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

The term "bariatric surgery" is new to me. I had heard of "stomach stapling" many years ago. I worked with a woman who had it done probably close to 20 years ago. She lost lots of weight and last I knew had kept it off, but her personality seemed to change. I am more impressed with these newer types of gastric by-pass surgery, and feel they will be more successful with fewer complications.

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

I had no difficulty with insurance, which is Wellmark. From the date on their letter, they approved me within 2 days of receiving the pre-approval form from the surgeon. My BMI is high and I have several co-morbidities, plus I've tried yo-yo dieting for almost 40 years! So, they must have agreed that it was time to try this.

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

My first visit was brief. He drew diagrams of the type of surgery he does. I told him I've learned lots of information about him and WLS on several web sites and that I've talked via e-mail to several of his patients. I had info about myself, and my co-morbidities already typed out,and had completed a phone survey from his office staff. He told me I was a good candidate for laparoscopic gastric by-pass and that he would dictate a letter for pre-approval to my insurance company. HOWEVER, I did not ask very many questions due to the wealth of info I've gotten from other people, and also I am familiar with the surgeon he studied with to learn the laparascopic by-pass procedure. IF YOU HAVE QUESTIONS ABOUT THE PROCEDURE OR ANYTHING ELSE, BE SURE TO ASK.

What made you finally decide to have the surgery?

I have a co-worker who had this surgery about 14 months ago and she has done well on it, although hers was open and mine will be laparoscopic. I did research on it through various web sites and correspondence with people who have had the surgery. This was a great help in my decision. The biggest motivator to have surgery, however, is the fact that I am SICK OF BEING OBESE! There are so many things I can't do; and also I worry about my health as I get older.

How did you decide which proceedure to have?

My surgeon does only 2 procedures - an open gastric bypass or a laparoscopic gastric by-pass. From all I read and talk to people, the laparoscopic bypass is easier on the patient and just as successful as the open bypass, so I chose laparoscopic as I will recover from it much easier. However, the surgeon's nurse did mention when setting up the surgery date that because I'm so short, Doc may have difficulty with laparoscopic surgery and may have to change to open; won't know for sure until he starts surgery.

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 haven't had the surgery yet, but my biggest fear is all the tubes that may be connected to me when I awake from surgery, and that I will panic, can't breathe and so forth. Also, I worry that in the pre-testing before surgery they will find something seriously wrong with me and won't be able to do surgery. AND, I also worry that I'll have a heart attack or something while in surgery. I haven't started having panic attacks yet (3 weeks to go) but my PCP prescribed a few Prozak tablets so I'll be able to sleep as time gets closer.

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?

So far, most of my family is very supportive. Only my parents, my sister and my children, and my co-workers know about it so far. My parents and my sister are very supportive, although my father worries something will happen to me in surgery. My kids (ages 19 and 24) are also worried about me, but supportive. My sister wishes she could have surgery herself - but she is not overweight enough.

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 several months ago that I was considering this surgery, and kept her updated. She is OK with it, but seems worried about me. I hope to be able to go back to work in 3 weeks after surgery. I'll update some of this later after I've had surgery.

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

My hospital stay was easy and uneventful. The nurses and aides and housekeepers were all kind and cheerful and helpful. My surgeon visited me about 4 times the day I had surgery and at least twice the next day. I had laparoscopic gastric by-pass, was able to walk around the nurse's station within 4 hours of getting out of the recovery room after surgery. I hated the hospital bed! It seemed to hurt my back. The nurse propped me up with pillows so I could rest on my side, and she also brought in a recliner for me to use, which greatly helped. I was released from the hospital about 4 p.m. the day after my surgery. I brought a lightweight cotton robe to wear over my hospital gown, but never could figure out how to get it over me, with the IV in my hand. I was glad I brought my book to read.

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

No complications to speak of. The site where the IV was inserted caused me quite a bit of pain and I was really glad to have it removed finally. I later got an infection in that. I was able to clear it up at home with antibiotic ointment. I also had mild bleeding from the catheter, but that cleared up in a few days. I had very low blood pressure after surgery, but that came around, and had an elevated temperature, which is to be expected, I guess. Also, I was having some heart palpitations, and they put a heart monitor on me for a few hours, said it was just a stress reaction to surgery, can happen to anyone.

