Jean McMillan

I don't see why they'd need to remove the polyp before your band surgery, depending on where in your duodenum it is. But even if it's at the top of the duodenum (where the duodenum connects to the bottom of the stomach), I don't think it would get in the way of placing your band. Yes, you can have endoscopy after your band surgery. Some bariatric surgeons do annual endoscopies as part of the post-op follow up protocol. I had an upper endoscopy earlier this year without any problem. Some surgeons recommend that your band be emptied of saline before an endoscopy, but mine wasn't. The only other concern I have is that if you have an endoscopy done by someone other than your band surgeon, make sure they know you have a band so they'll be extra careful inserting the scope.

You may have to post your own thread in the NY group. Yes, I've had Lap-Band surgery. I was banded in September 2007 and lost 100% of my excess weight. But I'm located in Tennessee, not NY!

Inside every so-called adult man is a little boy who loves nothing better than farts & burps.

It's important to practice good band eating skills even when you feel like you don't need them. Even if not using those skills doesn't cause side effects, it could be harming the healing of your stomach and the settling of your band against your stomach. And as you say, practicing them now will come in very useful later on!

If you're looking for a local mentor, you could try posting this question in the NY group: http://www.lapbandtalk.com/forum/46-new-york-local-lap-band-support/ You also might be able to find a local mentor at your surgeon's support group meetings. Good luck with your surgery!

A PB is a productive burp, or regurgitation of the food you just ate. It's not the same as vomiting because it's not associated with a feeling of nausea and it rarely comes from the stomach so doesn't have the bile content and taste of vomit. A PB usually comes from the esophagus, which is quick to object when it's overloaded with food. PB's can be avoided by practicing careful band eating skills: take tiny bites, chew very well, eat slowly, don't drink while you eat, etc.

