sleepyjean

1. What's the whole fear of bloodclots thing about? I lie in bed at night for hours without developing clots. Why would you get clots from lying on the operating table for an hour? 2. Related to the FAQ I just posted in another thread: The Band stays in forever. If it is removed you will regain all the weight you lost :eek I don't get it. The band forces you to change your behavior. If you change your behavior and live the new way for ten years, wouldn't it be odd if the band was romoved and you went right back to eating the way you did in the pre-band days? I guess I thought at some point you get accustomed to life with the band and learn to master it. This makes me wonder if this band thing will be just as much of a struggle ten years from now as it was the day the doctor put it in you. Maybe I'm oversimplifying, but if you learn in year 1 that filet mignon makes you PB, it seems like by year 10 you would have long since given up trying to eat filet mignon. Is obesity like alcoholism or something? Once an alcoholic, always an alcoholic. Once obese, always (potentially) obese again? Thoughts?

I thought this was a really great FAQ that answers a few more questions beyond the usual what is a band/how is it adjusted type of question. Also, interestingly, the doctor talks about the causes and repair of erosion, slippage, and pouch dilation. This docter says erosion has to do with the way the band is stitched to your stomach. If that's true, it might explain why erosion is more likely to happen with some surgeons than with others. Just a thought. liquids. That said, average weight loss is 50% of excess weight at 5 years. But this includes all patients, including those who have lost little or no weight. How is the Band adjusted? The Band is tightened by accessing the port with a needle. This is most commonly done in the office. Some surgeons do it at the hospital under x-ray guidance, but this is generally not necessary, and makes the procedure much more expensive. For patients with very thick abdominal walls, it may be more difficult to find the port. In our office we have an ultrasound machine which makes it possible to access most ports without need for x-ray. Can I adjust my own Band? In theory, yes. But the answer is NO. NO. NO :confused: (you just know somebody has tried this at home) Why do I have to take Vitamins? The LapBand operation is purely restrictive, so technically you don't need to take vitamins if you are eating a healthy diet. On the other hand, by definition you are eating a hypo-caloric diet, one which will cause you to lose weight. Because of this, we worry that you won't get all the vitamins and minerals you need. This is the main reason we ask you to take vitamins after the surgery. What about the gallbladder? We don't remove the gallbladder unless you already have gallstones that are causing symptoms. Weight loss is slow and natural, so the risk of gallstones is not sufficiently elevated as to make gallbladder removal worth doing. Can the Band be rejected by my body? The Band is made of silicone rubber, and cannot be rejected. Of course it can become infected and require removal, but this is not the same as being rejected like a transplanted organ. What happens after I lose my weight? The Band causes you to lose weight by restricting your caloric intake to less than your caloric expenditure. As you lose weight, your calorie requirements diminish. Once intake matches expenditure, you stop losing weight. How long does the Band stay in? The Band stays in forever. If it is removed you will regain all the weight you lost. What is a slipped Band, and what causes it? There are two types of slippage; anterior and posterior. This refers to whether the front or back side of the stomach slips. There is something else called concentric pouch dilation, but this is not the same as slippage. Slippage or prolapse is when the stomach slides up through the Band, making the pouch bigger. If this happens the Band usually becomes too tight, and patients experience symptoms of reflux (heartburn) as well as nausea and vomiting. This is because the amount of stomach being “squeezed” by the Band is increased, thereby obstructing the Band. There are several causes. Posterior slippage was more common when the Band was placed by the “perigastric” technique. With this technique the back side of the stomach was free to slide up through the Band. These days most surgeons use the “pars flaccida” technique, which was developed to prevent posterior slippage, and has more or less eliminated the incidence of this problem. Anterior slippage is when the front of the stomach slips up through the Band. We try to prevent this by suturing the stomach below the Band to the stomach above the Band, “locking” the Band in place in the right spot. In spite of this, slippage still occurs. It can happen because we haven't placed enough stitches, or they haven't been placed in the right place. Slippage can also occur if patients eat too much and vomit frequently. How is a slipped Band diagnosed? Fortunately, this is very easy. Often the diagnosis is made based on the history alone. A patient who has been going along fine, with no problems, and then suddenly develops reflux symptoms or symptoms of a too-tight Band will most likely have a slipped Band. The diagnosis is easily confirmed with an x-ray and barium swallow examination. Endoscopy is rarely necessary. How is a slipped Band fixed? A slipped Band needs to be fixed with an operation. The Band has to be dissected out, all the sutures removed, and the position of the stomach made right. Some surgeons remove the Band and place it back through a new tunnel. Others just straighten things out and re-suture the stomach over the Band. What happens if the Band slips again? That's a tough one. One could certainly try to fix the slip again, but my personal view is that, for whatever reason, the Band is just not working for that particular patient, and ought to be removed. What is a Band erosion? This is when the Band actually erodes into the stomach. It is a more serious problem, and generally requires removal of the Band. Band erosion is thought to be related to placing too many sutures (or too tight sutures) at the time of Band implantation. Surprisingly, Band erosion is often unnoticed. Occasionally the port will become infected if bacteria track along the catheter out to the port. Other times patients will stop losing weight. Diagnosis often requires an endoscopy. What is concentric pouch dilation? This is technically not the same as slippage. In this case the pouch just seems to be enlarged. Sometimes partial emptying of the Band may help with this. What is esophageal dilation? This is when the esophagus enlarges over time, and is probably related to either too tight a Band, or possibly improper placement of the Band around the junction of the esophagus and stomach. This requires loosening or removal of the Band. What happens if my Band has to be removed because of complications or failure to lose weight? One option, of course, is to give up on weight loss surgery. Another option is to convert to another procedure such as Roux-en-Y gastric bypass. This can be done at the same time the Band is removed, and is generally done laparoscopically. If you have questions that have not been answered by this FAQ, please send them to me and I will try to answer them for you. Mark A Pleatman MD 43494 Woodward Ave. #202 Bloomfield Hills, Michigan 48302 Office Hours: 9:00 AM to 5:00 PM Phone: (248) 334-5444 Fax: (248) 334-5484 Email: pleatman@laparoscopy.com

