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

I have 2 relatives that had bariatric surgery in the last 2 years. The results have been stunning and overwhelmingly positive.

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

I didn't have any problems with the insurance company (Cigna HMO). My PCP was willing to sign the letter I drafted for him. It listed all the diets I had attempted while under his care, the weight lost and regained, the health problems (diabetes & high blood pressure), the medications I was on as well as a detailed family history of heart disease. The surgeon's office didn't want to submit my packet to Cigna without proof of diets with Weight Watchers and NutriSystem. They finally did, and it was approved.

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

One of the office staff (Maria) met with my husband and me before we met Dr. Liem. She didn't give me the opportunity to ask any questions. Everything was like a canned speech. When she was through she said to wait for Dr. Liem and left the room. Have all your questions written out, leave room on the paper for answers, and politely, but firmly, insist that you be given the time to ask all the questions you have. I know for the doctors this is routine, but for me it was a first.

What made you finally decide to have the surgery?

My mother had her first massive heart attack at the same age I had surgery. I try to not be a pessimist, but I am very much a realist. I knew I would be dead before the age of 50 if I didn't do something drastic, and quickly.

How did you decide which proceedure to have?

My surgeon said he only did open, no lap surgeries. That was fine with me. If I had been given a choice, I would have picked open. It's that realist thing again. I figure if you've got an 8" incision to spread open and get both hands in there to move things around and see what's going on, there's less chance of a small bleeding vessel not being noticed until it causes problems a couple of days later. Besides, I'm not the bikini type.

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 didn't worry much about complications. I look at them as something that can be addressed, solved, and life goes on. The thought of dying worried me because of my teen-age daughter. I wanted to be around to see her grow into herself. That's part of why I decided to have the surgery in the first place. In the end, I put my faith in God and decided if He led me to it, He would lead me through it. If He decided it was my time to go, it wouldn't matter if I was in the hospital or walking across the street.

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 had a very supportive network of family and friends. Two other family members had RNY surgery durin the 2 years previous to mine. I would have spent more time asking questions about the emotional and mental aspects than the physical ones. My family physician has been wonderful with all the physical changes. Even my therapist is sometime stumped with the emotional and mental changes.

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

I let my supervisor know as soon as I submitted the paperwork for approval. When it was approved I let her know again, and asked if there were any time frames that I would be especially needed at work. She told me to let her know when I was going to be out, and projects could be worked around that time frame. My first day out of work was the day of surgery, Thursday, July 18. I was released from the hospital on Monday, July 22. We have an Employee's Clinic which must sign off on an employee returning to work after surgery. Friday, July 26 my surgeon agreed for me to go back to work half days, and the clinic cleared me on the same day. I was back in my office on Monday, July 29. I worked half days the first week, and was back 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?

My hospital stay was what I would consider average. Not everything was perfect, but nothing that I couldn't deal with. I was in-patient from Thursday morning to Monday afternoon, 5 days. I brought my own pillows from home, but that's normal for me. I don't visit relatives without my own pillows. I brought a couple of magazines, one paper back book, and a personal CD player with CDs. I spent most of my time walking the halls when I could. I found that the more I walked, the better I felt, and the quicker the anesthesia cleared from my foggy brain.

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

One very minor complication, I developed a seroma a couple of days after I was released from the hospital. I wound up taping a sanitary napkin to my belly because it was really leaking a lot of fluid.

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

Physically I felt much better than I thought I would. About the only thing I would not do was vacuum. My vacuum cleaner is very heavy and I thought that would be pushing it too much. I did laundry, had my husband carry the baskets, I cooked, etc. I didn't have any anxiety, at that time I was more concerned with my physical well being.

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

The anesthesia and pain killers made me somewhat weepy. Go with it, let yourself get over this massive invasion of your body. When the tiredness hits, give in to it, go to bed, take a 3 hour nap in the middle of the day. The world isn't going to end. If you push yourself too hard, it just gets worse. There were days during the first month that I would get home from work and have to lay down for an hour before I could get up the energy to cook dinner. My husband understood, and sometimes he cooked dinner if he wanted to eat earlier than I was going to get it done. He was very attentive. My daughter was more concerned that I was going to keel over in my tracks. Sometimes when I was laying down, she would come to my bedroom and ask if she could just sit with me. She needed to watch me sleep to know that I was okay.

