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

I was aware of some people who had the procedure performed years ago. I never pursued it as I thought of it as an expensive procedure and didn't even consider insurance paying for it. It really started looking like an option and a hope for me in about May of 1997, when I saw my brother's girlfriend's mother having such success. It was the first time I could see someone who was out of control like myself with their weight taking control. After that, I attended a conference in October of 1997 with a fellow educator who had had the procedure performed by Dr. D'Augustine. I couldn't believe what a changed man he was physically, but emotionally as well. I always thought he was a confident and intelligent person, but it was like he was walking on air with his newfound image. That impressed me so much that I quizzed him a little bit about insurance, the procedure, time off, etc. Upon arriving home from the conference, I wrote a long letter to Dr. D'Augustine requesting information. While waiting for his response, I found a site on the internet (can't remember its name) and most of my questions were answered there. At that point, I knew that this was the direction I was heading in.

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

Although I did have some complications/aggravation in getting approval for the surgery, I was one of the lucky ones. It took less than 6 weeks for final approval. My advice is to stay in contact with your physican as well as the insurance company (find a contact person at the insurance company and make them your new best friend). As I said earlier, if done professionally, "the squeaky wheel will get the grease."

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

My first visit was one-on-one with my surgeon. Because of the number of people who are opting for this procedure, he seldom meets one-on-one anymore, but in small groups of about three people. He fully discussed the procedure and gave me a complete booklet describing his credentials as well as the procedure to its entirety. I came armed with all my questions and that is what I suggest for anyone going into this procedure. I did not talk with many people prior to meeting with him, just my friend who had it done, and I didn't even tell him that I was considering the procedure.

What made you finally decide to have the surgery?

It was an easy decision for me. I felt that I had no other alternative to be successful and this was going to be my last attempt at gaining control of my weight.

How did you decide which proceedure to have?

The procedure was based solely on Dr. D'Augustine's expertise in the procedure that he performed.

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 would say that at the time of my surgery, I had no fears at all regarding the complications. I was at the point where if I died, I died and then I wouldn't have to worry about battling my weight. But I didn't want to die, I just wanted to finally take control of my weight and anything was worth the risk at that point. Also regarding risks, I knew that my chances for stroke, heart attack, physical disability and limitations, etc. might lead me to early death, so in my mind, it balanced the risk factor. Being almost three years out of it, I saw a news report that Dr. D'Augustine was part of and when he started talking about risks and complications, it sounded scary and I thought, I took that risk? Nothing had changed, but my focus had at that point.

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 family was very supportive. I didn't tell them about my having the procedure until my insurance had approved it and my surgery date was on the book. I shared the decision with a select amount of friends and to this day, I don't think a lot of my co-workers know what I had done. Although, they may have figured it out by now. My feeling is that everyone thinks they are an expert and even with the closest people that I shared it with, they were concerned for those risk factors, but I was firm in saying that my decision was made and they did support me. Personally, I believe that for your own mental health, be selective in who you share this information with.

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

For my primary job, I told my department chair, who was a good friend, of my plans once I was scheduled. She was wonderful in finding an appropriate substitute to fill my position while I was out so that I would come back to a smooth transition. I also told other members in my department of my planned procedure before leaving work and held them at confidence in not telling anyone and they did. For my secondary job, I told the podiatrist that I worked for. He reviewed my booklet and like any other person/professional who has never had a battle with weight, asked if I really had to go through such a plan to achieve success. I firmly said YES and I received his support and respect for my decision during my absence. For my primary job, I was out a total of 5 weeks. I had slated myself for 6 weeks, but opted to go back as I was feeling fine and was getting stir crazy. The first week back was Hell . . . I was exhausted and I would come home crying at night, wondering if I had made the right decision by returning to work, but after the first week, I was back on track and well-adjusted. For my secondary job, I was out a total of 4 weeks. During the fifth week, the doctor brought my transcription (I do medical transcription) to my home to work on. I was going stir crazy by myself and it helped me with the transition of being back on a schedule with responsibility when going back to work full time the following week

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

I had a very positive stay in the hospital. The only downfall of the hospital stay was that they are not equipped for morbidly obese people in their bath or shower rooms and It was hard squeezing myself onto the potty chair for measuring my fluid output as well as the chair they have for you in the shower (as you will not have the strength to stand up entirely for that first shower). I was there a total of 8 days. What to bring? Just about nothing. I used the hospital gown the whole time. I did bring things to read and some crossword puzzles, but my energy level was low and the television satisfied me.

