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

I saw something about it on TV. I do not remember the show. Then I went online to do some research and was amazed and excited by the things I learned.

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

I was very fortunate. Blue Cross and Blue Shield had discontinued paying for bariatric surgery at the end of 2005. But because our school district has a multiyear contract with them, they were continuing to pay for the surgery until the current contract would expire. When my doctor's office called for approval, they were told that I would not be covered. So I went to our on-site Blue Cross and Blue Shield representative and she immediately straightened everything out for me.

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

My first visit was acctually an orientation seminar put on my the man who was to become my doctor. He was very thorough in his explanations of both banding and gastric bypass surgery. He told us both the good and the bad. Since I had researched the surgery on the internet, I went with many questions and he took the time to answer them all. I think it is important to do research on your own before talk with your doctor.

What made you finally decide to have the surgery?

I had gotten up to 325 pounds (I am 5'6'' tall) and my weight was beginning to physially bother me. My knees began to hurt me very bad and getting up and down and around was becoming an issue. This concerned me and made me angry but still was not the trigger I needed to really make up my mind that I was killing myself. Then I developed fluid in my lungs and could not lie down without feeling like I was drowning and could not breathe. My doctor told me that I either had pneumonia or I was going into congestive heart failure. Turned out that I did not have pneumonia. So I decided that I had to do something or I really was going to die - it was not words any more. I went onto the SouthBeach diet and lost 40 pounds. Then gained 15 of it back. So I joined Nutrisystem and lost 40 pounds and then began gaining that weight back. Then I saw a show on TV about gastric banding and I realized that I could not do this alone.

How did you decide which proceedure to have?

Even though I had originally began my exploration into having the gastric banding process done, after doing research and talking with my bariatric surgeon, I decided that gastric bypass surgery (rou-en-y) was the path I wanted to pursue. My doctor told me that I was a good candidate for both surgeries and told me the decision should be my own. I chose the gastic bypass for several reasons but ultimately because it offered greater weight loss in a smaller amount of time.

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 was afraid of dying during surgery and I was very afraid of the potential life-threatening complications following surgery. But I knew that I was going to die if I did not have the surgery. I think that is very important to do as much research as you can. I think it is important to find a doctor with an excellent success rate. I think it also important to find one who tells you both the pros and the cons. Then it is important to wiegh those pros and cons against not having the surgery. This allowed me to reduce my anxiety towards the surgery. But since it is a major surgery, I got all my things in order for my family in case that I did not make it. And then I placed myself in my doctor's capable hands.

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 and friends have been extremely supportive, from the time I made my decision onward. But I live alone and sometimes I have to remember to reach out to them when I need to. My mother expecially has been a rock of support for me.

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

I am very fortunate. I was very honest with my supervisor from the moment that I decided to have the surgery. I knew that there were a lot of tests that I would have to undergo before the surgery and that I would have to take of from work for these tests. My employer/supervisor has been very supportive of my decision for this surgery. My original recovery took longer that anticiaped and I ran out of vacation and sick time. This is a grounds for dismisal where I work. But my supervisor called me at home and told me not to worry about my job even if I had to go into time off without pay. They told me to concentrate on doing everything that the doctor told me to do and on getting bettter. I was out of work for a month and even when I returned I sometimes could barely make it through the day. My supervisors have been so wonderfully patient and now (3 1/2 months past surgery) my strength and stamina are beginning to return and I am determined to do my very best for them.

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 for 4 full days. I spent the first two in intensive care and then was transferred to a private room. The nursing care in intensive care was phenominal. I only had one nurse who was uncaring and uncareful. Wile trying to help me roll over onto my side, she was not following proper procedure and she accidently hit me at one of my surgery points. She caused a lot of internal bleeding and pain for me. The nurses out on the floor were very caring and I was overall very happy with my stay. I am fortunate that my mother is a nurse. She stayed with me and made sure that everything went well after I got out of intensive care. As far as things to bring, I brought personal toiletries but did not need to as the hospital provided everthing that I needed. I also brough my CPAP machine to continue my breathing treatments in the hospital but I found out that the air pressure from the machine could force out my stitches and I was not allowed to use it. So I should have left it at home.

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

I have an excellent surgeon. I have had no complications from the bariatric surgery. My early recovery was difficult but I was unable to take my mental health medications because the pills had to be crushed following surgery and instructions on the bottles say specifically not to crush these medications. I have suffered from long-tern chronic depression and anxiety. Unfortunately, my psychiatrist was on vacation in Alaska for a month and I did not want to bother him with the problem of not being able to take my medications. My psychiatrist feels that not enough attention was given to the fact that I was on medication prior to surgery and that they should have had a psychiatrist on consultation for a patient under mental health care.

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

The weeks before I got my surgery date were the worst for me. I went from specialist to specialist to undergo the tests that would confirm that I was a good candidate for the surgery. Waiting for each doctor's decision was so nerve-wracking. After I got signed-off by each of the specialists and I finally got my surgery date, I was so happy! I continued to be excited all the way up to my surgery date. When I felt overly anxious, I put my personal effects in order so that if something did go wrong it would be easier on my family. Then when I knew I had done all the research I could do, that I had chosen an excellent surgeon and hospital, that I had put my personal effects in order, I had talked with loved ones about how important they have been in my life, I calmed down and waited for that incredible day.

