CowgirlJane

I had my band removed earlier this year. I actually started having problems in '03, by then I was back in the USA and at that time it was very hard to find a bariatric doctor to take on a foreign implanted band. I was also getting discouraged - the usual band problems - reflux with any fill, not losing weight anymore etc. I lost 70# with the band, but never got to my goal. In 2004 i had to have the Fluid completely removed as I was struggling so much with reflux and of course regained everything..... I found out this year that some time between my last floroscopy in 2004 and this year, my band slipped. I dind't have any symptoms, it was found as part of my pre Sleeve testing. Luckily, no erosion and the damage done wasn't too bad, considering I had it for 10 years. I decided to do the revision in two steps - the theory being that the adhesions etc are removed in the band removal surgery and things have a little time to heal. Revision from band to sleeve increases risk of a leak.... I was very happy with Prof Weiner, but what I know now is that the lapband has a low success rate and i believe you need a great deal of long term follow up - fine tuning the fills and just support in living with the dang thing. I could have probably used follow on nutrition counseling as well - I did great the first year but when I started having symptoms I didn't really have the support I needed. I don't really regret it though, I figure i would possibly weigh a lot more now if I hadn't done it then ... i wasn't interested in getting the gastric bypass, and that was the only real alternative at the time

So, I remember that if you overate, food could actually backup a little into the esophagus, which could lead to dialation. I know that with the gastric sleeve, you have a stomach, not a pouch. I was reading on the post surgery forum people talking about vomiting that sounded a lot like a "packed pouch" or food still in the esophagus. I plan to ask the surgeon about this, curious though if dialation is one of the risks of the sleeve. I fully intend to stop eating before overfilling, but I would like to know about this risk. I had a band for 10 years but had Fluid removed many years ago due to reflux and mild esophagal dialation. I had my band removed in September this year.

Thank you for sharing this info....my surgery is in 2 weeks and i am bracing myself...lol. My PCP told me that I will feel really really tired the first 2-3 weeks and then slowly start to feel better. She said that might be due to dehydration and that many people need to go for IV fluids as you just can't get enough Water in. Her little talk was good - take the "sip sip sip" seriously and don't hesitate to go get IV fluids if i feel awful. Your comments are helping me prepare for how food will feel. I will remind myself that after a few months, eating will feel more normal again, and those early months might be really hard.

mine has taken a long time. Mostly, that was me needing to wrap my head around such a huge decision.

Okay, i will say it - I am not sure why some docs make people go on these torture diets! Liver shrinking is done by going really low carb for 2-3 weeks before. I think some surgeons want you to lose a bunch of weight too so that is why they put you on these super restrictive diets. What is crazy is that i am eating real food and eating lower carb then some of thise "all liquid" diets are! Now, it isn't easy either because having 20-40G of carbs a day, including carbs in vitamins and all sorts of things you would never think about having carbs is also rugged. I take this preop diet very seriously and you should of course follow your surgeons instructions, just bear in mind low carb is what shrinks the liver.

I will check out the Citracal Calcium chews as those do look like the good stuff.

Well, I was shocked to find that they want me taking serious calcium - calcium citrate, not carbonate three times a day! Tums and the other ones won't cut it.

My Nut handed out some samples of various chewable Vitamins (Bariatric Advantage, Celebrate) and I am finding them to be awful, chalky and make me feel a little queasy - and I am still pre-op! I have been using the liquid Vitamin from costco - reViva. The thing I like about the liquid is i can swallow it and get it out of my mouth quickly. I just found out they have a liquid Calcium citrate too! Alot of my favorite chewable calciums are calcuim carbonate so i have been apparently taking the wrong calcuim all these years. I love the gummy vitamins from Costco too, but I think that the reViva is a more complete vitamin. Anyway, I am going to brave the liquid calcium since costco has a good return policy. They have twin packs for a decent price right now: sublingual B-12 discs because Costco had a coupon special. I found out that they are higher dose then the 1,000 mg recommended by my nut. She didn't seem overly concerned about it, but i wonder if I should return them and get something else. I have been using liquid ones but find that i don't keep it under my tongue long enough, think I will do better with a disc or lozenge. Now i just need to find a chewable Iron pill and I guess I am set.

I am starting my low carb two week pre surgery diet tomorrow. I have uncooked beautiful sweet potatoes and was thinking about roasting them and mashing and freezing small portions so I can use in my puree and return to solid food phases. I am curious how, in general, people deal with cooking such small portions? Any tips on freezing or other ways to handle this?

I found premier protein - 30 G of protein and low carb - at costco. I am still preop, but find it edible.

Krankenhaus Sachenhausen is where i had my band implanted nearly 11 years ago. Nice hospital - Prof Weiner was my surgeon there. We were living in Bavaria at the time, but I traveled up to Frankfurt as he had a good reputation.

My feedback is i couldn't read it. It isn't the font size so much as the font type and color against that background.

Other countries do have good medical care - including Mexico. I have never heard of this surgeon and maybe the take away for all of us is that our odds of a good result are better by going to a surgeon with a proven track record and happy patients - regardless of the country.

