GeezerSue

Shackdog, it COULD be "willpower," but it just as easily could be a dopamine irregularity. A Parkinson's drug turned otherwise non-compulsive, non-gambling people into compulsive gamblers. It is also involved in all of the excess behaviors. http://www.mayoclinic.com/health/parkinsons-disease/BN00043 I'm betting that we will learn that dopamine plays a FAR bigger role in any compulsive behavior than we imagine...which also explains why compulsive eaters become compulsive drinkers, or compulsive shoppers or compulsive sex-mongers (seemed like the right word for male or female) or compulsive anything-ers. Also due to the fact that a good number of MO people are very much in contro in many other areas of their ives...I think that it's something FAR bigger than willpower.

Generally speaking, things that melt at room (or body) temperature will go down faster/easier than things that don't. So, cheesecake will take a little longer than, say, ice cream. Really, though, the band is not very helpful with these things. It was meant to help with the second turkey drumstick, the third slice of meatloaf and the fourth piece of chicken. If you do not have a way to address this particular facet of your eating you COULD be in for a challenge. The band works BEST at making you unable to eat large quantities of solid food. If you "switch" to lobster bisque and Peanut Butter cup ice cream...you may not see the kind of progress you are hoping for. The band COULD BE just what you are looking for...OR you COULD BE someone who will feel a need to "eat around the band." Talk to yourself...listen to your answers..and good luck!

Oh, Jack...you are too kind. My "price" is that I DO have to make time for those three or four bathroom trips every morning and that I worry a lot about the LONG-TERM effects of malabsorption. (Also, I carry the very small can of Ozium and some flushable wipes in my purse, "just in case." I almost never use them, but they make me feel "safe.") I'm sure people treat me differently, but I can't claim that any difference is based on their shallow reactions to my outward changes...I think that my physical presentation of myself to the other residents of the planet has changed. On another thread, I posted: HOWEVER...the other night, my husband and I were walking to the elevator in our building to go somewhere and he disappeared. I stopped and looked over my shoulder and saw him behind me...down the hall...and asked, "What's wrong?" "Nothing," he said. "Aren't we going down to the garage?" "Yup." "Then what are you doing back there?" "Watching." "What?" "I'm watching you walk. It's VERY nice to watch." Deal is, I walk differently in high heels that I do in Birkenstocks! I haven't been around any really old friends, but that will be coming up soon. I'll let you know what happens. I'm currently about 50 pounds over what the BMI charts say I should weigh, at the high end of my height group. But THAT number is about five pounds less than I weighed at the end of Basic Training when I was 26...back when...well, back when Ford had just taken over from Nixon. (Are we old, or what?) I have NO plans to end up there!! I applaud your 35-to-go status, and I think I'm in generally the same neighborhood. I use the Obesity Help estimator: http://www.obesityhelp.com/morbidobesity/information/post+op+planner.php If I put in my starting weight and a presumed 75% ewl, I am following that prediction table pretty closely. IF IT IS ACCURATE, I should be hitting "overweight" around Halloween, and then I may lose another ten pounds or so...IF it is accurate and IF I progress as predicted. (My best friend always says, "If we had ham, we could have ham and eggs..if we had eggs.") But the honest answer to the "price" question is that the only things I have to deal with (so far?) are the several morning BM's (if I were working, I'd have to get up earlier to allow for that routine), the worry about how bad that might smell (I have impaired olfactory ability), and MOSTLY worry about whether my doctors are on top of my labs the way I want them to be. (Caveat: I am happy with the DS for ME...but I'm almost 60 and I might have chosen a different route if I were younger. At the same time, as I watch my mother's declining health at age 83, I see that dealing with any band-related problems at that age could be a challenge, too. Any surgery is more dangerous at that age...even something as simple as repairing a slip and even more so with having to remove an eroded band. That factored in to my desire to have a "alteration" as opposed to an "appliance.")

