Jean McMillan

Glad I made you laugh, and that you loved Bandwagon. My advice may be crap, but I'm always good for a laugh or two!

I'd like to tell you you're not a fraud, but you can still choose to feel that way. So I'll just tell you how I feel. I feel like I worked very, very hard using my band and my behavior to get me to my goal weight. Anybody who thinks that's "the easy way out" hasn't been down the same road as me, so who are they to judge? At the same time, the whole freaking point of my WLS choice was to make weight loss easier (and more successful) than all my previous attempts, and it would be foolish of me to deny that. Sometimes when I hear myself telling an acquaintance that I lost weight by eating less and exercising more (which is the truth), I catch myself thinking, "If only they knew!" But I have no way of reading other peoples' minds (my own mind is already hard enough to deal with) or predicting their responses to things I do and say, so I try not to waste a lot of time dwelling on what they think of me. If some of them choose to think of me as a fraud, that's their business. If they choose to tell me I'm a fraud, they'd better duck! Jean

I know of a better place to ask this question, but since it's on the website of a competitor of LapBand Talk, I won't post it here. I'll send you a private message about it.

The first thing you need to do is quit calling yourself a failure. The second thing you need to do is seriously consider counseling. (It's worked for me, anyway). Your bariatric surgeon should be able to refer you to someone experienced with WLS and/or eating disorder patients. Please don't give up! I don't know you, but surely you deserve the best effort you can give this.

You might want to remind your boyfriend that while complications from bariatric surgery are infrequent and unpredictable, the health consequences (including early mortality) of obesity are almost guaranteed.

Can you clarify what you mean by "hand in mouth mood"? If you're saying that every time you enjoy some weight loss, you sabotage it by overeating or snacking/grazing the following week, that's a form of self-sabotage. The reasons for self-sabotaging behavior are sometimes hard to identify. In my case, I think I do that kind of thing because I hate change, I want to have my cake and eat it too, and I sometimes feel like I'm destined to fail anyway, so why not fail with a plate of brownies? I have found counseling to be very helpful and encourage you to pursue that. Your bariatric surgeon should be able to refer you to someone experienced with WLS and eating disorder patients.

P, Have you been getting enough Protein and drinking at least 64 ounces of liquids a day? You might want to give your surgeon a call and get some feedback on the weakness you're feeling. I don't know much about gastric plication, but you could check out this site: sleeveplicationtalk.com.

I was starving hungry the day after my band surgery. I was allowed to drink 1 ounce of liquid every 15 minutes but I felt like I could chug a galloon without any problem. But....don't do that! The reason is that in the immediate post-op period, your stomach is still healing and your band is still nesting itself into your stomach. Drinking too fast/too much, not following your surgeon's eating instructions (liquids-purees-soft-solid) and vomiting (which can happen if you chug liquids and/or eat something you're not supposed to eat) can all interfere with the healing process and even cause your band to slip out of position.

Well, at least you know what you're doing wrong! Now, get going on doing it right! We'll be cheering you on....

I don't think that's an indictment of the band or its safety. It's about poor medical and surgical practice, and I'm glad Allergan is refusing to sell bands to that program now. It's scary to think of general surgeons jumping on the bandwagon without fully understanding endoscopic and bariatric surgery and all the patient education and support it requires. I have banded acquaintances in California who are livid when they see huge billboards advertising clinics like that place who promise effortless weight loss.

I'm a bandster with fibro, though my fibro wasn't diagnosed until 18 months after I got to my goal weight. What is your main concern? That your initial recovery will be difficult? Or that your fibro will affect your weight loss, or that the band might affect your fibro? When you had your gall bladder removed, you weren't being treated for fibro, but if you're being treated for it now, I would expect your recover from band surgery to be a bit easier, but that's very hard to predict. You might need to enlist more help from friends and family to make the first week or so more manageable. I've encountered quite a few bandsters with fibro. One has had very disappointing weight loss, partly because along with fibro she has some other serious health conditions and can't even walk without a walker. Another lost all her excess weight and feels that the weight loss has improved her mobility and reduced her fatigue, but it hasn't cured her fibro either. I write for Fibromyalgia & Chronic Pain LIFE magazine and have a lot of information about the relationship between obesity & fibro that I could share with you, depending on what your main conern is. Let me know if I can help you in any way. Jean

As Elcee said, it's normal to lose weight more quickly at the beginning, when you're heaviest, than later on when you're smaller and therefore burning fewer calories. I thought my last 10 pounds were never going to leave me, but they finally did, a little at a time. Sometimes a weight loss plateau means it's time to change things up - different foods, different workouts. If you know what you're doing wrong and just can't seem to work yourself up to it, maybe you need a weight loss vacation. Not a long one! It's very hard to keep up the same level of enthusiasm for any new venture month after month after month. Hang in there! You can do it!

