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

About two years ago I sent off for a brochure about bariatric surgery. In discussing it with my friends, we seemed to emphasize all of the negatives of the surgery such as lifestyle changes, no longer able to use dinner parties as a form of entertainment, being relegated to eating differently for the rest of your life, the drastic and permanent changes to the stomach organ just to mention a few.

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

I read somewhere in my information packet from Pacific Bariatrics, that we should call our insurance company and ask them for a hard copy of their bariatrics policy. When I did this, I was told they they didn't have a written policy per se. The person assisting me told me that she had just had the bariatric surgery herself 18 months ago and on a personal level, told me how I could help my case. She said that by submitting a letter along with my doctor's recommendation for a consultation with a bariatric surgeon could prove useful. She said the letter should contain information about how many diets I had been on, the struggles that I had had due to obesity and my motivation for wanting to change my lifestyle. My doctor had already submitted a request for a consultation for me, and in fact this assistant was able to tell me that it had already been approved. This information might help someone else. I would also recommend that you be very honest and include any diet that you have ever tried, for no matter how long, the results and also know your family history. I think insurance companies are realizing that heredity plays a major part in diabetes, heart disease, arthritis, etc.

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

After my hurtful visit with my primary care physician, who was totally appathetic towards my obesity, Dr. Rumsey from Pacific Bariatric, restored my faith in the medical profession. He and his staff were very supportive, attentive and listened to what I had to say. To get the most out of this first meeting, you need to do your own research about the surgery. Know what it all entails and what to expect during the recovery process and life after recovery. If you are on the same page with the doctor, he will be able to give you more information because you won't be going into denial when he talks about the complications of surgery.

What made you finally decide to have the surgery?

Realizing that I was fighting a losing battle on my own and if I didn't do something permanent, that I would have no quality to my life but would be relegated to an existance. I love myself and life too much to allow that to happen. I have already started saving so I can travel, as I have done in the past, but no longer could due to the inability to fit into an airline seat and not being able to walk for very long without pain.

How did you decide which proceedure to have?

Originally I looked into have the Fobi pouch. My insurance did not provide for this type of surgery, so I switched gears. After researching the Rous Y, I decided that it wasn't as radical as the Fobi pouch and actually had a much better track record. Once I made my decision, it seemed that former Rous Y patients were coming out of the woodwork. I have personally talked to 50 people who have had this procedure done and everyone of them said they would do it again in a heartbeat. Not to say they didn't have some complications, and some even required additional surgery for hernias or skin flaps, but all said that it had changed their lives and that they loved living. That was where I got the courage to get on board.

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'm not a very fearful person. I am a realist who realizes that if you try to avoid risk for fear of getting hurt or dying, you aren't going to be living your life anyhow. I knew that my chances of dying on the highways were much more likely to happen, yet I drove on them everyday. While I don't always adopt the adage, "no pain, no gain" it applies in this context. When you get desperate enough, when you hurt enough, when you realize that life is passing you by, then you learn a way to overcome those fears. Put it into perspective; more people have died from waiting to have the surgery, than ever died on the operating table. Thinking you will die from the surgery is about as likely as winning the lottery. It can happen, but will it happen to you? Are you living life to the fullest now? If not, then what do you have to do? Take into consideration that I am not married and have no children, so the decision was easier for me. If you have a valid fear, talk to others who have had the surgery and you will get a better perspective and can make a decision based on fact no feelings.

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?

All reacted positive to my decision. Each tried to be supportive and didn't realize that some of their comments may have been a little judgemental. I had a couple of people say things like "you have such a pretty face", which indicates that the rest of me is pretty much a wash. I heard someone suggesting that after I became svelt, that men would come calling. This insinuated to me that they felt that I wasn't married because I was obese, rather than the fact that I had made this decision because I enjoy the single lifestyle I live. There may be a time and a place later down the road when I will confront them with this and tell them that it came across to me as a form of prejudice. I know that they love me and want the best for me, but maybe they can learn to be a little more sensitive. My friends and family know that I have never been embarrassed about being obese; so they never thought that I might have some struggles on the inside.

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

I work in a church office and my co-workers are my friends and family. The board was very supportive and told me that I was not to use my vacation time to recovery from surgery, but approved that I have as much sick leave available to me as I would need. I returned to work after being off for 4 weeks. Probably should have taken the 6 weeks suggested, but I think it helped me in the long run. I know that this will not be a normal experience for others, but I found by getting people on your side and making them a part of your decision and being accountable to them, makes them open to help you. We limit ourselves by not reaching out to people because most of them are ready and willing to help.

