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

reading various publications. Sounded pretty risky.

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

Dr. Meilahn's office is in the process of handling that for me now though I would recommend that anyone seeking this treatment have more than enough supporting documentation to provide to the insurance review team. It is only logical (which is the scary part) that the insurance company will be saved significant future dollars by helping me rid of this obesity disease now.

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

Dr. Meilahn explained to me the various surgical procedures available and we discussed which one may be a viable option for me. Prior to our visit, I had significantly educated myself to the laproscopic gastric bypass surgical procedure and written down a number of questions. I believe chances of success are greatest for those to proactively take a role in their own care.

What made you finally decide to have the surgery?

I had contemplated it for the last several years and although I'm quite squeamish about medical procedures (needles, blood, etc.), I know that something radical must happen in order to preserve my life. At 38, I'm presently dealing with too many medical issues, mostly caused by all the excess weight.

How did you decide which proceedure to have?

After discussing the various procedures with Dr. Meilahn, I am convinced that the bypass will work fine for me. Reading singer, Carnie Wilson's book on her surgical weightloss journey has also been a big help.

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?

Well, it's just a matter of weighing the options basically of living and dying. If I don't drastically reduce my weight (currently 273), I will continue to suffer medical problems, and develop even more serious conditions. Studies show my life will be severly shortened due to weight-related problems. Though I have no fear of dying, I'd prefer to live a little longer.

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?

It's been a mixed bag. Some have been very supportive, some have disagreed strongly with my decision. The key has been to have the character strength to know what is best for me and to be firm in my stand. Sure, it may be a little risky by virtue of the fact that any surgery is, but when weighed against the other options, it's a no-brainer. It's all about calculated risk-taking. Bottom line: no one but me has known what it's like to live in this morbidly obese body. I don't want to do it any more.

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

I had my lap RNY performed at Temple University Hospital. Everyone to whom I had exposure was completely professional and caring. From the OR nurses, the ICU nurses, the orderlies, etc., were very attentive. Having said that, I wasn't crazy about one of the medical residents assigned to my case and I politely let me surgeon know about this. I was fortunate to have been assigned a private room, both in ICU and on the floor. Because my lap procedure had a complication and involved another major operation, I was in the hospital 10 days rather than the 3 for which I planned for. Funny how there are many things one can not attend to when one can not bend over. Thank God my mother was with me every day. She bathed me and took care of my personal needs. I didn't have much at the hospital. I did bring gowns, houseslippers, the personal toiletry items, a watch, a few photos of my cats, and that was about it. I believe I had a few extra pillows brought from home as the hospital bed was very uncomfortable.

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

Yes, during my Lap RNY, my colon was unknowingly perforated. Within 30 or so hours (when my fever and heartrate spiked), my surgeon was on top of it. On the third day when I was supposed to be released, we instead went back to surgery. Because I was still so weak and groggy from the anesethesia (sp), I thought (or at least tried) to pose critical questions to my surgeon (thank God my mother (former RN) was there), I really trusted my surgeon's judgment that a second surgery was necessary. He did not know of the exact nature of the complication until he "opened" me up.

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

Following two major surgeries in one week, I was very weak. I don't recall being anxious, but rather doing what I needed to do to grow stronger and to go home. I tried to walk during the day, begin to slowly eating again, etc. After being in the hospital for 10 days, I was so thrilled to return to my own bed (although I couldn't turn over at all).

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

If I had not had the complication, I would have been fine. Given my circumstances, however, I was up and around, but very slow. I had absolutely no appetite and had to be persuaded to eat. I still tried to be mobile and walked around the house and up the stairs for bed. I know the more you move, the better it is for the recuperation period.

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

Temple University Hospital is about 45 minutes from my home. For the first month, I returned every two weeks for a check up with my surgeon. At this point, we are at 3 month visits.

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.

Well, immediately following surgery, I began to drink the 1 oz of water every hour on the second post-opt day. Then, when the complication was discovered, I stopped eating everything for days. I believe it was on the last two or so days in the hospital that I began to eating clear liquids (jello, broth, hot tea, etc.). When I came home, we moved up to full liquids...tomato soup, Crystal Lite. At this point, just the smell of food make me nausecous. I believe it was the third week, I moved to soft foods, a scrambled egg, FF pudding, a scoop of FF ice milk. Over time, I was able to add items to my diet very slowly. It was frustrating at times at how slow I needed to chew my food in order for it to go and stay down. I cut my food up until I couldn't recognize it, but that was very important in the healing process. I became full VERY fast.

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

I was so weak from both of the surgeries. Other than to walk around the house, I didn't do much. I did, however, try to get up and walk at least once an hour. Eventually, about 5 weeks out, I walked around my block.

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

Now having stopped taking all prescription meds that I took pre-opt, I religiously take each day 1 chewable multi-vitamin w/ iron, 1000mg calcium citrate (not carbonate like TUMS), an extra iron supplement, and 1 B-12 sublingually once per week.

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?

As a testament to the program, I did dump which was evidenced by vomiting most of the time. Sometimes it was because I ate too fast, because I ate something with hidden fat or sugar (be really careful), or because I didn't cut up my food small enough. The first couple of months are critical in diligently following your surgeon's instructions. As far as the hair loss, thank God I've always had very thick hair. Almost to the day of my three-month anniversary, I began to lose my hair in large amounts. It has changed textures as well. I'm now five months, and it seems to have slowed down, at least. I knew this side effect was possible when your body is in a catabolic state of breaking down and adjusting to this reduced amount of nutrients it is receiving. Although I intellectually knew about some of these side effects, it bothered me to continue to pull all of that hair (mine) out of the shower drain. I repeatedly told myself "It's just part of the process."

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

1. All the blood work. I've always had bad veins from which to take blood. During the second surgery, I had a central line placed to avoid having to be stuck everyday. 2. The feeding tube. This was placed also during the second surgery. My surgeon wanted to keep it in for 30 days. After the 30 days when he collapsed the balloon and gave it a little "tug," I saw stars. over the course of the next few days, it fell out on its own, but it was VERY painful. I've been told that my experience is unusual. Had I not had the complication, I would not have had the feeding tube.

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

Temple University Hospital now has a support group that I have found somewhat helpful. My surgeon, his assistant, and the bariatric nutritionist are always available to me. This has been essential to my aftercare when I've run into problems and/or had questions.

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

My Lap RNY scars (6) are so minimal. They're more like little slits. I continue to apply Vitamin E/Cocoa Butter daily. I also have a 10" vertical scar up my belly which I'm told can be taken out, at some point, and replaced with a very thin scar. Not thrilled w/ the second scar, but I'm blessed to be alive, considering the severity of the complication.

Please describe any plateau experiences you have had since surgery.

I would say the weight just fell off for the first 3-1/2 months. For the last month and a half, I've lost about 2 pounds per week or 10 days. The longest I've plateaued at this point is for 11 days, but then I dropped 2 pounds and then another 2 pounds three days later. If you are dedicated to incorporating all the steps (i.e. protein first, some moderate exercise, at least 40-64 oz. of water per day, taking the required vits), the weight will continue to fall.

Do you notice people treating you any differently now?

It's been kinda funny. I do notice the men at my workplace look at me differently, but they can't seem to pinpoint the difference in my appearance. The women, on the other hand, have been very complimentary. I have experienced some jealousy from other overweight woman (what have you done?).