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

My first four weeks out of the hospital were a nightmare. I had no energy at all to do anything. I lay on my couch for four weeks and most of the time did not even have the energy to sit up. I could barely get up and drag myself to the bathroom. I knew that I was supposed to be getting up and moving around so that I would not get blood clots but I did not have the strength or energy to do. I am ashamed to say that I felt so bad (although I had no severe physical pains), that I did not have the will to live. I felt so bad that I would have rather been dead. This sounds extreme and I do not think that it is this way for most people. At about two months post surgey, I began to get my strength back and my mental state also began to improve. Now I am 3 1/2 months post op and I am beginning to feel great. My enery levels are rising and I am starting to gain a small degree of stamina. And I am now so happy that I had the surgery done.

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

I traveld from Fort Myers, Florida on the west coast to Hollywood, Florida on the east coast. It is about a three hour drive. The was a moritorium on gastric bypass surgeries in Fort Myers so I was unable to have the surgery done at home. My doctor had traveld from Hollywood, Florida to Fort Myers to identify if there was a need for his services in Fort Myers and when he found there was he alligned himself with one of our local hospital systems. He has an excellent staff in that local hospital complex and he travels here to provide aftercare at least once a month. But being across the state from the doctor's main practice has its disadvantages. There are a lot more opportunities for those patients to get to gether. And there are a lot more people who participate in them. I wish that I was closer to my doctor or that he practiced closer to where I live.

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 been very fortunate in that I can eat little bits of almost anything. But I have introduced things slowly into my diet and I do not eat the things that I have been told to stay away from, things like nuts and celery. I avoid fast food now even though it used to be about the only thing that I ate. I stay away from greasy foods as they sometimes cause me to be uncomfortable or even to throw up. I ate a lot of soft foods like applesauce during my first four weeks of surgery. I also ate green peas from a can that I prepared with just a little bit of pepper and pulverized with my spoon before eating. I ate dozens of sugar free popsicles because they did not cause me any discomfort and even seemed to make my stomach feel better. Eating was something that I had to force myself to do in the first two months following surgery. When I ate, it made my stomache ache - not severely, just uncomfortably, even when I ate soft foods like unsweetened applesauce. I also tried to force myself to prepare and drink the protein shakes that are so important to bariatric patients. Sometimes I did well with the protein shakes and sometimes I did not. But I still keep on trying and I am now experimenting with different protein supplements trying to find one that will work for me. My third month out has been one of experimentation. I have been to a few restaurants with friends and have ordered steak, chicken, oriental food, and even a milkshake. Some things, like the steak and the milkshake, caused me to be sick almost immediately and other things did not. In talking with other bariatric patients, it seems to be different for everyone. I want to contine to experiment with different things and I want to continue to try different resaurants with my friends. Even though I pay a full price for a meal and am only able to eat a few bites, I always take the rest home for two or three other meals. And I am able to continue to go out and have wonderful times with my friends and family. I am finding that it is the companionship that I most enjoy during these events and not the food.

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

I have never actively pursued exercise. I let a busy life with my family, my work, and going to school to further my education. I never worked an exercise routine into my life. This continued up until the time of my surgery. And I am sad to say that at 3 1/2 months post op, I still have not began to exercise even though I know that this is such an important factor to success. Yesterday, I returned from a bariatric conference put on by another doctor on the east coast of Florida. During the conference, we did different kinds of exercises and some of them did not seem like exercising at all, even though they cause me to be sweating by the end of the session. I have become motivated to start my exercise program and to make it a part of my daily life.

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

I have tried to faithfully take a chewable multiple vitimin each day and I think that this has truly affected my beginning to feel better. I two calcium chewable tablets each (1200). I take a sublingual vitamin B12 and have talked with my regualr doctor about taking B12 shots. I also take 15 mg of iron each day. In addition to that, I struggle to get in the vital protein I need to heal and continue to lose weight each day. I should be taking in from 60 to 80 grams of protein a day and I am not. This has caused me to lose muscle mass of course.

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 worst thing that I went through was the four weeks of debilitating weakness and mental apathy that I went through following surgery. As I slowly gained strength back, the only thing that I suffered from was the small to mediate stomachaches that I have when I eat. It does not seem to matter what I eat, soft food or otherwise, it still makes my stomache hurt - not severly but uncomfortably. This often makes me not want to eat anything at all. But I know that is not good for my recovery of my success so I just try and bear with the little stomache pains. It may be that I am still healing. I have only been back to see my doctor once since my surgery. But I am scheduled to see him next month and I will talk to him about this then, if it is still happening. As for my hair, they say it starts falling out about three months after surgery be cause hair follicle cycles are three months long. I am losing hair now but am reassured that it will grow back by the experts.

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

The worst part for me was the frst four weeks when I did not have the energy to move at all. I was totally unprepared for that and it caused me great emotional as well as physical distress. I do not think this happens to most people and I do not know why it hit me so hard. When I talked with my doctor, he reminded me that it was a major surgery but that I would regain my strength and stamina.

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

For three months post op, I have not physically felt like going to my aftercare groups until this month. I did attend a bariatric conference on the east coast of Florida and received tremendous suooprt from the many new friends that I made there. I will be attending my first aftercare support group meeting this week and am looking forward tremendously to going.

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

I have five small dark scars on my abdomen. I had been told by my surgeon that I would have five scars but I could not imagine them until I saw them. They have healed well and maybe one day will lighten up.

Please describe any plateau experiences you have had since surgery.

In the beginning of my second month, I stopped losing weight. I had heard that this might happen, so I did not become concerned. It lasted for a couple of weeks and then I began losing weight again but more slowly. I am continuing to lose weight slowly but have been reminded by other bariatric patients that I need to try harder to get in my daily protein and that this will stmulate weight loss.

Do you notice people treating you any differently now?

People are still very excited about the weight I have lost and continue to lose. I have always had a wonderful group of friends and co-workers who have never made me feel like a second-class citizen. I have always been the one to do that to myself.