I think people tend to post more often when they're struggling, confused, disappointed, upset, etc. than when they're doing fine and out living life, so that tends to skew the view. I've had my band for 4-1/2 years and I'm still feeling positive about it even though Ive had a band slip, a port flip, and now I'm having some issues with my esophagus refusing to do its job. This whole journey has been amazing and the weight loss is just one aspect of that. I've learned so much about myself and my body, made so many new friends, I'm doing things I'd never draemed of before.

1. To find a bariatric surgeon in your area, go to the top of the forum page and click on Surgeons, then on Surgeon Near You. Follow the prompts to search in your area. 2. Filling you in on anything you need to know before or after surgery would fill a book. In fact, I wrote that book (see my signature line for more info). 3. How long does it take to get the green light from your doctor? Which doctor? The bariatric surgeon? That will all depend on whether your insurance and/or your surgeon requires a medically supervised pre-op diet (3, 6, or 9 months), what your existing medical conditions are, how busy your surgeon's practice is, what tests & evaluations you need, etc. etc. It took me 16 weeks to get from the 1st WLS educational seminar I attended to the operating room. I've heard of other people who had to wait a year or more, and I know someone who had band surgery a week after her first consult with her surgeon. 4. How much it will cost and whether your insurance will cover it depends on the terms of your particular insurance policy. I suggest that you call your insurance company's customer service number and request details of your policy's bariatric surgery coverage in writing before you go much further with this. In addition to coverage of the surgery, you need to investigate coverage of other important things, like fills (just because the policy covers surgery doesn't mean it'll cover fills, or it may cover only a certain number of fills), pre-op tests & evaluations (like a psychological evaluation, a sleep study, heart stress test, pulmonary evaluation, etc. etc. etc.) and nutritionist services. I could tell you billion more things about the adjustable gastric band, but at this point, the most important things you need to know are: 1. Success with the band takes a lot of work. There is nothing in the band itself that will make you lose weight. 2. When deciding whether to have band surgery or another bariatric procedure, you must take into account the possible cost (in money, time, and energy) of the necessary aftercare. The band very rarely works without fills, and it almost always requires several fills and quite a lot of tweaking to achieve optimal band performance. Jean

You'll get more answers if you post this as a thread of its own.

My port flipped a few years ago. I had no idea it had flipped until my surgeon's NP started having problems accessing it for fills. I had one fill in the hospital radiology department which cost something like $1500 and took up an entire day for a stupid 2-minute procedure and decided to have it corrected. I had surgery to repair it and it's been hunky-dory since then. I didn't lose any Fluid from my band as a result of the flip or as a result of its repair. I suppose that could happen if the surgeon were careless and punctured the tubing, but since my port is about 12" away from my band, my surgeon would have had to make a major effort to get at it by way of my port site. I asked my surgeon what could have caused my port to flip - could abdominal exercises have done it, or what? She said it could be the result of poor surgical technique by my original surgeon (long, long story), or stress on the sutures during exercise or lifting, or none of the above.

That feeling of pressure usually means that your esophagus is unhappy about what you just ate. Did you mash the banana before you ate it? If not, that's probably why it's bothering you. When something like that happens, it's a good idea to revert to your previous diet phase (in your case, liquids) for 24 hours to let everything in there calm down. If the discomfort continues and/or becomes severe, and/or you aren't able to swallow liquids, call your surgeon ASAP. I don't know why bananas are problematic because they seem so soft and friendly, but even now I have to be careful of them.

I'm 2 lbs. below my goal weight and doing fine, thanks!

What can I do to increase my weight loss? That's really a question for your bariatric surgeon and/or nutritionist, but here are some things to consider. Are you exercising? Keeping a food log? Making good food choices? Getting plenty of sleep and drinking lots of Water? How long do your meals keep you satisfied (that is, in terms of physical hunger)? Do you feel like you might need another fill?