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

My surgeon's office and the hosptial he works from is almost a 2-hour drive from my home. I was told to call any time I had a concern or a question. I did call one time at 10:30 P.M. Dr. Liem called me back within 5 minutes, handled the situation, and all was well.

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.

During the first weeks, warm liquids went down the easiest. Hot tea in the fruit flavors with Equal was best. Cold things like cottage cheese were tolerated well, but sometimes caused pain from the chill in my pouch. The only way I could eat eggs was in egg salad. Tuna salad also worked well. I have found that the only way I can eat ground beef is in something that can simmer a couple of hours, such as taco filling. Even 2 years out I still can't eat chicken any way except in chicken salad when it's chopped really fine. I can't eat steak or pork. I like the taste of shrimp, but the texture of it makes me gag, so it's out for now. Broiled or fried fish goes down easy. Vegetables give me the least problems. The only exceptions are corn and raw cabbage. There are days that I can eat most anything, and then the next day, leftovers of the exact same food will make me sick. I can usually tell on the first bite if it's not going to agree with me. I have learned to listen to that little voice, and not push it.

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

The first couple of weeks were okay. Energy level was fine, but the discomfort of moving too much or too fast kept me in check. It was about 4 weeks out that the tiredness hit. I tried to just push through it, but quickly found that was a mistake. I had to learn to take care of myself first, or I wouldn't be able to take care of my family at all. It took about 6 weeks for the tiredness to completely lift and I was back to me. At about 3 months out, the energy level really went up.

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

I take 2 chewable Centrum multi-vitamins daily, 1 in the morning, and 1 at bed time; calcium citrate daily; vitamin C daily. I drink at least one protein drink every morning. Sometimes I have a protein drink for dinner if it seems like food isn't going to agree with me.

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 didn't ever have nausea. The only time I throw up is when something gets stuck, and that's always my fault, without fail. I still have to remind myself to eat slow and take tiny bites. I've only dumped once, and that was the absolute worst feeling ever. I haven't had any sleep disturbances. I tend to sleep like a log. I wake up with my ear, hip and shoulder hurting because I sleep on my side and don't move for hours.

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

Waiting for insurance approval. If I had been denied, I'm sure the appeals process would have been the worst part. I had researched, read member profiles, and asked hundreds of questions from my other 2 family members that had RNY. I knew there would be pain, but I looked at it as something to be endured until it was over, not something that would be forever. I knew that eventually some foods would cause me pain and vomiting, also something to endure and learn from.

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

At the time of my surgery, my doctor didn't have a separate program for post-ops. From what I understand, he does now, but charges a significant fee for this program. I think it would be helpful for me in dealing with the emotional issues. My husband doesn't understand why I still see me as being a very large person. He doesn't understand why having guys check me out makes me grin like the proverbial Cheshire cat. It's not that I'm looking for somebody else, it's that at the ripe old age of 44 I've got guys half my age making offers that make me laugh. Seriously, there is a guy 24 years old that has tried to convince me to take him seriously and have an affair with him. I keep telling him it would be like me being the teacher and him being my student in elementary school.

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

It goes from the tip of my breast bone to just above my belly button. It has faded to a pinkish white line approximately 1/4 of an inch wide. I have never had thick, raised, or dark scars. If it weren't so straight and long, it would look like some of the stretch marks I've got. Actually some of them are wider than my incisional scar. It's lighter in color than I expected.

Please describe any plateau experiences you have had since surgery.

Plateaus are God's way of letting us know he has a sense of humor. You exercise, you drink all the water, drink your protein shakes, eat the right foods in the right amounts at the right time, and still the scale refuses to budge. I finally decided I knew I was losing at least a pound a week. If the scales didn't show it, then I would tell myself "That's just the devil standing behind you with his finger on the corner of the scale. He's trying to make you cuss and doubt yourself."

Do you notice people treating you any differently now?

I notice people noticing me now. Before I lost all this weight, people would look past me or through me like I was part of the furniture. To be fair, I find myself treating people differently now too. I smile and laugh a lot more. I can make conversation with a complete stranger. I've been told I have a beautiful smile, and pretty teeth many, many times. I look people in the eye now, instead of looking down like I'm not worthy of their attention. My husband says he sees a challenge in my eyes now. He said he's seen me notice a guy looking at me, I catch his eye, and then almost dare him to speak to me. He says I have more self-confidence than he's ever seen in me before.