Jean McMillan

Well said!

I'd like to tell you to forget what that person said, but I've been cyber-stalked for almost 5 years by a sick person I met on a WLS support site and I'm not able to easily shake that kind of thing off. It's scary. I guess my best advice for you is to use the block feature and remember that you are well loved and well respected by many members of LBT.

OK, here's my speech. My background: I lost 100% of my excess weight with my band but had to have it removed at 4-1/2 yrs post-op because of problems caused by a 20+ year history of silent reflux that apparently my band was aggravating. A few months later, I revised to the sleeve and since then have lost the weight I regained after losing my band. So I'm speaking from personal experience with both WLS procedures. My opinion is that slow weight loss is not a good enough reason to remove your band unless you have very serious comorbidities that need to be resolved quickly. Aside from that consideration, additional surgery is probably riskier to you than the sIow weight loss. That's because all surgeries of all descriptions are risky. I won't quiz you on whether or not you've done your part to lose weight. You must've been doing something right to lose the 30 lbs. Your slow weight loss could be due to a dozen things, some of them not within your control. My greater concern for you is that you haven't been able to tolerate fills because of reflux. I've encountered quite a few bandsters who had the same problem and eventually revised to a different WLS procedure because of it. Medically, that makes sense to me, because reflux can cause serious damage to the esophagus and stomach. Remember what I said about needing my band removed? It's because decades of reflux had caused esophageal stenosis (thickening of the walls) and dysmotility (my esophagus couldn't move food down into my stomach very well). According to 2 gastro docs who treated me earlier this year, those problems can eventually cause serious malnutrition because the patient can hardly even swallow Protein shakes. Also, reflux can lead to a pre-cancerous condition called Barretts Esophagus. So I'm glad your surgeon is taking your reflux seriously. Is the sleeve a good option for you? Maybe, maybe not. Before you roll into an operating room for that procedure, you need to know that reflux is extremely common in sleeve patients. The ones who had before surgery find it's a LOT worse afterward, and most of us need to take meds for it (I take omeprazole) indefinitely. Some find that even the meds don't control it. I thought that the sleeve would be a good 2nd choice for me because I wasn't crazy about the malabsorption aspect of gastric bypass surgery, because one of the best features of the sleeve is that the reduced stomach size drastically reduces production of the hunger hormone, grehlin, and because the idea of a surgery that wouldn't require fills to achieve optimal restriction was appealing. Unfortunately, it didn't work out that way for me. I am now ferociously hungry on an hourly basis no matter what, how much, or when I eat. I have to eat 8-10 times a day in order to keep my blood sugar steady. I've had to start taking metformin for my type 2 diabetes after easily managing it with diet and exercise for 7 years. I've discovered that sleeve patients can dump just like gastric bypass patients because the small sleeve can't hold food for long and therefore "dumps" it quickly into the intestines, causing miserable symptoms of nausea, dizziness, drenching sweats, fatigue. That happens not just when I eat something with sugar in it but also when I eat so-called healthy foods (protein bars, milk, cottage cheese, yogurt, Protein Shakes, most fruits). I've become anemic and have to take an Iron supplement twice a day in order to give me enough energy to function. Turns out that micronutrient malabsorption isn't unique to gastric bypass and duodenal switch patients. Also, since my sleeve surgery I've developed a gastric bleed. When doing an EGD to locate the source of the bleed, my gastro doc discovered a gastric polyp (probably the cause of the bleeding) and duodenitis (inflammation of the duodenum), neither of which were present when I had an EGD 3 months before my sleeve surgery. Finally, I've discovered that sleeve patients can have "stuck" episodes just like bandsters do, and for the same reasons (in my case, careless eating). I'm not able to be objective about my sleeve at this point, and at 4 months post-op, it's probably too early for me to decide it was a mistake. But even if I decide it was a mistake, I'm never going to get that missing chunk of stomach back. It's gone forever. I do know that I absolutely refuse to go back to the land of obesity, and I'm grateful that my sleeve has helped me avoid that. My main reason for telling you all this is to warn you that there is no such thing as a risk-free, effective WLS tool. Every surgery has side effects, risks, and lifestyle effects to consider. It is always OK to quiz your surgeon about those issues, and if he/she doesn't respond to your satisfaction, I think you need to get a 2nd opinion. Good luck! Jean

Did your surgeon say why you need your band removed because of the hernia? I've been in the WLS game for over 5 years and this is the first time I've heard of that happening. Is it an unsually large hernia? Causing some other problems? Or what? I have a hiatal hernia that my original surgeon failed to repair despite his promise to do so. I lost my band at 4-1/2 yrs post-op but not because of the hernia. I've asked my current surgeon several times about repairing the hernia and she keeps saying it's not necessary, though I've read in several books by bariatric surgeons that untreated or undiagnosed hiatal hernias can be associated with band slips. Off the top of my head, I can think of 2 long-time bandsters who developed hiatal hernias after weight loss. Both had their hernias repaired and (while they were at it) their bands replaced. Neither had complications and they both still love their bands. I tell you all this because I hate to see you lose your band without a sound reason behind it. Maybe getting a second opinion would help? Jean

I understand members' need for support, encouragement, sympathy, understanding, and all those warm, squishy things, but none of us are mind readers and all of us are humans, full of weaknesses and strengths. I got a lot of education from my bariatric team, but I also got a lot from my online pals. The bariatric professionals who are trying to help us most often have no personal experience of obesity or WLS. The everyday, day-after-day reality of obesity and weight loss, the how to survive and thrive, how to stay motivated, and how to face the ways we've screwed up as well as the ways we're doing well, are what an online WLS community like LBT has to offer, if members are willing to take it. As the 12-steppers say: take what you need and leave the rest.