I've had a few problems (a band slip cured by an unfill, and a port flip cured by outpatient surgery), but I still love my band. You may have already made your surgery choice by the time you read this, but you should be aware that generally speaking, success with the band takes more work than with other bariatric procedures. To me, it's all been worth it. I was ready to make some big lifestyle changes, and that's certainly paid off for me!

As much as I love my band, I have to say that it's a fickle mistress. It can take several fills to achieve optimal restriction, and then as you lose weight and the fat surrounding your inner organs (including your stomach) shrinks, your band will feel looser so you'll need more fill. Also, restriction can be affected by the time of day, the climate, medications, allergies, hormones, and the position of Mars in the sky. You'll feel more restriction when you're making healthy food choices of SOLID foods, less restriction when you're choosing to eat soft and slider foods (some of which are healthy, like yogurt, but a lot of them are high-calorie and nutrient-poor, like ice cream and potato chips). We're all sick of dieting by the time we have WLS, but in a sense success with the band does involve dieting. Your band can't make good food choices for you, it can't make you exercise, it can't make you say no to trigger foods. That's all up to you. I'm over 4 years post op, 2 lbs. below my goal weight, with excellent restriction, and I still have to work on all of that in order to maintain my weight loss. It's a lifetime project. Finally I have to say: just because you can eat anything or overeat doesn't mean you should. Overeating can indeed stretch your pouch and/or esophagus and it can indeed cause your band to slip. Nowadays self-control seems to be a no-no word, but portion control is up to you, at least until you learn your soft stops. Your band won't ring a bell or flash some lights when it's time for you to stop eating. You have to eat slowly and pay close attention to how you feel as you eat. Soft stops are usually subtle - a hiccup, a sneeze, a sigh, a burp, an urge to clear your throat. If you eat through that kind of signal, looking for your pre-op sense of satiety (what I call "Thanksgiving dinner Full"), you'll go on struggling indefinitely. Success with the band is a lot of work. Although it's possible that you've stretched your pouch, only an upper GI study can prove that. If you go on overeating, it'll just make the situation worse. So I suggest that you make yourself do the evil D word (diet) for a week, pay very close attention to your satiety signals, keep a food log including the times of your meals or Snacks so you can get a handle on how long your satiety lasts, and only then go back to your bariatric surgeon to discuss another fill. Jean

I'll bet it's your hernia. When I was researching Bandwagon, a few bariatric surgeons said that the band can, but is not guaranteed, to prevent reflux, and also that hiatal hernias are associated with band slips and other complications or side effects. I have an acquaintance whose reflux was cured by her band surgery,but since she also had a hiatal hernia repaired at the same time, it's hard to say whether her band or the hernia repair is responsible for that cure. Is the Nexium helping?

Whether your insurance will pay depends on the terms of your particular policy. I know of quite a few bandsters (me included) whose corrective or revisional surgery was covered as a medical necessity regardless of whether the original band placement was covered. Good luck! Jean

I've been banded almost 4-1/2 years. I had a band slip that was cured by a complete unfill and rest period. While in the process of getting re-filled, I found out my port had flipped, which was fixed with outpatient surgery. Since then I've been fine except for night cough, occasional reflux at night, and sometimes the urgent desire to burp, but I can't. I'm having an upper endsocopy on Monday and hopefully an upper GI study next week. My own theory is that my current symptoms are related to my untreated hiatal hernia (that my original surgeon was supposed to fix, but didn't), not my band. I understand what you mean about doctors being reluctant to touch band patients, but what about your bariatric surgeon? Can he/she not help you figure all of this out and/or treat you? Jean

Drug addiction is considered a contraindication for bariatric surgery. Success with the band especially requires the patient to take personal responsibility for their eating and exercise behavior. Based on decades of experience with my brother's drug addiction (painkillers), personal responsibility is not in addicts' vocabulary. I feel empathy for your friend because I struggle with my own addiction (food), but it seems to me that she's got to prioritize her issues, put the drug thing on the top of the list, deal with that and stay clean for a year or so before she tackles the obesity issue. My fear for her would be that if she had WLS and was no longer able to turn to food for comfort, stress, etc., she would end up going back to some kind of chemical addiction. On a more practical level, drug & alcohol addiction do a number on the addict's liver. Part of the liver lies on top of the area on the stomach where the band is attached, so the surgeon has to be able to handle it safely. If it's enlarged or diseased, the patient's surgery is much more risky.