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

I was at Scripps/Mercy in San Diego for 4 days. I felt that I had very attentive nursing care and because there were others who had just gone through the same surgery, I was able to determine my progress by theirs. They would tell me what would happen the next day, such as the pain level decreasing, and they were right. They were encouraging and there was a bond and comradery that is developed amongst Bariatric patients. In turn, you have the opportunity to encourage someone who had their surgery after yours.

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

When I woke up in Recovery, I had several people around my bed. I heard one of the nurses say, "She can't breathe on her own. Check her CO2 count." I'm thinking, "I sure hope they are able to help that person." It took me a minute to realize that it was me they were talking about. I wasn't scared because I saw that I was being well taken care of. They put me back on the respirator until the anestetic had worn off. It gave me additional insentive to make sure that I walked as often as I could to help prevent pneumonia.

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

It has been 1 week since my surgery and I went through a couple of days in which I doubted that I had made the correct decision. Part of it was that I hadn't had my hormones reintroduced:-) Once that happened, and I finally got to eat something other than the sugar free jello, popsicles and protein drink, my mindset changed and I knew that I was going to be alright. What really encouraged me is when I feel different areas of my body and realize that there really is something positive happening. While it doesn't always show up in the scales, I feel my body getting smaller.

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

I experienced a little depression (actually more like pitty parties), but once I returned to work (after 4 weeks) my time was occupied and things were a little easier. It took about 6-8 weeks before I felt real energy. I had lost 40 pounds by this time and the arthritis pain was getting better. As of 2-1-01 (3 months) I have lost 64 pounds. I don't lose weight every week, but it does come off. I would suggest that you only check the scales weekly. The body can't lose weight that shows up on the scales everyday, but it does come off. I am into the smallest of my clothes and will have to start adding to my wardrobe. I feel like I am losing weight all over my body and when walking towards double glass doors last week, I didn't recognize myself. That was a pleasant surprise.

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

I traveled from Bakersfield, CA to San Diego, CA (about 4 hours). It was great for those traveling with me because they got to enjoy the sites in San Diego, but it was a little expensive for me. I did get into a hotel that has an agreement with Scripps/Mercy Bariatrics, but I had to pay for 2 rooms because I didn't want someone hovering over me everyday. Also, I thought that I would only be in the hospital for 2 days and it turned out to be 4; so that was an additional $200 for the use of the room while I was in the hospital. If a person has someone with them who will be occupying the room during their hospital stay, then they won't feel like they are wasting money. I'm hoping that it is a tax deductible medical expense. (Update - only $50 of my room was tax deductible, nothing for the other) The location of the hotel was 1 block away from the hospital. That made it convenient for family to visit. They would just walk from the hotel to the hospital. Also made the trip home very short. I knew that if an emergency were to arise, that I was so close that I could be driven there in minutes.

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've been very lucky and really haven't found anything that I couldn't eat. The only problem that I have had is eating too quickly, then taking the dreaded "one bite too much". After you adjust to paying attention to the "feeling" of fullness and stop eating immediately, there shouldn't be a problem. I ate some refined sugar fully expecting to experience the "dumping" syndrome. Unfortunately there was no ill effects. I miss the feeling of being satisfied after a good meal. I just get started and I'm full. I'm glad I wasn't a comfort eater. I only eat the recommended 3 meals a day. On a couple of occassions I have eaten a hand full of popcorn or a few almonds, but try to remain pretty strict on not eating between meals. Drink mainly water. Find that the protein drink is the best help in losing weight for me. Went 3 weeks without drinking it and my weight loss slowed drastically. When I resumed, the weight came off quickly. Update 4-16-02 I really don't have foods that are off limit, but I do limit my fat intake. I've been very fortunate. Also, I am now satisfied when I have eaten my meal. I think that is more from getting used to eating smaller portions than the fact I can eat more now. You get used to only eating a taco or a small piece of meat with veggies, etc. I don't even think about it much anymore. Sometimes when I am hungry, I order what I used to only to find that I can't even begin to eat it. Usually when I dine out, I end up bringing home enough for 2-3 more meals. That should say something about how people are encouraged to overeat.

