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

I was referred to a surgeon about gallbladder surgery in 10/01 and his recommendation was to have the RNY gastric bypass at the same time. I wasn't even considering weight loss surgery at that time so when he proposed it, I didn't really believe it was an option because my insurance company through my employer had never approved any patient, even after several lawsuits. I became more and more ill, missing work so much that my income was low enough to become eligible for medicaid. Medicaid was approving the surgery for those who had a medical necessity that was preventing fulltime employment, which fit in my case.

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

My medical insurance plan through my employer was less than worthless on this surgery. They denied everything, including the gallbladder removal surgery for which I'd originally been referred to the surgeon for. Medicaid covered everything and I had an approval from them within 10 weeks. I also qualified because I'd become so ill with the gallbladder and depression that I had to be hospitalized.

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

My first visit, my surgeon was really gung ho to get the surgery done. He even said, "I have an opening next week, do you want it?" Well, I wasn't even thinking about gastric surgery and I wanted some time to think about it. When I called back for another consult in 11/01, he was booked out for weeks. But I'm glad I waited, even so--I spent the time researching the surgery on the internet and deciding if it was really right for me. And to get the most out of meetings, ask all the questions you can think of, no matter how silly they seem.

What made you finally decide to have the surgery?

I was hospitalized for suicidal depression and I was extremely ill from gallbladder disease. I had several co-morbidity factors and I was taking over a dozen medications to control them. I realized that if I kept on the way I had been, I wouldn't have survived and I would have just kept gaining even more weight.

How did you decide which proceedure to have?

My surgeon recommended the RNY and he only performs it as open surgery. I researched the different procedures on the internet and decided the RNY with the pouch and the diminished food absorbtion would probably most likely result in success for me.

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 not at all afraid of dying of the surgery or of having complications. I was wheeled into surgery and I was completely calm. But then, I'd already realized that with my hospitalization for suicidal depression, I'd already reached rock bottom and had nowhere to go but up. Surgery was the way out of the dark abyss, at least in my case. During the 4th month, I began to develop complications and even so, I would still have the surgery in a heartbeat.

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?

They were incredibly supportive, both during and after the surgery. I'd been afraid they would disapprove but instead, they were extremely helpful and supportive about everything. They were even more positive about the surgery than I initially was. My mother even drove 200 miles to come and stay with me during and after the surgery. They were wonderful!

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 neutral on the decision but worried that I would be off work even longer than I had been. I'd been ill for several months before the surgery and was only getting a couple days a week in. I think they were relieved when I told them that I would only be out about 2-3 more weeks after the surgery and then I should be back to work fulltime again.

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

Sacred Heart Medical Center: Spokane WA. My post-op stay was 5 days and I had a lot of problems with pain. The morphine they gave me after the surgery didn't help with the pain, it only made my arm numb for 2.5 days. Once they got me switched over to a different pain medication, it wasn't as bad, but I was wanting more pain medication before the 10 minute self-dosing periods were up. Things to bring: Loose bathrobe & slippers you can slip on without having to bend over. Your own underwear. Chapstick. I had such terrible cotton mouth, I wished I'd brought some sugarfree lemon drops for once they let me start taking liquids.

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

After my 4th month post-surgery, I began having trouble with most solid foods, vomiting food right back up again (months 1-4 were relatively trouble free with little vomiting.) Had multiple tests & no reason could be found. Had 2 endoscopies to dilate the stoma but that didn't provide much relief. It varies from day to day what kind of foods I can eat. Now I just avoid many solid foods that typically bother me and I saw the dietician/nutritionist a few times to come up with ways to get enough protein in when I can't eat any kind of meat/fish/poultry most days.

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 got my surgery date in late 4/02 and my surgery was 5/7/02, so I didn't have a lot of time to become too anxious. And I'd already been so ill that the surgery seemed like it was only going to help.

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

I felt pretty weak the first few days but after that I started feeling better. I had a lot of diarrhea, nausea, and gas the first 6-7 weeks and it was hard going anywhere unless I knew there would be a bathroom nearby. But I didn't vomit at all. Thankfully, with a prescription for Reglan and Protonix, the intestinal difficulties began to abate about the 8th week. I had "cotton mouth" for the first 2 months. Usually I carried a water bottle with me and a few sugarfree candies in my pockets to combat the dry mouth.