I think that 65% is a rather generous figure and the average is actually a little lower. But it IS only an average. No one knows in advance whether you will be someone who loses MORE than average, LESS than average or the average amount. When I heard those numbers, I was sure that I'd lose MORE than average. I actually lost around 40% of excess weight prior to developing complications. (The band was filled and unfilled over the next year or so and then removed, three years after it was originally placed. By the time I had revision surgery, I actually weighed about three pounds MORE than I did before I got the band. I had the Duodenal Switch surgery and have lost around 70% of my excess weight in eight months. I'm still a newbie with that surgery and do not know what the future will hold, but the long term results tend to be a higher average weight loss than band or RnY...not without a price, but right now, I'm doing fine.) While my approach is very different than Jack's--I've had the bowel rearranged via invasive surgery, and I'm "suffering"...lol... the heartbreak of a BMI of +/-33 when it WAS, at one point, 52--he brings up a very good point. (As he is wont to do.) Using hypothetical numbers closer to mine, I suspect, than yours...if someone who "should" (whole different argument there) weigh 150, weighs 300 and loses 65% of her excess weight, she will weigh, 202.5. Is that good enough for you? (Hypothetical You.) That kind of progress is, depending on your perspective, GREAT because you are now only 52.5 pounds overweight instead of 150...or, TERRIBLE because you spent $12000 and had surgery on are still 52.5 pounds overweight. And that's just a case where everyone's mileage will vary. No one should be telling you that YOU cannot lose more than that amount...but they should be telling you that ON AVERAGE, band patients lose about 65% of their excess weight...and that means that for every person who is 100 pounds overweight and loses 85 pounds, there is someone else who loses only 45 pounds. ~~Standing with back to the wall and awaiting the onslaught~~ I think that anyone who cannot deal with the (very good) possibility of losing only 55-65% of their excess weight should shy away from surgeries that have that track record. I am one who cannot accept that long-term result and this is one reason I did not have a revision to RnY. Some people CAN accept that outcome and good for them because they are probably very reasonable people. But those numbers just don't cut it for me. Good luck figuring out which choices will be your best. Sue

Shawn, it's not just band patients who lose slowly! My first couple of post-op months with the DS, I had the standard predictable massive weight loss...like 54 pounds, going out the gate. But by the third month, it was FOUR pounds. In fact, since then, MOST months, I have lost only four pounds. (I am the EPITOME of the non-compliant patient...but my surgeon warned me that that's what often happens with revision patients. They've already "been there, done that" and it didn't work...so they are not exactly putting their all into effort #2. I eat foods that are not likely to help me lose weight, including TONS of chocolates...and, since I hurt my back and had to go on steroids, I've given up anything that resembles exercise.) HOWEVER...the other night, my husband and I were walking to the elevator in our building to go somewhere and he disappeared. I stopped and looked over my shoulder and saw him behind me...down the hall...and asked, "What's wrong?" "Nothing," he said. "Aren't we going down to the garage?" "Yup." "Then what are you doing back there?" "Watching." "What?" "I'm watching you walk. It's VERY nice to watch." He is, BTW, a keeper. So, four pounds is only four pounds, but cumulatively it seems to be noticeable!!!