Obesity bias. We all hear about, and some of us experience it, in the workplace and in social situations. But obesity bias lurks elsewhere, in places where you’d least expect it because the people involved are so well-educated. It lurks in what I call the “helping professions”. Teachers, ministers, people who ought to know better. Because of that, I addressed the last chapter of Bandwagon to medical professionals. Telling them how I feel about obesity bias is important to me personally, and awareness of the issue is important to us all, fat or thin, young or old. Politicians, educators, and the media can help (if they can just get their heads screwed on straight), but those of us who suffer from obesity can help by refusing to tolerate it. That’s why I’m reprinting my obesity bias chapter here: I want to put the fire in your belly. Curious? Read on. AN OPEN LETTER TO MEDICAL PROFESSIONALS You wouldn’t guess it to look at me now, but I was once obese enough to qualify for and have bariatric surgery. I was so fat that I got stuck in turnstiles, had to use handicapped stalls in public restrooms, and dressed in drab garments that looked like they were made by Omar the Tentmaker. I was so fat that children would point at me and giggle. So fat that I couldn’t fit in a booth in nice restaurants. So fat that fellow airline passengers groaned when I sat down in the seat beside them. Despite all that, I think I've been pretty lucky. I haven't suffered as much of the obesity prejudice that others like me have faced. My career might have been more successful if I was thin, but I was never aware of obesity bias in a workplace and I advanced further in my career than I ever could have dreamed possible. But I have experienced obesity prejudice, and some of that has come from you: the health care professionals with whom I've entrusted my physical and mental health, and that's a special kind of betrayal. I’m not a doctor; nurse; nutritionist; dietician; surgeon; exercise physiologist; physical or occupational therapist; medical, laboratory, radiology or surgical technician; or psychiatrist, psychologist or social worker, so I can only make assumptions about what motivates you in the practice of your profession. It’s probably a mix of things: the need for a paycheck; love of science; the expectations of your families, teachers and employers; laws and ethics (both written and unwritten); the desire to relieve suffering; and compassion for your patients. In reality, compassion seems to be undervalued in both the medical community and society at large. I'm told that medical students undergo training so grueling that it would be considered inhumane in any other environment. Then they leap into a practice that requires them to balance patient care with business, financial, insurance, legal and ethical issues that their formal education did not fully address (if at all). Americans of any profession live in a paradoxical society. We praise the athlete who finishes out a game despite a serious injury while we pop pain pills for the aches in our own inactive bodies. We give our children television sets, video games, cell phones and junk food, but don't have time to play with them or encourage them to exercise. Our government mandates the publication of nutrition information on food packages that we are unable or unwilling to understand. We admire the underweight women pictured in celebrity magazines while we wait in line at the supermarket to purchase a cartful of super-processed, calorie-rich, nutrition-poor food. During our daily trip to McDonald's, we recoil when we see an obese person enjoying the same meal that's on our own tray. We think, "What a pig! I would never let myself get that fat. Why doesn't she go on a diet? She must be too lazy or too stupid." Then we stuff another fistful of French fries in our mouths, take a big swig of Coke, and secretly loosen the button on our own straining waistband. The meal we have just eaten could feed a third-world family for a week, but neither our greediness nor their neediness concerns us. Somehow the careless eating habits of a normal weight person, the anorexic eating of an underweight actress, and the starvation of an impoverished child are all okay, but the overeating of an obese person is reviled. Despite the societal stigma associated with it, obesity isn't the shameful plight of "other" people — lazy, unlucky, immoral people. It can happen to anyone. It happened to me, and it can happen even to well-educated medical professionals like you. I am by no means lazy. God has given me many blessings, and I do my best to live in a moral fashion, but through a mysterious combination of nature and nurture, I suffer from the chronic disease of obesity. It is no easier for me to cure myself of this disease than it is for someone to cure herself of asthma, epilepsy or diabetes. I find it ironic that the only current "cure" for diabetes - gastric bypass surgery - is so often considered to be unnecessary “cosmetic” surgery when an obese person seeks it as treatment for their disease. When I asked him for a referral to a bariatric surgeon, the physician who diagnosed my Type 2 diabetes (who happens to be morbidly obese himself) told me, "You don't need something that drastic. You just need to try harder." Telling me that was as helpful as telling a patient with a broken leg, "Let's just wait and see if this gets better on its own. If you concentrate hard enough, that bone will mend itself." That same doctor told me many times to exercise more and eat less. We live in a small town and I see him and his family in local restaurants and stores, but never at the health club owned by the hospital with which he is affiliated. The most strenuous exercise I've seen him do is to repeatedly lift a fork to his face as he plows through a plate of Mexican food. Do I sound bitter? I suppose I am, and you would be too if you had been treated by your fellow human beings, including medical professionals, the way I have been treated. To hear me talk, you might think I'm nursing a grudge against my doc, but I'm not. My obese doctor is a really nice guy, and I have genuine respect for the talented, hard-working people who practice the "helping professions". But