FAQ's

Were you sick for a long time after you had the surgery?
Well, that counts on your definition of sick. Within a week of being home I was off all my pain meds and was moving around the house very well. I lost over 100 pounds in the first 5 weeks so that made a big difference in my mobility. And if by sick you mean vomiting....well sometimes I still vomit! Vomiting is all part of the process. One reason why my surgeon asks us to stay home for 6 weeks is to relearn how to eat. If I vomit it's most often my own fault. I ate too fast, I ate too much, I didn't chew well enough...all things that will get food stuck.

About how long was it before you could sleep in a bed?
I tried to sleep the first night home in my bed and was pretty miserable. I spent the next 3 nights in my recliner and after that was ok in bed. The only real problem with the recliner was that once I was fully reclined, I had one heck of a time trying to reach the lever to get out of it! So a word to the wise...be sure you have absolutely everything you think you will need before being tucked into the chair for the night!
Also, I had problems with drainage, and if I slept in bed then sometimes when I moved lots and lots of fluid would come gushing out of me. At 3am, that could be somewhat inconvenient, so there and there I would sleep in the recliner. Couldn't roll over so everything pretty much stayed where it need to stay.

Can you drink any carbonated beverage, if so how long was it before you could?
Can I? Well I suppose that physically I could. But will I? Nope! Carbonated beverages are out of my life. I have no problem with that. Bubbles are are part of my morbidly obese life. I can and do live very well without soda, beer, champagne etc :o) This was a trade off that I willingly made.

Will I ever be able to eat normally again?
Sure you will. But it took you a lifetime to become morbidly obese and get to the point of where you would have surgery in order to live, in order to control your appetite. It will take time to learn how to eat again. Time to establish a new relationship with food. You will find that what is normal postop is nothing like what was normal preop. You will actually crave good, nutritious foods. Pouch space is limited and you won't want to fill it with garbage.

Was the operation and recovery very painful, about how long did it take for the pain to go away?
Well, this is after all major surgery, so pain is to be expected. In the hospital I was on a PCA (patient controlled analgesia I think) and hit the button pretty frequently. I came home with Roxicet (a liquid percodan) and took that for maybe a week, mostly at night because for some reason I can deal with pain during the daytime but it gets bad at night. And something I've learned in subsequent surgeries is that narcotic painkillers will constipate you. And that can be pretty darn ugly! Ok, back to pain.....to tell the truth, I've had worse cramps. I mean, this hurt...make no mistake about it. Sometimes I would move the wrong way or make a sudden turn and get a sharp pain. But it was gone in seconds. A nagging throbbing pain? Didn't really have it much, except maybe while in the hospital.

When were you able to go through a daily routine with out having to worry about ripping something open or anything like that?
Well first you have to remember that at 500 pounds my daily routine mostly was eating and sleeping. Physically I wasn't able to do much of anything. The one thing you can't do is lift or pull anything over 5 pounds. Because it is major abdominal surgery you need to be careful of hernias. But I'd say that within the first week to 10 days of being home that I was getting more energy than I had in years!

Would this surgery in any way affect me being able to have children?
Many folks write me about getting pregnant postop, if it's a good thing or if it will ever happen. First of all, this surgery has nothing to do with your reproductive organs so in no way will WLS interfere there. However, it is strongly advised by most surgeons that you not try to get pregnant the first year postop. Matter of fact, some sort of birth control is a good idea.

One reason pregnancy isn't a good idea right away is that your body is going through some major changes. You could certainly get adequate nutrition in for yourself and a developing baby, but again...so many changes...why complicate matters with a baby at this point. The first year you will lose most of your excess weight while learning how to eat and act around food again. And here's the good/bad news. Because of the rapid weight loss, estrogen starts racing around your body...making you super fertile. That's why birth control is so very necessary. Give your body a chance to get used to the new you before you ask it to support a pregnancy.

Several women in my live group were pregnant before and after their WLS. They all had an easier and healthier pregnancy postop because for once in their life they were making good nutrition choices.

Do you think everyone's scars are as bad as yours?
My scars are bad?? Gee, they were pretty much the same as everyone else's! Matter of fact, mine looked nicer because Doc didn't use staples with me. Just steri-strips. Granted, at 500 pounds I was wider than I was tall. My waist measured 70 inches and my height was 65 inches! So my incision was big cause my belly was big! But that scar is gone since I've had my reconstructive surgery. Scars fade, fat stays forever!

What can you eat now?

Pretty much anything I can tolerate. The exceptions are any carbonated drink (as it could burst the staple line), corn, celery or raw string beans (any stringy vegetable) and chewing gum According to my surgeon gum gives you gas and could also rupture the staple line. Different surgeons say different things...this is what I've been taught and this is what I go by.