First, the mentioning the 50% isn't downplaying the amount that people lose. He just may not be stating it very succinctly. It is the AVERAGE. Of course people will lose more than 50% and less than 50%...that's how an average is calculated. To GET TO that 50%, for every person who loses 90% of their excess weight, there is someone somewhere who has lost only 10%...that's just how the math works. Then, having had two wls's to date, I can pretty strongly state that there is no BEST surgery. Whatever surgery you think will work best for you AT THIS POINT IN TIME IN YOUR LIFE is "the best surgery" for YOU, right now. But that doesn't make the other surgeries "bad." And it doesn't mean that you won't change your mind later. Several people here have done so. I've even heard from some band patient "pioneers" who are considering moving on in the not too distant future. (That's including Karla, of course.) Risks? I've had the riskiest surgery, the Duodenal Switch, as my second surgery. The band was my first surgery and it was pretty safe...but the end result was a damaged esophagus (now repaired) and I was STILL MO, so the my risk of death from MO was still there...and still killing me. I've now had the risky surgery, but I'm no longer MO...so there's risk and there's risk. I am down a little over 90 pounds from (my second) surgery date (and 110 pounds from my highest pre-op weight) and now I have to be vigilant about the problems that might arise due to malabsorption. But, I'm no longer MO. Look, insurance companies will use any reasonable excuse to not pay for something. If the RnY and DS were as dangerous as some people like to think they are, no insurance company would cover them...ever. Yes, more patients survive band surgery than survive the other surgeries...but bands are placed on lighter weight patients, and they have a lesser risk going in the door. (Again...before someone says, "Well, I have the band and my BMI is 4,375," I'm talking about ON AVERAGE. The more extreme solutions are generally applied to the more extreme cases.) EACH surgery has its pros and cons. Surgeons have more post-op interaction and repeat visits from band patients than they do from the other wls patients. So the surgeon may be thinking that six months ago, he did ten RnY's and ten band placements, and one or two of the RnY people had ER visits that were resolved fairly rapidly, but every single one of the band patients has been back for at least two adjustments, etc...and to him, that may SEEM like less successful surgery. The other surgeries don't have to be "bad surgeries" for your surgery choice to be right for you. BTW, this isn't addressed to anyone in particular...

There are a few issues involved. Many of us flew home uneventfully just a few days post op. (It wasn't pleasant by any means, but there were no emergencies involved.) As far as eating is concerned, you will probably be at the stage where you are screaming that you don't have any restriction and you think the surgery was a complete failure. (That's the averge 5-7 week deal.) So you'll probably be able to eat most anything you ate pre-op. However, are you flying? A lot of people have real problems flying. Sometimes, restriction kicks in and they can't eat or drink anything...so just go somewhere where they have heard of the band. Good luck.

The band often cures reflux in those who have it prior to banding...and often causes reflux in those who have never had it.

Yeah...stay away form the memorials. You can read about complications on OH or on Yahoo groups and, of course, here. I think that knowing about what could happen makes us better consumers of this service and makes us better prepared if any problems arise...and makes us aware of what is part of the normal healing process vs. a real problem. The band is the right choice for a lot of people. It also is the wrong choice for a lot of people. Be honest with yourself. Do you just eat large quantities three times per day or do you forage all evening? Did you get fat on (mostly) too many pork chops at dinner or (mostly) too many Peanut Butter Cups and drive-thru Snacks? Do you have to lose 150 pounds or is it more like 70? Are you ready to follow the new rules or will you find a way around them? The honest answers will guide you to your best choice. Good luck... Sue

Bettina, I had esophageal dysmotility secondary to the adjustable gastric band. That is, the band was hindering my esophagus' ability to do its job and it took two-and-a-half months after the band was removed to get relief from those problems. Turns out that people who are most at risk for esophageal dysmotility are older people (I was 55 when banded), the morbidly obese (duh), and those who have bands (adjustable or otherwise) implanted. If someone has the problem pre-banding, they are not a good candidate for banding, but my problem was purely band-related.

Not sure who "you lot" includes...how many of us are supposed to be insulted? BACK ON TOPIC, I felt bad that I had spend $10,000+ of our money on something that was damaging my insides...but I did not feel like I had "failed" anything. Also, I didn't feel "hysterically happy" OR that I had "hit bottom" before having the band placed. I was tired, I was exhausted, I was somewhat depressed that everything was harder to do than it should have been...but no barrel bottoms (or points of elation) in my viewfinder. I understand better now...if you were not MO and did not have comordibity issues and still felt you had hit an all time low about your weight situation, I can see how you might think others felt that way, too. I cannot speak for others, but MY experience was that "impending relief" from some physical problems was about to occur. (But my surgeon says that revisions OFTEN come in the door with issues about having failed. Not me. All those years of Catholic schools and the guilt thing is just not as strong as it should have been. LOL! )

Leona, That would mean--with the doctors I've deal with--that their fees are included. But the hospital fees are not. I hope yours is all inclusive. BTW, even with my Mexican surgeon, the "free lifetime adjustments" did involve a fluorscopy fee.