not for one minute do I believe that any of them are qualified to judge me. That privilege is reserved for God. Sometimes it's the most kind and well-intentioned people who inflict the most hurt and humiliation on an obese person. To suffer that at the hands of professionals who ought to know better has been especially hurtful and disappointing. When I first moved to Tennessee, I went to see Dr. X, the family physician recommended to me by a local friend. He gave me a prescription for my high cholesterol (essential, he said), refused me medication for depression (not necessary, he claimed), and told me I must lose weight (also essential). I asked him how I should do that. His response was, "It's simple. Put the fork down. Eat less and exercise more." When I said, "That's easier said than done," he answered, "You don't need to talk about it. Just do it." (He also inexplicably refused to give me a referral to a nutritionist, psychotherapist or weight loss support group.) From this experience I could only conclude that my obesity was due to a fatal lack of willpower. I reported that conversation to my friend, who said, "That's probably because Dr. X used to be very heavy himself, and he thinks if he can lose weight, anybody can." The fascinating thing about that factoid was that although Dr. X was specially equipped by his own experience with obesity to give advice, support, and compassion to an obese patient, he was unable or unwilling to offer me any of those things. I don't know what his problem was, because I never got to know him better. I found another family doctor (the obese one) and never returned to Dr. X for medical care. I've also experienced obesity prejudice in a mental health setting. For a year or so I attended a support group meeting for behavioral health patients at our local hospital. The woman who facilitated the group was an addiction specialist - entirely appropriate considering the high proportion of drug and alcohol addicts in the group, but even she laughed when I told the group, "It's all very well for you to talk about abstinence. You can completely give up drugs or alcohol and survive just fine, but if I completely give up food, I'll die." I'll admit I often say funny things with a serious expression on my face, but how was that statement funny when tears were running down my face? I've even experienced a subtle form of obesity prejudice in a bariatric medical practice. In the past five years, I've used the services of two different hospitals with well-established, well-respected bariatric surgery programs. I won't name them because medically I have no bone to pick with them, but I will describe them because they reveal a lot about themselves in their bariatric facilities' design. One facility is supplied with plus-size patient gowns; wide benches and chairs; wide hallways and doorways; big exam tables with sturdy step stools beside them; large, easy-access restrooms; specially-equipped operating rooms; large-size blood-pressure cuffs; and many other accommodations for large-sized patients. The other facility has none of that, and if a patient is too large to fit through the door that leads to the exam rooms, his or her consult may take place in the waiting room, in the sight and hearing of other patients. So much for patient confidentiality, huh? Both of these facilities have given me excellent and considerate care, but only one of them gives the impression of having thought deeply about what its patients really need. And speaking of what bariatric patients really need, I also have a word for the general surgeons who are jumping onto the bariatric bandwagon in hopes of increasing revenue: please, please don't lift that scalpel until you've established a complete patient education and aftercare program, employing the services of the experienced nurses, nutritionists, psychologists, exercise physiologists and other bariatric professionals who can make or break your patients' success. When you have your team assembled, please make sure they're all singing from the same sheet of music. One of the most common complaints I hear is that staff members in a single bariatric practice issue conflicting instructions - for example, the surgeon says you should eat 1/2 cup of food per meal, but the nutritionist says you should eat 1 cup. My response to this is always: follow the surgeon's advice until you're able to clarify the issue. But bariatric surgery patients, especially new ones who are trying to learn dozens of new facts and behaviors, do not need their bariatric team adding to their confusion. Just as you should not underestimate your patients' need for education and support, nor should you underestimate their intelligence. Surely as a scientist you can acknowledge that human intelligence is not inversely proportionate to body size, any more than it's related to skin color, ethnicity or religious belief, but I must remind you that mental faculties do not decrease as body size increases. While I appreciate any efforts you make to communicate clearly, it is not necessary to talk down to me. And baby talk is out of the question. I will never forget the doctor (about 15 years my junior) who explained to me that while I (age 50) was catheterized for surgery, I would "go pee pee" into a bag. I am not a child, and I will thank you to treat me as an adult. If you want me to call you "Doctor Smith", please address me as "Ms. McMillan" (or, if you are of a southern persuasion, "Miss Jean"). By now you may be thinking, "I don't have time for any more of this nit-picking," or, as a nurse practitioner once said to me, "I don't have any more time for you today. I have sick people to see." But before you run off, I also want to say this: Thank you for all that you do, for your arduous studies, hard work, and long hours; for the risks you take, your research, your continuing education; for being willing to treat a complicated and chronic disease like obesity with an expensive medical gadget that's being refined and improved even as I write this, even as you walk through the operating room doors to perform weight loss surgery on another patient. Keep up the good work, partner. None of us would get very far on the bariatric bandwagon without you!

