GeezerSue

As a six-figure parent of an adult child, I applaud your independent spirit. Is your husband a public school employee? Does his employer have Section 125 accounts available? (Almost all do.) If you don't know how that works, I can 'splain it to ya...but I don't want to bother with it if you already know. A little financed via Section 125 and little via an additional student loan for medical expenses (and a ten year payback at about 4%) ought to do it. Good luck! Sue

P-38 like the can opener? Just wondering, Sue Oh, yeah...welcome!

1--I know zip about financing. 2--Your husband probably has--or can set up--a Section 125 account at work. (You may have to wait until the new school- or calendar-year, but it could be worth it.) Once the first payment is withheld, he can take it all out. 3--You can get student loans--PLUS loans, even, that will let you spread the payments out over 20 years, and at a low interest rate. Exceptional medical expenses are exceptional medical expenses. 4--From Atlanta, consider going to Monterrey, Mexico (via Houston) to have surgery with one of the doctors who actually taught the US doctors how to do it...and for about $10,000, not $15,000. I can probably come up with more, but stop crying and get to work, Girl! There's always a way! Sue

Carmen, If you're as crazy as some of us (I'm not talking about Donali, really I'm not), even with more restriction, you will find ways to eat around the band. There are times we run into a brick wall and have to deal with the motivating factors and eating habits and patterns themselves. I know from personal experience that this process can take a long, long time. If I get a tighter fill, I'll just eat more food that melts on the way down. ("My lunch order? I'll take a box of meringue Cookies and a side of a half gallon of Dreyer's Girl Scout Tagalong Ice Cream, please.") And I'll probably get a massive case of reflux in the process. I need to work on the "other things to do instead of shoveling food down my throat" issue. And I'm 57, so I've got many. many years of habits to deal with. So, you didn't make the wisest choices for someone who wishes to consume a healthy diet. But have you crunched those foods into fitday.com to check on what you really consumed? It may be massive in terms of your first few solid-food meals, but not as horrible as you think overall. You are allowed to have a "less than perfect choices" day. Or even a "less than perfect choices" week. I seem to be in the middle of a "less than perfect choice" fiscal year, and I'm about ready to move on. But... WE EACH NEED THE TIME WE NEED TO LEARN THE THINGS WE NEED TO LEARN. Feel free to cross stitch those those words of wisdom onto a few pillows. (Then send them to me to tie to my head while pound it into the wall in frustration.) Just keep on keeping on, and remember that if you mostly eat, what you mostly should, when you mostly should, you will mostly be healthy. The only thing you can fail is "a diet," and we're not on one of those! Sue

You have lost an average of 2.21 pounds per week for 16 weeks. Most banded people would KILL for stats like that. Just putting things into perspective, Sue

All Right! Let's settle this! In the interest of public service, I ordered a Bailey's on the rocks after dinner. Here is what I learned: It burns a little. I shoulda had the booze before the meal (see above). I am even more convinced that sex is a really good plan. Husband is wondering if he can buy me yet another band. Gotta go...I have some...er, uh...plans. Sue

You could try sex. It isn't fattening and it's pretty good exercise. That's where I'm headed next, excessive sex*. ;-D (*which explains the wink and the smile, now, doesn't it?)

Well, of course we all KNEW that, right? (This is where everybody else is supposed to say, "Sure, we knew that."

Some insurances pay for a panniculectomy when there is a medical reason. (I'll look for an example to hook you up.) Then, no insurance (I think I can safely say that) pays for an "I lost weight and now my boobs droop" surgery, HOWEVER...there are policies which pay for medically necessary breast reductions, which--interestingly enough--have a side effect of a lift...and there are those policies which pay for "reconstructive" surgeries. Start with researching YOUR policy. Sue Hee's Aetna's. See how close you are...and don't consider it written in stone. http://www.aetna.com/cpb/data/CPBA0017.html

...and sometimes it's because a reader is sitting here thinking "Hmmmm. Now that you mention it, I wonder, too...."

