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

I am a nurse, so I have known about it for a long time. I, like most people, thought that the surgery was like a death sentence. When I developed the high blood pressure and my vision was blurry and I had a headache that hurt so bad, I did an internet search. I found the Weight For Life website. Then I found this Website.

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

July 4, 2001 I was approved on June 26, 2001, one day after my paperwork was submitted to my insurance company. I found out that the day the paperwork was submitted that it was looking like I wouldn't be approved. My doctor showed me what was submitted, and what Weight For Life submitted about my medical history was just a portion of the information I had given them. They had me down on one antihypertensive, and a lower dose than I was really taking. They did not mention that it was the third change to the medication in an effort to correct the high blood pressure, and it was still high. One of the criteria is that the high blood pressure be poorly controlled with multiple attempts to correct it. The insurance does not consider well-controlled high blood pressure as a risk factor. I was really upset that I filled out Weight For Life's paperwork as detailed as I could and they were so sketchy on what they turned in to the insurance. The night before approval when I was pretty sure I would not be approved I was very upset. Not necessarily because I would not get the surgery paid for, but that I was in the situation I was in. I wondered how I had let it get this far and what a desperate state I was in. I felt really hopeless and completely disgusted with myself. Originally I had promised myself that I would not give up on trying to lose weight during the approval process, but I did. I wouldn't say that it was a free-for-all, but I was indulging like it was the last meals I would ever have. I felt very ashamed of myself, and I didn't know what I would do because I knew that every time I dieted, I gained more than I started with. The next morning my husband found out I had been approved for the surgery, he came to my work while I was standing outside for a firedrill. His face looked very grave and from a distance, I was sure that he was coming to tell me I was denied. I had already decided I would not appeal and I would take the decision as a sign from God. He told me I was approved and I cried. The funny thing was that I was not crying tears of joy or even relief. The best way I can describe what I was feeling was a feeling of loss, and a little more of the shame I felt the night before. I saw my therapist later that day, and she was the only one I could accurately explain my feelings to. She reminded me that with any change a sort of mourning occurs. I would have to go through all of the stages of grieving with this, just as anyone does when they lose something. I must mourn my former way of life. This is no little thing, binge eating, as sick as it is, has been my comfort, my happiness, and my way of life for a long time now. Not to mention that I feel that if this doesn't work, and if I find a way to screw this up, what else is there? What advice do I have for others in this stage? Be realistic. Don't count your chickens before they are hatched. Know what the inclusion criteria is for your insurance is before you submit the request. If you meet the criteria, you will be approved, if you do not meet the criteria, you will not be approved. Not being approved is not the insurance company being unfair or mean. Your policy is what it is, and we are all supposed to know what we have agreed to have as coverage. It might be that you have chosen the cheapest policy available, and if that is the case, you are getting what you pay for. Or it might be that your employer is only providing you with the policy they can afford. If you do fit the criteria, then they have an obligation to provide you with what they have agreed to. I think people should appeal if they meet the pre-established criteria. But if you don't, you don't.

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

My first visit with Dr. Newhoff was great, and he made a great impression, because he is so thorough. I think that everyone can get the most out of the first meeting with the surgeon by doing some soul searching, doing their homework on the procedure, and asking every question they have, even if it seems silly. I got the definate impression that he has heard it all. Nothing anyone could have asked would have been anything new to him. He treated the group of 6 I was in with the utmost respect.

What made you finally decide to have the surgery?

I finally decided to have surgery for sure after my meeting with Dr. Newhoff. He was absolutely honest and open about the risks and benefits. I had a lot of respect for him when he told the group that he does not perform surgery on patients who are actively smoking at the time of the surgery, who do not pass the psychiatric examination (and the therapist verified this) or people who profess that they have never lost weight on a diet (he said this means they have not tried hard enough). We should not have a surgery that we perceive as too risky, and he should not have to risk his reputation and license to perform a surgery that he perceives as too risky. I respect that so much.

How did you decide which proceedure to have?

I didn't. I feel very comfortable with Dr. Newhoff and he does only one kind at this time, an open RXY. I am comfortable with the fact that he needs to be sure that the lap procedures are as effective as the open procedure.

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 am terribly, terribly afraid of the potential complications (actually less than 1%, I think, but still present). I am a nurse, and nurses tend to imagine the worst case scenario. I am absolutely terrified of throwing a blood clot to my heart, brain or lung. But I know that Dr. Newhoff is going to do all he can to prevent this, and he will make me agree to do all I can to prevent it. I will do what I can and pray for the best outcome. I know that being morbidly obese is terribly risky. I don't think I am increasing my risk any more than it is for me now by having surgery. But I am still very afraid.

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 husband, family and friends did not meet this decision comfortably, and for the same reasons most people do not feel comfortable with it. Everyone has heard about terrible outcomes and people unable to absorb any nutrients and being chronically ill at best. I had to show my husband research showing that it is not as horrible as he imagines. He wants me to be healthy. He would rather have me around than not. He is now comfortable with the surgery. He is even excited that maybe I will be able to comfortably participate in activities he loves like hiking down into the Grand Canyon. My family and friends are still apprehensive (except for my friend who had the surgery June 18th of this year), but excited to see how it turns out.