IMO, a surgery that involves cutting holes in the anesthetized patient's abdomen, sticking instruments in there, moving around organs, and clamping a medical device around the stomach is invasive, so to me, both the band and the sleeve are invasive. But... the invasiveness of the sleeve is permanent. If you don't like it afterwards, you're stuck because the 75-80% of your stomach that was removed is never coming back. Neither is the sleeve adjustable. I lost my band for various reasons (mostly unrelated to the band itself). I thought the sleeve was going to be a good 2nd choice because it would elliminate my physical hunger, and it wouldn't require numerous adjustments to achieve optimal restriction, but I was wrong. Since my sleeve surgery, my physical hunger has been ferocious no matter what or how much or how often I eat, and I have to eat 8-10 times a day to keep my blood sugar under control. I've become anemic because of micronutrient malabsorption and have to take an Iron supplement every day. I've had to start taking metformin to treat my type 2 diabetes that was always controlled with diet and exercise before. I've also discovered that sleeve patients can dump just like gastric bypass patients do because the sleeve capacity is so small, food gets "dumped" into the intestines very quickly, causing me miserable discomfort from nausea, dizziness, and drenching sweats. Finally, I've discovered that sleevers can experience stuck episodes for the same reasons that bandsters do: careless eating. I've been told that I take a dim view of the sleeve since I loved my band so much. That may be true. I was sleeved on 8/16/12, so it may be too soon for me to judge anything about my sleeve. It's also true that the band isn't risk-free - but there's no such thing as a risk-free surgery of any type. The good news about my sleeve is that it's made it possible for me to lose the weight I had regained after losing my band in April. Jean

My husband says his 12" ruler is 24" long. If you get his drift.

Fills won't help with head hunger and the many adjustments needed to align your old thinking to your new upper GI tract, but they will help create early and prolonged satiety after you eat a small amount of food, and hopefully they'll also reduce your physical hunger. It sounds to me like you're already doing a lot of good stuff for yourself, like trying to "detach your brain" from your stomach. Just the fact that you're aware that you have a lot to learn is a big plus. A wise and wonderful gastric bypass patient wrote on her blog a few years ago that the emotional WLS journey takes a lot longer than the physical one, so try to be patient (but firm) with yourself. Exercise will help you burn calories and build muscle, so you look better, weigh less and less of your weight will consist of fat. Muscle burns calories more quickly than fat, so building muscle is a good thing. Exercise should also improve your mobility, flexibility, energy and endurance - also good things. And for me, exercise has turned out to have a wonderful side benefit - it fights depression.

Did your dietitian not give you a food/meal plan?

Looking back, I now believe I didn't really get into the Green Zone and stay there until I was about 3 years post-op. I had already lost all my excess weight by then, using hard work and a smaller appetite. In the Green Zone, my physical hunger was greatly reduced.

I had a sleeve revision in August and have had 2 stuck episodes since then, for the exact same reasons as they happened when I was banded - eating too fast, not chewing enough, taking bites that were too big. I've heard that bypass patients can also get stuck.

I've asked my British friend to answer your post. Hope she's able to help you. You're smart to research all of this in advance. I see so many people leave the country to have surgery, come home and only then ask, "Now what?" Good luck! Jean

No sooner did I post my earlier response did I think of another thing to say (an ongoing problem I have). I think bandster hell is sadly unrecognized by bariatric medical professionals, and I wish more bandsters were warned about it so they wouldn't be tortured by "Is my band broken?" thoughts so early in their journey. My dietitian told me several times that I wouldn't be hungry after my band surgery, but I was very, very hungry. I asked about it at an in-person WLS support group meeting and no one there said a thing to confirm or refute what I'd said. It wasn't until I joined some online WLS support sites that I discovered I wasn't alone! That discovery didn't solve my hunger problem, but it sure helped with the "Am I imagining this?" thoughts.

Sounds like bandster hell to me. A fill may help, but you may need several fills to achieve optimal restriction and those fills aren't going to make weight loss automatic. Relying heavily on fill magic can get you in trouble, because tighter isn't always better. I've gained weight when my band was too tight because I was eating "easy" stuff (yogurt, pudding, etc.) instead of the solid food that provides the early and prolonged satiety that the band is meant to give. So hang in there!

