Alexandra

Well, the way it works at my surgeon's seminars is that there are people sitting right there ready to make your appointments for you. My surgeon's practice requires nutritional, psychological and physical evaluations, and if a patient hasn't already taken care of that they will make appointments for all of those things as well. Of course a patient who is self-pay will be able to move ahead much faster than one who has to wait for insurance to come through, but no matter what you'll have to do all the medical stuff just the same as everyone else. So, depending on how efficiently you and your doctors move things along, I'd say it's going to be a minimum of two or three weeks before surgery. And it could be much longer if it's a very busy practice with lots of scheduling issues.

The seminars I'm familiar with start out with a nurse describing the various bariatric surgeries performed by the practice (RNY, banding, whatever). This is a general description of the way the surgeries work and an overview of the aftercare and what makes a good candidte for which procedure. Then there's a discussion of insurance issues, followed by testimonials from post-operative patients. At the end the surgeons get up and answer loads of questions from the audience. Your seminar may be different, but it's probably aimed at the same goal: to make sure that the patients have a good grounding in the information they need BEFORE they get into a room with the doctor, and waste his very expensive time asking about the basics. If you already know which surgery you want to have, this seminar may feel like a waste of time to you. But it's a great time to get a better feel for the surgical practice, get to know the people and see how they treat patients. Meet some postops in person and ask them what their experience has been like. You'll think of loads of questions as you listen to the seminar, and in the end you'll be glad you went.

I also have hypothyroidism, well-controlled by meds. No one ever said anything to me about difficulty in surgery, but my docs did require that my levels be stable and controlled before scheduling surgery. It's important that it be managed, because if your levels aren't responding to meds there may be something else wrong. Get it checked, don't be sorry that you didn't take the extra step to make sure you're as healthy as you can be before having surgery. Good luck!

Personally, I wouldn't send something like that unless I had some indication that it was going to be needed. It sounds defensive, and might get the relationship off on the wrong foot. Do you have any reason to think they'll be anything less than cooperative?

Wow, Angel, that sounds PAINFUL! I hope the lancing helped and it's all healing up now. It is true that an infection at the port site is often the first indication of an erosion, but the two are not inextricably linked. Obviously you need to have more testing done to set your mind at ease; nothing we say can alleviate your worry. Stress can increase restriction all by itself, so worrying about what's wrong with your band could be what's increasing your tightness. But there's only one way to be sure. Have you had a fluoroscopy done recently? What about an endoscopy? These are tests your doctor should prescribe to find out what's going on with your band. What's your next step?

This is just a payment-processing service, nothing more. Any doctor willing to make this payment arrangement with a patient would be willing and able to do it with the patient directly. I'd say save the service fee and work out the payments with the doctor.

I'm another one who never had maternal urges, at all. I truly didn't understand the allure of children or how I'd ever come around to wanting any. That was fine with me. But when I met and married my "real" husband (after a brief, unhappy marriage in my 20s), things changed. As time went on the idea of completing our family became real to me, and it was a big surprise to find myself actively wanting to have a baby. But like Wheetsin, I'd resigned myself to the possibility that it might never happen--and I was fine with that, too. After 18 months of trying I finally got pregnant, and had my first baby at 36. I'm still TOTALLY non-maternal. I feel like these two girls have been plopped into my life and I'm just borrowing them for a brief time. My job is to keep them safe, clothed, fed, and let them grow and explore. It's not always fun, but it's added a dimension to my life that I truly never imagined could be there. So I'm just going to be an old biddy and tell Laurend to keep an open mind. You have a long life ahead of you and hey, you never know what might happen. :biggrin1:

Hi Dave, Every doctor has his or her own regimen, and I'm sure you'll get instructions from yours as the surgery approaches. Immediately post-operatively, you'll be told to stay on liquids for some length of time (usually somewhere between three days and three weeks), followed by soft foods or "mushies" for another few days or weeks. This period of avoiding solid food is very important for healing purposes; the less your stomach has to work while it's healing, the better chance your band has to stay where it's put in the long run. Once you're all healed up from surgery, there is no specific eating plan. Recommendations are like those of any weight-loss regimen: eat high-protein, low-fat foods in small portions. The difference with the band is that this diet will actually be satisfying, once you get used to the way it feels to eat as a bandster. It won't happen overnight, but if you allow it to teach you what "enough" feels like, you'll be able to eat much less than you're used to doing and still be satisfied. And you'll lose weight!