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

It is 3 1/2 weeks now until surgery and I'm still OK. But I am sure as the date gets closer, I will start getting panic attacks. Two years ago I had a lump removed from my breast, and I was very panicky before that. Of course, part of that was worrying I'd have cancer. The outcome of this surgery can only be GOOD! Maybe I'm less nervous because I've had surgery once with the lump removal. I do frequently pray which helps alot, also I keep mentally reassuring myself that I can do it, if anyone can. Also, my PCP has prescribed a few Prozak tablets to take if the panic starts overwhelming me as surgery nears. 3-23-01: Guess what? I never did panic before my surgery. I never took any of the Prozak. I was able to sleep about 5 hours the night before surgery. As I lay on the gurney outside the surgery room, I did have one moment when I thought, "WHY AM I DOING THIS TO MYSELF?" and then I remembered why, to regain my health and live longer, able to do things I enjoy.

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

For me, it was a shock even in the hospital the day I had surgery, to realize that I would be HUNGRY! For some reason, I was thinking that with this tiny stomach, any little thing would fill me and I wouldn't be thinking of food. I then realized that my stomach had changed, but my "head hunger" hadn't. It is difficult, especially at first, to get accustomed to the small meals and the pureed food, and how to prepare it, and how to get in as many nutrients as possible. There is some pain, and I had definite weakness about a week after my surgery, I believe from lack of food. That is much better now. My laparoscopic incisions are healed fairly well, not completely yet. It's been 2+ weeks.

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

The hospital where my surgery was done is approximately ONE MILE from my home. Actually, the surgeon let me go home one day early because I live so close to the 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.

My surgeon requires that we follow a special "gastric by-pass diet" under the direction of a dietician. The day of surgery, absolutely nothing by mouth, not even water. Second day starts liquids like broth, jello, fruit juice, 3rd day is full liquids like cream soups, some cooked cereal, milk. Also we go from 1 oz. to 2 oz. to 3 oz. of food per meal. Only 3 meals are allowed per day, and by the 4th or 5th day we are to what they call the "pureed" diet. This consists of 1 oz of protein, 1 oz of pureed fruit of veggie, 1 oz of starch. An example would be: 1 oz. low-fat cottage cheese, baby food peas, and 1/4 slice of whole wheat toast. This must be eaten very slowly, and chewed very thoroughly. They recommend using a baby spoon, and it should take 20-40 minutes to finish the above meal. We are not allowed to drink anything 30 min. before or after a meal. Also, every hour we can drink 3 oz. of liquid such as skim milk or fruit juice or water. We need to drink at leat 2 cups of the skim milk each day. I have not had problems eating anything on my recommended diet; however, one night I tried 1 oz. of baked fish with lemon pepper sauce, and got VERY sick! I have a lot of "head hunger" and want things like casseroles, cheeseburgers, pizza. Chocolate and desserts don't appeal to me yet, but when I walk by a bakery or can smell the candy in the aisle at the grocery store, it makes my mouth water! This "pureed" diet continues for 2 months after surgery, and then starts what they call the "ground" diet, which does include things like hamburger, ground chicken, etc, and you can start adding other foods that can be completely chewed, still in the very small portions. No snacks at all are allowed, other than the 3 oz. of liquid every hour. Also, no caffeine is allowed and no carbonated beverages. We are not allowed even to use a straw to sip a beverage. 05-01-01: I am now on the ground diet. I am able to tolerate most foods. The most trouble I seem to have is wanting to eat too fast on this diet. If a person eats fast, it causes a gas build-up and is very uncomfortable. I still try to follow the equal protein, veggie or fruit, and starch combination. I have gradually added fresh veggies. There are some frozen strawberry fruit bars from Schwan's with pieces of strawberry and real juice, that are VERY good. If anything, I tend to want to eat too much protein. I never did use any protein drinks, always go for the real thing! I am good about not eating between meals and not eating sweets at all.

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

The day after surgery my energy/activity level seemed almost normal. I walked around the nurse's station and hallway 9 times, read my book, watched some TV, talked on the phone and wanted to get out of there! (I did go home about 5 pm the day after surgery.) A week after surgery I started to feel very weak, no strength in my arms and legs. I believe this was my body's reaction to the tiny bit of food I was eating. I had to force myself to walk and to do every day chores. By about the 3rd week after surgery, much of my strength was returning, although I was still more tired and my stamina was much less than what it had been before surgery. At the end of the 4th week I am going back to work, full-time. We'll see how that goes! It's been more than 2 months now since surgery. I'd say my energy level is back to normal, probably better than before. I do not exercise as much as I should, but I am very active. I am up at 5:30 every morning and work 40 hours per week. I have a handicapped teenage son who requires constant attention, so that keeps me busy. I have become interested in yardwork this spring/summer and did some landscaping last week-end. Looks nice! I worked 6-7 hours on that and it was physical labor. Once I got really tired, but a 15 minute break re-fueled me. The next day I was stiff and sore in some of my muscles but not physically tired.

