Jean McMillan

You came to the right place for support! Congrats on starting your WLS journey. March 27th will be here before you know it! Jean

I could give you a million words of wisdom, but I don't think they'd fit in a single post! I'd be happy to answer any questions you have, but it's hard for me to predict what they might be. I hope your insurance gives you the OK fast, and wish you the best for the start of your WLS journey. Hang in there! Jean

Do you have medical insurance? If so, I'd call them and get a list of particpating providers in PA. You can use the surgeon search feature here on LBT: go to the top of the page, click on Surgeons, then click on Surgeons Near You and enter your zip code. Or here: http://www.obesityhelp.com/find/bariatric-surgeon/PA/ Or post a question here: http://www.obesityhelp.com/forums/PA/a,messageboard/board_id,4840/ As for whether the surgeons are accepting new patients or out-of-state patients, only the doctors' offices can accurately tell you that. When I had to change from a KY surgeon to a TN surgeon, I got a list of participating surgeons in my area and called their offices. Some wouldn't take me on, others would do it if I paid a patient transfer fee ($300-$400, non-refundable, not covered by insurance).

We're not sure if the dilation and slip are related. Maybe, but they happened 2 years apart. My original bariatric surgeon lost his medical license due to substance abuse problems, and sometimes when talking with my current surgeon I get the sense that she's hinting that he didn't do a good job placing my band in the first place. We'll never know for sure. I always thought my 4 cc band was perfect for me too. I have the feeling there are newly-recognized problems with the size of the 4 cc band, no matter who the patient is. A surgeon who spoke at last year's ASMBS said that the long-term effect of the band is to create a high-pressure system that can put too much stress on the esophagus, resulting in dilation and motility issues. He didn't specifically mention the 4 cc Lap-Band, but since it's the one that's been in place in American patients the longest, I have to wonder if it's the #1 culprit. My understand of the design of the Realize band is that the inner "pillow" is continuous rather than baffled, so that it distributes pressure more evenly. But I don't know that much about the Realize band, so I suggest that you ask your surgeon about it. You can add that to your long list of questions! Jean

My band slip was cured by a complete unfill. I had another complete unfill 4 weeks ago to treat a dilated esophagus, and I feel the same as you. Suddenly foods that I'd lost interest in are invading me again...I feel like my food demons are having a wild party in my brain. Some foods that had been tasting bland to me taste fabulous again. It's definitely showing me how my band had been doing for me (and that I was taking for granted). I also have the old 4 cc Lap-Band, which I think is still manufactured but sold only in Mexico. I haven't had much trouble getting fills that are manageable. I'm not sure it's been proven that having one slip predisposes you to another one, but I understand you feeling that way. My current surgeon did tell me that (in her opinion), the 4 cc band is too small and too tight, even without fill in it. Now she won't re-fill my band, and as much as I love the band, I've decided to revise to the sleeve (fortunately, my insurance will cover the revision). From what I've learned so far, the sleeve eliminates physical hunger but doesn't provide the early satiety or appetite suppression I've experienced with my band. If I were you, I'd be tempted to revise to a bigger band, probably the Realize rather than the Lap-Band. Good luck! I hope you get good news at your next upper GI. Jean

That's why I don't recommend the band to people who don't have the willingness or means to go back to the doc for frequent fills/adjustments.

