Jean McMillan

You might want to make an appointment with your surgeon or nutritionist to get a band refresher course. Basically, go back to the routine you followed as a new post-op. I'm a food tracker and calorie counter, though not slavishly so. Many studies have shown that people who log their food intake lose more weight than those who don't. As for ideas, heck, I could write a book about that. Oh, wait, I did write a book about that!

I'm not answering because I have insurance from Kaiser Permanente, but because no one else has responded. And that's probably because they didn't understand the subject line of your thread. In the future, make the subject line as specific as possible, such as: WLS covered by Kaiser Permanente? The all-purpose answer to your question is that bariatric surgery coverage depends not on the name of the insurance company but on the specific coverage in your policy. Kaiser probably offers hundreds of different medical policies, tailor-made for the needs of their clients. So the best way to answer your question is to call the customer service number for Kaiser, give them your subscriber ID #, and ask if your policy covers bariatric surgery and if so, which procedures and under what circumstances.

David Letterman isn’t the only one who composes top 10 lists. Here’s my top 10 list of the things you need to know about gastric band surgery, served with a generous helping of GJTL™ - Genuine Jean Tuff Luv™. TIME FOR SOME TOUGH LOVE? Genuine Jean Tuff Luv™? What’s that? It’s my version of the kind of love that hurts so good, because it gets you going in the direction you want to go. Stern but caring parents, teachers and coaches who maintain strict rules and demanding training regimens are said to practice tough love. Those rules and regimens may not be fun, but they can turn around kids, students or athletes who’ve gotten off track or are underachieving. Tough love may seem too severe, too tough. It works best when the parent, teacher or coach believes in, proclaims, and respects the inherent value and purpose of the person they’re trying to help. Sometimes all we need is a wakeup call to shake us out of our stupor and pull us out of a rut. The drills and discipline of tough love can help (even as they hurt) when our bandwagons have gotten lost or stalled somewhere along the way to success. A bandster once said of me, “Jean tells people the things they don’t want to hear.” I chose to take that as a compliment. Many times in my life, I’ve benefited from a slap upside the head by a concerned friend. When I do the slapping, I try to do it with just enough emphasis to get a friend’s attention long enough to deliver an important message, followed by a gentle and loving kick in the butt. So here’s my top 10 list of things you need to know about adjustable gastric band surgery. Consider yourself kicked! THE GJTL TOP TEN LIST 1. You will not wake up in the recovery room at your goal weight. Average weight loss with the band is 1-2 pounds per week, and virtually no one loses weight at a nice steady pace of (say) 1.75 pounds per week. Some weeks you’ll lose, some weeks you’ll stall and some weeks you’ll gain, but as long as the overall trend is downward, you’re doing great! 2. Slower weight loss with the band does not prevent sagging or excess skin. How your skin reacts to massive weight loss depends mostly on your genetics and your age. As we age, our skin loses elasticity. If the possibility of sagging or excess skin worries you, start tossing your change into a plastic surgery piggy bank. 3. Weight loss surgery (of any type) does NOT cure obesity. Obesity is a chronic and incurable disease characterized by relapse and recurrence. Although bariatric surgery is currently the most effective way of treating obesity, obesity is something you’re going to have to manage for the rest of your life, with or without surgery. For most of us, a tool like the adjustable gastric band makes that a lot easier, but it’s not effortless, either. 4. Most eating problems after band surgery are due to user error, and can be prevented by using good band eating skills. Read an article about those skills by clicking here: How to Eat Like a Bandster. 5. In order to decrease your weight and increase your health, you must decrease your food intake and increase the quality of your food choices and the time you spend exercising. While you may be able to lose weight for a while by just eating much smaller portions of Chicken McNuggets, potato chips, and candy bars, eventually that approach will stop working, and at the same time it will start biting your health in the butt. And though it may be difficult for you to exercise at first, each pound you lose will make it easier, and each additional hour you spend exercising will not only burn calories but improve your physical and mental health. 6. No weight loss surgery procedure will cure eating disorders, eating demons, emotional eating, boredom eating, stress eating, celebratory eating or food addiction. Changing those behaviors is your job. If it’s too hard to tackle yourself, consider getting some counseling with a therapist experienced with eating disorder and WLS patients, and/or joining a 12-step group like Overeater’s Anonymous. 7. The band rarely works without fills. Even if you initially lose weight with one or no fills, sooner or later, you’re going to have to face the fill needle. And if you’re too needle-phobic to tolerate a fill needle, why did you choose band surgery in the first place? 8. The restriction “sweet spot” is a myth. There is no such thing as “perfect” restriction, or if there is, you can’t count on it to last more than one hour, one day or one week. This is because the band is an inert silicone object implanted in a living, breathing human body that changes constantly in reaction to the time of day, time of month, time of year, hydration, illness, medication, stress, you name it. Restriction variability is part of the gastric band package. 9. There is nothing magic in the band that makes you lose weight. Changing your eating and exercise behavior is what makes you lose weight. All the band does is make that work easier for you by reducing your physical hunger and increasing your satiety. 10. YOU are responsible for your weight loss. Not your band, not your surgeon, and not the server at McDonald’s who invariably asks you, “Want to supersize that?”

