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

I learned about bariatric surgery from my primary care physician. In 1998, I went to visit his office to be treated for Asthma. Back then, I was up about 285lbs. My doctor informed me that if I did not loose weight, my body would eventually break down. He told me that being that most of my weight was from my waist downward, my feet, ankles, thighs, legs, hips, and lower back would be my downfall. He went on to explain the possibility of me having bariatric surgery. My first impression was to "curse" my doctor up-down-and sideways, and I responded to him by saying: "I have been big all my life, and as long as my weight don't bother me, I will not bother it!" I stormed out of his office with an attitude, and I did not want to go back to see him. Well, my doctor truely earned his medical degree because he was right and I was wrong! Everything the doctor predicted would happen to me, happened to me! In 2002, I was up 314lbs., and oh yes, my feet, ankles, legs, thighs, lower back, and my hips hurt me whenever I just walked down one half of a block.

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

I am covered by GHI. Dr. Nicastro's staff took care of everything with the insurance. I was approved within four days of submission. My advise would be to choose a hospital that takes care of the insurance company. Do not try to do it yourself. The hospital staff is more knowledgeable than we are about what to do to get approval.

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

My first visit with Dr. Nicastro was very "chilling". He explained all the gory details of the bariatric procedures. He emphasized the possibility of fatality. While going over all that he explained to me, he did not blink and eye. Dr. Nicastro was extremely "militant" in his initial meeting with me. People can get the most out of this meeting by being prepared to listen, and ask lots of questions. Be prepared to accept and understand whatever the doctor suggest or explains to you. Take a note pad and write down your own thoughts and questions before going to see the surgeon so that you do not forget anything that concerns you. The anxiety of meeting the surgeon can make one forget what is on his/her mind.

What made you finally decide to have the surgery?

I decided to have the surgery after my last visit with my primary care physician in November 2002. I walked into his office engulfed in pain from my waist down. He assured me that if I go through with the surgery, "all my aches and pains would disappear." I was fed up with the way things were. As I stated before, the surgery was my last stance! If I did not make it, I was willing to die trying rather than continue on the way things were.

How did you decide which proceedure to have?

Dr. Nicastro explained the various procedures to me, and I decided against the RNY, and Lap band. First to have the RNY, one has to get staples put inside the stomach pouch, and one has to experience the "dumping syndrome". Being that I was never a "sweets" person, meaning that I did not eat much junk food, I didn't feel that I would need to have the RNY. Second, the lap band seems like a waist of time to me. I was 300 plus pounds, I needed to be able to loose more that a pound per week, and I did not feel good about having to have the band reajusted periodically. Finally, the only procedure that seemed suitable for me was the Duedenal Switch. With this proceedure, there is no dumping syndrome, and nothing has to be reajusted. The only surgical follow up is to have the "tummy-tuck":)

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 did fear dying, but I did not fear dying from the actual proceedure. I beleive in Jesus Christ, and I knew that HE lead me into the surgery. If it was HIS will for me to be called home, I did not beleive it would have been from the surgery. My advise to anyone having these fears is to: 1.) Make certain that you are not doing this for cosmetic reasons. 2.) You can not make this decision based on anybody else's opinion of what you look like. 3.) Make certain that you extensively research your options. 4.) Be honest with yourself and your doctors 5.) Make certain that you follow your doctor's recommendations to the letter. Do not miss any pre-op test or appointments. 6.) Make the choice to "LIVE"!

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?

I am blessed to have a family that has always been supportive with me. I called a family meeting and dinner party. I prepared all of my research materials, and I presented a Power Point slide show of myself over the years, and I also prepared handouts for each of them to study from. I made certain that I was as straight foward as Dr. Nicastro was with me, and I did not blink an eye. At first, the family was in complete shock that I took such measures to inform them, but after the presentation was over, they all assured me that I had their support. I would not change the way I presented my decision to my family and friends because I beleive that establishing a strong and cohesive support group is of the greatest importance for anyone considering this surgery.

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

Again, I am blessed to have a wonderful supervisor. Her reaction was very positive. I shared everything that I told to my family, and when I was completed with my presentation, she stated to me that I had her support and that I should do whatever it takes to improve my health. I was out on sick leave for two months.

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

My hospital stay was as comfortable as it could be. I was in a great deal of pain, but having my family and my friends there help tremendously. One of my brothers work in the hospital that I was in, and because of this, the entire staff was at my beck and calling. I was given a private room, and my mom was able to stay for the duration of my time in the hospital. I was in the hospital for four full days, and on the fifth day I was released. It is important to bring with you the things that make you happy and comfortable. Make sure you have a really soft pillow or teddy bear, flat/soft slippers, and very loose fitting garments. Even if you are a male, you should consider wearing a loose fitting gown.

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

Yes. The complication that I had was called upper respiratory failure, and I also had a right side lung calapse. I swelled with pockets of water in throughout my upper chest cavity, and I could bearly breath. After being released from the hospital, two days later I ended up back in the hospital. Once I was back in the care of Dr. Nicastro and his team, I underwent a few test. I had a cat scan to check for leakage, chest xray to see exactly where the water was being stored, an echo cardiogram/sonogram to make sure the fluid was not surrounding my heart, and then I was given an antidote to release the fluid buildup. I remained in the hospital for two more days, and then I went home. The pain I was in was still a very strong facture, but I could breath a whole lot better. I dealth with everything that I was experiencing with confidence. I felt like I was a soldier at war, and GOD was my general, so I knew I'd be victorious!

