CowgirlJane

Once my band was unfilled, the only food I couldn't really eat was rice. Otherwise, I feel like I have no restriction.

Okay, I did decide to do medifast. I have survived my first week - including two restaurant meals (related to taking a kid off to college). I have stayed on program really well and.... drum roll please... have lost 11.6 pounds in week one. I felt like crap the first few days, but have not been hungry nor had food cravings. Wish me luck for week 2!

I have a lifetime of dieting under my belt, but never really embraced the low carb thing. i guess because by the time that become huge, I had sorta given up and/or didn't really understand it. I was indoctrinated under the false diet rules of low fat being the thing. Also, it seems I really like carbs which is probably a good reason for me to restrict them. Anyway, due to family reasons, I won't have my sleeve surgery for several months. My BMI is 49 and rising, so I have decided to get on a program and lose weight! It will make the eventual surgery easier and I hope will set me up better to achieve my longer term goals if I can shed some pounds before my sleeve surgery. Anyhoo, I suck at eating low carb. I was shocked at how many carbs were in even what I consider non starchy veggies!!! So, I was doing okay doing a low GI type diet where you always combine carb with a Protein, but I sorta fell off the wagon. my sister had good success with Medifast so convinced me to give it a try. The boxes are here, so I start tomorrow. It is the deal where you do the Meal Replacement and have one real food meal a day - lean meat and green veggies. Medifast is NOT low carb, as you have something like 80-100 total carbs a day. It is more like low GI eating, but their literature says that after 3 days you go into ketosis. People lose weight fast on this, and I am told after those first few days, are not hungry. My surgeon does NOT require a liver shrinking diet (20-40 total carbs per day) for the band removal which is end of Sept, but does require it for the actual sleeve surgery. That is fine, I will follow whatever they want me to do during those last two weeks. So, here are my questions... Will eating this moderate carb thing, if it really does result in ketosis shrink the liver too? If I am able to stick with this medifast thing for the 3 months while I await the sleeve, I think I have a pretty good chance of losing maybe 40 pounds. My BMI is currently 49, so that will help some. Will this mean that when I first have surgery, I probably won't lose very fast since I would have done the fast weight loss presurgery? After I have the sleeve surgery, I am hopeful I can figure out how to eat low carb, using real food and not medifast, but right now I just get too hungry and get too many cravings. Are there like, different levels of ketosis so you can kick it up by going to the stricter low carb? Is it useful to test using those ketone strips? Any suggestions on where to learn more about the ketosis, how to know when you have acheived it etc? i have read the Adkins website, but like I said, I just can't seem to follow the low carb thing for more then about a day. Medifast has so few decisions to make, I feel like I might have a better chance as it is very black and white what you eat.

Mindy, have you discussed with your surgeon and / or nutritionalist?

That is good information. My band has slipped, so I can imagine there is scar tissue in more then one place. I think he will know better once he takes the band out at the end of the month. I was supposed to have it removed yesterday but I got a really bad cold (lots of chest congestion) and chickened out and rescheduled to end of Sept.

I find it frustrating that you cannot get independant data on leak rates. My surgeon told me that he sees about 4-5% risk of leaks in revisions; as opposed to the 1% (if memory is correct) for people who the sleeve is their first stomach or weight loss surgery. I know that people say that Dr Aceves in Mexico has a 0% leak rate, which I assume covers revisions as well, but I don't know how to verify it. That is a second hand knowledge statement, and one which I do not know the accuracy of. I would ask the surgeon what percentage of his patients have leaks - revision and first timers. The way it was worded sounds like 100% of his revisions if done as one step had leaks and I doubt that is the case. My doc prefers to do them 4-6 weeks apart, but he will do them at the same time if the patient insists, especially the self pay ones it may be a more practical solution.

Sounds very strange, and it does make you wonder if the person was confused. I have not yet had the removal, but my approval is for two separate procedures - removal and then secondarily a sleeve. I am pretty sure that the "repositioning" is a different CPT code.