You guys are making me doubt my sanity...so I went to the files. On 8/10/04, I had a required preliminary appointment with the doctor at Cedars. Insurance was billed $340, actually paid $108.18 and I paid $27.04. On 8/24/04, I was billed $621.04 for "Health Services." Insurance paid $224.58, I paid $148.06. AND...I was billed $446.00 for "Surgery" and $90.00 for "Testing / X-ray / Lab." Insurance paid $296.20 and I paid $74.05. AND...I was billed $74.00 for "Testing / X-ray / Lab." Insurance paid $8.58 and I paid $2.15. So, to get a fill at Cedars-Sinai, in August of 2004: ~~Cedars and the doctor billed a total of $1573.06; and ~~My insurance paid $637.54; and ~~I paid $251.30. So I DID overestimate, but still, it was WAY more than a couple of hundred bucks. AND, if I hadn't had insurance I'd have had to make prior price arrangements or be responsible for the whole $1573.06. Add THAT to the cost of an apartment in Los Angeles and you get an idea of why--even though the pay is higher--many people won't come here to work!

NewSho...remember, I was banded back when in the greater Los Angeles area, your choices were the guys at Cedars or Quebbemann in Newport Beach. As new band docs came on board, one or two would CONSIDER doing a fill for Mexican surgeon's patient, if--and only if--I had endoscopy first. My last Cedars' fill (circa 8/2004), insurance was billed around $850-900 and I paid about $300 out of pocket and insurance paid MOST of the rest. (I think.) The thing about "what insurance covers" and "what insurance doesn't cover" is that it can change every plan year. In my case, it didn't cover banding at all when I was banded. Then it changed TO cover banding and the fills. Later it changed to exclude BMI's over 50 from banding. Now they have this little ditty: "Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline. Note: medical necessity criteria for adjustments are based on whether or not the original surgery was considered medically necessary. Note that it DOESN'T say by WHOM it has to have been considered medically necessary. Any surgeon in any country? What if the insurance you had at the time okayed banding for BMI's of 51, but this insurance does not...would that still be considered to be retroactively medically necessary? (Can you tell there are too many attorneys in my family? LOL.) Sue

Should YOU have the band surgery? Only you--if honest with yourself--will be able to figure that out. Do you eat "too much" at three meals a day...or do you graze and eat most of the time? What is your relationship with sweets? Those things may impact how successful banding would be for you. The surgery itself is a relative piece-of-cake. The immediate post-op time can require numerous band adjustments or may require NO band adjustments. People can move along with no problems and their friends can have real issues. Read what others have been through, good and bad, and choose what's best for you. Oh...one other thing. Do you have the resources for the required follow-up for whatever wls you choose? I'm picky and spend a good deal on Vitamins and supplements because I had the band removed and now have the DS. DS people HAVE TO HAVE special vitamins and supplements. Band people HAVE TO HAVE adjustments and they CAN cost quite a bit. (Up to $800-1000 per adjustment at the big city hospitals with fluroscopy.) If you haven't factored in the aftercare costs, it would be a good idea to do so. Again...a few people need NO adjustments. But in the first two years I had my band, I had about a dozen. Ka-CHING!!! Good luck!

I'm just going to pop in and say that SOME of the posters haven't been banded long enough to say they've really tried. (It SEEMS like a long time, but a few months isn't enough time, really.) HOWEVER, I want to add for those who HAVE been banded a long time and are getting nowhere, that the band isn't for everyone. It's where most European surgeons START...but they have a brisk business in removing bands and moving patients to different options. There is a "right surgery" for each of us, and no surgery being performed today is "wrong" for everyone. Far too many people explain whay they've chosen the surgery they've chosen by mentioning what they think is WRONG with the other surgeries. (I did it, too. But I was wrong.) And it's bullshit. If you haven't give the band a chance, slow down and listen to the good advice proffered here and give it your all. BUT, if you've already done that, and are sure you don't want to go back to "flying solo," talk to some of us who have moved on to other surgeries. So far, we sound like a fairly satisfied group to me! Sue (Eight months post-op from DS, BMI moved from about 48 to <34.) (And, yes, my poop stinks, but it never was an olfactory delight.)

