one of the 'zipper club' as many I have talked to call themselves.

Please describe any plateau experiences you have had since surgery.

While I have been able to basically keep loosing weight on a steady basis since surgery, there have been times where for a week to 2 the loss was relatively little. The first time this happed, I was really bummed out because I thought that I had gone the distance. I noticed however, that during that time, many of my clothes became much looser on me. I then realized that even during these plateaus that my body was still changing. That helped me out mentally. Now, if I only lose 1 pound or stay the same, I am satisfied with my progress. I also noticed that the greatest difference in weight loss started in the extremities - foot, hands, then legs, arms face, and finally the torso. I have gone from 6x+ pants to a 46-inch waist, a size 6x shirt to 2 or 3x (depending upon the maker), shoes from a 13+ to an 11 . I have had 3 new belts since surgery. The friends I have that have had this surgery gave me a lot of their old clothes that they 'out grew'. This helped in the financial department. It gave me a ready-made wardrobe of downsizing I was able to use as I lost weight. I have in turn given my clothes to a friend who is very large. I did keep one good set of the biggest I had and plan on doing a wall display sometime in the future. Yes, I am odd.

Do you notice people treating you any differently now?

I don't get as many odds looks anymore. I also don't get the comments of 'My God, you're huge'. But more than other peoples treatment, I have noticed that I am treating them and myself differently. Before surgery, I now realize that I would take just about anything from anyone and internalize it. And that would make me eat. If you had asked me before surgery, I would have denied this. The realization came one day after a particularly stressful day at work. During the drive home, I wanted to stop off and eat a pie, cake, whatever. When I realized that that was not an option, I really got to thinking. Food had become one of the most important factors of my life. Since I could no longer do this type of comforting, I realized that I could no longer take the type of stress that led up to this behavior. I started to stand up for myself, to speak out for what I felt was best or right for me, for what I believed to be the best for the situation with the given information at hand. This, more than the surgery, has led people around me to treat me differently.