I am 5'5" barefoot, and measured just a hair under 3" on the elbow test - so that makes me large framed. I believe it as I have broad shoulders etc. The range that it shows for me is 140-159. According to what I have read elsewhere (dsfacts.com), a person who has been more then 100# overweight for many years probably has extra skin, denser bones, more fat cells etc that could add another 10% to their goal weight. I have been very overweight for along time. The goal I have been thinking of is in the 160-170 range, which I think makes alot of sense given this chart and knowing I will have extra skin. So, i currently weigh about 295, a reasonable goal might be 165 so I should lose about 130# to get to goal.

Can somebody explain to me why you are less likely to have reflux with the RNY? I never had reflux before being banded and the idea of the "pouch" and related problems of the RNY makes me "shudder". Anyway, I don't get how a revision from a sleeve to RNY solves the acid reflux since you have already lost that 85% of your stomach.

I don't think that this is considered "elective" if you have the co-morbidities etc. Maybe that varies plan to plan... but my view is that getting a facelift is elective surgery, but WLS is medically necesary for obese persons. As a person who has been a supervisor/manager - don't trust what he says, go to the HR experts in your company.

I just registered at realize and they don't let you use alot of the functions until post surgery - so I can't track exercise for example. I have been using livestrong.com which is a great website, but lousy smart phone app.

Just goes to show, there is a reason they call it "practicing" medicine!

http://www.ncbi.nlm.nih.gov/pubmed/21803660

fern, I thank you for sharing as I think the risk from the lapband are often understated. I found out today from my docs office that the band removal is a more technically difficult surgery then doing the sleeve because they have to cut away some scar tissue and stuff.... I sure didn' t know that when I was banded.

I have an adopted son and a biological son, they are both now young adults. I should tell you that there ARE some differences. A person who is adopted may have some issues to work out, in our case it showed up in the teen years. Anyway, not too long ago my 22 yo son gave me a big hug and thanked me for adopting him as he is happy with his life. I think adoption is absolutely wonderful, and I feel blessed he is my son, but it does have it's challenges as well.

Okay, I have been banded since March 2001 (and need to have the band removed now due to slippage) and while I am NOT a band advocate I feel that some of what was stated was not exactly right on target with my experiences, for example -there is no reason to be unfilled when you fly/travel. I traveled ALOT for business in the first year I was banded (as in several times a month for that first year) and I never had a problem whether it be planes, trains or automobiles. -I have never experienced or heard of this mucus thing... sounds like someone who is way too tight This night cough is reflux and is a very serious issue. It means you can't eat within many hours of bedtime and for some people it means you need to sleep with some elevation of your head. That for me was one of the biggest problem of the band and ultimately the reason I had to have all the fill removed. One thing I experienced, and this was more after the first 9-12 months was that I felt hunger even when my pouch was full. It was not a nice experience. Finally, was the level of restriction. I lost well if I was pretty tight and that could be coped with over the short term. Over the long term, that leads to all sorts of complications like dialation etc. My opinion now is that there are several false logics in terms of how the band works over the long term. First the idea is that if you have the bad experience of upchucking food it will train you to not overeat. Throwing up with the band isn't like vomiting from the flu. I aint saying it is nice, but I don't think it trains people to eat better. In fact, you are much more likely to have problems with dense Proteins and veggies (okay, and bread) then any other types of food so I would say that the vomiting when you overeat actually trains you to eat poorly. The other false information is that it is easily reversible and is the lowest risk WLS. Well, they can take the band out, but it has created scar tissue... so it is not like you return to normal immediately. I feel that at the time I was banded, this was not clearly communicated AT ALL. The actual surgery is quite low risk, but the risk of complications approaches 100% over the long run. Are people told that the band will likely have to be removed at some point?