I see quite a few people who've responded on this thread with their own frustrations about slow or disappointing weight loss. Have any of you discussed that with your surgeons? It's your surgeon's JOB to help you lose weight! Even if they can't easily solve your problem, they should be giving you suggestions about things to do or other health and fitness professionals to see.

Thanks for the plug, Jim!

I think it's your gall bladder, but I'm not a medical professional. Rapid weight loss often causes gall bladder problems. Talk to your doc!

You don't have anyone to talk to about this? What about your surgeon? It's his/her job to help you lose weight. If your surgeon and/or nutritionist haven't already given you guidelines for eating, etc., make an appointment to see them and ask them what you could be doing differently to get the weight loss going. There isn't a single "right" way to do it, and finding the "right" way that works for you is a challenge, I know.

Eating planned meals or Snacks every 3-4 hours was/is essential for me. You also need to start thinking about whether your hunger is always physical. After you eat one cup of solid food, are you still having hunger pangs, tummy grumbling, etc? Or is it more that you just feel unsatisfied - that you haven't eaten enough and want more? It took me a long time to get used to the idea of a small amount of food being "enough". I had to weigh/measure my food and put it on a small plate (like a salad plate) so it wouldn't look so meager.

I don't think the hard thing under the ribs on your left side is your band. Could be your port, or scar tissue. The band is on the upper part of the stomach, which is in the area of your chest, approximately midway between your breasts but slightly more to the left than the right. I could never feel my band, per se, though I could feel foods and liquids moving through my stoma from time to time. After I lost some weight, I could feel my port by pressing on the abdomen in the area near my biggest incision (on my right side, about at waist level). I could also feel my port sometimes when I bent at the waist, did abdominal exercises, or bumped into to kitchen counter.

At a bariatric surgery conference I attended in July 2011, several surgeons stated that one of the most common reasons for failure to lose weight is the failure to separate liquids and solids....in other words, drinking while you eat. My #1 reason for not drinking while eating: the liquid would come right back up, in a fountain. Do that in public a few times, and no one will ever invite you out to lunch again. For further confusion on this interesting topic, read this article by Australian dietitian Helen Bauzon: http://www.lapbandtalk.com/page/index.html/_/healthy-living/food-nutrition/yes-you-can-drink-and-eat-at-the-same-meal-time-r63

If your surgeon tells you not to swallow pills or capsules whole, don't do it, no matter what anyone else here tells you. Your surgeon presumably has a degree in medicine and experience in bariatric surgery. So far I haven't met any other LBT member who can honestly state that they are an MD. According to every bariatric surgeon I've talked about this with, the consequences of swallowing pills or capsules whole are that the pill/capsule won't go through your stoma, so it sits there in your upper stomach pouch or esophagus slowly dissolving into a possibly corrosive chemical mess that can badly irritate or damage the surrounding tissues. So not only would you be injuring yourself, the medication that you need would not be making its way into whatever part or system in your body that needs it. You might as well flush that pill down the toilet. And throw in the contents of your wallet while you're at it.

It's really very simple. If your doctor tells you not to swallow pills, don't swallow pills. If you feel you absolutely must take a pill, call your doctor's office and discuss it with the doctor or a nurse before you take the pill. Some of the gas you're having is in your abdominal cavity, not your intestines, so swallowing a Gas-X pill isn't going to help it even if the pill manages to get through your stoma. In the meantime, the pill slowly dissolving in your esophagus or stomach pouch can cause a lot of irritation. I speak from experience here, having spent hours in 2 different emergency rooms after swallowing an antibiotic capsule. Do not open capsules or crush pills without asking your doctor or pharmacist first. Some medications, like time-released formulas, must be taken whole (or at least in pieces). You can get an inexpensive pill splitter or crusher at any drugstore.

