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

Extreme, horrific, moronic, desperate. Who would ever do such a thing?! When my endo first uttered the idea to me, I was immediately, deeply offended. "What are you saying? I'm out of control and only a surgeon's knife is going to save me?!" (I burst into tears and he suggested therapy.) But after 4 of my other doctors earnestly suggested it and having seen more media coverage and hearing more talk, I grudgingly began to investigate it, pro and con. I wanted the whole truth.

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

Fought with Mid -Atlantic, but it was firm ... my emploer did not opt for WLS so Mid-atlantic was under no obligation. Fianlly pisked uo my husband's insurance (duh)BCBS who then gave me grief over a pre-existing clause. After contacting the DE Insurance Commission, my approval was seemingly expedited (who knows?) Insurance companies, it appears, are in a bad habit of having ill-trained, semi-informed customer reps. It is wise to keep a record of any dealings you have: Get name of the rep and don't hesitate to speak with the supervisor and/or case manager. Hold the company accountable for what they say and do. Often they conduct business in a vague manner, often exuding a sense of "we-have-the-power-over-your-life, hoping perhaps, that you'll be intimidated. Don't be. Expect thorough, courteous, and accurate service. Let them know that is what you expect because after all, you've been paying your premiums. Don't throw tantrums, but be firm and follow through with the "big guns" if you must.

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

I came prepared with a lengthy list of questions. I'd jot them down as they occured on the months prior to the consult. I was not afraid to ask his stats ...his death and complication rate. You must ask the hard questions. If your doc seems insulted, it's time to look for a different surgeon! Any intelligent, professional person with ethics will appreciate and accept being examined, in this context.

What made you finally decide to have the surgery?

A couple things at different points: When, as I sat on the examining table, my PCP took both of my hands in his, looked me directly in the eye and said: "You must do this or you will die." But most deeply when my husband of nearly 2 decades said,: Sandi, I've known for a few years now that my time with you is limited. I will be a widower at a young age. I won't always have you with me so I need to enjoy you as much as I can now." (mmmmmm .. that was a rough one)

How did you decide which proceedure to have?

The surgeon I chose does RNY, the vast majority are lap, but he will resort to open if necessary.

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?

Of course I had fears. I agonized over the idea of dying and leaving my family, and also of putting a burden on my husband should I become handicapped. I reconciled myself to these possibilities, believing them to be remote, given the expertise of my surgeon and my own determination to "play by the rules". I did feel a gnawing need to spend time individually with each of my children (24 and 22 y/o daughters and a 17 y/o son) The week before, we separately went out to dinner and then parked in a quiet area so we could talk. We had already had various Q&A sessions and conversations. This was different. This was very personalized for each. I had 3 rather emotionally intense but very satisfying evenings as a result. It was important that they understood WHY I was doing this. Also, I wanted to address any resolvable conflict if possible. And of course it was our opportunity to tell each other how important and how loved we are to each other. Regarding fears ... I'm a huge proponent of tackling them. Be straightforward, identify the monster and it shrinks ... it's not so big after all. Nonetheless, I must say, I had a few OMG moments when I thought, "WTF am I doing?" The answer always was, "I'm saving my life, that's what I'm doing"

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 husband, children, in-laws, and most friends were and are very supportive. My mother and siblings who live several states away seemed mildly intetested. One sister expressed strong concerns regarding the "drastic" step I was taking. My colleagues wished me well, though I'm sure I was the topic of a few whispered conversations (BFD). I sense that some of them anticipate either failure or significant personality change on my part. Others seem to look for unrealistic rapid physical change. But for the most part, I've had a huge amount of support.

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

Unfortunately, my boss happened to have lost 80 lbs. traditionally, and thougfht that maybe I hadn't "tried everything" Hmmm.. whatever. She offered to pay for a fitness boot camp of sorts (As if! I was a 324lb. diabetic with a host of other co-morbidities!) later, she revealed that she had lost a 19 y/o nephew to WLS, so i put her objections into that perspective. It didn't matter anyway. I was researching for myself ... I would make the decision based on my truth not on the yankings of others around me. When she saw my diligence to making lifestyle changes pre-op, she seemed to lighten up a little and even expressed encouragement after reading some related articles in medical journals. (We're in the nursing field) I was out of work for 6 weeks ... 6 wonderful, relaxed, heal-and-adjust weeks!

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

Short and not so sweet! My surgury was uneventful, textbook even, for which I am forever grateful to Dr. Irgau. It was the damned drain tube nestled near my diaphram that drove me nuts. I was in the hospital for only 2 days! I was up and walking around as often as possible. I couldn't sleep so I'd be up at 2 and 4 in the morning, doing the slow laps around the unit. One of my concerns/complaints was that some nurses and techs did not seem to understand the value of firmer-fitting leg massagers. They'd put them on ridiculously loose to where the benefits were nominal, if existent at all. Or they wouldn't bother turning them back on after I'd return into bed. Fortunately, I had no problems with clotting, but it still bothered me. I knew that absolute importance of having the massagers on and having them fit snuggly enough. What about other people who really don't know that???

