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

From a friend at work and on TV. Then I started to research the surgery on obesityhelp.com. All the information I needed was there. At first it was scary, which surgery is, it is an invasion of your body. Also there is always the thoughts that how pathetic I am that I have to go to this extreme to lose weight. The nutrition part of it scared me, as a nurse, I know to much about the body and its needs to function properly. The common sense person in me wanted to run and hide but the fat person in me wanted to run as fast as I could to have it done.

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

My husband's insurance would not approve the Lap Adjustable Gastric Band because they said it was still experimental but it would have approved the Gastric Bypass surgery. My insurance had just started approving for this surgery so I had no problem with them. Insurances need to consider preventative medicine. If they would consider how much they would save overall in a persons insured lifetime what they would put out for all the health problems related to obesity the initial cost of the surgery would be minimal for them. They could save alot of money overall by approving the surgery.

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

The first visit was a group meeting for general information. The doctor had overbooked people so he had very little time to talk detail or personal concerns during our individual sessions with him. People need to be aggressive, this is your mind and body and you have the right and obligation to have all your questions and concerns answered for you. We must insist that this is done. Doctors are not unapproachable Gods, they are humans beings and are providing a service. They are obligated to teach and help us.

What made you finally decide to have the surgery?

As a nurse, at 48 years old, I was finding that my health was worse that some of my patients at 70 years old. It was getting harder and harder for me to get around, walk the halls and give the care that my patients deserve and expect. My dream job was becoming a challenge due to the physical requirements. I wanted to live to see my grandchildren born. I wanted to live, plain and simple, I wanted to live.

How did you decide which proceedure to have?

Because of my health problems, diabetes, heart and blood pressure my doctor would not approve of the gastric bypass and I did not want my body altered that drastically. So I researched the Lap Adjustable Gastric Band and gave him copies of the research and we both decided this was the best surgery for me. My doctor's and my biggest concern was with healing, since I am a insulin dependent diabetic on large doses of insulin it effects healing and recovery.

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?

This was one of the biggest fears, not waking up from surgery. This is a big concern for many people. I had also just heard that a woman died from a leakage and infection from it. That really scared me and it took me a couple of weeks to get the courage back up to continue my research. Since I have multiple health problems such as , sleep apnea, asthma, diabtes and cardiac that escalated those fears ten fold. As a nurse we have a saying, if any complication will happen it will happen to a nurse. I want to put people at ease. It was so much easier than I had imagined. Those doctors would not consider any patient they thought was too high risk for the surgery. Pick a surgeon that has done many of these surgeries and has a good track record. Talk to him, gain confidence, ask his former patients and do a lot of research about the procedure, the doctor and the hospital. I felt so much more at ease after I had done all that. All our fears are, for the most part, unfounded but it is only human nature to imagine the worst and to fear.

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 was very apprehensive at first. He kept saying I love you no matter how you are. But I did not love myself and I feared for my health. After I had done all the research and talked to the doctor my husband was more at ease with it. He also knew I was determined and he just wanted me healthy again. My family were all scared but again were worried about my health. My friends were apprehensive and at first some of them did not support me. I think their fear over rode their common sense at that point. Now a lot of them are looking into having the surgery also. At the time I was researching and talking to my friends and family about this surgery the media was having a hay day with the few complications some people were having at that time and of course they made it sound much worse that it really was. My family and friends are very supportive and keep in touch for progress reports.

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

I had a lot of support from my assistant director of nurses. She knew about the health struggles and she is a nurse. I told them from the beginning what I planned to do and that I would need some time off. All my fellow nurses were wonderful support. I was off work for 3 weeks. I could have gone back in 2 weeks but being a nurse I do a lot of lifting and I had some minor complications post op that took me another week off to get through. I was of course tired and my energy level was low but that is to be expected.

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

The hospital I was at was very understanding and prepared. They had special beds for BMI's over 50. The bed was amazing and easy to get in and out of. They were all very supportive and understanding. I was there for a little over 24 hours. Bring things to read, personal items, loose comfortable clothes to go home in, a house coat and slippers and a personal radio or CD player with music. Most of all bring your self determination and confidence with you.

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

I had a post operative incisional bleed. My hemoglobin went from 12.8 preop to 9.1 one week post op. My incision just oozed continuously for a week. I applied pressure dressings and changed them several times a day. As a nurse I should have contacted the doctor but I thought I could manage it on my own. I had horrible nausea after surgery so I got dehydrated which with the blood loss just all became a cycle. I should have gone in for some IV fluids but was stubborn and determined not to give up. It all resolved with determination and perseverence. I forced myself to drink and I did take oral iron to bring my hemoglobin back up since I could not eat the foods needed to do that.