First of all, congratulations on starting your weight loss surgery journey! Everyone's pain tolerance is different, and since I don't know if men experience surgical pain and recovery differently from women, I hope a guy answers this post too. If not, I can put you in touch with a very successful male bandster, Tom (at http://beariatric.com). I've had several types of surgery and found my band surgery to be a piece of cake by comparison, but I can't say it was fun, either. I think the worst pain was from the gas they pumped into me during surgery. Unlike intestinal gas, it tends to irritate the diaphragm and send pain signals to the left shoulder, and it's a pain that's resistant to pain killers or products like Gas-X, but it doesn't last long - takes maybe a week to resolve. Some people find that using a heating pad helps, and moving around a lot helped me. My port incision (near my waist) was the most uncomfortable one because it's so hard to turn over in bed or get in and out of a chair without using the abdominal muscles whose fascia the port is stitiched into. But unless I was doing one of those moves, none of my incisions hurt much thanks to the painkiller I was given. I stayed in the hospital overnight because my surgeon felt that if anything's going to go wrong, it'll be in the first 24 hours. I was OK with that and got plenty of ice chips and pain meds from the nurses on duty. The staff will make you get up and take short walks starting a few hours after surgery, to help prevent blood clots. I had a room to myself (it just happened that way). I've had annoying hospital roommates in the past but when it's just an overnight stay, you can't agonize over that. When I was banded, I was doing a sedentary job working at home, so I could rest whenever I wanted. I was bored and restless after about 3 days. How long you'll have to take off work will depend on what kind of work you do. Most people are OK taking a week off work. If you're an out-of-town patient, you'll have to plan for your trip home. If it's by car, I suggest that you bring a bed pillow with you to the hospital, because you'll find it makes your return trip more comfortable - you can hold it against your middle to sort of protect your tender incision areas. I was told to stop the car and walk a little bit about every half hour (to prevent blood clots). If you're flying home, you won't be able to get out of your seat and walk every time you want, but if you talk to a flight attendant when you board the plane, you should be able to make some kind of arrangements.

I haven't lived outside the USA since being banded, but I know a bandster who travels extensively in underdeveloped countries, one who lived in Seoul, Korea for a year, and one who lived in Kuwait for her job. None of them got unfilled before going abroad. The first one had a band problem while in Thailand and had a difficult time getting an unfill because of the language barrier. The second one had no problems even though she was eating local food. I think the third one wasn't eating much local food because of her living arrangements in Kuwait. I've traveled overseas a lot in the past for my job and suggest that you check with the CDC regarding immunizations for travelers to Africa, so that you'll be less likely to contract indigenous diseases. Of course, drink and brush your teeth only with bottled Water. Don't eat fruit or vegetables that you haven't washed (with bottled water) and peeled yourself. Don't eat food prepared or sold by street vendors. Get and fill a prescription for anti-nausea meds to take with you. If you're doing this as part of your job, ask if there's someone in the company/organization who can advise and prepare you for eating, living, and getting medical care when you're in Africa. And ask your bariatric surgeon if he/she can help you locate a bariatric surgeon (or qualified general surgeon) somewhere near your location in Rwanda, maybe not in Africa but somewhere in Europe or another location closer than the USA.

Sarah, Is the pain at your incision sites, or is it gas pain? Did your surgeon give you a prescription for pain medicine? Is it not helping? If so, call your surgeon's office and tell them what's going on. If it's gas pain, it's from the gas pumped into you during surgery, and that will take a week or so to dissipate. I found that moving around, including swinging my arms, helped. Some people swear by Gas-X, but that's for intestinal gas, and it hasn't worked for me. As for the liquids, try to sip an ounce at a time, every 15 minutes. You may have to experiment with the temperature of the liquid to make it easier to swallow. If you're not able to drink at least 64 ounces of liquids a day, call your surgeon's office. You don't want to get dehydrated. And hang in there! It'll get better, I promise!

I know, it's frustrating to have the surgery and then have to wait so long for your band to really start doing its job. Sometimes the careful, incremental fill process seems endless, but it's safer to do it that way because overly aggressive fills can cause very unpleasant complications. I started feeling a little bit of restriction after my 1st fill, a little more after the 2nd, and the 3rd fill really did the trick. Looking back, I'm glad it was gradual because if they gave me that much fill (2.5 cc in a 4 cc band) all in the 1st visit, my eating problems would have been unmanageable. The way it worked out made it possible for me to practice good band eating skills and slowly adjust to the fills. Hang in there! Edited to Add: don't assume your surgeon gives fills only once a month just because they automatically schedule appointments for you once a month. My surgeon will do fills at 2-week intervals if you ask.

Welcome, Christina, and congratulations on starting your weight loss journey. If you have any questions, ask away!

