GeezerSue

Alrighty, then. I'm not sure that "a perfect fill" is one that lets us eat anything. Although I have had a (very inexperienced) doctor disagree with me, I believe that MOST banded patients have SOME foods which, when there is restriction, they cannot eat. I don't know why your restriction suddenly kicked in, but anyway... From your list, I cannot eat bread, white meat chicken or salad when I have saline in my band. EVER. Chex Mix is not possible. And you can add raisins, and any dried fruit and potatoes and rice and cakes and more to my "can't eat" list. Don't get offended, here, but the answer is not to put up with the PB'ing, the answer is to stop eating those foods. The bread is unnecessary. Try very moist, very mush dark meat chicken. It's the lettuce in the salad that is responsible for most of my issues. So I order a "cobb salad, hold the lettuce." Or find a way to just eat the veggies I can handle. Nuts are, by nature, dry and will clog me up in a heartbeat. One or two nuts. Or a teeny bit of Peanut Butter. (In a spoon, not on bread.) Really, you can live without the foods that are causing a problem...but you can't go on with the PB'ing without causing potentiallly serious damage. It's all about choices. Not easy ones btw, but choices nonetheless. In my case, I can eat everything I want to eat and not lose very much or very fast, or I can lose weight and accept that there are a few things I just can't eat.

What was the basis of the denial (if you don't mind my asking)?

So you're saying I shouldn't have had that beer? Just kidding. I rarely drink anything. But I have had a sip or two of beer. (And I drink carbonated Water all the time...but not straight out of the bottle. It has to sit a while, first.) My advice would be that slow, small sips of beer may be do-able. And chugging a beer may be a no-no. One of the things I'd REALLY like to learn is that eating (or drinking) things slower actually lets me taste them longer. You may find that you enjoy beer differently now.

Aha, a tune-up. This is a good thing. And potentially aerobic.

Nancy, Since all that was posted was the abstract of the study (pre-publication, at that), I have no clue. However, my guess is that a certain percentage of excess weight had to be lost in order for one to be "successful." I am in the "unsuccessful" group, myself...at least for the time being. But I need to work on my issues and, perhaps, have a teensy bit of saline in my band, as right now there is none. I could go get more...but I think I'd better work on why I was (at least some of the time) eating around the band. Sue

Where is that woman hiding?

Natasha, There are people with ANY KIND of bariatric surgery who lose only a few pounds the first year...or ever. The results are VERY subjective. The only problem I know of is that, here in the colonies, very few doctors have even heard of one. But since you can chunnel your way to the guy who invented them, why not? Sue

There is, I think, a Dr. Fox in Washington who has partnered with and published with Dr. Rumbaut in Monterrey, Mexico. I think it costs a little more to go TO Rumbaut for surgery VIA Fox, but then they have some kind of deal where Fox does the follow-up care. Call him and ask! I'll look for more info.

Just a darned minute! You'd give up that easily? Think it through again! You SAID you have related health problems. Many insurance companies cover people with BMI's of 35 AND related health problems. And there is always Mexico...it's NOT a "second-best" place to go. There's a handful of Mexican surgeons who together have more experience than all the US doctors put together. And there are loans and your school district probably has a Section 125 plan, so that the money can be taken out monthly over a year, and tax free at that. Sue

I've had adjustments with three doctors. Two of them popped the needle right in--no pain, no blood, no problems. The other eventually gets it done, but not without making me quite nervous. The port just isn't where he would have put it and I end up feeling a little like a pin cushion. In the end, they all get the job done, though.

The actual name for a fill is an "adjustment." The inner part of the band--the part nearest the stomach--is tighter or looser depending on how much saline (or air) is in its inner-tube-kind-of-thing. (Although it's not really inner.) I'll look for a link to band basics.

Where are you? Are you okay? Are you all skinny and leading a happy, active life and too busy for internet bulletin boards? Keep in touch!

I'm fine; thanks for asking. I just sent you an email. I've been her for months and don't have any idea what these symbols all mean, but they're cute!

Anne, I hate real world choices, don't you? Okay, in response to your question, some thoughts: •Call me selfish (and you'd be right), but I'm not willing to be part of someone's learning curve just for the benefit of others. I am glad that others are sufficiently altruistic, because I enjoy the benefits. But I'm not going to join the line-up. •How did a band-unfriendly surgeon get that much experience? A wonderment to be sure! •There is a VERY experienced surgeon in the midwest, who does beautiful surgeries and apparently has the bedside manner of Atilla the Hun, and an office staff of ex-drill sergeants. But his work is good. So that's probably where I'd go. (On the other hand, we'd probably argue later and part company and I'd be sorry about my decision.) •Please note, that nobody died in either group. And, that even the more experienced surgeons had complications. So there are no guarantees, either way. •I'm not a particularly lucky gambler, so I like the odds on my side to begin with. Not everybody feels that way. •I'd rather be patient #1, #2, or #3, than patient #9 or #17. That's because the first three surgeries are proctored, with a thoroughly experienced LapBand surgeon in the room. My preferences are not better-informed than anyone else's, they're just mine. We have to do what we have to do to save our lives. Remember, I just said we should ask the question...I didn't mean to make your decision for you. Sue

The authors (I imagine) did the surgeries and the study. Now the questions are: •which group were you in; and, •did you have any problems?

A recent study showed that there are five times as many complications in patients whose doctors are new at the LapBand. (All LapBand doctors are experienced at laporoscopic surgery, but experience with the LapBand makes a difference.)