Renata, I tend to think it's a relatively rare complication that is seen more because more and more bands are being done...you know, a "law of large numbers" thing. Here's a study on port placement and complications. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14738680 I would hope that my doctor read it before s/he tried to replace the port. Good luck, Sue

Jean, The "How Much" is secondary to "What" I'm eating. I just fixed stuffed zucchini for tonight's dinner...but it has no rice or breading in it. I'll probably end up eating my portion tomorrow. Last night, we were out, so we stopped for a very early dinner at a local restaurant chain. Husband ordered the (huge) 1/2 chicken and a mini-slab of ribs dinner. I ordered my own cup of Soup. They had three selections, and I decided against the chicken tortilla, because the tortilla can turn into glue once inside me. I debated between the tomato basil artichoke soup and the garden veggie soup...opted for the far more fattening tomato soup, because I had (yet again) been having a little reflux and wanted little to chew. My husband ate his soup and the chicken breast and a little of the ribs...and the veggies and his potato whilst I diddled with my soup. Just about the time we were ready to leave, my stoma opened itself and I nibbled on a very little meat. When we got home, I had a little more meat. Breakfast this am was half of an organic instant oatmeal packet. I put in about a teaspoon of Peanut Butter and some soy milk...and, of course, real maple syrup to sweeten it. lunch was a few bites out of a Del Taco beef burrito. I brought it home and ate SOME of the meat filling and no tortilla. I just finished a little more chicken (I think it was my dinner) and feeling like THAT was a bargain meal, as the bread and one veggie are still in the fridge. I don't think I'm too tight. I think I'm too old. (On a number of levels.) My brain does not get the "That's enough! Stop right there!" message. My brain gets the "Now you've done it...you've already eaten too much!" message. Esophageal motility--how fast the esophagus processes the food, moving it where it needs to go--slows with age. So, I think what happens is that it takes so long for the food to get to where it's going that I keep eating too much, too fast. The other part of the age thing is, of course, that we old dogs sometimes take a tad longer to learn new tricks. I can eat lots of stuff. But things that get in the esophagus and sit there and start to absorb liquids and swell (breads, pastas, rice, dry meats, etc.) will make me miserable. Some banded can eat anything, but many have issues with the same foods. It's all a matter of learning what YOU can eat. Sue

Just 50 bands. there appears to be a great improvement after 30, but they keep getting better until about 50...when they kind of max-out. Here's one study: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14625767 I'll gather more. Here's one that says they needed to do 100 before they were really good... http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12582760

According to the research, the magic number is 50. When a surgeon has done more than 50 LapBands (not just more than 50 bariatric surgeries and not just more than 50 laporoscopic surgeries, but more than 50 LapBands), the patients have fewer complications.

Oh...I thought I was at a South American soccer game. Never Mind. Gooooooooooooooooooooooooooooooooooooooooooooal! Sue (good work!)

Jean, Can we look at your menu in terms of what I can eat when I have any restriction at all? I'm stuck on a "chicken tender." But if it's breaded and/or white meat, I would be unable to eat it. Two TABLESPOONS of rice? I wouldn't be able to eat two GRAINS of rice. Hummous can plug me up a little, the way a banana would, if I were tight. Tabouleh? I'm okay on the parsely, but the barley (or whatever the white stuff is) would plug me up. As would any cold Cereal. A couple bites of very-well-chewed DARK meat chicken. A piece of mushed-up, well-roasted carrot or sweet potato, some well-cooked Beans (navy, kidney, pinto, small white, lentils, butter beans, etc.). The nicer you are to your stoma, the fewer Prilosec/Nexium/Aciphex you will buy/take, and the better you will sleep. Take it easy, Sue

Almost thirty years ago (back when they kept people in the hospital for long times), I had cancer and had to have a hysterectomy. Since I was a whopping twenty pounds overweight, I figured that the "silver lining" on the whole surgery cloud was that at least I'd lose a little weight through the whole surgery process. At discharge, after over a week on nothing and then mostly broth and Jello, I weighed five pounds more than I had at admission. I asked my surgeon what the hell he had put in my IV. He said 4400 calories per day. Seems he didn't want me to get weak. Sue