It's good that you got some fill removed. The longer you let problems go on, the harder they are to fix. I'm afraid it's quite possible that your hunger and ability to eat more will return, though you can't really judge that until you've been on solid food for a day or two. All I can say is, I've been there, done that, and encourage you to just hang on! Oh, and have you scheduled another appointment for follow up and possible re-fill? I would do that so I have something to look forward to.

Happy birthday! And hey, I'm 58 and feel better than ever in my entire life, thanks to the band I got shortly after my 54th birthday. The band is going to be the best birthday present ever!

Genetics is indeed a big factor in obesity, plus a host of other idiosyncrasies (especially neuro-endocrine) over which we have no conscious control. All we can do is use the WLS tool (whichever one we choose) to make the best of the body we've got.

I stand corrected! And thanks for the info.

I understand what you're saying, but I think you may have leaped to an incorrect assumption about what the other poster meant by eating whatever he/she liked. You can't assume that what he/she liked to eat was just junk food. It's common to experience eating problems when eating healthy foods like solid protein, veggies, fruits, etc. when the band is too tight, and many bandsters struggle continually to find a good fill level that allows them to eat properly and not suffer side effects.

Gastric plication is a new technique that reduces the size of the stomach by stapling pleats into it. It can be done as the only procedure, or in conjunction with band placement. I know someone who had plication only and has done very well with her weight loss. And someone else who had band plication and has lost over 200 lbs with it, but she has another 150 or so to go and will probably revise to RNY or DS in order to tackle the rest of her weight. Plication is too new to have any long term success or complication statistics.

Congrats on the start of your weight loss journey!

I've had fills take up to 2 weeks to kick in. I've also had fills that felt way too tight at first, but as I readjusted my eating (take tiny bites, chew very well, eat slowly, etc.), that too tight feeling went away.

Yes, I still love food, but it is no longer the love of my life. I'm a little bit more objective about food now, appreciate it for its nutrition as well as its taste, but I've got so many other interesting things going on in my life now that food is not my #1 interest these days.

Each one of our journeys is different. And just like the doctor that has to tweak our fills, we have to tweak our minds and hearts, pasts and presents, hurts and joys and falls and goals. Beautifully said, and so true!

Every time my band has been too tight, I either stopped losing weight or I re-gained weight because I was eating high-calorie, low-satiety "slider" foods. The band does not provide early and prolonged satiety unless you eat solid food. Your stomach has to expand and contract to digest solid food, and that action stimulates the vagus nerves that send satiety messages to your brain. liquids and sliders don't do that, nor do they keep hunger at bay for very long.

Many things besides your band could be affecting your weight. If you feel you now have great restriction and are consuming less calories than you burn through activity and exercise, then you should be losing weight...unless you're on medication or have medical conditions that affect weight. There is nothing in a gastric band that will automatically trigger weight loss. All it does is reduce your appetite and create early and prolonged satiety when you eat solid foods (preferably healthy ones). Have you tried logging your food to see what you're really consuming in terms of calories and macronutrients? I highly recommend weighing/measuring your food and logging it, at least for a week, so that you can determine if you're really consuming less calories than you burn. Personally, I'm terrible at guesstimating food amounts. I cut myself a piece of chicken that I think weighs 2 ounces, but when I actually weigh it, it's 4 ounces. Jean

If you're a person who holds a grudge and feels betrayed about something like that, then my guess is that your friend and your in-laws didn't share their WLS "secret" with you because they were afraid of hurting your tender feelings by suggesting that you're morbidly obese and should have bariatric surgery to deal with it. I see people every day (strangers, friends, acquaintances, coworkers, etc.) who I think could benefit from WLS, but it would be mighty intrusive and presumptuous of me to approach them and say, "You really need to consider bariatric surgery for your weight problem." Their weight is their own business, not mine.

Different people, different scars. Just because two people had horrible scars doesn't mean you will. And honestly, I'd rather have a few small, ugly scars on my abdomen than 92 big, heavy, ugly extra pounds to carry around everyday. As it happens, the only band-related scar you can see on my now is my port incision, and it's pretty boring. Of course, even at my goal weight, I have no desire to wear a bikini in public...