I found this medical guide written by doctors for doctors, so it's very technical. There are photos of the procedure. It's hard to tell what's what -everything is pink and yellow - but it's kind of interesting. It's kind of weird to see the band it there. It really does look like a foreign object. http://thinforlife.med.nyu.edu/assets/REN%202.pdf?RCD=J53039&NAME=Christine_J._Ren

What do you think about going under the knife?

Found out three weeks ago that my company is changing from Healthnet to BC california care effective (in theory) today. However, last week, our HR lady was still fooling around with the paperwork. (She told me the doctor I'd selected was no longer taking new patients. I had about 2 hours to find a new banding program I was comfortable with and find a medical group that would refer me to that program. Night. Mare.) Anyway, I'm ready to go. I want to get in to see my new PCP as soon as humanly possible. However, since the HR lady hasn't finished everything, Lord only knows how long I'll have to wait to get a membership card, number, etc. Is there anything I can do to get this show on the road? I want to go ahead and make an appointment with my PCP for the referral, but at this point, I don't even know if I've been assigned the doctor I selected. Any advice? I wouldn't mind the waiting so much if I felt that at least I was making some progress. But I'm starting over from square one after dealing with healthnet since September.

I can't even tell you how much hope you have just given me. God bless! Rene - did they say it's *just* because of your BMI? That's bullcrap. I hate the health insurance industry. (By the way, thanks for posting the BC policy a while back. It was good to have that to read over.)

Oh Lord, I really do not want to see this. I'm about to initiate the is process with Blue Cross California Care...

Realizing that I am morbidly obese is what finally drove home to me that if I don't do something, this condition will not only cheat me of a good life but will kill me much sooner than my peers.