I don't know...but do you really want to be one of his first patients? The complication rate is far lower when the doctor has done 50 lap bands or more. (All lap band doctors are experienced lap surgeons. The difference is how many lap bands they've done. And the less experienced guys don't routinely make mistakes, either. It's just that when you look at the big picture, there are half the problems with more experienced doctors that there are with the less experienced doctors.) Maybe you can find an experienced guy who does take your insurance. Good luck, Sue

Just my humble opinion, but I'm convinced that surgeons who want patients to lose weight before surgery are assholes. (Am I allowed to say "assholes" here? NO? Okay.) I think doctors who insist on patients losing weight before surgery are exactly the same jerks who will be berating you for gaining (or not losing "enough") weight during the post-op phase and will have you begging for adjustments. AND, any moron knows that weight lost with those drugs is regained about 97% of the time, so what's the point? I know you have the national health service to deal with, but can you find another surgeon? Sue

I have heard: a) from many, many Rodriguez patients who are thrilled with him; and, from two Mexican doctors who say that Rodriguez has had emergencies his little clinic was not prepared to handle. (Truth? Gossip? Who knows?) I can tell you that IF there is an emergency, once you cross the border and get on the US side, it's a 150 mile drive to San Antonio for a big city hospital. Rumbaut practices in a large, state-of-the-art teaching hospital, which has plenty of doctors of various specialites there, just as you'd expect in a medium-size city here. His follow-up has been wonderful for me, although I'd avoid e-mail as a way to reach him. He answers his own cell phone (even when he's on a stage in Chicago getting ready to deliver a lecture) and returns calls placed to him when he's unavailable (on a plane.) The only charge related to post-op service is for the flouroscopy. If I had it to do over, the only change I might make is paying him and the hospital separately, as that might have saved me a few hundred bucks. (He has an all-inclusive price, which covers everything, no matter what...and then a pay-doctor-and-hospital-separately-price which save money, but if you need an extra day or extra services, you're on your own price.) Sanchez is also in Monterrey and has thousands of happy patients. Kuri, in Tijuana, is very experienced, does repairs for Inamed problem cases and is almost always available by phone. He has two facilities--the bargain place for $8500 and the oceanside place for $10,000. Have you checked out Cirangle in San Francisco? Rumbaut recommended him to me as a US doctor for adjustments. I've heard their price is closer to $12,000 and that it includes a few post-op adjustments (fills/unfills). If I were self-pay (which I was) in AK (I'm in CA), I think I'd check out Cirangle and whatever group Jessie Ahroni is involved with in Washington state. If they came within a thousand or two of the Mexican price, I might stay closer to home...not because anything is wrong with Mexico, but because when you need a tweak to an adjustment, you'll probably delay needed visits, and that's not good. Good luck, Sue

Marsha, If things, overall, are getting better, relax. If things, overall, are getting worse, call Dr. Kuri. Have you had general anesthesia before? Do you know how you respond to it? Our daughter had breast reduction surgery last summer and the third week post-op was her week from hell. There was nothing that was really wrong, but not enough was right, if you follow the theme here. We all react so differently to the anesthesia, that we have to be prepared to feel like hell just on general principles. BUT, if you are sure that something is getting worse, call Kuri.

Hi, Sam....I have met other AK banded, but you are the first here! One went to Mexico, but I think you can get pretty experienced LapBand surgeons in Washington state these days. And there are excellent follow-up people in Washington, as well.

I know you probably hate this kind of answer, but one of my doctors said, "No eating before fills," one said, "Liquids only before fills," and my surgeon said, "Come into the office after Breakfast." And they think it's the obese who are a little crazy.