Several (many?) of us have had our bands removed due to complications...erosion, slippage and other problems. Some of us have moved on to other procedures, namely the RnY or the DS (Duodenal Switch.) Others are just "flying solo," without any other surgical intervention. Sue

Okay...on the whole "overeating" thing. When your esophagus malfunctions, you can eat a teensy, tiny bit of food and--because the food doesn't move to the stomach--it will STILL get stuck in the esophagus and STILL might cause dilatation. Are you "overeating," as in "eating more food than you should?" Absolutely not. Are you "overeating," as in "taking in more food than your damaged esophagus can handle?" Maybe. I'm grasping at straws for examples, but...imagine two identical balloons, only one of them has a defect where there's a little weak bubble. You go to blow them up and one pops, even though you have MORE air in the other balloon and it's fine. What's up with that? The damaged balloon cannot hold as much air as the good one. When your esophagus isn't working, even a very small amount of food can be too much food. I think that any medical professional who calls that "overeating" knowing how the rest of the world defines "overeating" is not being very helpful.

This might help: http://lapbandtalk.com/showthread.php?p=264744#post264744

Logic would dictate that since the (insurance) requirements in the US* are generally that the patient have a BMI or 40+ (or a BMI of 35+ with comorbidities), then ALL OF THE PEOPLE who qualify for ANY wls have collectively sunk to exactly the same "terrible low." The only difference is which solutions(s) are attempted. In Rachele's case and mine, we first tried the band. Then we moved on. (*In other countries or for self-pays, YMMV.)

Might they have said, "esophageal dysmotility?" See, when we eat something, the esophagus--unlike the pictures we see in cartoons--isn't just a tube the food drops through. The esophagus massages the food on down to the stomach, where it can be digested. When the esophagus doesn't massage the food correctly, it's call "esophageal dysmotility." (There's a test for this...manometry.) In my case, the band CAUSED esophageal dysmotility. Food and beverages just sat, trapped in the esophagus, moving up a little...moving down a little, until the esophagus FINALLY moved them through. Meanwhile, my trainer was going insane because I could not get in a reasonable position for most exercises. And we'd go out to dinner and the ONE-THIRD of a cup of Soup would get jammed in there and then I couldn't eat dinner. It was miserable and the band caused it. When I had the band removed and was revised to the DS, the situation changed and all was well. So...most GOOD band doctors will not band someone who, going out the gate, already has this condition because it will probably only get worse. The manufacturer of the band says it's not a good idea. Scroll down to #6 at the bottom. http://www.allerganandinamed.com/products/obesity/us/clinician/lapband/risk.html

http://www.duodenalswitch.com

Those from the "medical field" show up not only as "alarmists" but as "defenders" as well. So, applying the same logic, just because someone who is in the field says it's a good idea, doesn't make it so, either. (BTW, that link I provided eventually leads to some of the letters sent by the FDA to some of the "colon cleanse" gurus regarding their false claims, false advertising, etc. Usually, they STOP, but then immediately start up with some other enterprise of similar dubious veracity.)

Those colon-cleanse schemers are more full of $h!t than John Wayne and Elvis's colons ever were. http://www.quackwatch.org/01QuackeryRelatedTopics/detox.html

After we went out to dinner, a friend's husband (a rather quiet 70-year-old man) asked her if I wasn't starving since I couldn't eat anything. I was surprised HE noticed. Ther RnY DOES have malabsorption...that's why the dumping. But it primarily restrictive in nature. So it has more in common with the band than one might imagine. Even similar "end results."