I can't even look down the snack food aisle when I go food shopping!

A kick in the butt? (just kidding!)

I'm pretty sure that the one style of Realize port is a low-profile design, less likely to protrude after weight loss.

Before my weight loss surgery, I tried to anticipate who in my circle of friends and family might attempt to sabotage (with the most innocent and loving intentions) my weight loss effort. Since I share a home with an adult male who has a driver's license, a debit card, a hearty appetite, and easy access to all the junk food at Wal-Mart, fast-food restaurants and dozens of convenience stores, I warned him that I would need his help in keeping junk food out of our house. Although he's slipped up a few times, on the whole, my husband has been great in supporting my weight loss journey. Much to my dismay, I've discovered that JEAN is the worst saboteur in this household. I've always liked to think that I'm a detail-oriented, logical, analytical person. I just hadn't noticed before that I frequently apply my (occasionally) brilliant mind to rationalizing the absolutely worst self-defeating actions. For example: I work with a dozen or so college students who are always hungry and always short of the cash, time, and willingness to cook for themselves. Since I have no (human) children of my own, I take care of these kids by baking for them. Brownies, cookies, cupcakes, muffins...you get the idea. But let's be honest now. Somehow those baking binges happen only when JEAN is in the mood for a sweet treat. Somehow it's OK for me to bake a batch of cookies and eat six of them as long as I take the rest to work for my adopted kids. And it's extremely ironic that these kids never observe me eating sweets or junk food. I bring my own healthy food for lunch instead of running out to Taco Bell. I have the reputation of being a health nut, but little do they know about the spoonful of cookie dough that disappeared down my gullet before those cookies went into the oven. At a meeting the other day, I forgot myself. I picked a mini Milky Way candy out of a basket on the table and began to unwrap it. The youngster sitting beside me watched in alarm and exclaimed, "I think I'm going to faint!" Someone else said, "What's the matter, Sam, are you sick?" and she replied, "No! Don't y'all see? Miss Jean is eating candy! The world as we know it is ending!" WHY DO WE SABOTAGE OURSELVES? As I explained in Bandwagon, self-sabotage is the deliberate destruction of property or the hindrance of operations by an enemy. As you start your weight loss surgery journey, you might believe that your mother and her famous biscuits and gravy, or your husband and his Pizza Palace Frequent Customer card, or your children with their 9:00 p.m. demands of "Mom, I need some cookies for our class Christmas party tomorrow", will be your worst saboteurs. But beware! There is another saboteur who is with you 24 hours a day, 365 days a year. Who is it? Go look in the mirror. The saboteur is you. That earnest, innocent face hides a food demon who is determined to prove what you believed for so long...that you are destined to fail at weight loss...that you don't deserve to be slim and healthy....that without your protective layer of fat, you'll be too easily hurt or too easily noticed...that once you're up on the Pedestal of Success, you'll lose your balance and tumble back down into obesity anyway while all your friends and enemies point and laugh at you. Melissa McCreary wrote an excellent 2-part article about overeating and self-sabotage for the LBT WLS Magazine. Check it out here: http://www.lapbandtalk.com/topic/144909-overeating-and-self-sabotage-part-one/. It describes common erroneous (or dysfunctional) beliefs (“It’s not OK to be selfish”) and head-games (“I don’t have time to spend on activities that are healthy for me) that can trip you up. If you read Melissa’s article and even one of those beliefs or head-games sounds familiar, put that one up at the top of your to-do list. Unfortunately, self-sabotage is sometimes disguised beyond easy recognition. If you’re feeling frustrated and not losing weight but you’re not sure why, take a look in your mental mirror. Some signs of self-sabotaging thinking are: jealousy (comparing yourself to others), extreme anxiety, negativity, procrastination, giving up easily, ignoring feedback, feelings of worthlessness, living in the past, blaming others, and the all-time favorite: DENIAL. How can you overcome tough stuff like that? Professional counseling has helped me tremendously. Attending in-person support group meetings such as Overeaters Anonymous has also helped me. Checking in daily with my Accountability Partner helps me. What’s an accountability partner? I’m working on an article about accountability now, so watch for it!