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

I actually work for the insurance company that approved the surgery, but only two people know about it so far, the medical director that approved it, and the nurse that has put the surgery into the computer. They don't really talk to me about it, it wouldn't be professional. I haven't told my boss yet, and I don't know when I will. My surgery is scheduled for September 2, 2001. I need to make sure with Human Resources that I will be able to take short-term disability for the two weeks I take off. I think my manager will say that this is elective (which it isn't, my insurance does not cover elective surgeries, only medically necessary ones).

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

I stayed in the hospital two nights after my surgery, and I actually regretted not staying the third night like my doctor advised. I was treated excellent! I was so incredibly, overwhelmingly nauseated for the first 24 hours after surgery. I would have traded all the pain medicine for the anti-nausea medication. Walking wasn't a big problem, it was hard to find the motivation, especially the first 24 hours, but it actually made me feel better to walk. When I got home I was so excited about sleeping through the night in my own bed, but I hurt worse not walking. I don't think it is important to bring anything to the hospital. Maybe a robe. Many people saw parts of me that I never wanted shown. I just slept during my free time when I wasn't walking. I packed all kinds of stuff, didn't care about it, and friends brought me gifts and I couldn't have cared less.

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

No post-op complications at all.

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 so unbeleivably tired. I ended up going back to work 2 weeks post-op because all I was doing was sleeping. I didn't have a whole lot of pain. Exactly one week post-op I went to school and sat through a 4 hour class and drove myself home. I did have a lot of anxiety every time I needed to eat. The first time I threw up, two weeks post-op, it was pretty traumatic. I tried a bite of pizza and a bite of a chicken wing. I swear, more came up than I took in. I was really scared to eat after that.

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

The overwhelming desire to eat out of habit still exists. I paced a lot and opened the refridgerator door and the cupboards, and I wasn't the least bit hungry. I was terribly tired all of the time. I felt like I was really disrupting my family's routine. I was anxious every time I had to eat. Everything tasted really good, though. Pain wasn't bad. I didn't weigh myself during the first couple of post-op weeks.

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

Only about 10 miles.

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.

I definately couldn't eat pizza and wings! I have been able to eat almost anything! No soda pop, doesn't feel good, no bread, gives me horrible stomach aches, eggs don't taste good anymore, and sugar makes me feel bad, but doesn't give me dumping syndrome. The first few months I couldn't drink water unless it was disguised. Crystal lite was ok, but not water (go figure). Cold water was painful. Now it is ok. I pretty much eat anything, but I try to concentrate on the protein and then some vegetables. I never liked spinach, but now I do! Food tastes better, I guess because I don't inhale it anymore.

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

For the first two weeks post-op, I just wanted to sleep. That's it. I tried to walk about a mile a day, and I succeeded about 5 days a week. I couldn't walk it all at once, so it was about 1/2 mile twice a day. I really had to force myself to do that. Now I feel energetic, but I am still lazy.

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

Two childrens chewable vitamins with iron, a vitamin c lozenge, two viactin calcium chews (taken atleast 1 hour apart from the vitamins) and 40g supplimental protein a day. I am pretty sure I won't loose any hair. Actually, my hair and complexion are great! **About 4 months post-op I had to cut all my hair off. I don't think it was necessarily falling out, but it was breaking off in handfuls. The hairdresser said that the anesthesia takes a toll on the hair.

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 don't have any side effects at all. I do vomit if I eat too much or too fast. That's unpleasant, but I do it to myself. I am getting better about that, maybe once a week or so. I am now three months post-op. **At one year post op, I still vomit once a week. It doesn't have anything to do with eating too much or too fast. It just randomly happens. Actually, if there is anything close to a pattern, I almost always throw up chinese food.

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

The surgery itself. It was so, so much harder than I imagined it would be. I am a nurse, and I have had surgery before, and it was still much worse than I thought it would be. The anesthesia made me so nauseated. It seemed like I didn't feel like me for a week. It was such a violent assault on my system. Of course, I didn't like waiting to be scheduled. I convinced myself once my insurance approved me that if I didn't have the surgery right away I would have a stroke or a heart attack.

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

There are twice monthly support group meetings that I have never attended. The whole first year post-op the meetings were on the night I went to school. It seemed like whenever I had a night off of school, there was no meeting. I have two friends who had surgery within 6 months of me, we all talk. And I find this website very helpful.

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

My scar is a big 8 inch line from my xyphoid process to my belly button. It is very pink and I have very white skin. It is pretty ugly. It kindov looks like a big stretch mark. I know in another two years it will be smaller and skin colored, so I don't mind. I wasn't showing my belly to anyone before! It is what I expected.

Please describe any plateau experiences you have had since surgery.

I have hit many plateaus. The last one lasted for about 4 1/2 months. I was sure I was done loosing, and at one year post-op, I lost another 5 or so pounds and went down another size!

Do you notice people treating you any differently now?

Yes, and it makes me angry. I work in an office with about 100 other employees, and so many people who never spoke to me say hi in the elevators and such.