GeezerSue

Rumbaut did the PRE-FDA testing which allowed the FDA testing to be done in the states. He's a band pioneer...and a band patient. And he proctored the guys who now consider themselves to be the experts...if that tells you anything.

October 2002

Your immediate post-op weight loss was merely fluids. You rehydrated and then lost fat. Step away from the scale! Use your belt to see how you're doing.

Let the body heal. THEN decide how to proceed. (And don't consider only band and RnY; have her look into the DS as well. I say that because the DS leaves a larger stomach area than RnY.)

Not always. If you have a MEDICAL reason...you need a breast reduction, for example...or the hanging pannus that was the result of your losing weight is causing intertrigo (and you've been going to the doctor and documenting that you are trying more conservative approaches) and backaches (and you have gone to the chiropractor to document that the hanging pannus is the cause of the problem), then you will likely just have to pay what you pay to go to any other specialist. (My daughter and I have different insurances. She had a BR...no WLS was involved...and she paid about $50. I pay a $35 co-pay with anay specialist, including the PS.) BTW, I had both the panniculectomy/abdominoplasty and the abdominoplasty/breast reduction while MO and insurance paid. If I lose a hundred more pounds and need another surgery, I'll get another surgery and insurance will likely pay again. But I needed it and got it.

I don't think a child that young can follow through on a project such as "clean up your room." I used to have to sit there with my kid and make the project less formidable. I'd sit and say,"First, put away everything that is blue. I don't care what it is, what shape it is...if it's blue, put it away." When EVERYTHING that was blue was back where it belonged, I'd change it a little and say, "Now put away everything that's round. Wheels, cars, buttons, toys...anything that's round." It would take forever, and we would take breaks, but she (and I) have a lot of dificulty (and become paralyzed) by BIG MESSES and just stare at them. She's thirty now. When she is cleaning her apartment, she occasionally calls and (jokingly) says, "Mommy! Tell me what color to start with!"

The "program fees" are the latest way to make up the difference between what the doctors get paid and what they think they should get paid. It's not just for LapBand. while researching the other surgeries, I have found $800 "program fees" and $3000 "program fees." They are charging that because, so far, it is not prohibited by their insurance contracts. Once it is, they'll probably charge $3000 for pre-paid parking, even you you take a bus. It's about the money.

Many years ago, I very nicely told my mother that I would no longer communicate with her when she behaved that way and would need AT LEAST a two day time-out to recover from the verbal assaults. If she did it when we were on the phone, I'd just hang up (and keep hanging up if she called back) until the two days were up. In person, I'd just turn around and walk out. Even if we were in the middle of lunch in a restaurant, I'd say, "We're done. I'm leaving. Do you want a ride home?" OR, "We're done. I'm leaving. I'll take a bus back to my car." (I never actually had to do that, she drove me.) It actually stopped. It only took a few times, and the phone part lasted longer because she couldn't "read" my responses as well, but it stopped.

That's why comparing WEIGHT lost is fairly meaningless, even considering that higher weight people may lose more pounds faster. (No offense to those who DO put their weight in their sig lines.) What WOULD be important is changes in BMI. Then we could kind of compare to each other.

Two things: 1--most of the very most experienced doctors have the least restrictive pre-op diets; AND, 2--I don't recommend using the term "to cheat" regarding any of this journey. I think it shows that we are in a "game" mind-set and that that getting away with "cheating" might be a good thing, and I really think that those who use that language often are just not ready for the changes that are needed to succeed. IMHO.

PLEASE stop assuming that a panniculectomy or abdominoplasty or reduction mammaplasty is purely cosmetic. INVESTIGATE!!! My surgeries were covered (BC-PPO) and when I finally lose more weight and regain the same symptoms, I'll need a revision and that should be covered, too. Our daughter's BR was covered by her insurance (Aetna). OF COURSE, the insurance companies automatically denied the preauthorization the first time around. That's what their computers are programmed to do...certain codes are just flat out denied by the computer without human review. If you are willing to accept that response, they will save a lot of money and you will spend a lot of money. But all you have to do is develop data which shows that YOU meet the criteria that YOUR EMPLOYER and THE INSURANCE COMPANY agreed to. Once you do that, they have no choice but to honor their end of the contract.

#1--What they all, but mostly Tropicana, said. #2--The only reason you "have time" to shower and brush your teeth is that you have made it a priority. It works for exercise, too. #3--If you are not taking care of your baby's mom, then you are not really tending to your baby's needs. Twelve-year-olds need moms, too. Are you doing all you can to be there when your baby is 12? #4--The band isn't about having surgery and then carrying on as usual. It's about making life-saving changes in your daily life. This part takes a tremendous amount of work, but unless you sign on, all you've done is had needless surgery. Good luck...

WARNING: MY LAST SCIENCE CLASS WAS HS CHEM, IN 1963. They passed me with a "Gentleman's D," to keep me from returning and taking the class yet again the following year. Seems they were still holding a grudge about the thing with the zinc and magnesium and the Bunsen burner and the explosion and all. Gawd...you'd think they would have planned on inquiring minds wanting to know. Just so you know I'm a less-than-reliable source for scientific issues.

PS--"Esophageal dilatation" (widening of the esophagus) is also a treatment for "esophageal stenosis" (narrowing of the esophagus.) So it can be a diagnosis or a treatment.

I'm thinking that what the doctor was saying is that you have "esophageal dilatation." (I hate the word "dilatation.) If so, "Esophageal Dilatation" is the widening or expanding of the esophagus, at the bottom of the esophagus where it starts to connect to the stomach. This happens when too much food is eaten. It packs itself in, waiting to get into the stomach. But it just sits there, because of the logjam at the band. The usual treatment for this is to loosen the band and hope that the esophagus returns to normal size. (Because it isn't meant to be used as a holding area for the stomach.) I did this a lot...maybe still do. My motility is slow...this is common in older patients. By the time I figure out that I'm packing it in, it's too late. It's all just sitting there. this can happen very easily when there is some swelling around the stoma area and the band is tighter than usual and, without aqny warning, you've overeaten.

When I have restriction, I lose weight and get reflux. When I empty the band, I get rid of the reflux and gain weight. Right now, I have less restriction that the doctor wanted and I STILL have reflux. And I'm mostly out of the mood. The band works well for 75-80% patients. But not for everyone. I'm almost 59. I don't have a lot of time to have more surgery or to play this game much longer. So I'm making appointments for revision to DS. It was my second choice surgery and it appears to make sense to move on. It's a HUGE step, and I'm scared. But I have friends who have done well with it and seems like a real option. I was fortunate to have the resources, and a husband who didn't mind my utilizing them, to pay for the band out of pocket. And I'm not sorry I tried for the least invasive method to solve this problem. But I have insurance that pays for the DS and that's what I'm looking at right now. In no time at all, they'll be saying, "Sorry, dear, you've passed our cut-off age." So, I'm off to see some wizards, so to speak. My highest BMI was about 53. At surgery, it was 47-ish. I got down to 39, and that's when the reflux started. Currently, I'm at about 43. Would I do it again? Probably. Would I wait this long to move on? Probably not.

The band can "cure" reflux for those who have had it and cause reflux for those who have not had it. But reflux is not just an irritation. I've previously posted links to what that acid is doing to the esophagus...it ain't pretty. I've taken various drugs...but, to me, I'm merely patching something I'm simultaneously causing...by having the band there in the first place. Kind of like putting band-aids on a place I keep stabbing. So, no, it did not go away and is another reason I'm thinking of having my band removed. I look at my 82-year-old mother and see her frailty and wonder how long I can put up with this before I find myself suffering, but declared too old for surgery.

I've gained back the majority of what I lost. The band is successful for about 75-80% of patients. Therefore, one out of every four or five banded patients do NOT do well with the band.

Do a search here on his name..but spell it correctly. Rumbaut.

Gender? It's Geezer...as in, I'm an old broad.

You go to the literature...peer reviewed medical publications. Anyone who doesn't might as well use fortune Cookies. However, when you DO go the the medical literature, the band is not a walk in the park, either. Just a cursory search on the topic of adjustable banding reveals recent studies involving: •Access port site hernia •Lap-Band removal for band erosion •Severe intra-abdominal infection due to Streptococcus Milleri following adjustable gastric banding •Late gastric prolapse with pouch necrosis after laparoscopic adjustable gastric banding •Migration of adjustable gastric banding •Complications of gastric banding presenting to the ED •A minimally invasive solution for necrotic fundus following slipped adjustable gastric band •Port complications following laparoscopic adjustable gastric banding for morbid obesity •Obstructive symptoms associated with the 9.75-cm Lap-Band in the first 24 hours using the pars flaccida approach •Critical extreme anterior slippage (paragastric Richter's hernia) of the stomach after laparoscopic adjustable gastric banding: early recognition and prevention of gastric strangulation •Early lap-band erosion associated with colonic inflammation: a case report and literature review •Band slippage--a potentially life-threatening complication after laparoscopic adjustable gastric banding And those are only SOME of the articles from just THIS YEAR. Banding was my FIRST (but not LAST) choice. I used to be highly defensive of banding and, like most of the responses here, really down on bypass surgeries. But, to me, the object is to have the procedure that will save my life. And the band isn't doing that. So, I am one of approximately 20% of banded patients who does NOT get the desired result. I knew those statistics going in. I just wanted the least permanent and least invasive surgery which would WORK for me. I think that knowing that ANY of the WLS procedures has its plusses and its minuses leaves us in a better position to HAVE a second choice and a second chance should we be in that one-out-of-five for whom the band does not provide relief from MO. In other words, neither those on the other boards NOR those of us here should knock something we might later need. IMHO

Yup, the band is often the "cure" for reflux for those who have it...and is often the "cause" for those who don't. I'm glad you are one of the former...I'm, unfortunately, one of the latter. Keep up the good attitude!

I'm glad you're happy, but I believe it's a few more than three patients with problems...and that's on this board alone. There are other support boards. But it is nice that you are having success. Edited to add: I just noticed on another thread that you are only ten months post op. I am NOT wishing you anything but success here, but for some people, the problems show up a little longer after surgery.

Having a band placed is nowhere near as painful--nor does the pain last as long--as having a knee or hip or ankle go out from obesity. It's all relative.

Well...I fit best in maternity clothes...because for some reason, my waist has decided to be my largest measurement. Weird to be in maternity items pushing 60. Anyway...layer stuff. I have a new outfit. It's a tank top (WORN TUCKED IN) and pants, that I wear with a blouse or sweater (WORN OPEN.) The tucked in thing IMPLIES a waist and the blouse or sweater hides the details. If I button the sweater, I look pregnant.