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

via a TV commercial for BTC. The RNY backed me up a few steps. I didn't know if I could adhere to the strict regimen and post-op eating structure. Until I found out the details of the BPD/DS procedure. I was ecstactic when I read all the info re: the DS. That is the surgery I went with.

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

Have your PCP in your corner. If they're not, then find another Dr. that will fight for you. Be sure to have your medical records forwarded. Find a customer service rep. that is willing to 'walk' your request thru the system. I didn't wait for the surgeons office to request insurance authorization...I just called my ins. carrier, and asked what forms were needed, where to send/fax them and I had my PCP do all the authorization work. I called the surgeons office to get the actually billing code of the procedure I was going to have, and included that on my authorization papers. That way, there is no question as to what procedure(there are several)is being approved. I was approved in 3 days. That way you can get a surgical date that much FASTER, and don't have to rely and wait on the surgeons extremely swamped staff to do the paperwork.

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

It was very pleasant. I had to let him know that I knew what nutritional supplementation the DS would involve for the rest of my life. I was extremely informed about the DS going in. I knew what to insist on as far as how much common channel i wanted in relationship to my eating habits that would give me the most weight loss. WRITE down ALL the questions you want to ask him. Go down the list re: each question, writing his replys. If you don't like what you hear...ask him for details as to why he answered that way. You WILL forget to ask certain questions if you don't write them down going in.

What made you finally decide to have the surgery?

The fact that when I stepped on the scale after I knew I wanted it, and I was over 300#. YIKES!!! I had never seen that number even when I was pregnant 2ce before. I saw a never ending spiral up of my weight if I didn't do something and NOW.

How did you decide which proceedure to have?

RESEARCH, RESEARCH, RESEARCH. I didn't like the small portion sizes and un-natural eating habits that the RNY restriction caused. Sweets were NOT my problem, so the dumping factor would not benefit me in my weight loss. The DS procedure restricts fats, or you'll regret having eaten them. More normal portion sizes, and the distal (more intestine bypassed) bypass. I also liked that my unused portion of my stomach was being resected (removed all together) to lessen the occurance of ulcers.

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?

None, really. I didn't have any threatening co-morbidities to speak of. I just put my trust in God's hands. The way all the authorizations and scheduling of my surgery just fell into place, I knew it was meant to be. I actually couldn't wait to be put under, because the bowel prep I had to take the night before made me extremely nauseous. ICK!

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 family and friends were ALL for it. My husband didn't say much either way. He's uncommunicative these days. He's also learned after living with me for 18 years, that once I set my mind to something, there really is no changing it. :)

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

I work at a large company, and they know enough about legality to not ask specifics or delve into an employees personal affairs. We have FMLA and long term disability that kicks in after 30 days. The first 30 days is coded to FMLA and paid at full salary.(Family Medical Leave Act) I told them I was having stomach surgery, and to expect me to be out approx. 6 weeks. I was actually out 4 full weeks, and then went back 1/2 days for the 5th week, and was back full-time the 6th week.

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

It was very nice. The nurses were wonderful. I only saw my surgeon once post-op. The other times I saw his surgical resident. I had surgery on a Monday, and could have been released Fri. afternoon after rounds. But due to the long drive home they let me stay over, and we left on Sat. morning first thing. I took WAY to much in prepartion for post op life in the hospital. You WON'T read or do hand held electronic games. Take a hair dryer so after your first shower post-op you can get 'prettied' up, and again join the land of the living. LARGE LOOSE underwear. A robe, cuz the ones they give you are awful. Even though they give you those slipper socks at the hospital I stayed at, I'm glad I brought my SLIP ON slippers. No bending required to put them on OR take them off. DEMAND a stomach binder to assist while walking and getting out of bed/chair. The cinching really makes your incision feel better, as gravity can really pull on the apron and your muscles in the abdomen need all the help they can get.

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

NO

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

Each day was better and better. I was a little dismayed at the very small qty of food I was able to consume, even though I had a 10 oz. capacity stomach. But now 18 mos. out, I can eat a NORMAL size portion. NOWHERE near the qty pre-op, but more than a dixie cup at a time.

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

REST, REST, REST. It's best if you have help. Housework should be done by someone else for at least the first 4 weeks post-op. If you have a family member that can stay with you, that would be best. I'm glad I had a recliner to sleep in, cuz I would have never been able to lay flat in a regular bed. I first slept in a regular bed 3 weeks post-op.

