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

A friend of mine had her stomach "stapled" about 20 years ago and lost a ton of weight. I had forgotten about that. But as I began approaching 100 pounds over my ideal body weight, some celebrities began undergoing bariatric surgery with phenomenal results and I began to view this as an option. The final factor that really convinced me was when I had my initial consultation with my surgeon who informed me my diabetes would most likely resolve after the surgery. Initially, I had looked at the surgery from a standpoint of vanity. But when I learned it could save my life, I was like, "Sign me up!!"

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 getting approval from my carrier for the surgery. The surgeon's office took care of it all.

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

My main goal was to gather as much information about the procedure as possible, determine his experience and guage whether I could tolerate dealing with this surgeon for a couple of pre-op visits and in the hospital. Your initial meeting is like an interview. You pretty much know you want and meet the criteria for the surgery, you just need to find someone to perform it. Be sure to find one board-certified and with whom you can have a working relationship, including his office staff. There are a ton of doctors out there who can do the surgery for you--YOU are in control.

What made you finally decide to have the surgery?

Learning that having the gastric bypass could potentially cure my diabetes was the final deciding factor to have the surgery.

How did you decide which proceedure to have?

The physician recommended the RNY laparoscopic procedure rather than gastric banding and I trusted his judgment.

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 don't know: would you consider writing letters to all of your family members in case you didn't come home from the hospital a fear of dying? I did write such letters not because I actually thought I would die, but because there is always a risk when general anesthesia is used and, hey, why not be prepared? My biggest fear was being one of those people who appeared to be "out" but could actually feel everything. I spoke to the anesthetist about this (while on the OR table) and he allayed my fears. What i would tell others is to believe you are doing what is best for you and your family and have faith in God.

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?

My mother was predictably horrified. My father was surprisingly supportive. Co-workers were generally supportive although would ask me, "Why do you want to mutiliate yourself?" nearly every time I saw her. My friends were generally supportive but worried about the seriousness of the surgery and any possible complications. I would not have communicated things any differently if I had to do it over. After the surgery, when I was fine and losing weight, everyone was really supportive.

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

My nurse manager actually knew several people who had had the procedure, so she was generally supportive. I initially planned to return to work after six weeks but then had it extended to eight weeks because I am a nurse (lots of physical activity) and work long hours (12.5 hour shifts). I know my boss will not be thrilled because the unit is rather short-staffed at the moment, but my health has to come first. I returned to work at 9 weeks post-op and my nurse manager was overheard to complain about the fact that I had taken additional time especially when, a few weeks later, I had the unmitigated gaul to develop a kidney stone and need more time off.

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

The hospital stay was fine. The nurses were wonderful and the facility was nice. I was in ICU so had a private room for the 2 days I was hospitalized. I don't think I would have enjoyed a room-mate when I was in pain. I brought lots of books and magazines to read but ended up not feeling like reading at all (and I am an avid reader).

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

No complications at all--I was very fortunate that things went very well. I had a Jackson-Pratt drain (small, football-shaped collection container) for almost a week but felt SO much better after it was removed. When I shower in the morning, I do see a lot of hair in the drain, but I cannot say it is any more than pre-surgery. I did notice my hair thinning at my temples and increased my protein and vitamins and it seems to have improved.

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

Initially, my bowels were hyperactive and the constant rumbling in my belly made me think I was hungry, but I was not. There was quite a bit of discomfort for the first month or so, but I feel great now (6 months down the road). For quite a while (several months), I felt a little nauseous after meals, but that has resolved. The key, for me, is to eat just a little more times per day than just the 3 meals my physician instructed me to eat. If I eat just 3 meals, I tend to be so hungry that I eat too quickly and therefore too much so I don't feel so terrific afterwards. If I eat smaller more frequent meals, I tend to feel better.

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

Expect to be exhausted and hurting. I felt very easily fatigued for the first 8 weeks or so. I am also a stomach sleeper, so being unable to sleep in a favored position contributed to the tiredness. Again, I felt quite a bit of discomfort until the drain was removed. Thereafter, I felt less discomfort and steadily improved.

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

The hospital is about an hour away. This certainly affected my attendance to support meetings (none, and has made MD appointments challenging, especially since there was either rain or snow for every appointment in the initial pre- and post-op periods.

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 physician advanced my diet much more rapidly than the nutritionist indicated he would. I started off with jello for a week, then to yogurt for a week then to soft foods for about a month or two. Now, at 6 months, I can eat salads and meat without difficulty. Fried foods are not well-tolerated, but are an excellent "home remedy" if you're feeling constipated! No soda, of course. I used to be quite a soda drinker, but do not even miss it anymore. If I occasionally steal a sip, it always tasted too sweet and causes bloating. One lesson I found of the utmost importance is not to drink during your meal. The only times I ever vomited were after drinking while I was eating--it seemed almost as if the food was like a sponge and when I added liquid, it suddenly "poofed" and made me feel so full and uncomfortable that I vomited. It doesn't take too many times of doing that before you get the message that it's not a very good idea. Now I am able to drink small amounts--cautiously--with meals.

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

The first week, I spent a lot of time in bed and if I would venture to the family room, it would be for short periods and then I would have to go lay down again. The following week, I was able to stay up for a few hours at a time (like 4 to 6), but was then pretty tired (this was at Christmas and company was at our house so I couldn't just lie in bed). I remember feeling very easily fatigued for a very long time (like 7 weeks or so). Eventually, I returned to work at 9 weeks, to a job where I work 12.5 hour shifts and do a ton of walking. I was able to tolerate that pretty well, but i don't think I could have returned to work any sooner.

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

I was taking 2 Flintstone chewable vitamins and 2 Viactiv calcium supplements per day. Then I developed kidney stones and hair loss. Now I take 4 Flintstone vitamins per day and calcium just once in a while (my internist thought I should change the form of calcium I take but wanted to a 24-hour urine test before I made that change to see if the calcium I was taking had contributed to the formation of the kidney stones. I never did the urine collection so never changed the calcium. I should change it and begin the calcium again, I know.)

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?

The nausea was difficult to deal with. It was to the point that it hardly seemed worth it to eat because I knew I'd feel awful afterwards. This persisted until, at about 5 months, I decided to eat 5 or 6 small meals per day rather than just 3. Now I feel terrific.

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

The actual getting on the table. I was just so nervous about the anesthesia and was wondering about the post-op pain--I mean, they did a lot of work in there! The pain was significant but endurable. I don't think the post-op pain management was adequate but, then again, I know you cannot expect to be pain-free after major surgery. And the drain was uncomfortable--after that came out, things improved a lot.

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

There is a support program available, but i have not attended. My post-op course was uneventful. If I had been having problems, I think a support group would have been invaluable. I did attend a meeting prior to surgery which really helped allay my fears.

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

I have six small scars that range from undetectable to about an inch. I can certainly deal with that!

Please describe any plateau experiences you have had since surgery.

I plateaued about 2 months after surgery but found that when I returned to work, I lost a pound each day that I worked. I plateaued again at about 50 pounds, but then we moved and my activity level increased and my intake decreased so I rapidly lost another 10 pounds. Here I am at 70 pounds, and I feel like I've been here forever. So I'm trying the smaller more frequent meals approach and, now that summer is here, am trying to increase my activity. I "only" have about 30 more pounds to go, so I expect the weight will come off more slowly the closer I get to my goal.

Do you notice people treating you any differently now?

My God yes!! And it's really sad, because I work in health care where we are supposed to be a little more "enlightened" about obesity, or so I thought. People take me more seriously now--I guess only dumb people get fat, right? People also tell me I look much younger, and I think I have more confidence in myself than I did before.