Another recent study: 1: Surg Endosc. 2003 Nov 21 [Epub ahead of print]. Related Articles, Links _ Laparoscopic adjustable gastric banding: is there a learning curve? Shapiro K, Patel S, Abdo Z, Ferzli G. Department of Surgery, Staten Island University Hospital, 65 Cromwell Avenue, Staten Island, NY 10304, USA. Background: To be certified for laparoscopic placement of adjustable gastric banding, surgeons must have advanced laparoscopic experience. Despite previous exposure to other kinds of laparoscopy, there may a learning curve specific to Lap-Band placement. Methods: Sixty consecutive patients were prospectively separated into two groups: the first 30 patients operated on (group 1) and the second 30 patients operated on (group 2). Results: Both groups were similar statistically in regard to gender, age, and body mass index. Operative time for group 1 was 79 +/- 31.1 min. There were 11 (37%) complications in 10 patients. Operative time for group 2 was 59 +/- 19.9 min. There were two complications (7%). All operations were completed laparoscopically. Operative time was significantly lower in group 2 ( t-test; p = 004). Complications were also significantly lower (chi-square; p = 0.005). The number of reoperations was also reduced and approached statistical significance (chi-square; p = 0.054). Readmissions, although reduced, were not statistically significant. There were no deaths in either group. Conclusions: Despite a surgeon's history of advanced laparoscopic experience, there is a definite learning curve associated with the laparoscopically placed adjustable gastric band. PMID: 14625767 [PubMed - as supplied by publisher]

Eat Weight Disord. 2003 Sep;8(3):218-24. Links Therapeutic outcome of adjustable gastric banding in morbid obese patients. Hotter A, Mangweth B, Kemmler G, Fiala M, Kinzl J, Biebl W. Department of Psychosomatics, University Clinic of Psychiatry, Innsbruck, Austria. alexandra.hotter@tilak.or.at We examined 77 obese patients treated with bariatric surgery in order to analyse treatment success, and compare those with a good or a poor outcome. The subjects, who were recruited one year after undergoing adjustable gastric banding, were asked questions concerning their sociodemographic status, postoperative course, past and present weight status, eating behaviours and difficulties in changing eating habits. Furthermore, we also used two body image questionnaires, and considered the patients' evaluations of positive and negative changes, as well as their wishes for the future. There were no preoperative differences between the 71% of patients in the good outcome group and the 29% in the poor outcome group. With regard to the postoperative course, the poor outcome group had more problems in adapting to new eating behaviours, experienced significantly more post-surgical complications, and had a persistently negative body evaluation. Both groups were satisfied with their achieved weight loss achieved, and their improved self-esteem and mobility. Adjustable gastric banding seems to be successful in inducing weight loss and allowing a better quality of life. However, factors such as postoperative complications, the ability and willingness to adopt new eating attitudes, and an improved body image seem to be crucial for therapeutic outcome. PMID: 14649786 [PubMed - in process]

In southern California, the clinical trials for the Obtech Band were conducted at Scripps (La Jolla, I think). I'd start there, in the bariatric surgery department. Try (858) 554-5522, Dr. Brunson. My guess is that other than those doctors who were in the clincal trials, US doctors will have almost no experience in this department.

Janel, Do you know how many LapBands she has placed? I ask because many surgeons have lots of Lap-experience, but if they haven't done at least fifty bands, they are still in the "learning curve" phase. Sue

Also, have hubby go here: Jamba juice - Whole Foods/Philadelphia 929 South Street PHILADELPHIA PA 19147 (215) 733-9788 to get you a Peanut Butter Moo'd. (Or a chocolate one.) Get the free Protein boost. If you get the large one, it has about a billion calories, (actually about 1300) but you don't care right now, and most of the protein you need (42g) to get through a day. Make the shake last all day if you can. They are really good. Sue http://www.jambajuice.com

Sultana, You didn't ask me, but that never stops me! So here I am. You are, IMHO, working the general anesthesia out of your system. That takes AT LEAST three days, during which your emotions should be all over the map. You may need weeks! Our daughter's worst time post-op (for PS) was week three, during which she was just generally not fit to be around any life forms! Meanwhile, three days post-op, almost all doctors have you on clear liquids...the more liberal allow "full liquids." No egg...maybe some of the yolk from a soft boiled egg. No purees. No cottage cheese, yet. Your stomach needs to let the band heal in place before it takes any chances. Slow down! You were under a general and had a appliance implanted. Just drink liquids and be grumpy and sad and know that this is really normal! Sue

Happy New Year, and thank you for this board. Sue

How's 2004 so far? Is it a big party? :banana :Bunny :banana :Bunny :banana :Bunny :banana :Bunny :banana :Bunny :banana :Bunny :banana :Bunny :banana :Bunny :banana :Bunny

She will "admit" to being bigger than she'd like to be. And I know she accepts that she feels lousy, because she mentions how tired she gets. But she also says that she's "large-boned" and that therefore all of the weight charts and BMI calculators are wrong in her case. She asks lots of questions, so I know she's interested...but then she says aloud the justifications she's giving herself. And those are the things that are hard for me to ignore. I don't want to agree with her, and buy into her fantasy. And I also don't want to say anything she's not ready to hear and alienate her...so I don't. She asks a lot of questions and then "terminates" the discussion with "Well, I'm glad you're doing better. But I need to find another answer for me, because my weight isn't from my eating too much, and those charts are for people with tiny bones." Then I say something like, "Well, those charts sure don't know how you feel. Your'e the only expert. You have to trust yourself. " And that's where I end it, because I'm not ready to lie to her. So I say things that can be interpreted two ways. I'm just wondering how the rest of you deal with those friends.