I avoid anything that has sugar as one of the first three ingredients because I don't want to have dumping. I've found that anything over 10 grams of sugar will make me dump. Red meats are very difficult for me to get down, so I pretty much stick with chicken and fish. (As of 2002,; I'm having troubles with chicken and turkey so pretty much eat lots of veggies, fish and salads. Nothing bad, just meat in general doesn't agree with me right now. Hopefully it will come back to me, but for now it's not my friend!) Bread and rice seem to triple in size in my stomach so if I eat them I am very very careful to eat small portions and not to overdue it. I'm now 5 plus years post op, and this all still holds true.

How much does the surgery cost?

Dr Fisher's answer to that one is less than a new car. Here it averages from 18K to 21K but with the cost of malpractice insurance in Nevada I wouldn't be surprised if the price increases. I was lucky, my insurance covered almost everything. I had to pay my deductible ($1500) and Dr Fisher's fee for the panniculectomy. The insurance company felt that this was cosmetic surgery and though we appealed it three times they refused to pay for it. Hard to believe since my apron of fat was just about hitting my knees. I had no lap to speak of. What they did agree to do was pay for everything but Dr Fisher's fee for the tummy tuck. They said that once I was in surgery they wouldn't separate them and say ok, gastric bypass is done, now start billing for the tummy tuck. So all the anesthesia and other fees and services were covered.

I firmly believe that if this is the answer for you and that if it is

something you want, you will find a way to pay for it.

Borrow from relatives, take a second mortgage on your home, don't buy that new car, take a personal loan, put it on your credit card, borrow from your retirement. This will save your life! And if it was for your child or a loved one you would find a way to make it happen. It's for you so for once in your life, put yourself first!

How long did it take you to get approved? Did your insurance company pay? Who were you insured with?
I was approved for surgery in about 3 weeks. At the time of my WLS, I was insured with United Healthcare. Honestly, they were great. Even though they didn't pay for the panni, they did pay for everything except the surgeon's fee for the panni. That includes my entire hospital stay of 5 days as well as the visiting nurse I had (wound complications) and all the dressing supplies I needed at home as well.

Will my insurance company pay? What if they don't, what can I do?

That's something you may be able to find out right away. If you have a copy of your benefits book, go right to the exclusions section and read the fine print. If it says something like surgery for weight reduction is specifically excluded...well you are pretty much dead in the water. But it may say those magic words...may be approved with a diagnosis of morbid obesity under medical necessity. Now that's something workable.

You can also call your insurance company and just ask of gastric bypass surgery is a covered benefit. It's not like this will raise a red flag to them. They won't mark your file. Just ask, see if they can send you any documentation, or tell you where you can find it in your book or on the internet.

Can it be reversed?

I hear this all the time and my reply is, "Why would you want it to be? Heck, my cardiologist even asked me that. My reply was if you replaced a bad heart valve, once I got to feeling better and got my health back, would you then remove the "good" valve and put it back to the way it was? I want you to understand that this is a permanent change to you. This surgery will effect the way you eat and respond to food for the rest of your life. And for many of us....that's going to be a long, long time! Certainly there are exceptions to the rule. Dr Fisher explains at his seminar that though it can be reversed, your tummy won't be the same as it was before surgery.

Is it healthy to lose weight that fast?

I like to answer this with the question, "Is it healthy to weigh 500 pounds?" Let's face it, as long as I had water I could probably live off my fat for a year in the Sahara desert. My body has been storing up reserves for the famine for a long time. Unfortunately, that famine never came. Initially I was losing about 30 pounds a month. After I lost my first 150 it slowed to 15 to 25 a month. Now it's coming off much slower, probably about 5 to 10 a month. Of course the more you have to lose the more you can lose. My BMI went from 87 to 28, so less of me is fat now. Now I have to work hard for every pound I lose, but that's a good thing. If it continued to come off easily I believe that it would also be that easy to gain it back.

Can you gain your weight back?

You bet I can! If I ate the wrong foods or consumed sugars (ice cream, shakes, puddings) it would go back on quickly. That is one reason why it is so important to limit the portions of food and the amount of time it takes to eat it. If you pick all day, the weight will go back on. Again I need to stress that this surgery is not a cure for obesity. It simply gives you a tool that can restrict the way you eat. You alone determine what you put in your mouth. If you eat the wrong things, you gain weight. If you choose to listen to your body, eat healthy and make smart choices you will lose or maintain your weight.

How long were you in the hospital?

I had the open procedure RNY. I'm not divided. At the time of my surgery I agreed to be part of a study so didn't find this out till I was 2 years postop. I was admitted on Monday morning and discharged on Friday. But remember too, that I had 2 surgeries. The RNY and a panniculectomy. I was NPO till Wednesday and was petrified to eat my first meal! Now you get out of bed the day of surgery and get your first liquid meal the morning after!

How big is the scar?