I do not have experience with bulimia, but I was under the impression that bulimia was a contradiction to weight loss surgery. Most of the guidelines for weight loss surgery limit it people over 40 BMI or over 35 with comorbidities. I guess the reason for this is that it is a very drastic step! I guess it is obvious - but this is a permanent removal of part of your stomach. It would really suck to do it and still struggle with the gain/loss cycle because of the underlying bulimia issues. I am very sympathetic to how useless counselors are though - I really have lost faith in talk therapy. I get more out of talking to supportive friends. I did find EMDR to be a very useful treatment for post traumatic stress, but I am not sure if treatments like that are useful for eating disorders. Hope you find support in resolving this. I am glad you shared this with us here, and I would encourage you to share this with your surgeon before you are operated on. Take care

My doc told me that it is believed that pretty much all leaks actually happen in the first 14 days, even if they are caught later. What I was wondering is this - it seems like almost everybody does that leak test the day after surgery and it never catches leaks, perhaps because the swelling hasn't gone down. I was just curious if anybody on here that had a leak, actually found it in the one day post op leak test that so many surgeons perform before you are allowed to have anything by mouth..

I am curious if the leak test most surgeons seem to do the day after the surgery actually finds leaks or if most leaks are actually found later based on patient symptoms?

I forgot to mention. I still have the BioEnterics brochure from 2001 when i had the lapband. Right in there it says that it should be considered temporary, and that most people will need to have it repositioned or removed at some point. I can't believe I didn't catch that the first time through, but i guess you hear what you want to hear.... Anyway, the manufacturer has known this is the case for at least a decade, the band is not a permanent solution and will most likely require follow on surgeries of some sort.

Posting here, you are very likely to get pro-sleeve/anti-band sentiments because this is a sleeve forum! Do your own research, get info from people who have had the procedures at least 2-3 years ago!!! Most people are in the honeymoon stage the first year or so and will give glowing reviews of their procedure of choice. I was banded in 2001, it was never easy, but I did lose 70# the first year. I was looking pretty good, lots of exercise etc. If you had asked me then, i would have been pro-band. Yes, fills were a hassle, and toward the end of the first year the reflux started showing up, but I still thought it was worth it because I loved getting trimmer. By 2004, I had pouch dialation and really couldn't tolerate any fill without having reflux. I was starting to regain and I was hungry alot. It was such a relief to finally give up and have the fill removed. I had my band surgery outside the country (I lived in Europe at the time) and when I returned to the usa I received very little support - it was hard to find a doctor to take you on so I didn;t get much support in trying to fix whatever the problem was. So, I lived with an empty band and an ever expanding waistline until this year when i found out my band had slipped. I had to have it removed, along with the adhesions and scar tissue as it damages your stomach! It was nothing like the pictures you see in the brochure, your stomach kinda pushes up through the band. I weigh about 30 pounds more now then i did when i was banded 10.5 years ago. Anyway, my primary physician has a lapband and is doing okay with it. I have known others who have had long term success, but, the stats look like about 40% of excess weight kept off over the long term - pretty poor results. Based on people I know, that means that many regained everything and some have done really well. Not enough people have done really well or pretty good... too many complete failures (ie insufficient weight loss or a complication like slippage or erosion) I personally think the band was a reasonable experiment to try, for those of us that didn't want the gastric bypass (or couldn't have bypass) but I would NOT recommend it now based on my personal experience and based on the statistics that are now available. I will also tell you that having a band FIRST increases your complication risk if you later revise to a sleeve or bypass. I would NOT recommend starting with the band if you have it in your mind that it is easy to revise to something else. Yes, people do it all the time, but who needs the extra risk???

Thank you for sharing your story. I am not sure that the plication is showing very good results so far overall, no matter who does it or what country. You know this, but I am saying this for any newbies that may be reading this - the plication is a totally unrelated and different surgery then the gastric sleeve. I hope your revision goes very well. I am a band to sleeve revision patient... it is disappointing when your first surgery doesn't work as advertised.

You have done great, just keep up your slow and steady pace and you will get there!!! So, I guess you know all the basics, but drink lots of Water, eat Protein first, moderate your carb intake, and excercise, even just walking! You really are getting very close to your goal and I know you can make it.

This was the gist of it (I copied from the link) but there was more in the printed article. Impact of surgeon experience and buttress material on postoperative complications after laparoscopic sleeve gastrectomy. PG - 88-97 AB - BACKGROUND: Sleeve gastrectomy is gaining popularity whether as a primary, staged or revisional operation. The aim of this study is to evaluate the perioperative safety and the learning curve for laparoscopic sleeve gastrectomy (LSG). METHODS: We performed a retrospective review of the prospectively collected data for all patients who underwent LSG for the treatment of morbid obesity at our institution from January 2003 to December 2008. RESULTS: Data from 230 consecutive patients [male 47%, female 53%; mean age 44.0 +/- 10.0 years, mean preoperative body mass index (BMI) 56.7 +/- 11.5 kg/m(2)], who were operated upon by three surgeons with different degrees of bariatric experience, were analyzed. There was no 30-day mortality, but there were two cases of late mortality (0.87%). Early complications were noted in 23 cases (10.0%), including 10 cases of leak (4.3%) and 10 cases of hemorrhage (4.3%). In 17 cases (7.4%) reoperations were performed. The rates of overall and major complications did not differ among surgeons or between early and late period of experience for the three surgeons; this trend held true individually and in subgroups. Overall, over the course of the learning curve, a significant decrease in operative time was noted. The only factor that was independently associated with complications was use of buttress material; the likelihood of complications was found to be 72% lower in patients in whom buttress material was used. CONCLUSIONS: LSG constitutes a potentially safe anti-obesity procedure with acceptable morbidity. Experience at the beginning can be discouraging, even for surgeons with advanced laparoscopic skills. LSG can be performed safely, with proper mentoring and in appropriate settings, even by less experienced bariatric surgeons. The use of staple-line reinforcement was associated with improved perioperative outcomes, and it should be considered in an attempt to decrease leaks.

