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

I have heard of it for years - all bad. When my heart specialist first mentioned it to me - I thought he was crazy!! I put him off for probably about a year. Then he told me he checked on my coverage with Group Health and as a Federal worker it was covered. I asked him if he thought my heart problems would not preclude me from surgery and he said he thought I would be ok. I took the referral still determined not to have the surgery. Went to see the surgeon with my husband. My husband adamant about no surgery. Dr. Bock spent close to two hours answering question. He told me I should not feel a failure because I was to this point. Told me this was basically my last chance because I was not going to be able to lose the weight on my own, because of my current size and amount of insulin I have to take. Insulin makes you gain weight. I was so blown away to hear a doctor actually believe me when I said I truly attempted to stay on a 1,200 - 1,500 calorie low sugar diet and had no success in losing weight. I am still very scared at this point because of heart situation. Doctor told me if he sees anything on preop stress test that scares him, he will not operate. He will not put me, knowingly, into a harmful situation. At that statement he had my complete faith. I pray that I will be ok on preop and can have the surgery. I know I will eventually die of obesity and diabetes if I don't do something radical. Having problem with my feet and the doctor told me I am probably two years from an amputation at the rate I am currently progressing.

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

Because I have Group Health, an HMO, I had no problems with approval. My heart specialist sent in referral and I went to "gatekeeper" doctor who calculated my BMI and made sure I was actually a Federal plan member (WLS surgery covered). I have been told that Group Health now covers WLS for all plan members not just Federal. I really have no advice for others because I did not have to go through any real approval process.

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

My first visit with the surgeon was good. He spent a lot of time with my husband and I. Unfortunately, I was not well prepared for this visit and did not know certain questions to ask. I have now seen several copies of lists of questions to ask your surgeon and I wish I would have had these prior to going in. He explained his type of surgery but I didn't know difference between proximal and distal. I had to get a lot of information over the internet from others that had surgery with him. You can get the most out of your meeting by doing your research and having a lot of questions to ask. He told me I would be in ICU for a couple of days. I thought this was standard procedure but found it not to be. Now, I wonder is it because of my heart situation? Wished I would have known to ask that question. So my strongest advice is to educate yourself. Be a smart patient.

What made you finally decide to have the surgery?

My visit with my surgeon. He made me believe I was not a failure and that this surgery was going to help me with my diabetes and CHF. He told me point blank that it would not help any damage already done to my heart but it would help with further problems. I know I have to take the weight off and he believed me, truly believed me, when I told him I had done everything I know to do. He truly believed me when I told him I did stick to a 1,200-1,500 low sugar diet. He believed my husband when my husband told him that I really didn't overeat. I think it was his quiet, honest belief in me that made me see I didn't have a lot of options left. I trusted him to do the best for me.

How did you decide which proceedure to have?

I really had no choice in the procedure. Dr. Bock is the only doctor in the Group Health system in the NW that performs WLS and he only does one type of procedure. I asked him about doing it laparoscopically and he indicated that it would take him longer to do the procedure laparoscopically and he would prefer to get me under the anesthesia and out again as quickly as possible. Again, due to my heart situation. He felt the safest procedure for me was an open RNY.

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

I had surgery on a Tuesday and went home on Saturday. I spent 3 days in ICU because of my prior heart attack and heart medicine I received while having the surgery. I was up walking the next day and then there was no keeping me in bed. My doctor used a new pain control device called "On Que" which has a catheter going directly into your incision and delivers a local anesthetic. I had absolutely no incisional pain. I had sore ribs and back, but no other pain. I wish I would have brought a CD player and CDs as daytime TV is horrible. Also, one of those long stick, grabber things. I dropped several things and if I had had one of those I could have retrieved without bothering the nurses. I received wonderful care in the hospital and had a very positive experience. Got poked too many times, but that is to be expected with major surgery. On the ward I was in private room and that was pleasant.

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

I am only three weeks postop right now. I have had no complications whatsoever and hope to not encounter any in the future.

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 scared to death after I got my surgery date. Unfortunately, I coped with the anxiety in the same way I cope with everything - I ate! My family was a big support to me. I also continued to read and research every thing I could on WLS so I felt totally prepared for any complications that might come up.

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

I am probably not the best person to to advice on what to expect. I do not think my experience was like most others. I felt so great and have not had any change in that feeling. The day after I got home I went shopping with my husband, got on one of those carts and drove around. I was driving a week after my surgery. The only problem of any type that I encountered was sleeping in my bed when I got home. I was a little sore and could not find a comfortable position. I took pain pills the first couple of nights to mainly aid me in getting to sleep. I know lots of people sleep in their recliners and I almost did that except my husband and son sit up so late watching TV that I knew that would bother me more. I wish I would have rented a hospital bed for the first week and that may be good advice for people that have more trouble than I did with being sore.

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

I traveled about 60 miles to have my surgery. So far the only affect of this is a miserable drive which is normally bumper to bumper no matter what time of day you go 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 doctor started me on pureed foods in the hospital before I came home. He keeps you on pureed food for approximately 4 weeks and then you advance to soft type foods. I have pureed about everything! I cannot have carbonated beverages or foods high in fat content. I cheated and pureed bacon. I paid a dumping price for that! I try to do puree high protien, low fat. Right now I would kill to be able to chew something! I am not quite three weeks postop, so still doing the liquids and pureed stuff. I believe a miracle happened after my surgery, though. I have been a regular Pepsi addict for about 30 years, and I do mean addict! I drank Pepsi right up until midnight before surgery and I was scared about having to face the withdrawal symptoms as I have tried so many times to get off of the regular stuff. I had no withdrawal symptoms and have not once craved a Pepsi since my surgery. I hated diet drinks (Snapple) and things like that. Now they taste pretty good and I can't seem to taste the sugar substitute like I could in the past.

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

Pretty darn good so far. I walk and move around great. In fact, I think my activity level is a little bit better than before surgery. However, at three weeks post-op I have not lost enough weight to make much of a difference in my activity level.

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

Vitamin B-2, child's chewable 2xd, and iron.

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 am only almost three weeks postop and have no side effects yet.

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

Having the IVs started - bad veins, and having blood withdrawn, and getting heparin shots. My back hurt very badly after surgery and the doctor said that was from being on the operating table for so long in one position.

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

I have the Weight Management program and then several WLS patients in the NW have different support groups and we all sort of inter-attend. The internet is a great resource. We are trying to start our own support group internet version for Group Health patients as they are starting to do more surgeries. I think support of fellow WLS folks is very important.

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

My scar runs from beneath my breasts down to my belly button. It is what I expected, as my surgeon had shown me exactly where it would be. When I first saw it I told my surgeon "Well, now I am going to look like crap in a bikini!" He laughed and asked me what I looked like befor in one. I told him, "Like crap." I am putting vitamin E on it and hoping it does not keloid on me. The scar is very unimportant when I compare it to my blood sugars which are going down dramatically day by day.

Please describe any plateau experiences you have had since surgery.

Only three weeks postop, no plateaus yet.

Do you notice people treating you any differently now?

No, but again at three weeks postop I have not been out in public much, nor is my weight loss noticeable yet.