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

My sister had Gastric By-Pass surgery 20 years ago, when she weighed 378 pounds. When I got to 230 pounds, I realized that I was morbidly obese and needed to do something. I went to Dr. Fox in 1992 to consider surgery. But, my insurance denied payment and I could not afford to pay for it myself so I gave up. Now, 40 pounds heavier, I have decided to try again.

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

I have double insurance coverage and they both have limitations regarding gastric bypass or any other surgery intent for morbid obesity. If they only looked at the amount of money they have spent on my weight related health issues, they would realize this is a preventative method to ultimately redude their costs. I am now research paying a premium for an insurance company that will cover the surgery. Otherwise, I will get a loan or refinance my home.

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

I went to an orientation with Dr. S.Ross Fox. My husband, my support person, and I thouroughly enjoyed our four hours there. Dr. Fox answers every questions, good and bad, and he made me realize that underneath my obesity is a very beautiful and "tiny" woman. I have never been told I was tiny, and when he said this to me it made me cry. I loved being in a group of people who could relate to the embarrasing and hurtful experiences I have had over the year. They really understand! Dr. Fox's patient advocates, who are also patients of Dr. Fox, were incredibly helpful, understanding and encouraging. When I saw their photo albums, I realized that there really was hope for me and that this surgery is the answer. I can't wait to have it done and to begin to start my life over again, as a thin woman!

What made you finally decide to have the surgery?

I ran out of options. I think I have tried just about everything, from Weight Watchers to Richard Simmons, from SlimFast to diet pills, from exercise to liquid protein. I personally own over 20 different diet books. After all of my sincere attempts, I have continued to gain rather than lose weight over the years. So, surgery seems like my last option.

How did you decide which proceedure to have?

I have a tendancy to eat sweets, especially ice cream. I realized that if I just did the vertical band surgery, it would still be possible for me to partake in this detremental food. With the distal by-pass, not only will I eat less, and absorb less of my food, I will also become ill if I eat sugar or milk. I know myself well enough to realize that I need a detourant.

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 have had 13 surgeries in my life, so the thought of surgery is not frightening to me. In fact, the surgery release form that I signed is very similar to those I have signed for other surgeries. Surgery is a risk; but I do not feel it will kill me. I am a bit worried about post-surgery infections. I have had staph infections before, which were treated with massive I.V. antibiotics that caused massive yeast outbreaks throughout my body. So, I want to be sure to get my yeast under control now...I need to stop eating sugar, vinegar, breads and cheeses, which all contribute to yeast growth in my body. I also need to ask for acidophillus pills if I am on antibiotics to keep that organizm functioning properly so it will fight off the yeast. Basically, everything is cureable. I just don't want any complications as I will have to pay for them myself if my insurance won't.

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 are very happy and supportive of me, which tells me that they really care about me and have been worried about my weight, but have not said anything. They have all watched me as I went through my exercise/diet routines. They know how hard I've tried.

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

I told my supervisor that I was researching this surgery and that there would be times when I had appointments that I would need to go to, and that when the time came, I would need 2-3 weeks off from work. At first, she said "No problem". Now, she is more hesitant, mostly about the surgery itself, saying things like, "This is pretty drastic, isn't it?" and "this is a big decision!" I keep filling her in on my life experiences with obesity so she knows this is not a decision I take lightly. She is naturally thin and has never experienced obesity, so it is hard for her to understand. I am planning on being out of work for two-and-a-half to three weeks, depending on how I feel.

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

On the day that I made arrangements to have a family member with me at all times, to act as my advocate, my stay was wonderful. However, the second day, I had a nurse who was awful to say the least. My I.V. pole was one that twisted itself around when it moved. My I.V. and NG tubes, and electrical cord were wrapped around the pole. She repeatedly come into my room informing me that I had to get out of bed and walk, I when I asked if she could fix the pole, she said I would have to learn to walk with it. The bed's head was elevated 14" higher than the feet, so it was not comfortable lying in it! But, I couldn't walk with the IV pole all twisted. When I needed to go to the bathroom, the nurse walked in, pushed the commode to me and walked back out. I finally became very upset and started to cry, as my phone was ringing and I couldn't reach it because the tubes were so badly wrapped around the pole. My nurses light had been on for 20 minutes, so I started asking loudly if someone would please help me. Another nurse came and replaced my pole. When my nurse heard about me getting upset, she came in and gave me Valum through my IV without telling me until afterwards, "because your not handling this surgery very well"! The respiratory therapist and the P.A. came in and checked my lungs, saying they sounded wonderful and that I was doing a good job of breathing. But the nurse came in and told me I had fluid in my lungs and was going to get pneumonia if I didn't walk (which I had been doing). It was a nightmare for that one day, as the other nurses were terrific!

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

I got a deep tissue infection of my incision at my belly button. I went to my Primary Care Provider, who gave my IV antibiotics, ordered a CAT scan to rule out an abdominal abcess, and admitted me into the hospital for one day. Once they took out the staples, the infection went away quickly.

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 was so excited! I read a book called Preparing for Surgery and Healing. It came with a relaxation tape that I listened to daily, and I wrote up a script for the Anesthesiologist or Nurse to read to me as I was going under anesthesia. I remember feeling completely relaxed hearing these positive affirmations. I made up a tape of my favorite music, and they played it for me (through my ear phones) while I was under anesthesia. What a terrific experience!

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

I have a Patient Advocate available to me through my surgeon's office. She met with me prior to surgery to answer any questions I may have. Since she had the surgery six years ago, it was very nice to talk to her. She also came to the hospital in the morning of my surgery and stayed with me until I went into surgery. She called me during the two weeks I was recovering at home, and encouraged me to call her if I need anything. I also attend a monthly support group with other people who have had the surgery, people who are thinking about it, and support people. It is great to get together, and there is always a topic to discuss related to this surgery, ie. depression, saboteurs, nutrition, etc. I am also in bi-weekly counseling to help me really address my eating disorder and issues around losing weight and how it effects me and those around me. I feel all of these things are vitally important for me to make this surgery a success.

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

It's pretty long...from 3 inches below my belly button to my sternum. I think it is what I expected, but I think it is ugly. It is healing fine, but I don't want my husband to see it. When people find out how large the incision is, they cringe, but it really was not that bad of an experience.

Please describe any plateau experiences you have had since surgery.

My weight lose has slowed down since the first week, but I haven't hit a plateau yet. I keep expecting to though, as that is my usualy "diet" experience after 30 - 35 pounds. Maybe it won't happen...we'll see.

Do you notice people treating you any differently now?

My friends are just very happy for me and make regular comments on how quickly my body is changing. My husband has fallen in love with me again, and can't believe how much my body has changed. We are very excited! I haven't noticed strangers treating me differently...we'll see...