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

5 miles, no effect

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.

1st 6 weeks after surgery = blended foods only. After that, I began adding solid foods and didn't have too much trouble with anything except dairy foods. After the surgery, I became lactose intolerant--never had any problem before the surgery with this. About the only food I had trouble with for months 2-4 was breads and meat, especially red meat & steak and also chicken. After month 4, I began developing complications and having trouble with any kind of meats, fish, poultry, bread and many other foods, until finally I was just getting down soups and liquids, practically back to the blended diet again on many days. Some days I could eat certain foods with no problems and then the next day I wouldn't be able to eat them at all. The doctors and surgeons I've seen have not been able to diagnose any reason, other than "spontaneous closure of the stoma for unknown reasons." So usually I eat just a bite of foods and see if I can get them down. If not, I throw them up and then try something else. If I do okay, I eat carefully, making sure to chew completely. And I get a lot of protein from non-meat sources, like beans, tofu, soy, protein drink mixes, etc.

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

Week 1 after release from hospital, riding short trips in car and taking short walks, ie:grocery store shopping. Week 2 after surgery, no problem with riding in car or walking longer distances. Week 3 after surgery, no restrictions & able to drive Found using the surgical wound binder for 3 weeks helped--I didn't feel as much pain while I kept the binder on and the surgeon had recommended 3-4 weeks with the binder.

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

Calcium citrate, chewable multivitamins, sublinqual B12 tabs, protein shakes 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?

I had a lot of diarrhea and gas for the first several weeks, plus some nausea. No vomiting. No dumping, but a lot of problems with dairy foods--after surgery I became lactose intolerant. Now I buy lactose-free milk and/or take lactaid tablets. Not as much trouble with cheese and yogurt. No sleep disturbances at all after the surgery--in fact, I hadn't slept so well in years as I did after the surgery. The GERD stopped right after surgery and that's part of why I hadn't slept well prior to the surgery. Hair loss was bad the 2nd & 3rd months but it got better when I added protein shakes and bars and made sure to get enough protein in.

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

In Post-Op when the morphine didn't do anything for the pain & just made my entire arm numb for 2.5 days. I remember coming out of the anesthesia and just moaning and crying with the pain--thankfully the nurses quickly realized there was a problem and got my pain meds switched over to something that worked better for me. And also, the anesthesia making my period start right after surgery, even though I'd just finished a period before the surgery. That wasn't fun to deal with in the hospital when I was feeling less than wonderful.

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

Live support group meets 2x/month, online support groups with message boards. Very helpful as you can compare notes, ask questions of people who have already gone through the surgery, ask advice for problems and get reassurances that things are going okay. Lots of people panic--"Did I break my pouch?" and the support groups are a good place to find out if what you're experiencing is normal or if you should get into the surgeon's office pronto.

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

I had open RNY, so I have a large scar from my sternum to my navel. It's not very pretty, but it healed well and I have no problems with it. I figured that it's not like I was ever planning to wear a bikini when I was heavy, anyway, so I didn't really lose anything. Someday, once I lose all the weight I want to lose, I may consider having plastic surgery to remove loose skin and the surgical scar. But that's still a ways down the road and it's not something that's critical for me. I knew I would have the scar right from the beginning, so it wasn't a shock or a disappointment of any kind. My surgeon was up front from the very beginning about what to expect in that matter.

Please describe any plateau experiences you have had since surgery.

7th - 9th months, had plateau, but it was my own fault. Was having trouble with most solid foods and so I began drinking Coca-cola (I admit it, I'm a (now reformed) Coca-cola addict. Saw the dietician/nutritionist and she recommended cutting out the Coke again. Did so and began losing weight again. 11th - 12th month, having plateau, but again, is my own fault. Taking in sugary foods too often (I don't get dumping from sugar.) So I'm cutting out the sugar and I've started swimming at the Y a couple times a week. Hopefully this will do the trick.

Do you notice people treating you any differently now?

Yes! Before my surgery, strangers would say unkind things to me about my weight--they seemed to think that was okay. Mean, impolite things, right to my face. Like because I was fat, it was okay to insult me. Now that I'm not so obese, strangers don't do this to me anymore. And friends and family mostly just comment how great I'm looking now and how much happier and healthier I seem. I still have a ways to go, but now I feel more like a "normal" person, weight-wise.