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

I am required to sip on 3 oz. of skim milk for 5 hours out of every day. Also I am required to take 2 Flintstones Complete chewable children's vitamins each day. In addition to that, I take 1200 mg. of calcium, and glucosamine to help my arthritic legs feel better. 05-01-01: I've started using chewable calcium, and on the dietician's suggestion, I have started taking Vitamin B12 supplements.

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'm only about 4 weeks post-op right now. I've had no hair loss. The only sleep disturbance was for about the first week when I could not sleep on my stomach at all. I've had nausea only occasionally, and I accept that as part of the reason this diet works! As far as vomiting, I have done that twice when I was trying to swallow crushed medications with a tiny bit of water. Yuk! I've had some diarrhea a couple times, which might be considered dumping, but it is always in the morning, when I haven't eaten for many hours, so it may not even be connected with this surgery at all. AT SIX MONTHS AFTER SURGERY: I finally realize that it is sugar that bothers me most, and fat. If I would eat a piece of cake with frosting,for example, I would be fine when I ate it -- but about 8 hours later, I would have stomach cramps, diarrhea and possibly vomiting. I also get an incredibly bad taste in my mouth immediately after eatign sugar. A large amount of fat passes right through my system and exits via diarrhea within 1/2 to 4 hours after I eat it. I have also had some hair loss, starting at about 3 months after surgery. It has been a little over 6 months after surgery now, and the hair loss is slowing down. I have thick hair and my hair loss was never observable to anyone but myself. As far as coping, I simply don't eat cake with frosting, or cake at all for that matter, except possibly a bite occasionally. That works fine without my getting sick. I don't crave that stuff like before, and when other people eat it, that's fine, but I know it will make me sick and I don't want it.

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

For me, so far, the worst part has been trying to adjust to the tiny bit of food, the pureed diet and the head hunger. Sometimes I'd LOVE to be able to eat a cheeseburger, fries and Diet Coke! 05-01-01: Guess what? Now I CAN eat cheeseburger and fries at least if not Diet Coke! I can eat a small bit of cheeseburger with only a little bit of the bun, and a couple fries. I don't do that very often because of the high fat content, but just knowing that I am able to have it if I want it, makes this acceptable. 09-30-01: The worst part of the diet is tuning out my "head hunger" and not overeating. I do NOT want to stretch out my small stomach. I think I do at least reasonably well.

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

So far, our only aftercare is a series of e-mail buddies from this area who've all had gastric by-pass surgery or are going to be having the surgery fairly soon. We e-mail back and forth and support each other, almost daily. We have talked about starting a support group because it is very helpful to know what reactions other people have had, how they handle it, and just to be amongst people with the same concerns, to keep our spirits up. This is not an easy thing to do, and it affects the rest of our lives.

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

I have 5 small scars, not quite healed up yet. One is about 3 inches above my naval, one about 3 inches above that, one on my right side and two on my left side. These vary from about 1.25 inches to about .75 inches in size. This is from the laparoscopic procedure. Actually, I had thought the incisions would be somewhat smaller, more the 3/4 inch size for all of them, but this doesn't matter to me. At six months after surgery, the scars are starting to fade.

Please describe any plateau experiences you have had since surgery.

Not yet. 5-01-01: Nothing yet 09-30-01: I don't weigh myself, and only know my weight when I visit a doctor's office occasionally, so plateaus are hard to be sure of. This past visit to my doctor's office was a pleasant one: the gown actually fit me -- AND -- I had lost 19 lbs in 6 weeks!! 9-30-02: It took approximately 18 months for me to complete my weight loss - about 50% of my body weight before surgery!

Do you notice people treating you any differently now?

Not yet. 5-01-01: People tell me I look "different" than before. Imagine what they'll think when I lose another 90 pounds! Yes, I either feel more confident, or people do not stare at me as much. I feel like I am more a normal size and that seems to be how other people perceive me also. 09-30-01: I now weigh about 175 lbs and wear a size Large in regular ladies sizes. It feels SO WONDERFUL to take a size Large coat off the rack in a store, for example, slide into it and easily zip it up. The other day I noticed a man my age at the gas station, looking admiringly in my direction! I don't know how to react to that! People everywhere seem to notice me where I was "invisible" before, and I'm more accepted as a normal human being. 3-8-03: 2 years ago today I had by-pass surgery! I've had fantastic experiences since then. I am 5'1" and now wear a size Small clothing, even at 56 years of age I can run UPstairs! I can wear zip front blue jeans and a snug t-shirt and look good! I can do anything or go anywhere and fit in just fine. My whole personality has changed; I'm no longer the shy, withdrawn person from before. I've been going out and meeting people; actually have a "boyfriend" for the first time in 20+ years. My life is VERY good now!