I haven't watched the video yet, but my surgeon also said that revision patients typically lose slower, don't lose as much and that there aren't alot of published stats. I have a personal theory is that people who had a miserable experience with the band have learned how to "eat around" the band as a self defense mecansim (ie healthy food hurts, junk food oddly goes down fine). I believe that the band CAN teach you bad habits so you maybe have to work extra hard. I have no evidence to back this up, just my personal theory.

Beautiful mother and daughter!! Congrats many times over

okay, <sigh of relief> So, when they said no erosion after that endoscopy I know that is the final word! my band is slipped about half way down the stomach, can be seen clearly on the floroscopy so I didn't need to do the CT.

Congrats on getting the date set! What made them decide to do the CT scan? I have had a band for 10 years that is slipped. They did an endoscopy and told me I didn't have any erosion. I am curious how erosion is typically diagnosed.

I have felt some anxiety starting with just researching WLS. When I feel anxiety, I tend to eat a bit more. I felt like I was gaining a ton of weight over several months, but when I finally got brave and weighed, it wasn't THAT bad. I have now started tracking what I am eating and just trying to be "sensible". For me, the tracking helps me have that feeling of being in control. BTW, I tried both fitnesspal and livestrong.com So far, I prefer the livestrong.com tools for food tracking. I am not a big believer in the "last supper". Heck, I have done all sorts of weight loss programs and the reality of it is that you will be able to eat again! The point with the surgery is that at first your food is very very restricted. Once you hit maintenance, you should be able to enjoy small, healthy portions of normal foods. The last supper idea makes you feel like you will never eat again and that just isn't the case.

I am terrified too, but I KNOW you will be fine. Once you get past that initial healing, I am sure you will be so happy with this wonderful tool to lose weight! Our thoughts and prayers are with you..

You know the saying, "everything looks like a nail to the hammer" I think we DO need to listen to advice from the surgeons that is why maybe it is even good to talk to more then one as they have their biases too. My sleep apnea doc pushed me to look into the sleeve. I have not had good results with the band and just was never comfortable with the gastric bypass. This whole pouch thing is for the birds, a smaller stomach is more appealing to me. The first surgeon I went to didn't like the band, felt it was a big money maker but not the best for the patients. He does the gastric bypass and the sleeve, but felt that since I had already "failed" at a restrictive only procedure that he would recomment the bypass. I put all my investigation on hold (this was last year) as I just don't want a bypass. By chance, I had an encounter with someone who was pretty jazzed about the sleeve and asked me to give it a closer look. I went to a second surgeon, who has done alot of revisions to the sleeve to see if he thought I had good prospects for the sleeve. He really did. He also gave me a real shakeup over the complication rate of for revision from the band to any of the other surgeries. (just another lie about the band, it is reversible, but it comes with possible problems due to scarring etc). I felt both more positive and perhaps a little more scared after meeting with the second surgeon as I was pretty naive about the problems caused by having a band implanted for 10 years. My personal opinion is that ALL of the surgeries require a great deal of patient compliance to be successful. The bigger you are, the more that is a factor I believe. For people with 50pounds to lose, they get to goal really fast. I have a BMI of 48 or 49 so I know that I will really need to work to get to a "normal" BMI. I am thinking that the sleeve and gastric bypass have fairly similiar results - the weight comes off pretty easy at first so take advantage of that and really work it! After that... it slows way down... and eventually, you really have to watch your diet to keep the weight off. No free ride, but I am sure hoping for something better then I acheived with the band. Anyway, I think you are asking good questions - keep checking it all out and maybe consider a second opinion.

I totally agree with you on the importance being on the long term risks. One of the reasons I went with the band was the relatively low risk of surgical problems - of course the long term issues were considerable.... Anyway, just another interesting tidbit of info

I finally got a date to have my band removed, Sept 1. Just this last weekend I have been having some tooth discomfort and I thought.... dang... i bet i need dental work. I seem to remember hearing that you shouldn't do dental work near a surgery date. Does anybody know more about this?