I've had that. My original surgeon said that when you're asleep in a horizontal position for 8 or so hours, mucus drains into your throat and esophagus and causes the morning "tightness". That makes sense to me because the morning tightness has always been a bigger issue when I've had pollen allergy attacks or head colds.

Port revision surgery may be done because the port flipped, got infected, had a leak, or protruded too much after the patient lost their excess weight. It's not done because the port wears out after a few years or anything like that. At 8 weeks post-op, I think it's too soon for you to judge how your port's working out. Have you had a fill yet? As long as your port is accessible for fills, I wouldn't worry about it. Even after your port site completely heals, the surrounding muscles may complain from time to time. My port flipped when I was about 2 yrs post-op. I had no symptoms from it, but suddenly fills got hard to do. I asked my surgeon if my workouts could have caused the flip, and she said yes, but that's not a good excuse for avoiding exercise!

I'd have to say, "Yes, I'm really going to pee. I'd invite you to come and watch, but I don't think Chez Louis wants men in the ladies' restroom." Or you could call him on your cell phone and let him listen to you tinkle and flush the toilet.

I either burp like a champ, or want to burp and can't. No harm in burping, really, but keep an eye on it. Burping after every single sip of liquid or bite of food doesn't sound right to me. While it's true that you tend to swallow a lot of air when you eat or drink too fast, all that burping could be a sign that you're really too tight. I went through a week or so of constant burping (or need to burp) recently, and it got to be so bad, it was interfering with my daily life. "Good morning, [burp] thanks for calling JC [burp] Penney. This is [burp] Jean. How can I [burp] help you [burp]?" Turns out I was way too tight, and a lot of other bad stuff was going on in there along with the burping.

Oh, dear. The inner brat in me would be all prepared with smart-aleck responses to the "Are you going to get sick?" line. "I will if you keep staring at me." "I don't know, but I'll be sure to let you know if I feel a hurl coming on." "Why do you ask?" "Maybe, maybe not. Is that why you came tonight, to watch me puke?" "I know you're really looking forward to that, but not tonight."

Yeah, the dear of dying young was a pretty persuasive argument for me, too.

I'm impressed that you've been able to overcome fear of food deprivation with a background like that. I have an acquaintance who adopted 2 small children (sister & brother) whose food deprivation was so severe that their pockets were stuffed with cat kibble, and even now 2 years later, those kids stuff their pockets with ketchup packets, sugar packets, and the like when they're eating out with their new family.

Wow, you've got a lot going on here! I'll try to tackle each issue... > Should have lost more than 10 lbs in 2 weeks? Are you kidding? Average weight loss with the band is 1-2 lbs/week, and you've lost 5/week! You're doing fabulous! > Do you need a fill? Most surgeons wait 4-6 weeks after surgery before doing a fill, to allow surgical swelling to subside and for your band to settle into place. You say you think your portions are more than you think they should be, but what amount did your surgeon or nutritionist tell you to eat at one sitting? If you're physically hungry, eat. Just don't eat a Thanksgiving dinner, OK? Why are you only eating twice a day? If I ate only twice a day, I'd be in a dead faint. > If you're on solid food, why are you relying on Protein shakes for your protein? You can keep experimenting with brands and flavors, and maybe try putting the shake in a covered beverage container (so you can't smell it) or serve it icy cold (my preference), but you can also get good-quailty protein from Greek yogurt, cottage cheese, moist animal protein & fish, eggs, etc. etc. >If you get gas pains every time you eat, you may be eating too fast and swallowing extra air. And if you're starving hungry by the time you eat (because you're only eating twice a day), it's very hard to practice good band eating skills (take tiny bites, chew very well, eat slowly, don't drink while you eat). Also, you may be experiencing some lactose intolerance,especially if your Protein Shakes are made with whey protein and/or you mix the protein with milk. Try a different protein (based on soy, for example) and different liquids, like almond milk, soy milk, rice milk.