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 can not emphasize enough about the PAIN. It was absolutely horrible. I could bearly get comfortable sitting, standing, or walking. Getting in and out of the car was the worse! The pulling sensation that I felt was as if someone was trying to rip my incision open. However, I did have a great deal of help from my family and my friends, so it was a matter of taking one day at a time. I began to feel anxiety during the second month post-op because I became sick of staying indoors. I wanted things to go back to "normal" for me. I desired to go back to work.

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

My first few weeks home, I was sleeping most of the time. The pain medication I was given was very powerful. Most of the time when people came by to see me, it felt as if I were dreaming that I'd seen them. I could not eat any solid foods for the first four weeks. People should prepare themselves for the fact that they will not have a sense of normalcy until the pain begins to subside.

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

The hospital was 15 minutes away from home, so it did not affect my aftercare negatively, in fact, it helped me a great deal.

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.

In the very beginning, I could not eat solid foods at all. I could only drink liquids for the first four weeks. During the second month, I slowly began to eat solids. My first solid meal was oatmeal with 4 raisin in it. I ate chicken flavored soup with very little postina in it. I could only consume 3 ouces of anything at one time. By the third month, I began to feel hungry all the time. I was back to work, so I started bringing salads and protein drinks for lunch. Watermelon was and still is my favorite in between meal snack. During the summer months 2 ounces (four bite size pieces)of Watermelon would be a typical meal for me. I would also eat soup all the time. Soup and salad are also my favorite meals post-op. By the fourth month, I began to try breads. This is a NO-GO! I can't seem to swallow bread. I don't like it at all. Steak is another NO-GO, but I am a meat lover. I have master the art of having steak without actually consuming it. My stomach can not take it, so what I do is, I chew the steak as if it were a piece of gum, and once all the flavor is gone, I disgard it in a paper towel. In fact, my husband had become so accustomed to me chewing and spitting, that he carries paper towels around with us each time we go out:) During month five, I begin to eat different vegetables, such as, string beans, peas, carrots, and corn. Corn is a NO-GO. I can not hold corn down for long. I also began to ground all meats that I want to eat. I ground turkey, chicken, steak, and even cold cuts. I am learning that each month that goes by, I am able to add a little more of a variety to my diet, but I am happy to say that my diet does not include junk foods. Since my surgery I have not desired any potatoe chips, cookies, candy, soda, cake, or pie. However, over the summer, there were many BBQs, and I literally pinched a piece of pie or cake, but I made sure I did not consume much at all.

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

I slepted most of the time, and whenever I was awake, I watched tv all day long.

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

I have been on a regiment of vitamins. I take liquid Geratol complete for women, Ferguson Iron pills, Potassium pills, and water pills.

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 nausia and lack of sleep was the worst. Although I was on heavy sedatives, I could only rest for about 10 minutes at a time. I would wake up often because of the pain. I would only become nausious whenever I took my medication because I had to crush up the pills. The taste was horrible, and I would gag every time. The nausia and lack of sleep last for the first six week after the surgery, and I coped with it one day at a time.

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

THE PAIN, THE PAIN, THE PAIN!!!!!!!!!!!

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

I attend a support group that is offered by Staten Island University Hospital on Staten Island. It is offered once a week on Wednesday evenings from 7:00 pm to 9:00 pm. In between group meetings, Mon. Tues. Thurs. and Fri I attend a gym where I work out for one hour. I also stay extremely busy. I work one full time job and a part time job. I am constantly on the move. It is extremely important to attend a support group outside of your related family and friends because you need to build a sense of community with people who have actually gone through with the surgery.

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

My scar is my badge of honor. It is representation of my efforts to fight for my life. I have named it "the alien". It has a mind of its own, and we are getting to know one another really well. In the beginning, it had complete control over my body and it had no respect for being given orders, but now we have come to an agreement. We are fighting on the same team, so we both called a truce. My scar and I are partners to the end now. It is not what I expected to have, but I am honored to have it! It is now begining to blend in with the coloration of the rest of my skin :)

Please describe any plateau experiences you have had since surgery.

Now, plateauing is the scary part for me. When I hit 237lbs. I plateaued for 3 weeks straight! I was mortified. I thought the weight loss was going to stop and that I was going go back the other way. I was depressed and I cried a lot. I stopped eating, and I became sick. I was weak and tired all the time. This went on for the entire three weeks. I went to see my primary care doctor who told me that I needed to eat more in order to get the weight falling again. My response to him was "all of my life doctors have been telling me not to eat so much, and for the first time I am being told that I am not eating enough!". My doctor thought it was the funniest thing he ever heard from a patient before, but I did not say it to be funny. I was as serious as a heart attack! However, I am a firm beleiver in following my doctor's recommendations, so I went home and baked a piece of sole fish with lemon pepper marinade and a salad. I ate very slowly and reluctantly, but I consumed the meal. I continued preparing what I call "inviting" meals for the rest of the week, and to my suprise I dropped an astonishing 10lbs! My doctor explained plateauing to me in a very scientific, but comprehensive manner. He explained that my body is going through sort of a "menomorphisis" and that my heart has to constantly reajust to my bodies activies and my weight. After loosing such a dramtic amount of weight in such a short period of time, my body has to stand down and regroup so to speak. This explanation was completey understandable to me and my husband, so now I expect to plateau every now and then, but I am not afraid anymore. The key is to continue my new lifestyle regiment, and I can't go wrong.

Do you notice people treating you any differently now?

YES!!!!!!! People that hardly spoke to me in the past are stopping to ask me questions and make comments about my weight loss. It is absolutely amazing that when I was 300 plus no one stopped me to ask me anything about myself, and now they treat me as if I just dropped out of the sky from another planet. Sometimes it annoys me to be questioned because it makes me feel like some sort of "science-project", but the stares that I am getting today are stares of "ENVY" so I welcome that.