Okay, fills... Some of us have surgeons who want to approach the adjustment (what a fill is really called) in a Let's-Get-This-Show-on-the-Road kind of way. They tend to be foreign and/or very experienced LapBand (not just experienced at lap surgery or experienced at bariatric surgery) surgeons. Other of us have the "Let's-Be-Very-Careful-and-Do-This-Slowly surgeons, who tend to be located in the US and/or kind of new at the band. So, what that means is how many fills one has had is completely irrelevant. And, IMHO, the whole little-by-little approach is silly. Because let's say that YOUR ideal fill is 2.3cc's. Dr. Little-by-Little puts in 0.5 at adjustment #1, then moves it up to 1.0cc's at adjustment #2 and so on. When the patient gets to adjustment #4 (2.0cc's), it still isn't enough and then at adjustment #5 (2.5cc's) it's too much and whatever the doctor was worried about in regard to an overfill is going to happen anyway. AND, some of thee surgeons only do fills once or twice a month. So the patient is six months post-op until he/she gets the needed restriction. And we all know how WE deal with that kind of frustration and "failure." And then they say the band doesn't work. Right. Figure out what your doctor is doing. Explain whay YOU don't want to wait six months for restriction. See if you can get the adjustment YOU need. Sue My experience with fills is almost all outside the US. Those doctors used flouroscopy and most got the restriction as tight as they thought I could reasonably handle, and didn't even look at the syringe until I asked them how much saline we were talking about.

I hate when they say "Do not open oven door while baking." I want them to say, "If you open the oven door while baking, the souffle will be flat as a pancake and you'll have to feed your boyfriend's mom a Peanut Butter sandwich, you moron." THEN, I'm more likely to follow directions. Jean, do you have the Inamed bookelt? It is not as informative as it should be, but it's a start. http://inamed.com/products/obesity/us/patient/lapband/information.html Then, some of the stuff you learn/make up as you go along. Here's one I finally wrote about, a year or so ago on another board, since I hadn't seen it anywhere...the saliva (also called "slime") thing. One of the things that is probably happening--or will happen once you start eating--is the saliva thing. In a normal, healthy, unbanded stomach, the food just moves on through the esophagus to the stomach. In a banded stomach, the food can move only so far before it gets to the band and the whole process gets hung up. The brain (which has not read the band owner's manual) interprets the "hang up" as food that's stuck and needs to be moved to save your life. So it sends a little saliva to move things along. Then it sends more. Then it sends gallons (or so it seems) of thick, gooey, saliva to really make it move. When that doesn't work (which it can't because of the band being in place) it all (everything north of the band, so to speak) has to come up. So...my advice to newly banded folks is to head for the bathroom the minute the saliva starts...and start spitting. It may take five minutes or twenty minutes or longer. (And the getting up and walking to the bathroom helps, too.) That saliva has nowhere to go except into your esophagus, which is already blocked at the bottom. So, IMHO, trying to keep it all down is a waste of time. MY goal is to get rid of the extra saliva until the "blockage" has had time to work its way through. The "cure," which I hope to learn pretty soon, as I have been banded for almost a year and a half, is to eat less, chew better and WAIT between bites. I'm an older patient...I was 55 when I was banded. And I had to get unfilled due to reflux, and kind of start all over. But I apparently STILL haven't figured out that the way my system works, it takes several minutes for the signal that it's time to stop eating gets to my brain. If I keep eating during those several minutes, I am inevitably sorry just a few minutes later. AND, I need to negotiate with myself before I eat (I'm often in restaurants) regarding how much of what is being served I'm actually going to eat. Today, I'm going out to lunch with a slew of other old farts and fart-ettes. I have already gone online and checked out the menu. Then I called to see what Soups were being served today. Next, I'm going to call to see if I can order a Breakfast at lunch, because that would be easiest and best for me. If not, I'll have a lunch choice and a SECOND choice, because I don't want to spend the time in the restroom. Right now, I'm thinking that the cup of Soup and half a sandwich sounds good...except I'm concerned about celery in the tuna and about chewing everything else well enough. I'm working on this band thing. I'm obviously a slow learner. This is another reason I'm glad I opted for the band, instead of the bypass. If I had had the bypass, I'd be my thin ideal self by now, but I'd still be just as dysfunctional about food as I am right now. So, after the two year "honeymoon," I'd be one of those bypass people who gains it all back. WITH THE BAND, WHAT YOU LEARN SHOWS, AS YOU LEARN IT. I've learned a little. I'm still learning. Good luck on your journey, Sue