I'm glad. I rewrote that a couple different ways because I really didn't want to offend you, but then I decided to stop fussing with it and leave it alone. I'm glad you took it in the spirit that it was meant. I practically had an emotional breakdown after I found this site posted a couple of times. For me, obesity has been very lonely. It's been a lifetime of feeling different from everyone else. So to come here and realize that there is not one feeling I've felt, not one experience I've had, that hasn't been felt and experienced by most of the people here...okay, I cried like a baby. :laugh Hopefully you will come to see that too and begin to feel more comfortable with the whole banding thing so it's less frightening. ((hugs))

It sounds like you got pregnant pretty soon after banding. I'm guessing the whole thing is making you mental because you're still getting used to being banded and now here's another challenge for you. Maybe that's why I keep reading the advice not to get pregnant for a year or more after banding - maybe it's to help you wrap your brain around the whole thing! All I know is: 1. This will continue to make you crazy. :cross-eye But that's normal. 2. You will do what's best for your baby. I don't even know you and I can tell that. You won't starve yourself and the band will prevent an old-school binge. 3. I hear that breast feeding takes the weight off real quick! :laugh

I'm curious to know if any given doctor is charging each patient the same amount and if not, why not? What's the pricing based on?

Here in Southern California, we have a prominent talk radio personality who went through GB. His name is Bill Handel and I think he's pretty funny - no holds barred, tell it like it is. (Some people do believe he is a little offensive, but that's not relevant to this piece) Anyway, Bill had GB two years ago and this year. He started out at 300+ pounds. After he lost the weight, he talked about the experience on his show. Even though it's about GB, I think a lot of it is relevant for us too. (His description of the bowel prep and post-surgery gas pains are especially...ahem...realistic.) And he talks about his wife's reaction (She was one of the ones who said GB was the "easy way out.") I was planning to have my surgery at the same place but had yet another insurance crisis yesterday and had to choose a new medical group. AGAIN. Anyway, it's pretty interesting, so if you've got a high-speed connection, you can listen to it here: http://www.centinelafreeman.com/memorial/HospitalServices/BillHandel Oh!and one thing I thought was interesting was he had a doctor come on the air and talke about the statistics and why health insurance companies are willing to pay for the surgery. One thing he said was was about a study of obese people. He said of all the morbidly obese people in the study who had considered GB and decided not to do it, 6 years later, 20% of them were dead. Of the morbidly obese people who went through GB, 9 years later only 6% had died. (I think I wrote it down correctly.) I'm sure there are other factors such as age, comorbidities, lifestyle, etc. that impacted the outcome, but that's a pretty freakin' scary statistic and probably even scarier when compared against the percent of people who die after being banded!

Thanks everyone!

I haven't really read anything about that around here, which is a little surprising. Exercise, exercise, excercise is all you read in the magazines these days, so it seems like the surgeons would tell everyone to get moving. I'm wondering if most bandsters start doing some kind of exercise, or if the band pretty much does the job all by itself? Those who do exercise - do you feel it's made a difference in terms of speed of weight loss, excess skin, etc. Or does it mostly just make you feel better overall?

Do you get any exercise? Maybe try walking around your neighborhood?