Fear of death is a uniquely human phenomenon. It has kept me awake on some nights, indeed, though as I age it gets easier and easier to face. The thought that brings me comfort is that death is the ultimate shared experience--every single living entity that has ever existed has faced it, and I am no different. My long line of ancestors have all gone before me, and so too someday my day will come. It is just how it is. I find comfort in knowing that however special I may think I am, the fact of the matter is that I'm just another human like everyone else. The highest of the high, the lowest of the low, we all come to the same thing in the end. All that matters is the here and now.

Dorin, I'm glad you were able to get professional care for your band, and I hope this fill leads to the weight loss success you want. Clearly medical standards vary from country to country and we all have to work with what we have. It's not "spoiled" to expect competent professional medical care from our providers. I'm just sorry Romanians don't have access to the same.

Coughing by itself is very unlikely to cause slippage. What's much more likely is that the soft tissues in the pouch and esophagus are irritated and causing increased restriction and discomfort. That's VERY possible. So take it very easy--go on liquids for a few days until the illness passes--and then see where you are. Good luck and I hope you feel better!

A loss of restriction is not necessarily a sign of disaster; please don't panic. Several things may be going on. If you're really concerned go see your doctor! I believe that after a couple of years we lose some sensation at the base of our esophagus, or the nerves at the top of the stomach get less sensitive. Whatever the exact biological mechanism, it's just a fact that long-term bandsters have to be more alert to their stop signals, and ever more careful to not overeat. Nothing at all may be "wrong" except that you're moving in to a new phase with the band and have to learn a new set of realities.

Just so no one panics: I totally agree that this situation should be brought to a doctor's attention as SOON as possible. But residual blood in vomit doesn't always mean a life-threatening emergency is taking place. I had esophagitis last spring and had two episodes of the coffee-ground thing going on. It sure is scary, I'll say that, but the NP and gastroenterologist I saw about it both said it's not uncommon with the level of irritation I had. No treatment beyond an unfill and Prevacid was called for. Everything was fine. So don't delay a call your doctor, but don't panic. Just do everything you can to resolve the irritation until you can get a firm diagnosis and treatment. Stay strictly with liquids and avoid anything acidic. Ask for a prescription for the interim that will calm things down. Good luck, and please let us know how you're doing!

I just finished reading this thread, and I agree it's served its purpose. I'm going to lock it, but leave it up so anyone searching for information on doing one's own fills will find it. Bottom line: DON'T do your own fills. Even the most qualified band professionals say they wouldn't do their own band adjustments, and that's excellent advice.

Hi Leenerbups! Sorry to have missed this thread. Now that you have an aggressive fill, BE CAREFUL! Take it really slowly with solid foods; chewing carefully isn't all that matters, you also have to really wait a while between bites. This is the hardest thing for me--still is, even 3.5 years out. Good luck with this fill! I hope it sticks this time and you find the help you need to lose weight.

Annette, you should always start with a complete physical at your primary care doctor's office. It's crucial to get a good picture of your health before you start, and every subsequent doctor is going to want to know that you've done this. It's required by surgeons and every insurance carrier as well, and you'll probably need a letter of support by that PCP if you're asking for insurance coverage. When you go, be sure they make a note of the diagnosis of morbid obesity in your file. The diagnosis code is 278.01, and that's the very first thing anyone down the line is going to want to see in your record. The earlier it goes in there the better.

I agree completely. :clap2: :clap2: :clap2:

:nod: :nod: Very nicely said, Sunta. I'd like a bumpersticker that says: I believe in God, I just spell it N-A-T-U-R-E.

Yes, your esophagus SHOULD be pushing food down and through, just like it's supposed to do in everyone. The small stomach pouch, above the band but below the esophagus, is where the food is supposed to sit and keep us feeling full. There's a valve at the base of the esophagus that is supposed to keep food from rising back up, and that valve may be made dysfunctional over time if this process continues. If your band is too high, the pouch may be too small or absent altogether, which means your eslphagus is being used as a pouch no matter how careful you are being.