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

Minor annoyances but no complications thus far! I had to have my CPAP adjusted almost immediately because the setting was so high (17) that it infused my new little tummy with too much air. It was adjusted (12) and I'm sleeping well and still benefiting from the forced air. A far as real surgery-related difficulties... none that i know of. It's up to ME at this point. I have never been so compliant with my health EVER! I know that following the "rules" os essential to a positive outcome and that's what i'm determined to do! (How so unlike me! Very cool!)

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

Continued to research, ask questions, and deal with my feelings,as well as communicate a lot with loved ones. Prior to getting my surgery date I had begun seeing a therapist for eating disorders. I was and am determined to be as healty as possible going into it and maintaining it afterward. I began to eat more conscientiously and connect with my physical being. I had to quit smoking. I knew I'd be approved so I didn't play around. By the time I got an actual date, I was well on my way to my new life. The surgery was definitely going to be a tool. My only regret is not having this attitude about my body long ago. I could've avoided years of abuse and neglect. But I can't grieve my regrets .. here I am NOW.

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

Lots of mood swings. Lots of anticipation and not much patience... for me, anyway. I lost my initial weight significantly slower than my peers. They'd drop 70-90 lbs. in 2 -3 months ... I dropped 30. (But guess who has kept it off?! However, enough of that! Can't get too cocky, lest I fall.)

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

Between 4 and 8 minutes, depending on traffic. It's nice to live in a development so close to the regional hospital!

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 followed the pureed to mech. soft diet the amount of time specified (4 to 6 weeks). Yes, I was pretty tired of it, but I wasn't taking any chances with my safety and health. I struggled a couple times when introducing solids; mainly with taking my time to chew properly... I recall hurling on spinach simply because it was stringy. I'm fine with it now. Fresh salads fill me up surprisingly fast. I still struggle with "solid" meats, like steak, from time to time. I don't barf, but I can get that rock-like feeling, so the cut has to be very tender, the bites small, and well masticated. As for how much I eat, I try to listen to my body. I stay alert to what my gut is telling me and stop before I am uncomfortable. Comparably, I eat a fraction of what I once was capable of consuming, but my biggest ace ... the thing that has saved me is that I eat absolutely NO sugar, (with the exception of naturally occuring or unavoidable sugar.) I have not eaten cookies, cakes, pies, etc. for 3 years ... not even a nibble or crumb. My mantra is "sugar is my heroin". Unfortunately, I can chow some Cheetos!

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

Within hours of surgery, I was up and walking with my IV pole around and around and around the nurses station. It sucked, but all I was : I was NOT going to "throw an embolism". Did the same at home, only around my kitchen island, until I gained more and more strength to actually get out and walk., and eventually increased to Curves and at-home exercise.

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

Every day: multi-vitamin (and not Flintstones!), cal-mag-zinc, colloidal minerals, B complex. I don't think I take in all the extra protein supplements I ought to, at least not as consistently as I should.

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?

Vomiting only when I did not take my time. No dumping because I ingested no sugar. No significant hair loss; it did thin for a short time, but I kept my system boosted with the right nutrients and shampooed my hair every other day instead of every day. Used "quality" products and took to allowing my hair to dry naturally. I have better hair now in my 40s than I did in my 30s. Amazing.

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

Discomfort with the drain tube for 2 days. My own impatience. Honestly, I can't think of anything that was unbearable or negative. Truth is, it saved my life. My surgeon perform a flawless procedure, I complied, and my life has been changed for the last 3 years. I don't recommend it to everyone, but I'm not remotely shy about promoting WLS, to be sure!

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

There's one available, often and close by. I'm just not a big support group kind of person. I am, however, interested in educational sessions. I'll try to attend those, but I'm not one to gather to exchange Splenda recipes and weight gain gossip. My family and friends are very supportive (and very impressed) ... no one tries to subvert me with "oh just try a little piece" nor do they police my intake.

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

What scar?? Oh, you mean those 5 teeny little round marks ... geez, with "I've-been-attacked-by-a-rampaging-bear" stretch marks, who cares!

Please describe any plateau experiences you have had since surgery.

Everything came off me sloooooooowly, at least compared to my peers. Got stuck at 220 for 6 months. I hold at levels for months, then suddenly - bam! I'm on the scale and I've lost 5 lbs.

Do you notice people treating you any differently now?

Big Time! People who haven't seen me in awhile are amazed! "OMG, look at you!" "Is that you!", etc. That's always a nice "rush" and reminder. People who do not know me are more courteous, in general. My professional peers are typically more respectful. I've been called "skinny", which is major BS, as I am still 30-40 lbs from my ideal weight. (But it's still cool, in a weird sort of way, to hear it; so does this make me shallow?) My husband seems pleased, but he's always loved me. Women seem to treat me with more regard ... (what? I'm so fashionable? ... geez!) Men are more attentive and accomodating, which is neither here nor there, (unless I REALLY DO need that door opened, etc .) It's a shame though ... I am still the same person I was 130 lbs. ago.