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

5.5 hrs one way! From SE Iowa to Minneapolis MN. I really dread having to make that trip for a 10 minute visit. I'm going to insist on seeing my PCP from now on, and letting them send all my 'stats' up to the surgeon. This is what we agreed on in the pre-op consult due to the distance, but so far, I've had to make the trip 3 more times. Two weeks after being home (3 wks postop), 3 mos. post op, and I have one scheduled for 6 mos. post op, but I'm going to call and have my PCP do it. The gas prices and the day off from work, not to mention the 11 hour round trip is ridiculous for a 10 minute visit with the surgeon. They can ask those questions over the phone, and i can officially weigh in at my PCP.

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.

1st week home: could eat - yogurt, 4 oz AAT(at a time). Bananas, 1/2. Pork & Beans, 4-6 0z. Hard Cheese & crackers. STring cheese. Soups. could NOT eat: eggs in any form. Meats in any form. it gradually got better until now. 5 mos.post-op. I can eat just about anything now, EXCEPT: macaroni, paste-y thick noodles, anything high in fat content ie: potatoe/tortilla chips, etc. I limit my carb intake as much as possible and push the PROTEIN. I even still drink my protein shake every morning and take my vitamins/minerals with it. I can even do eggs now. I'm glad, cuz I really like them any style. If I want a cookie or 2, I eat them. I don't want to revert to the diet/deprivation mentality ever again.

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

Very LOW. I took it very easy while my mom was home with me, and let her wait on me hand & foot. She came up from TX to be with me for JUST this reason, so I let her. That way I feel I healed to my best abiltiy, and could return to work that much quicker after having open DS surgery.

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

1 multi-vitamin per day. 1 prescription strength iron capsule. At LEAST 1 30 grm/protein shake every day. Occasionally a protein bar.

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've only thrown up 4 times since surgery. 2ce was with meat, and I think I just tried them too soon post-op. The other 2 times were with some form of paste-y macaroni or noodle. So I'm staying away from those. I should anyway, because they are nothing but empty carbs anyway :) I have not experienced any hair loss or lactose intolerance.....yet. No sleep disturbances either.

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

The first time the nurses from hell (just kidding) MADE me get out of bed by myself! It was only 12 hrs. post-op, and that HURT! I also thought coughing was very painful. I didn't care much for the breathing exercise-thingy either. The bowel prep the night before was AWFUL!!! Not all surgeons require this, but unfortunately mine did. Although, it only makes sense. I sure wouldn't want to be sliced open and have all that un/digested food in my tract fouling things up.

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

An online support group. I live in a rural area of Iowa, and the closest personal support group is about 2 hrs away. Although most of the people on the online list are from the IA/NE area, we try to all meet in different locations around IA/NE to meet SEVERAL times per year for social gatherings, and clothes exchanges. It's great! I absolutely LOVE the support we give each other. The members run the range from "just looking into wls" to those that are 2 years and more post op. Now that I'm post-op I really like giving advice, and pointing out good sites to research information for the pre-ops.

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

It's a little 'rough' at the top where a scab formed, but from there down, it's GREAT! My surgeon used sub-cutaneous (SP?) self disolving sutures instead of staple to close, so at least I don't look like I've been 'zipped' closed. I'm never gonna wear 2 piece swimsuits or mid-drift shirts, so the scar isn't that big of a deal to me.

Please describe any plateau experiences you have had since surgery.

I had several. Particularly at weights I was at for periods of time on my way up the weight scale. My body seemed accustomed to those weights on the way down. Happily, I am now at goal 18 mos. post-op.

Do you notice people treating you any differently now?

Not really. My best 'normy'friend is my biggest supporter! She's as excited about my weight loss, as I am. One of my larger friends is kinda being a little different. I think she sees me shrinking and is a little envious. I've given her all the resources to research it for herself, but she says the thought of being cut wide open scares her. She's never had any type of surgery and doesn't have any kids. So I think the 'pain' thing is limiting her. Men!! I actually LIKE them looking at me now. :) I have the BEST boyfriend ever. (side bar: I was divorced 5/02), but had nothing to do with my wls, and weight loss, it was bad for several years prior to wls. It just gave me the courage to finally end something that should have ended a long time ago.