Aside from the issue of conflicting/confusing instructions coming from different surgeons, I discovered an extremely persuasive reason to avoid drinking during meals and especially if I was stuck. When my esophagus and upper stomach pouch were busy trying to break down and move my food in a southerly direction, even a small sip of liquid had nowhere to go except back up north and out of my mouth, often taking food along with it for the ride. Which was extremely unpleasant for me - to say nothing of my dining companions.

Call your doctor. As far as I know, no one on LBT is a medical professional. Those blisters could be from reflux, an infection, or whatever, but we can't see them and we can't diagnose the cause or prescribe the treatment. Let us know what your doctor says, OK?

You are doing yourself a big disservice by not talking about everything with your surgeon. it's his job to help you lose weight and he can't do that if you're not honest with him.

You're getting blisters? Where?

CarolinaGirl's response to you was (IMO) neutral, and as specific as you can get because weight loss (pre and post-op) varies hugely from one person to the next, for dozens of reasons. Now, my own specific answer to your question is that I lost 19.5 lbs on my pre-op diet.

Ain't that the truth! One of the reasons I was obese enough to qualify for WLS is that each new miracle diet always started on Monday, or the day after a vacation, or the week after a business trip, or the month after Christmas. And ended a few days later. It wasn't until I approached healthy eating & exercise as a permanent lifestyle that I actually succeeded at long term weight loss.

When you're allowed to have full liquids, drink the liquids that are on your surgeon's/dietitians approved list. Nothing more, nothing less. Just because you feel like you don't have a band doesn't mean it's not in there, trying to settle into position against your stomach while your stomach heals from being sutured. Do your absolute best to follow your post-op eating/drinking instructions. One of the most common causes of band slips is the failure to follow the post-op eating progression. When you eat food of any description, your stomach automatically expands and contracts to break it down into small enough pieces to be handled by your intestines. The expansion and contraction can disturb your sutures. I know the liquid diet seems endless to you now, but in the long view (assuming you have another 3000 weeks ahead of you to live), it's very short-lived.

I apologize if what I said seemed rude or unclear. Let me try again: The best people to advise you about what to eat or drink are the medical professionals at your surgeon's office, not the members of LBT, since as far as I know, none of us are trained or certified in medicine, surgery, or nutrition.

Did your surgeon and/or dietitian not tell you in advance what was allowed on your post-op diet? Or they did tell you, but you went ahead and had surgery anyway? Scrambled egg substitute would be fine - if it's on your doctor's list of approved foods. Same for cream of wheat. If you're struggling to find foods that are both approved and appealing, why don't you call your dietitian and ask for suggestions? I know I must sound unsympathetic but surviving the post-op diet (which is, after all, temporary) is a piece of calorie-free cake compared to surviving other medical treatments. For example, your post-op diet might last 4 weeks, but if hypertension is a comorbidity for you, a stroke (assuming you lived through it) could involve months of hospitalization, physical therapy, occupational therapy, medication, etc. etc.

I'm sorry to hear that you're disappointed in your band, but I think it's too soon for you to give up on it. You may find my comments below uncomfortable to read, but try to think of them as tough love. Checking for a leak is extremely simple. In fact, many surgeons automatically withdraw all the Fluid from the band to check the amount before they add more saline. So if your surgeon's records say you should have 5 cc (for example) and they can pull only 1 cc out of your band, it's likely that you either have a leak or the fill needle has been missing your port altogether. Have you had a fill since your port repair surgery? Do plenty of research before you jump into sleeve surgery. It's not as wonderful as it may seem, and I say that based on personal experience with both the band and the sleeve. I had to have my band removed in April for reasons too complicated to explain here (mostly unrelated to my band) and revised to the sleeve in August. Ever since then, I've had a bad case of buyer's remorse. The sleeve didn't eliminate my hunger - in fact, I'm constantly hungry no matter what or how much or how often I eat. I've become anemic, my blood sugar has gone crazy, I experience dumping syndrome when I eat anything with more than 5 or so grams of sugar in it (and sugar lurks in places you might not expect, like milk, Protein powder & bars, fruit, yogurt, etc.). As a result of all that, I've had to take time off work and spend $$ on gas & medical co-pays in order to have more medical tests & visits in the past 3 months than I needed in the 1st 24 months I was banded.

It's your surgeon's and dietitian's JOB to help you lose weight. They are better qualified to do that than anyone else you know, and avoiding seeing them is (as you've discovered) self-defeating. So many bandsters are embarrassed or fearful to admit their problems to their surgeons, but unless the doctor has a lousy bedside manner, I can't think of a single good reason to avoid a come-to-Jesus meeting with him/her. Your surgeon and dietitian already know that you have an eating problem, as evidenced by the obesity that brought you to their office i the first place. Every single bariatric professional I've ever talked with or heard speak at a WLS convention has expressed chagrin over losing patients to aftercare. It's very, very frustrating to them to have a patient drop out of sight. That said, I will also say that the prodigal bandster may not like what he/she hears when finally talking with the surgeon again, but sometimes we need some tough love to get us back on track.