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

Nothing major. I had an allergic reaction to the Morphine. My whole body was itching and I had to ask my poor mother to put on a rubber glove and scratch places I could not reach. Also, about Day 4, I had a wave of nausea that hit and would not quit. That kept me in the hosptial for longer than expected, but that was about it.

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 really felt great after the surgery. I just had to get used to eating slowly and with small bites. The one thing to remember is if you forget, your small tummy will remember and it helps keep you inline when eating future meals.

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

No problems at all. Just tired for the first few weeks, but I was right up to par physically 8 weeks post-op.

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

The hospital was 90 miles from where I lived. I grew up in the area of where I had the surgery, so I had family within 20 miles. I spent my first three weeks at my Mom's place for aftercare. From there I felt that I could take care of myself and needed to take care of myself as it was easy to take advantage of a free nursing service with my mother at my beckon call. I knew I needed to start moving more for myself, so opted to return to my own home and be on my own. That was not 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.

The biggest shocker in my post-surgery was adjusting to eating chicken. I lived on chicken as my primary source of protein for years and years, but I could not digest chicken easily for about a year (without vomitting). At this point, chicken has no ill effects on me. Many people have problems with pasta. I have never had a problem wiht pasta, but I double its cooking time, so it is WELL done. To this day I cannot drink a carbonated beverage with my meal or a cold beverage. They tend to want to bring my food back to surface. I may find that I need to vomit every 2-3 months, if that at this point in my surgery.

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

I have and still have a mental block when it comes to physical activity. I still view myself as a "BIG" lady and am self-conscious about exercising in public. I have yet to join a gym or be on a regular exercise regimen. As heavy as I was held two jobs which kept me busy from a 6 a.m. wake-up to a 10 p.m. arrival home from the jobs and a midnight bed time. I was never really sedentary. I know that my energy level has gotten much better in some ways, but I can't say that I am all that ambitious when I have some time off and a chance to breath, I still often like to crash and try to catch up on sleep, etc.

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

I have been a poor example of being a good patient when it comes to taking my vitamins. I have done it in spurts ever since my surgery. Last summer, I got on a good regimen, but when returning to teaching in the fall, I stopped everything and felt fine. Once again, this summer I started taking my vitamins as prescribed by my surgeon, but to be honest, I don't physically feel any better than I did when I didn't take them. I have to remind myself that they vitamins are not necessarily for now, but will be better for me in the long-run. So here is what I take: Vitamin B12: 500 mg/day Iron: Nefrex Capsule Twice a day Poly-Vi-Sol: Chewable Multivitamin Twice a day Calcium: Extra-Strength Tums Twice a day

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?

Nausia was immediate, but really better once I got home. Vomitting only when I didn't take the time to chew. Sleep disturbance, very seldom. Dumping, not until about a year post-op and it hits me occasionally to this day when I least expect it. The first time was scary, but then it just becomes part of your life. Hair Loss--I thought I was going to go bald. My solution was a hair salon product called, Nioxin. It came as a two-pack of shampoo and conditioner. Althoug very expensive in comparison to your department store brands, it immediately helped subside the hair loss and the procuct lasted almost a year for me.

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

For myself, there is absolutely nothing for me personally that is a downside. With all the complications/reactions, etc., that I had nothing would ever keep me from saying I should have never done this.

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

I have attended a support group meeting on a monthly basis faithfully since two months before my surgery. This support group is 90 miles from my home (at the hospital where I had the surgery performed). I love seeing people who can relate to true morbid obesity. Programs like Weight Watchers never really had a lot of people attending who were in my category of weight and I never felt any ownership.

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

My scar runs from my breast bone to my belly button. I have what is called Keyloid skin, so I scar pretty easy, but my scar has faded a great deal and it truly doesn't bother me. I knew that I would never be the type of person to wear a bikini and if I never had the surgery, I would have never worn a bikini anyway.

Please describe any plateau experiences you have had since surgery.

At about my two-year point, I plateaued and have been the same weight for almost a year with the scale going up and down 5 pounds. I truly would like to lose 40-60 more pounds, but I haven't concentrated on really giving it a good push.

Do you notice people treating you any differently now?

I have told many people that one big side affect of this surgery is that you lose weight but your brain size increases. That would be in the eyes of those around you. People have a whole new respect for my opinion and actually believe I have something upstairs at this point. I find it complimentary, yet insulting at the same time.