If "the boys" really NEED potato chips, could they not eat those necessary potato chips somewhere besides your home? If I keep stuff like that in the house, it's way too easy to eat it. But if it's truly essential to have potato chips in the house, go ahead and eat them...but do it this way: 1. Read the nutrition stats on the package. If one serving is 13 chips, count out 13 chips, put them on a small plate or bowl. Then close the bag and put it away where you can't see it. 2. Take the plate or bowl of chips to the dining table. 3. Sit down at the table, all by yourself with the chips. No computer, no TV, no magazine, no radio, no distractions. 4. Eat the chips one at a time, concentrating on their texture and flavor, so you get the maximum enjoyment out of them. 5. When the chips are gone, put the empty plate in the sink or dishwasher. 6. Go back to doing whatever you were doing before the potato chip attack hit you. The point of all that is to put you in control of the food, instead of the food in control of you.

Everyone else has given you good advice. I'll just add a few comments. Getting some psychotherapy (especially if the therapist is experienced with eating disorder and WLS patients) is a great first step. While obesity is caused by a combination of factors, not all of them within our conscious control, it's important to take a multi-disciplinarian approach to treating it, so be sure to talk with your surgeon and dietitian as well. I guarantee you, you will not be the first self-sabotaging patient they've ever had, and they might just have some good suggestions for you. In the meantime, stop calling yourself a failure. Weight loss and management is lifetime project, and it's going to be extremely hard for you to accomplish that at the same time as you're piling shame and disgust on top of yourself. That kind of self-talk has a tendency to become a self-fulfilling prophecy.

You've lost 37 pounds and aren't happy with that? That's 9.25 lbs/week, and average weight loss with the band is 1-2 lbs/week. I would suspect that your body is now in a quandary because of the big initial weight loss and trying to readjust your metabolism. It's way too soon to judge your restriction or your band's success. I think you need to work on your band eating skills. Read the article I wrote about that here: http://www.lapbandtalk.com/page/index.html/_/support/post-op-support/how-to-eat-like-a-bandster-r58 ) Also, you need to re-think what "full" means to you. It's not healthy for anyone, especially a bandster, to eat and eat until they feel "full". Eating that way is overeating, and overeating is how we got fat in the first place. And when a bandster overeats, it overloads the stomach and esophagus and can cause esophageal dilation,stomach dilation, and band slips. So, don't go looking for "Thanksgiving dinner Full". Eat only until the physical hunger pangs are gone. You wrote: I'm really think I'm wanting a bypass but, figure that sense I haven't had the band that long that I Probaly won't be able to get it and I supose there got to be something wrong like the cabs slipping before I can get a bypass ? As I said before, it's way too soon to decide your band isn't working. And no, you won't be able to revise to the bypass so soon after your band surgery unless you have a lot of cash and can persuade your surgeon to do it. The bypass isn't going to work like magic either. Weight loss is hard work no matter what surgery you have. I don't know what you mean by "the cabs slipping." What is "cabs"? If you mean that a complication like a band slip could justify revising to the bypass, you're right, but you can't assume that your insurance is going to pay for revision to another procedure because some policies allow only one WLS in the patient's lifetime. So your insurance might pay to remove your band, but not to do the bypass. I was hungry at lot as a new bandster. It will probably take a few more fills for your band to start helping with that. In the meantime, hang in there!

One more thing. You need to be extremely careful about what you put in your mouth until you get this resolved. Every bite of food you put in there is probably making things worse, whether your band has slipped or eroded or your esophagus or stomach pouch is dilated. It doesn't matter how much you "can" eat or how hungry you are when you eat it. Your best course of action is to follow a liquid diet and let everything in there rest until a bariatric medical professional and/or gastroenterologist can figure out what's going on and what to do about it.

I had kind of a similar experience, except that my symptoms started suddenly. An upper GI showed my badly dilated esophagus; the gastro doc who did an EGD found food in the lower third of my esophagus (I hadn't eaten for 12 hours) and diagnosed me with an esophageal motility disorder called achalasia. My surgeon removed all the saline from my band and strongly recommended removing it. I decided to revise to the sleeve,but when my surgeon removed my band, she was unable to do the sleeve because of a stricture we didn't know I had. I went to a different gastro doc who said I don't have achalasia, I have stenosis (thickening of the tissues) from 25+ years of "silent" reflux. He dilated the stricture and I'm having surgery again in August to try to do the sleeve. My unfill greatly relieved my symptoms. I'm still taking omeprazole. My symptoms were like yours but I wasn't vomiting blood. That kind of thing URGENTLY needs attention. I would be concerned about ulcers or band erosion. I hope you get in to see a specialist at Hershey Hospital ASAP. Good luck!