When my cousin's first baby was born, he didn't see the point of child-proofing the house. My cousin's opinion was the kid would learn on her own. She'd only have to put her fingers in a socket once to learn not to do that ever again. (Yeah, he's father of the year material.) I think of the band as a similar approach. It will only take one attempted binge for me to really "get it" that I absolutely cannot do that anymore. As crazy as it sounds, it's going to take some pain and discomfort to break me of the habit of eating a LOT and eating it FAST. And it won't take long to figure out what I can and can't eat and how much I have to chew before I swallow. But I'm prepared for the change - looking forward to it, even. I was also terrified of this surgery when I first heard it. I hate doctors, needles, pain, bleeding, etc. I couldn't imagine volunteering to let someone cut me open, much less actually paying thousands of dollars for it. But I finally reached a point where the fear of living the rest of my life as an obese person (with all the medical issues that entails) overcame my fear of the surgery.You may not be at the point yet, and it's okay if you aren't. I totally don't mean this in a harsh or patronizing way, but you aren't unique. We are ALL here because we eat too much, eat too fast, etc. I didn't see anything in your message that would make you a special case (e.g. you're missing all your teeth so you have to make like a python and swallow everything whole). I also think your worries are normal. We all worry that we won't have the self control to follow through on this (after all, if we had that kind of control, none of us would be in this boat in the first place!) I guess my thought is, if all these folks here can win that battle, so can you and I. It won't be easy, but it is winable. Spend some time really thinking about it and searching your heart. If you think this is something you truly cannot do, then I suggest you don't get banded. Or at least put it off and think about it some more. If it helps, I don't think I've run across any stories in this forum about people who were hospitalized for swallowing a big bite of food. Or anyone who has died from the procedure. That would be front page news around here if it had happened.

I'm no expert, as I'm pre-band as well, but it seems to me that your endocrinologist's advice is well and good, but she's not the surgeon. I'd either wait to talk to the surgeon, or else call his office and find out if they usually ask people to lose a certain amount of weight before the surgery. (Just tell them you are wanting a head start) Personally, I would never go on Optifast unless I was sure that I was getting banded, because that's a setup for failure. If you go on optifast and decide not to get banded, you'll probably gain the weight back, and then some. But if you do decide to get banded, and the surgeon does want you to lose weight, Optifast is an option. the only thing I know about the gastric balloon is that it's insertion and/or removal has not been covered by any of my health insurance carriers. The balloon seems like the old/outdated approach to me. That was popular about 10-15 years ago, wasn't it?

Laparoscopic Adjustable Gastric Banding : Achieving Permanent Weight Loss with Minimally Invasive Surgery by Jessie H. Ahroni Is it any good? [ame=http://www.amazon.com/gp/product/0595311148/ref=ord_cart_shr/002-3799863-7120807?%5Fencoding=UTF8&m=ATVPDKIKX0DER&v=glance&n=283155]Amazon.com: Laparoscopic Adjustable Gastric Banding: Achieving Permanent Weight Loss with Minimally Invasive Surgery: Jessie H. Ahroni Ph.D. A. R. N. P.: Books[/ame]

I think the best thing you can do is just hang around here for a while and read through the threads. This group discusses the good, the bad, and the ugly! You'll get an idea of what it's like to go through the surgery and how yuor life will have to change afterward. I also recommend Weight Loss Surgery for Dummies. It was pretty useful for me when I was just getting started. I also think that at your height and weight, you're just shy of a BMI of 40. Most insurers will require you to have a BMI of 40 or a BMI of 35 plus one or more "comorbidities." I'm not sure if your other health issues would count. You'd have to check with your insurer.

How "fizzy" is beer? If it's as fizzy as soda, might as well kiss it g'bye

ONE-DERLAND! woohoo

Does opportunity cost count?

Hee hee hee! Ok, that part did not make me feel any better about this...

How long did it take you to get through each of these steps? 1. get referral --> surgery consult 2. surgery consult --> surgery scheduled 3. surgery scheduled --> the actual operation 4. operation --> leaving the hospital 5. left hospital --> first fill (If you're self-pay or self referred, you can skip #1) I'm hoping everyone's answers will help me feel a little less frustrated. It's been about three months for me and I'm still trying to get a referral from my PCP! In the immortal words of Gwen Stefani: It's bananas. B-A-N-A-N-A-S. http://www.ebaumsworld.com/flash/peanutbutter.html

I really enjoyed reading your story. This probably sounds horrible, but I was kind of glad to read that you struggled at some times along the way. It makes this seem a lot more doable for the rest of us. :-) Totally unrelated and random question: your hair is naturally curly, yes? Did you have it chemically straightened? Was it damaging? That's one of the things I want to try when my face gets less pudgy.