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

My family, friends and doctor were my rocks. They all helped ease my anxiety even the friends that were not at all sure I had made the best decision. After I made the final decision and made my consult date I really felt good about it. I talked to people that had gone through the surgery. I emailed people on obesityhelp.com and that was a big help. I just wanted to hurry up and get it done so I could start seeing the results.

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

For the most part most people do very well. I had a slow start because of my compications but lost 51 pounds the first month. After the first month was over and the nausea and other problems disappeared I felt great. I could eat almost anything in moderation. You just must learn to listen to your body. All the signals change and your body tells you what is happening to it. Don't hesitate if there are any questions or problems call your doctor. Stay active do not be a couch potatoe.

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

I had to go to Scottsbluff which is an 8 hour drive from where I live. It was the only place, at that time, that was doing the Lap Adjustable Gastric Bands in Nebraska. The doctor goes to Ogalalla once a month for appointments and to do consults for this surgery which is a 4 1/2 hour drive so they arranged it so we only have to go there every month for the aftercare. It is a long drive but gives my husband and I time together which is a plus.

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 only had liquids the first week, such as, jello, tea, coffee, juice and cystal light. I started introducing bland semi solid foods after that, such as, cream of wheat, creamed soups, cottage cheese, protein drinks and milk. With in 4 weeks after surgery I start introducing very tender small amounts of meat, lettuce and veggies. I have never handled bread very well, at times even dry toasted bread does not work. Everything must be chewed very well. Now, 3 months post op I eat almost anything. Your body will tell you if it was the wrong thing very quickly. I can not drink carbonated drinks they burn all the way down. I try to avoid caffeine as it stimulates appetite. Some meats are too stringy or dry to make them comfortable to eat. I only order the appetizers when we go out because I can not eat a whole meal. I avoid alcohol because I heard from others that it really affects you quickly and harder. Some foods are too rich and are hard to digest or feel like a lump sitting in my stomach. If I over eat I feel miserable and can't eat for 12-24 hours after that.

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

Since I had the complications my enery was minimal but I forced myself to get up and walk around the house as often as I could for the first several days. As I regained my strength and stamina I started back to Aquasize 3 times a week, which is the best exercise when you are overweight because it supports your weight and you don't jar your body. I was having trouble with fatique for about 4-6 weeks after surgery but that is very normal. It is essential to keep as active as possible.

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

I take calcium and 2 Flinstone complete vitamins a day because they are chewable and just work better. I had to take oral iron for two weeks post op.

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 the worse and it lasted for 4 weeks after surgery. The doctor said that was not a normal complication for that long of time. They had taught us not to avoid vomiting because it can cause problems with the band. I vomited twice in four weeks. After the doctor and I figured out the problem I now know what to look for and what not to do to avoid that problem. I have no problem with dumping syndrome in fact I have a slight problem with constipation if I don't drink enough liquids. I have very minimal hair loss that I have noticed. I have never had a good sleep pattern so that is no different. I have had to learn what foods my body tolerates, to chew slowly and completely and to take my time eating.

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

I do not appreciate pain or losing control of my body or the sitution around me. So giving up control, having to ask for help and dealing with pain and nausea was the worst part. I have learned that you must give up control at times to get control of your life again. I have learned that the pain is minimal to the lifetime of pain I have indured up to this point and it is only going to get better with time.

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

Since the only support group at the time was 90 miles away we started our own in our community. The hospital I work for lets us use a room once a month. It is very helpful. We all talk about our experiences and successes. We give each other ideas and hints. We exchange nutritional information. We try out new products. We have people come talk to us about exercise, nutrition and plastic surgery. It is very important to be able to relate to people "that have been there and done that".

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

It is only 3 inches long plus the other faint red marks due to the Lap procedure. It much more minimal that an open procedure and a lot less scaring. The incision is a little more raised and red than I thought but it will fade more in time and it took a little longer to close and heal

Please describe any plateau experiences you have had since surgery.

I have had 2 plateau's since surgery. The support group helped there because everyone has them. They can last from a couple of days to several weeks. They are frustrating but you just keep plugging along unti your body resets its metabolism rate and you start losing weight again. The doctor talked to me about them and they are normal and to be expected. All people that diet go through them too. Don't let them discourage you or defeat you. Let them make you even more determined to overcome them.

Do you notice people treating you any differently now?

I have noticed some difference. I have only lost 70 pounds so I have a long way to go yet but it is a welcomed change. I notice a lot of people and doctors staring but not sure what to say. I just smile and go on my way. If they ask I talk to them about it. It is still not very common in my small community so I am almost a lab speciman to some people. That is fine, they can watch and learn. I am very willing to teach them about the process. Even with the weight loss I feel it should not have been a factor in how I am considered, it does not make me anymore itelligent or it does not make me more of a person in any respect. I am the same person inside.