Do you ever look at your plate of tiny bandster food portions and think, "That's not enough to keep a bird alive"? That thought, or one like it, crossed my mind every time I sat down to eat in my early days as a bandster. Although I was eating tiny portions, losing weight, and feeling stronger and more energetic as each day passed, my brain kept whispering, "Something's wrong with this picture." Eventually I grew accustomed to those small portions, and now I rarely think about it unless someone else makes a comment about it - like my coworker who looks at my doll-sized lunch and exclaims, "I don't know why you even bother eating!" ONE MEAL AT A TIME Getting used to bandster food portions took me 6 or more months. At first I would look at my small plate with tiny portions of food on it and instantly feel deprived and sorry for myself. Never mind that the small portions were plenty of food for my banded stomach...they just weren't enough for my brain to accept. By paying very close attention to how I felt as I ate, I realized that small portions were indeed enough to quell my physical hunger and that I wasn't going to drop dead from malnutrition. Of course, the small meals didn't keep the hunger at bay for very long until I'd gotten enough fill in my band for a small portion of food to send long-lasting satiety messages to my brain. Since I was terrified that eating too much at one meal would hurt my band somehow, I stuck it out. My nutritionist's eating plan included 3 small meals and 3 planned, healthy snacks each day. I have to admit, I looked forward to each and every one of those meals or snacks. It wasn't until after I'd reached my goal weight that I began to forget to eat and stopped looking forward to each upcoming meal as if it were a happily-anticipated Thanksgiving Dinner. Yes, it would have been nicer and easier if the long-lasting satiety had kicked in earlier on my WLS journey, but really can’t complain because later is better than never at all. Maintaining my weight loss means eating like a bandster for the rest of my life. So I had to work my way through one challenging year in order to enjoy 35 or more years as a healthy, normal-weight person with a small appetite. Seems like a pretty good deal to me. But then you know me, Little Miss Sunshine! A MATTER OF PERSPECTIVE One day when I was about 9 months post-op, I found myself in a restaurant looking at the food on someone else's plate and thinking, "Oh my God, look at genormous plate of food!" That genormous plate of food contained the same huge serving sizes I ate as a pre-op, but because of the mental adjustment I'd made, it no longer triggered the "Oh, goodie!" button in my brain. In part, it's a matter of perspective. Perspective refers to the appearance of objects (or subjects) in relationship to each other. When my personal perspective was to view a Thanksgiving dinner plate as my "normal" food portion, the genormous plate of food looked right to me. After 300 or so bandster meals and snacks, my perspective had changed so that a tiny portion was my "normal", and the genormous plate of food looked ridiculous, even overwhelming. MASTERING THE FEAR OF FOOD DEPRIVATION The issue of food deprivation is a topic that deserves more attention. If we don't learn how to deal with it in a healthy way, achieving weight loss and a healthy lifestyle is going to be a lot harder. Fearing food deprivation is a basic instinct that drives every living organism. Every creature - human, animal, insect, you name it - survives by seeking food and shelter. So when I tell you that you need to master your fear of deprivation, I'm not telling you to deny this basic instinct by not eating when you're hungry. In fact, I'm telling you to respect it, that in fact you should eat when you're physically hungry. If trying to ignore physical hunger has been your strategy during years of dieting, it's time to try another strategy. You will never learn to recognize early satiety, or to experience and honor prolonged satiety, if you ignore your hunger. There's nothing intrinsically wrong with hunger. It's simply your body's request for more fuel. Food is fuel that you need, fuel that you deserve, fuel that you must have to stay alive and be healthy. While you're re-training your conscious mind to respond appropriately to physical hunger cues, you may go on experiencing uncomfortable emotions about eating less. There's no shame in that. Talk about it with your support group, friends, and/or counselor, or write about it in your journal. Generally speaking, keeping your emotions bottled up gives them more power to hurt or control you. On the other hand, talking about them to the exclusion of everything else isn't helpful either and borders on the obsessive. When I need to talk or journal about something upsetting or painful, I give myself a time limit. The time might be a 50-minute counseling session, or 10 minutes of journaling. When the time's up, I go on to something else. THE HALF-PORTION APPROACH I talk a lot about this approach because it's a good way to prevent overeating, and I’ll repeat it now because the half-portion approach is also what made it possible for me to survive my fear of deprivation while my mind and body adjusted to eating small food portions. Here's how it works. 1. Do not put serving dishes on the dining table. 2. In the kitchen (or wherever), measure out your planned bandster portion. Put half of it on a small plate (like a salad plate or the saucer for a tea cup), take it to the dining table, sit down, and slowly eat it, paying as much attention as possible to how you feel as you eat. (If you're eating in a restaurant, ask the server to bring a to-go box with your meal, put most of the food in the box, close it, and start eating what's left on your dinner plate.) 3. If your body gives you any "soft stop" signals, stop eating. You can throw the uneaten food on your plate away, or if that makes you anxious, put it and the other half of your portion (the one you left in the kitchen) in a storage container in the refrigerator, knowing that you can eat it later if and when you get physically hungry again. 4. If you finish the half-portion without getting any soft stop signals, go back into the kitchen, put the rest of your portion on your plate, take back to the dining table, and eat it, following the same instructions as in #3 (above). 5. If you get physically hungry again before your next planned meal or snack, go ahead and eat the reserved food portion. Eating it is not cheating, because you had planned to eat it, you measured it, and it's yours if you want it. This approach helped me get used to eating small portions while staying alert to satiety signals without the overhanging fear and anxiety of food deprivation. Give it a try, and let me know how it works for you!

Yes, this is something you can bring up with your surgeon, but preferably not as a last minute thing before surgery. A pre-op upper endoscopy helps the surgeon get the lay of the land (so to speak) even if the patient doesn't have reflux or another UGI issue. Sometimes reflux is caused by hiatal hernias, and an upper GI will show the surgeon if that's the case with you. Since reflux is as much of if not more a problem after band surgery than before, it's very important that your surgeon or someone else on his medical staff address this issue now. As for the lack of communication by your surgeon's office...let's give them the benefit of the doubt. My surgeon's office has been so inundated by the influx of new patients that they are all struggling to keep up with all the work involved in communicating with patients. My surgeon employs a person as a Patient Advocate who does nothing but coordinate all that. I suggest that you call your surgeon's office and don't hang up until you speak to a live human being. Tell that person you have a number of questions that need attention and ask for the name of the best person to answer them. Ask to be transferred to that person and leave a voice message for her/him if necessary. Then follow up with that person a day or so later.

Yes, your body is adjusting. You have lost a ton of weight already and your body's probably thinking, "Holy moly! What's going on here? Is she trying to starve us to death? How can we stop this weight loss? OK, metabolism, you slow down right this minute! Take as long as you want to burn those calories she's eating. The longer the better..." Please don't feel disappointed in yourself. Everybody hits plateaus sooner or later no matter how hard they're working at healthy eating and exercise. If you're not eating more than you were before, you don't need a fill quite yet. Hang in there!

Ah, you guys and your big bites! A single forkful of food for my husband would take me 30 minutes to eat! Yes, more fills wil make eating more painful if you don't master good band eating skills: take tiny bites, chew very well, eat slowly, don't drink while eating, etc. etc. I find it helpful to cut my food into those tiny bites as soon as I sit down to eat. If I don't, I get distracted by conversation or whatever and don't pay enough attention to what's going into my mouth.

All true, but grehlin is also produced elsewhere in the body, not just in the stomach.

Yup. Normal. It's pain referred to your shoulder by your diaphragm, which gets irritated during surgery.