I was reading this in the NUT waiting room, but didn't have time to finish it. Online, all i can find is the summary http://www.ncbi.nlm....pubmed/20526621 This article was VERY interesting, not the least of which mentioning that leak rates are found to be much higher then the commonly cited 1%..... Edited to add: I found the whole text of the article. It was very interesting and I think worthwhile to read http://www.springerlink.com/content/9751m0k2r0158687/fulltext.pdf Basically, it looks like rate of leaks and other complications varies alot as the surgically technique has evolved. It is important to know that this data includes some of the earlier surgeries, so maybe that is why the leak rate is higher (around 4%). It does make me wonder though....

I am sorry your feelings are so hurt, this just sucks. i have to tell you though, maybe in some kind of strange way this is a good learning experience. A friend of mind has a saying "you don't have to get on the crazy bus" meaning, it is your choice in how to react to someone's meanness (hysteria, irrationality or whatever it is). This woman has some kind of game she is playing and she has reeled you in! I personally think that the next time she wants to discuss your size, your weight, your clothing, giving you clothing or really anything of a personal nature related you should just politely tell her to "get lost". By politely tell her i mean something like saying "no thank you, I am not interested". Or when she asks you about weight loss say something like "I am really happy with my progress" and just walk away. It will drive her bonkers as you won't be so much fun to toy with anymore, but she'll get over it and move on. Next time she hurts your feelings and you just politely say "no thanks"... just visualize that crazy bus driving off without you and don't give her another thought. And part two of my friend's saying "don't worry, another crazy bus will come along soon, you aren't missing out"

Weight loss... women's bodies... seems to be a very emotional topic. I haven't had surgery yet but as I have read this thread it occured to me that I don't really have any friends that are morbidly obese. I have a few aquaintances that i know through my horse's boarding barn that are a bit overweight, but most of the people i know and associate with are quite trim. My younger sister was quite heavy, but she passed away 4 years ago (breast cancer which is known to hit obese women more often!!). I feel so far that everybody WANTS me to be successful and get this damn weight off. Maybe it is because i am high BMI of around 49, maybe because I am in my 40s and not younger, but I don't feel any of this negativity. Everyone I have told has wanted me to be a success across the board. A key difference is that I work from home and my co-workers that I interact with are almost all guys that I only see a few times a year. It might be different if I went into an office with the social interactions there. We'll see what happens when the weight starts coming off..

I am still pre-op and i think that the sleeve will reduce hunger and capacity to eat at first, but I wanted to start a thread about the "success factors" that are making a difference for people... those lifestyle changes that are needed for long term success. When I look at myself, I love to be active and am confident that getting weight off will help me return to a high level of activity. I have horses, dogs and a small hobby farm - there are things that are just easier to do when you weigh less so for me, being more active is one of the reasons I am having this surgery. I am someone who actually likes exercise, but it is better when it doesn't hurt so much.... For me, i see my food issues to fall into 3 catagories: 1. Big appetite, especially later in the day. i hope the surgery helps with this because man, I have tried every tip I have heard and I still tend to have a big appetite (sorry, low carbing doesn't help - I am still hungry and want to eat especially in the evening after dinner!). It is like I just have this ridiculous stomach capacity and appetite. Many years ago, I used to wake up in the middle of the night hungry, and feel like i needed to eat to sleep but I broke that habit thank goodness. 2. planning/carelessness. This is especially on weekends when i am not on my regular schedule and frankly "convenience food" doesn't support my goals that well. I have been doing better about keeping things with me in the car to keep from getting overly hungry and being tempted while out and about. I carry Water so first thing I do is drink that before deciding whether to eat. This does continue to be a challenge because my premier Protein drinks are super convenient, low carb and high protein, travel well, but don't put much of a dent in my hunger. I am hoping that is also better after surgery. 3. Occasional stress eating when things go really sideways at work or something. I have been getting alot better with this one and have found many substitutes as well as just learning to "feel the anxiety/stress" or whatever and not react like I need to somehow fix it or numb it. I have gained a lot of confidence on this one, and have learned that the number one trigger is really just getting over tired.... so for me the best solution is regular decent sleep/rest Anyway, I am sure everybody has their own unique list and possible solutions. Would love to hear about what is working for you and maybe get new ideas.