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

I walked on the treadmill as was suggested. I have not yet started a regimented exercise program. Pretty much just walking. I think the more weight that comes off, the more the arthritis pain lets up, the more active I will become. Update: 5-30-01 I have had to dispense with the treadmill as my ankles could not take the continued pounding. I now use a reclamation bike and it is much easier on my joints and low back. I'm not as consistent as I would like, but with the weight loss that I have seen so far (7 months and 98 pounds) I move more rapidly and find myself going places I didn't before, thus I am walking more than I did before the surgery. It might sound rather unorthodox, but exercise is exercise.

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

I took the dreaded "sugar free" Bugs Bunny multi-vitamin for a month. After I saw one of the Bariatric doctors, I was released to resume my regular vitamins. I have used MDR am/pm and stress formula for several years, and about 2 weeks after taking them, I noticed an increase in my energy level. I was told that I do not need to take a Calcium or Iron supplement. My blood test levels were all in the normal range and are being monitored closely by my doctors (and me as I have my lab work faxed to me). Update 5-30-01. I began taking a chewable calcium tablet and also resumed the B12 sublingual. After studying calcium in the bloodstream I realized that my blood would make certain to maintain its' calcium level, but where was it getting the calcium from? Until my lab work indicates high levels, I will continue with the calcium supplement.

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 have never had nausea or sleep disturbance. I am beginning to see a lot more hair in the sink, but I take comfort in the fact that I know it will grow back. Thinning hair is a small price to pay for the increased energy level and pain decrease. Update 5-30-01. I am right at 7 months and the hair loss has stopped. I am now looking at new hair beginning to come in. They say you lose it at about the 4th month and begin to regrow at the 7th. I hope that it isn't just wishful thinking on my part, but I think I see regrowth. Update 4-16-02 My hair has all grown back and is as thick as it ever was. I did intake a lot of protein and protein supplements, and while they may have helped, I think if you eat correctly it is inevitable that your hair will regrow.

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

Adjusting to the new way of eating, chewing and focusing on food all of the time. It is more routine for me now and I am eating to live rather than living to eat. Update 4-16-02. As I explained in an earlier question, I no longer have this feeling. I have adjusted to my new stomach capacity and it feels normal for me. I take bites of things rather than finishing things and have been satisfied and just expect to have leftovers. I usually will try to split a meal with a friend and that seems to be the best idea.

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

I didn't attend the support group until 1 month after surgery. It is helpful for me, but more importantly, we can provide support for those about to undergo the surgery. It would have helped me to know that what I was experiencing was normal. It would have relieved a lot of anxiety.

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

My scar is smaller than expected. I had previous hernia surgery and the incision had opened up and left a very wide scar. Dr. Rumsey did a great job of reducing the hernia scar. It gets smaller every week and never was anything that I worried about.

Please describe any plateau experiences you have had since surgery.

The longest plateau I had was three weeks. I thought I had done something wrong or had introduced too many different foods and my body wasn't going along with the program. I went back to the basics and concentrated on my protein intake. I dropped 10 pounds about 2 days later. Now I'm not so anxious about plateaus. They will happen and the body adjusts to the previous loss during that time. I can feel the weight going off before I see it on the scales. I didn't measure prior to surgery and now I wish I had. The tale of the tape will help during those plateau periods. Update 5-30-01 I do not lose weight on a weekly basis. I lose about 10 pounds a month, sometimes less, but am still satisfied with my weight loss so far (98 pounds). Because I have lost it slower than I expected to, one side benefit is that my skin does not hang. I look more toned than some of the women I know who have lost more weight faster. I won't have to have any follow up surgeries and I am grateful for that. Update 4-16-02 - While I am no longer losing weight (I stopped after 9 or 10 months - 120 pounds total) I am not gaining any and am eating more than I thought I ever would. I guess that I am lucky in the fact that I don't have very much trouble with food other than fats. I can eat meat, chicken, veggies, salads, etc. If I have too much mayonnaise or butter I feel a little queezy, but that is simply remedied, right?

Do you notice people treating you any differently now?

I'm getting a lot of attention at the office. People can't seem to stop commenting on how they notice the change. They are very encouraging and really go out of their way to support me. They are surprised that they can see the weight loss even though they are around me all day. I've been honest with them and told them that this is not an easy solution. It was a desperate decision for me, but one that I am glad I found the courage to make. I now know that I will be living my life rather than existing.