Everyone asks this! My incision goes from just between my breasts to just above my pubic bone, then side to side, similar to an anchor. In 2 years it had faded tremendously. I had no staples or stitches, just steri-strips. All the stitches were inside. Yes it itched, still does some days! But to tell the truth, I am attached to my scar. Its a sign of where I've been and where I'm going. The only people to see it are my husband and doctors. I'm 47 years old, let's face it, my bikini days are ancient history! (as if I ever wore a bikini...lol) Also remember that at 500 lbs, my belly was pretty big when I laid down. I was probably 2 feet high laying down, so he had a lot of cutting to do to get where he needed to get.

I wrote the above before I had my reconstructive surgery. I know have a smaller, finer scar. My RNY scar is history as is my excess skin. Click here to see the pictures from my plastic surgeries.

How long were you out of work?

I was out of work for nearly 10 weeks, but that was due to the problems I had with drainage and my incision. The average time is 6 weeks. Dr Fisher feels that while you may feel well enough to go back to work sooner, it's important to take the time to learn about eating again. If it's possible for you, try to take the whole six weeks off. Remember to put yourself first! For once in your life, it's all about you :o)

What about the pain?

Yup, there most definitely was some! In the hospital I was on a morphine or Demerol pump. I'm not sure which it was, just that it worked well! When I was discharged I had a prescription for a liquid percodan (roxicet). It had to be liquid because it's next to impossible to take pills right away. I stayed on that for the first week home, pretty much just at night. The pain is due to the incision. Internally nothing hurt, so as you heal the pain gets better. I've had worse cramps but if I moved the wrong way, it hurt like hell. But just for a few minutes, then it was gone.

What about side effects?

Well, due to the amount of vomiting I was doing, staying hydrated was an issue for me. I had to remember to take teeny, tiny sips of water. No more big swallows! I'm sure you've heard about dumping by now. And if not...then check out the glossary! I have found that I can tolerate very small amounts of sugar. Anything over 10 grams of sugar has the power to make me dump. And that's something I don't' want to do!

There will be hair loss for the majority of folks. Mine started about 2 months post op. This has to due with protein. Your body would rather take any protein it gets to use for things like your heart. It sees hair as a luxury. I was losing handfuls every day. This went for about 6 months, till I could start eating regular foods again. It wasn't like I had bald spots, but it got very thin. (the first thing on me to get thin!) For a while I had the punk thing going, short spiked hair on the top as it grew back. And that's the important thing to remember, it will grow back! Also when you are in the rapid weight loss phase you are also more prone to gallstones. If you had them to start with, your doctor will probably remove your gallbladder at the time of your bypass. Dr Fisher prescribed Actigal for me to lessen the chance of gallstones.

What about the excess skin? Can you have plastic surgery?

No one can tell you what will happen to your skin after WLS. We are all different and have lead different lives. Part has to do with how much your starting weight is, how long you carried that weight, how many diets you were on in the past. Was your skin stretched, shrunk, stretched over and over from diets? The overall condition of your skin, how many times you got bad sunburns or how often you tanned. All this effects the skin elasticity. Exercise can help but only so far. Think of your skin like a stretched out rubber band. It's hard to get it to go back into it's original shape after a while.

It's different for everyone so it's so hard to say what will happen for you. I was very, very lucky and my health insurance paid for all my reconstructive surgery. It wasn't easy and I had to appeal but in the end I won! Bottom line...what matters is your body image. If you hate your excess skin and obsess about it, then you will do something about it. On the other hand you may decide that you look great in clothes and are ok with yourself naked. That's ok too! It's truly a personal choice.

What can you tell me about iron and iron deficiency?
I know that some people have no troubles with iron and others do. I'm one of the ones who do. I am unable to absorb iron from my food or from any type of pills. Not really clear on the specifics, but I know that the part of intestines that is bypassed on me is the part that would absorb iron. Now it took me quite a while to become iron deficient. Seems to me about 6 months out I was put on prescription iron. I had terrible side effects (bloating, tarry poop, cramping) and altogether feeling miserable. Slowly my ferritin level kept dropping till I was sent to a hematologist for my first iron infusion. It became apparent that oral iron was doing me no good.

I met with the doctor, and we discussed my situation. She is experienced with WLS patients. The first infusion I got a double dose. And it's basically the proverbial piece of cake! I came in around 10 am and was taken to this room with recliners, bathroom and TV. The nurse started an IV and explained that although rare, some people have a reaction to IV iron so they first give you a dose of benedryl and a test amount of iron. If all goes well the infusion starts and you also get a Tylenol. I forget exactly why the Tylenol. Invariably I fall asleep from the benedryl. Nap, read, nap, watch TV. That's pretty much how the time goes. It takes anywhere from 4 to 6 hours. So pack a lunch, take a good book, water, and maybe a Walkman.

Would you do it again?
I would do it all over again in a heartbeat! I would do it without anesthesia.....on my kitchen table.......with a rusty knife.....holding a flashlight in my teeth, every single day for the rest of my life!!!