Nykee: food is sitting in your esophagus and is not going down, that's why it's so easy to make it come back up. This means that your esophagus--which is a muscle--is not efficiently doing the job of pushing your food down toward your stomach. The problem is that the esophagus is NOT supposed to hold food in it for any length of time. That's why you hear of people's esophaguses becoming "dilated" in some cases; it has expanded to accommodate the holding of food. This is a common issue that people can have, but it's not good and should be addressed. In normal circumstances, it's very uncomfortable for there to be any food that hasn't gone all the way down. Everyone's familiar with that sensation--think about how that felt before you were banded. That's why we'd drink while eating--to wash the food out of where it's not supposed to be. But when someone's been banded a long time, it's possible for our esophaguses to both lose a bit of their function AND lose some sensitivity. We have to be more careful than ever that we don't overeat and pack our pouches, because we're not as sensitive to the feeling of "too much." The way this can cause damage is by wearing at the lining of the esophagus, leading to an increased risk of esophageal cancer. I'm not saying it's inevitable, but that is a HORRIBLE disease and an increased risk is something you really don't want. I'm sorry, I don't know much about hiatal hernias, except that people who have them before banding have to have them repaired either at the time or banding or prior to banding. It does not seem that having a hiatal hernia is compatible with having a lap-band.

Hi Nykee! I can sympathize, it's really frustrating sometimes. Your band may indeed have slipped, or it may not. Either way you have to address this issue for reasons other than weight. You don't want to damage your esophagus because that can lead to future problems that are way worse. Since you have esophagitis give Prevacid a shot. It will ease the inflammation and can help settle things down so you heal. And you have to figure out how to get the nutrition you need without upchucking--repeated PBing (which is what you're doing) just makes the problem worse. Stick to Protein drinks and yogurt/other mushies until you are sure this problem is kicked. From what you say it sounds like you'll need further medical attention. An endoscopy will diagnose erosion or a bad slip. Also, I don't believe a hiatal hernia with a band is something that can be ignored. Good luck and I hope it gets straightened out soon!

When I unexpectedly lost my dear, dear father, for a while I honestly did not feel like I could go on. It was a tragic blow like no other I've felt before or since. It felt utterly incomprehensible that I would never see him again, and to my surprise the glimmer of a "faith" in an afterlife emerged. It did seem that I had a nugget of pure rock inside me, solidly reassuring me that we would meet again. It's the closest I ever came to feeling religious. I can completely understand how, at such times, people find comfort in their faith. This feeling did, indeed, fortify me through the painful time of adjusting to life without my best friend and advisor. But time passed, pain retreated, and that impression born of sudden tragedy faded. In fact, my father DOES live on, inside me. He taught me what I need to get through life; I am who I am because he was my father. I dream of him often, and in my dreams he's met my daughters. Whenever I think of him, I still feel the hugs he was so generous with in life. So rather than wallowing in sorrow, in time I found myself being thankful for what he gave me, feeling sorry that he left us so soon. I believe that "nugget" of belief in an afterlife that I felt was an instinctive, natural human reaction to sudden loss, and there was nothing supernatural about it. It did help me get through a very difficult time, indeed. (The resourcefulness of the human brain is amazing!) There have been other sorrows and trials in my life, certainly. In every case I cope by turning my attention to the people who need it, and handling details of whatever business is needed. When I'm very stressed I retreat to my bedroom and have a good cry.

Hi Jodie, I've had what you describe, and also had the upper GI test. There was no slippage but I did have esophagitis. The cure for that was liquids for a week, a precription (they gave me Prevacid, but others probably work) and a complete unfill. Try sticking to liquids for a good long time, and ask your doc for a scrip. Antacids work in different ways and some just don't do the trick for people. It's worth finding one that works for you.

Except "religion" in my statements does not equate to Christianity, and "rational" does not equate to "smart." So your analogy is off the mark. Of course I can grasp the concept. I just don't believe in it. Yet there were people in those times who were able to make those leaps in purely rational ways--the scientists--and it would now indeed be possible to explain the Internet to my ancestors, using purely scientific terminology and without relying on anything supernatural to fill in gaps. Gotta go to bed now. Have a nice evening!

There is room in the same lifetime for both rational and irrational pursuits. It's what makes the human mind so awesome. And it's not mutually exclusive to serve a deity and our fellow men--but elected officials and ministers have to choose one over the other. I don't see how both could be on top. No, I am not saying that I view anyone as being an irrational person, necessarily. That would depend on their actions and the extent to which they let religion govern them. There is room in the same lifetime, and in the same person, for varying frames of reference to be operational. As I said, the human mind is awesome that way. :biggrin1: