GeezerSue

~c~ Here's a link to a rather graphic depiction of what a "Grade 1" through a "Grade 5" pannus looks like. (I'm 2-ish, but because of two previous abdominal surgeries with vertical pubis-to-navel incisions, it all hangs rather like Austrian drapes...you know with the whole thing raised in the middle.) From what I've read, most US insurance companies require BOTH (although some require only EITHER) that the pannus be Grade 2 or better and that the ongoing intertrigo is documented. Backaches are a consideration as well. (In fact, when I first lost weight, I had to hit the chiropractor's a couple of times because I was standing/walking like someone who had more belly weight to hold up, and that was causing back pain.) Find out what your health service requires and then see if you meet that criteria. The hardest part :sick is showing it to someone to document. A digital camera might help. http://www.cstobesity.com/articles/p531.htm

Are you doing okay?

I picked June, because I'm running for an office in my homeowners thingy and the election date is June 12th and I don't want to be doing recuperation during "the campaign season." And my sister will be home from her cruise on June 9th, and can be acting daughter-in-chief for our mom. Gives me more time to get things in order...like finding a cheap, used recliner to live on. Intertrigo is the rash--I believe it's a yeast infection, but I don't know--that forms on skin that touches skins and sweats and gets nasty. Usually, insurance companies require that the pannus hang to a certain level (generally the pubus), AND that intertrigo that doesn't respond to treatment (I think it always responds, and always comes back) is there. I'd been hiding my ugly, hangy belly from my spouse, who had not seen the intertrigo. He's really impressed by how ugly it is and thinks I need to have this surgery to rid myself of the rash, if nothing else. Donali, I asked our daughter how she finally got brave enough to have breast reduction surgery, since her getting the shots she needed for camp as a child always turned into high drama. She said, "I think it's like when women are about nine months pregnant and decide that the kid is coming out, even if it means using a melon scooper. I was finally tired of all the pain and the lack of clothes that fit and rolling over my own tits in bed. That's how I knew." Summer's coming and I think I don't want to deal with yet another summer of this. I guess I'm afraid that it's not a good idea before reaching goal, but I know that Dr. Fobi does a panniculectomy at the time of the Fobi Pouch RnY...so I know it can be done. I'm just a coward is all.

:nervous ya think?

I am nowhere near goal. But, I have needed reconstructive abdominal surgery for over 25 years. Gaining weight made the problems worse. Losing weight made the sagging and intrigo worse. I thought there would be some resistance, but there was none. The doctor said #1--that the pannus hangs low enough and #2--that the intertrigo just reinforces the decision that it is medically necessary. And did I want May or June? He also says that he may do SOME abdominoplasty work to make the upper and lower parts of my abdomen look like they go together. I asked why so many doctors want the patient at goal. He said that they don't want their work messed up. But that in my case, if I manage to lose the NEXT 80 pounds I need to lose, I can have the area "tweaked," because it probably WILL drop a little with that much weight loss. He DID push about what my goal weight is. But I told him that if it stopped right here, I could live with it, and that at age 57, I don't want to take the chance of getting to goal a few years from now, with a huge hanging pannus and then having him tell me I'm too old for PS. I'm not sure whether I'm excited or scared or (more likely) both. It would be LOVELY to get rid of this rash. It would be LOVELY to have my waist measure LESS THAN my hips. (Every pair of pants I own hangs on my butt and thighs, but I need them that big to fit my waist.) It would be LOVELY to be able to "bring your knee up to your chest" when the Pilates chick says to do that. Right now, my thigh cannot get to my abdomen because of the pannus. I have had a another plastic surgeon tell me I should do it. Not sure how many "second opinions" I'm going for, since I want this and I think he can do it and it would be at no cost to me. Hmmmmm....

Candy, If I recall accurately, the Inamed list includes doctors who have SIGNED UP for learning how to do the surgery, but have not yet done one. Checking the list is a great idea. But make sure you also find out how many surgeries the surgeon has done. Sue

Rumbaut uses dissolving stitches. All you do is take off the bandaids (steri-strips or surgi-strips) a few days later. I think Kuri has you remove your own, and a really, really high percentage of those patients do just fine. :cheeky The others usually ask for help from a nurse or PCP back home. The staples????

Have you considered surgeons who are just a little father away, but who have experience and positive expectations? Where I'm going here is that surgeons who start with this attitude would seem to be the most likely to throw up their hands at the fist plateau and say,"Well, see, we TOLD you it wouldn't work."

I haven't read every word, because I'm trying to get to an appointment, but... If there is a doctor ANYWHERE who says that it takes a year until you need a fill, I'd avoid him. First because he's wrong. And second, because he sounds like he has an imagined "ideal schedule" and won't be too fliexible. Rumbaut is wonderful (and about $10,000), but you will have to get adjustments (fills and UNfills). To get to Rumbaut from Las Vegas, Aviacsa (not Avianca) Airlines has (had?) a non-stop flight and was very reasonable. ALSO, Rumbaut suggested that Cirangel in San Francisco might do my adjustments. I haven't been there, but...last I read anything about him, Cirangle was about $12,500, for the surgery and a fill or two. Finally, there are many cities in Mexico. And many surgeons, many of whom do adjustments on the patients of other doctors, both US and Mexican. So, you can get adjustments in Tijuana. Many patients drive to the border and cross into Tijuana for adjustments. There are options. Also, you wrote "original band." Unless something goes wrong, we each have only one band.

Okay, while those numbers ARE accurate, they make a mountain out of a molehill. What the research calls "nausea and vomiting" is not at all like any kind of nausea and/or vomiting you've ever experienced before. Because the stoma (the passageway between the upper and lower parts of the stomach) sometimes senses the food going down the esophagus as a blockage, it sends signals of a blockage to the brain. The brain (not having read the owner's manual) decides to send what seems like gallons of saliva, to wash the non-existant blockage through. But all that does is clog up an already full esophagus. If you can find a place to spit until the brain gives up, all is well. But, if you try to tough it out, and keep swallowing, then the nausea (the brain's back-up plan for blockages) goes to work and you need to empty the esophagus and maybe even part of the stomach, down to the stoma. This (erroneously IMHO entitled) Productive Burp is a regurgitation of the food which you have chewed and swallowed, but which never got to your real stomach. There is no stomach acid involved. So, the banded person's job is to not eat the stuff or not to eat so fast or not to swallow without chewing better, so that the entire episode described above doesn't happen. AND, this is a big part of the learning we all have to do. I can't eat much bread, others can. I can eat small amounts of un-doughy bread. I drink carbonated Water all day. But, I pour it and let it sit for a long time. If this helps, a huge part of being banded (and the part I'm working on as we type) is learning that the stuff you thought you needed to make your life complete, and deal with frustration, anger, loneliness, boredom, abandonment, etc. really isn't necessary at all.

Rumbaut and Lopez, while both in Mexico, are about a three hour FLIGHT from each other. Rumbaut was my surgeon, Lopez was Donali's. I haven't heard anything negative about either of them.

WHERE in Mexico? Which doctor?

Your guys ARE J.D. Salinger fans, right? The "Perfect Day for Bananafish" short story (or mini-novel) is one of his classics. Well, everything is one of his classics, because he's been holed up in New Hampshire or somewhere since about 196?. Seymour Glass committed suicide in his hotel room on his honeymoon...leaving, one can only surmise, his bride Muriel a tad pissed off. Here's a Salinger link: http://vision.york.ac.uk/articles/137/books/43137.shtml

Patty, Most of this diet would plug me up (and give me hiccups, too) in a heartbeat. For me, ANY chicken breast is too dry. I now eat dark meat only, usually stewed, seldom grilled. Cheese sticks would not work, again, too dry. And some people say cheese is just fat, anyway. Were there noodles or potatoes or rice in the cup of soup? I'm not sure about the V8 or yougurt, unless you ate/drank it too fast. Lettuce is almost always a no-no for me, although vey finely chopped, crispy romain sometimes works. You may be filled too tight. If you are, you will start "eating around the band," by eating liquids to avoid problems. Not good. Okay. So what TO eat. Fish? A little halibut or salmon or snapper that is NOT cooked until dry. And, when I'm protein deficient, I sometimes try a little chili, with or without beans. I'd suggest going like we do when we introduce foods to a baby...try one food at a time. And avoid things with multiple ingredients...because I can eat crab just fine, but crabcakes have breadcrumbs and I can't eat bread. And if the roasted winter veggie soup has potatoes, I'm sorry I ate it. And pay attention to how fast you eat and when you stop eating. (My usual mistake.) There are days that I think I ate the right amount and stopped at just the right time...and then four or five or even ten minutes later, I start with the saliva. THAT may be age-related, as we older folks have slower esophageal function and by the time I FEEL like I should stop, I'm way late. You are learning, give yourself time.

Sorry. I just missed you. Post a hello on the intro board. (I'm old and going to bed now.) Sue

Alrighty, then, I answered the scammer. Dear Dr. Harrison, May I call you Siju or Sijuwade? I apologize for taking so long to reply. I haven't studied your country, but I certainly understand how things can get messed up when such entities as the military and democracy get involved. I'm a widow, Sijuwade...or Siju...or Dr. Harrison. I don't have a lot of money, and what I have I had to fight the insurance company for after the whole suicide thing. That goddam Seymour. Right there in the hotel. Anyway, a little extra cash would be a great thing. Costs are rising you know, especially medical. By the way, what kind of doctor are you? Are you by any chance a psychiatrist? If so, we sure could have used you with that whole bathrobe deal with that frickin' Seymour. Am I going to need some kind of contractor's license? I ask because I'm not as good at taking tests as Seymour was. But Franny is very good at taking tests. That whole family is pretty famous for being Wise Children. I just married into it. I can probably pass the test, but I might need to study for a couple of days. We've got a few problems. I'm traveling with my sister-in-law Franny and her daughter right now. I'm using their email and and won't be able to answer you right away. And, they don't often leave me to my own devices, if you get my drift. But what's the deal? Sincerely, Muriel Glass P.S. How is the cost of prescription drugs in Nigeria or Lagos right now? Nothing fancy. Maybe just the stuff Rush Limbaugh uses. I mean used. Whatever. Do they cost a lot there? Opinions? And apologies to J. D. Salinger. Sue

When your doctor tells you to call your surgeon...you want OUR advice? :mad: Okay, I apologize for the sarcasm, but I'm trying to make an important point. Your doctor SAW you and just told you to contact the surgeon. No one here can give you a more informed answer. Pick up the phone! Dial! :ninja Sue

Here's one link for you Potter fans: http://www.scamorama.com/harrypotter-ayokure.html

BTW, I KNOW Nigeria is not in Europe. But the gal who ran the scam on the scammer met them in Amsterdam, I think.

I've been on the internet since the early 1990's and I FINALLY got my first Nigerian bank scam email. There's a really good website somewhere where they guy played along with one of these crooks for a while...but I don't have any current plans to go to Europe. (But now that I have a reason???) Anyway, for your entertainment: From: "Sijuwade Harrison" <sijuharrison@gaza.net>__Add to Address Book To: (me) Date: Wed, 21 Apr 2004 09:06:17 -0700 Subject: FOR YOUR KIND ATTENTION Dr.Sijuwade Harrison Plot 19A ,Osborne Street, Victoria Island ,Lagos. Email:sijuharrison@netscape.net FOR YOUR KIND ATTENTION RE:RELATIONSHIP/PARTNERSHIP. It is my great pleasure to write this letter to you.First I must solicit your utmost confidentiality in this transaction. I am making this contact with you based on reliable information available to us,courtesy of the internet business index and confirmed locally by our chamber of commerce and industry, thus we are convinced that you would be capable of providing us with a solution to a money transfer transaction of US$16,500,000.00 (Sixteen Million, Five Hundred Thousand United States Dollars). Source:During the last military regimes here in Nigeria, government officials set up companies and awarded themselves contracts that were to be paid from the Petroleum Trust Fund (PTF) set up by the military regime for the purpose of financing special projects and these were grossly over-invoiced.The present civilian government have constituted an Interim Management Committee (IMC) with the mandate to investigate all contracts awarded as well as carry out debt verification of all claims that have not yet been paid with a view of settling all legitimate debts owed by the Federal Government of Nigeria to both local and foreign contractors before the government wind up the Trust Fund. We as members of this committee have identified a lot of inflated contract funds which are presently floating in the Central Bank of Nigeria.In the meantime,the government have already made a budget allocation for the payment of these contracts,but by virtue of our position as civil servants and members of this panel, we cannot acquire this fund in our names. I was delegated as a matter of trust by my colleagues to look for an overseas partner into whose account we would transfer the funds totalling (USD16,500,000.00) and you will be adequately compesated with 25% of the entire sum, hence we are writing you this mail. The present Civilian Government is determined to pay foreign contractors all debt owed so as to maintain an amiable relationship with both the Foreign Governments and Non Government Financial Agencies and to attract foreign investment into our economy.We have decided to include our bills for approval with the co-operation of some officials of the Federal Ministy of Finance (F.M.F) and the Central Bank of Nigeria (C.B.N.).We seek your assistance in providing us with a good company account or personal account into which we can remit this money,you will be acting as an ORIGINAL CONTRACTOR in this deal, the fund will be paid to you. This we can do by SWAPPING of account information and changing of beneficiary information to apply for payment. We will prepare letters of claims and job description on your behalf,on confirmation of your willingness to assist us. It is our intention therefore,while having your understanding and co-operation to invest 70% of this funds in pulp and paper manufacturing plant for worldwide distribution and importation of agricultural and oil prospecting equipment to sub-western region of Africa.While the balance 5% will cater for all local and foreign expenses incurred in facilitating the transfer of this funds. Please contact me immediately on my private email address(sijuharrison@gaza.net)immediately you receive this mail thus signifying your capability and willingness to assist us.We are building our trust on sincerity of purpose, mutual understanding and recommendation.The business itself is 100% safe and fail proof, provided you treat it with utmost secrecy and confidentiality and you follow my instructions carefully and religiously.Your line of specialization does not matter as it cannot hinder the successful execution of this transaction. Again we look forward to doing business with you and solicit your utmost confidentiality in this transaction.Thank you for your co-operation. Yours faithfully, Dr.Sijuwade Harrison N.B.(PLEASE,DO QUOTE REFERENCE NUMBER (SH/01)IN YOUR RESPONSE.)

nightingale, I think the idea is that when you want to chat, you add to the post Donali started, which will bump it into the "new posts" area, then others popping in will know you're there. Sue I think.

Shelly, Notice the date on the article. Since that was published, it was also mentioned that the woman didn't want anyone to know she had the LapBand, AND she did not contact her band surgeon and she went to a hospital other than the one that did her LapBand (so the hospital had no records) and that by the time she or anyone in her family notified the attending that the surgery had been performed and s/he was able to contact the band surgeon, it was just way too late. There may have been a surgical error. But the reason she died was apparently fear of having others know of her surgery. (Granted, SOMEBODY should have asked what the big white silastic circle showing up on her x-rays was...but, who knows.) Sue

I think it's like "the cranberry juice for urinary tract infections recommendation." My mom's doctor's office--in a senior community--always tells the patients to get cranberry capsules or to drink cranberry juice for a uti. Deal is, if you check the research, cranberry MAY provide a slight benefit in preventing uti's if you use it for a year or so, and BTW, that has never been studied in in elderly population. But, research proves that it is of no value in treating a uti. However, they've said it so often, they believe it. Last I checked, about two years ago, two surgeons from New Zealand were doing a study on whether their two-weeks on liquids diet really made a difference, or if it was just a new urban legend. I wrote to one of the doctors, and his response was (a rather arrogant IMHO) comment that people who couldn't do two weeks on a diet weren't ready for banding. But, I haven't seen any results published on his study. Many surgeons want the two week liquid diet, but I think it's based on not much more than a rumor. I asked my surgeon, and he said that when the proof was in, he'd consider it. Turned out, my liver was positioned in such a way that it wouldn't have been an issue in my case. I didn't mean that your surgeon doesn't know what he's doing. But one thing that is crucial to successful banding is a supportive doctor. If he is convinced, before the fact, that you won't be successful, it may be that HE hasn't had success with larger patients, and--no matter how wonderful he is with other patients--he might not be your best choice. Check those other websites and see if you encounter rave reviews about him from other extraordinary bandsters. THEY would be valuable resources. Good luck, Sue

You might want to consider another surgeon, as the one you have spoken to is using OLD information. Here's the abstract of a six-month-old study on the subject (I added the underlining): Surg Endosc. 2003 Oct;17(10):1541-5. Epub 2003 Aug 15. Related Articles, Links _ Laparoscopic adjustable gastric banding for massive superobesity ( > 60 body mass index kg/m2). Fielding GA. Surgery for massive super obesity is a formidable challenge. No existing open or laparoscopic procedure reduces BMI below 30 from a starting point above 55. Laparoscopic adjustable gastric banding has been used to treat 76 massive super obese patients with a BMI > 60 kgs/m2. Median weight was 193 kgs +/-34.7 kgs (154-335 kgs). Five patients had a BMI > 100 kgs/m2. There was neither mortality nor pulmonary emboli. hospital stay was 3 days (1-6 days). Excess weight loss was 46.69 +/-10.5 at 1 year; 59.14 +/- 11.7% at 3 years and 61 +/- 15.1% at 5 years. At 2 years, 84% of the patients had greater than 50% excess weight loss and this was maintained at 3, 4, and 5 years. BMI fell from 69 +/- 6.2 to 49 +/- 7.73 at 1 year to 37 +/- 4.45 at 3 years and this was maintained at 4 and 5 years. BMI in 13 patients with > 5 year follow up was 35.09 +/- 53 kgs/m2 (27-44). Weight loss with laparoscopic adjustable gastric banding in this group of massive super obese patients has been similar to all other surgical techniques with reduction of BMI from 69 to 33 kgs/m2 at 3 years. The relative safety of the Lapband avoids bowel surgery in these very big patients, suggesting that laparoscopic adjustable gastric banding is a valid surgical approach to these difficult patients. PMID: 12915973 [PubMed - in process] Sue

Carmen, There are never guarantees. When my husband had a heart attack (which he survived), our daughter said that in her head, she kept thinking that there had been a mistake with the phone call...that I would be the one to suffer life-threatening illness or disease, and he--younger, physically active, dangerous job, etc.--would simply have an accident. She was in shock because she had aways assumed, based on doctors' diagnoses, which of us was more likely to be the first to be in an ER due to illness. But you never know. You don't know how long you'll have him...nor does he know how long he'll have you. And you probably want him to do whatever he can to be with you as long as he can. And he likely feels that way about you, too. If you were in an airplane going through a drop in pressure (like your life is right now), you would put YOUR oxygen mask on first and then see to the masks of your family members. If you didn't do yours first, you might not be able to help them. The same logic applies. Even though you may be feeling very terrified and alone and even angry or potentially abandoned, when you can, you should try to tend to your needs first in order to be of assistance to the others. And, forgive yourself when you rely on old methods of comforting yourself. Sue