My criteria (not necessarily in order of importance): 1. surgeon accepts my medical insurance 2. surgeon is located as close as possible to my home (because it's a pain to have to travel a long way for frequent fills and other aftercare) 3. surgeon's practice is at least 50% bariatric surgery 4. surgeon has done at least 250 bariatric surgeries 4. surgeon has done at least 125-150 adjustable gastric band procedures 5. surgeon and/or clinic offers complete patient education, aftercare and support program (with dietitian & psychologist available, support groups, nutrition classes, etc.)

As Cazzy says, it's hard to figure out what the real cause of death is in some cases. I know 2 bandsters who died, seemingly because of their bariatric surgery history, but I'd be hard-pressed to blame their deaths specifically on the band. One lovely girl died of an accidental overdose of meds she'd been prescribed for severe pain related to complications from her revision to gastric bypass. Another lady died from something that went wrong during her revision from band to duodenal switch. But I don't know of anyone who died solely because of their band surgery.

No, I don't mind you asking, but it's a long story, so I'm going to make it short. Early this year I learned I had a badly dilated esophagus and signs of a esophageal motility disorder call achalasia. All that resolved when we removed all the fill from my band, but my surgeon felt that adding fill back in would be asking for trouble and strongly recommended removing my band. I decided to revise to the sleeve because there is no way I could manage my weight for the rest of my life without some kind of surgical tool. After my surgeon removed my band, she couldn't do the sleeve revision because of a stricture we didn't know I had. I went to a new gastro doc who said I don't have achalasia; that my problem is stenosis (thickening of the tissues) caused by longterm "silent" reflux that I've probably had for 25+ years. He dilated the stricture, and in August we're going to do the sleeve procedure. I hate, hate, hate that I lost my band. I think the sleeve is going to be OK, but I can't expect it to work the way my band did. I'm just trying to make the best of the circumstances. Life is like that.

It must be making you crazy to see all the different surgeons' instructions on this as well as a million other issues. I've read all the responses so far (I think) and don't recall seeing this tidbit which came to me from my original and current surgeons and was confirmed by the surgeon who vetted my book (Bandwagon): Alcohol is a gastric irritant, and it can cause inflammation and (eventually) ulcers. Just something to keep in mind. My personal comments on this heated issue are: 1. Alcohol is liquid calories with no nutritional benefit. Yes, some people believe that there are health benefits in drinking moderate amounts of red wine, but if you have to use the health excuse to justify something you're going to do anyway, well....OK, go ahead! 2. Alcohol loosens your inhibitions and makes eating something stupid (or drinking a second or third glass of wine) seem like a really good idea. Finally, thanks for starting such an entertaining thread. I haven't seen so many irritable, rude, defensive, ornery, inflammatory posts on a single thread here in quite some time. I know what my excuse is: it's 99 degrees outside at almost 7 pm. That's enough to make a saint cranky.

If no one told you to stop eating and switch to liquids when you have an eating problem, you've probably gotten into a horrible and never-ending cycle of eat-stuck-irritation/inflammation-eat-stuck-etc. etc. I hope St. Francis doesn't assign you to Dr. Weaver's anti-band partner. That doesn't sound likely but it wouldn't hurt to call and verify it. The office staff there is very helpful and there are a couple of patient advocates (mine is Janell Gill) who can help coordinate your care and communications. After recommending Dr. Weaver, I have to add that I'm not sure she's pro-band, but she's the one who does all the band surgery at St. Francis, and she's smart, compassionate, and has a great bedside manner.

What your insurance will cover depends on your particular policy. My insurance paid for the removal of my band and will pay for my sleeve surgery because my surgeon was able to prove "medical necessity". In your case, the "necessity" could be the inability to tolerate fill in your band and frequent side effects (like stuck episodes, regurgitation, etc) when you try to eat with fill in your band.

One more thing...I live in west TN and your surgeon is infamous in this area for his lousy bedside manner. So it's not just you who has a problem communicating with him. I highly recommend Dr. Weaver at St. Francis Hospital in Memphis, although her partner in that clinic is anti-band.

You should be able to eat solid food, including Protein, without all that struggle. When you're able to do that, the band does provide the early and prolonged satiety that you were hoping for. So, don't give up until you've gotten a 2nd opinion from the new doctor. In the meantime, I strongly suggest that each time you have a stuck episode or other eating problem, immediately stop eating, and follow a liquid diet for at least 24 hours to let everything in there calm down. After that, try eating pureed food, then soft food, before you try solid food again. Good luck!