Jean McMillan

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.

They're probably going to put an antibiotic in your IV anyway. Antibiotics shouldn't affect internal bleeding. It's things like aspirin that increase bleeding.

I think the #1 issue will be whether or not your breathing is affected by this cold or whatever it is. They won't want to anesthetize you if it is. I wouldn't want to have my surgery postponed either but it's really for the best. Good luck, and keep us posted!

Good to see you here, Kate! It'll take a while to learn your way around the site, but I hope you find these forums more congenial than our other WLS "home"!

Are you pre-op or post-op? If pre-op, your body's probably complaining about the drastic change in your food intake. And depending on what liquids you're consuming, it could be reacting to the ingredients, especially artificial sweeteners. If you're post-op, the above comments still apply, and on top of that, the anesthetic is still working its way out of your system. I don't understand why you're not allowed to take an OTC pain reliever, though, so if I were you I'd call your surgeon's office and ask if it's OK to take some liquid Tylenol.

I didn't have to do a pre-op medically supervised weight loss diet for my insurance so I can't speak to that. I did have to do a minimum of 4 weeks of a liver shrinkage diet before my surgeon would operate on me. My nutritionist said the average weight lost during that diet was 25 pounds. I "only" lost 19.5, but I was still able to have surgery. My feeling is that you do need to get your rear in gear pretty soon because pre-op weight loss is a good thing. It gives you a head start on weight loss, it improves the size and texture of your liver, and it also makes your surgery safer.

I hope you enjoy Bandwagon!

Taking an anti-acid pill to make it possible to take vitamins, minerals, or medications seems silly to me, but if your surgeon tells you to do it, do it. The main thing about taking pills and capsules is that if they're too big, they can get stuck in your stoma. Not only is that uncomfortable, but depending on the contents of the pill, it can corrode and inflame the surrounding tissues. I don't think there's one hard-and-fast rule that applies to everyone, because we're all different and even in the same bandster, the ability to swallow foods and meds varies depending on restriction, time of day, time of month, illness, stress, etc.

Swallowing pills and capsules can be tricky, especially as you get more fill in your band. Some pills and capsules should not be cut up or opened (ask your doc if that applies to any of yours). I use chewable calcium by Bariatric Advantage (you can also try Viactiv, from any drugstore) and chewable adult multivitamins (Centrum Silver for me).

I've had sciatica for almost 40 years and my weight (up or down) has never made a difference in the symptoms. Most of the doctors I've seen about it basically told me "learn to live with it." One doc told me to use capsicum cream (found with OTC pain relief products in most pharmacies) but I couldn't stand the burning sensation. I've tried prednisone to reduce the inflammation in the nerve but it didn't seem to touch it. I've tried physical therapy; it didn't help but the therapist explained that the sciatic nerve is located in 2 possible places, and if your sciatic nerve is in the "wrong" place, it's likely to be impinged upon by the surrounding muscles. In other words, I was just born with the potential for sciatica. Lucky me. The most helpful things I do for it are exercise (yoga, pilates, stretching), avoiding sitting (sitting always makes it worse), massage, and Biofreeze spray (available from chiropractors, amazon, or you can get a generic version at Walgreens named Icy Hot spray.

I'd love to see that but I can't find it. Would you please post a link to that video? Thanks!

Three other good books about the band: Laparascopic Adjustable Gastric Banding, by Jessie H. Ahroni (she's a bandster and a family nurse practitioner, so she knows both sides of living with the band Weight Loss Surgery with the Adjustable Gastric Band, by Robert Sewell, MD & Linda Rorhrbough (he's a surgeon & she's a bandster & writer - the book is excellent & very thorough) Bandwagon, Strategies for Success with the Adjustable Gastric Band, by Jean McMillann (me!) (it's the giant encyclopedia of band advice!)

I'm pretty sure I go on burning calories indefinitely after a workout. Maybe not at the same peak as immediately afterward, but as long as I'm alive and breathing, I'm burning calories, even when I'm sleeping.

I thought it would be a big hurdle for me, too, but it hasn't bothered me. I drink (usually cold water) generously up until about 5 minutes before I eat, and that way I'm not as thirsty while I eat unless I'm eating something salty (which I shouldn't eat anyway because the sodium pushes my blood pressure up). And if I eat something too spicy, drinking doesn't help it anyway, whereas eating something bland does help to neutralize the spice.

I agree with the comments everyone else has made. You should not drink while you eat for many reasons, the ugliest of which is that when your stoma and stomach pouch are busy with solid food, the beverage has nowhere to go but back up out your mouth - put on your raincoat and duck! Also, I want to mention that at a bariatric conference last year, at least 3 bariatric professionals stated in their talks/workshops that one of the #1 causes of disappointing weight loss after any kind of bariatric surgery procedure is drinking while eating. Doing that flushes the food through your digestive system too quickly and prevents the food from triggering your satiety signals.

Restriction varies a lot due to ordinary stuff like time of day, time of month, stress, weather, allergies, illness, medication, etc, but a sudden and extreme change of restriction would worry me. You say you've been off the wagon for a few months - have you been overeating a lot during that time? Was the 2 pieces of chicken parmesan even more than you'd been eating in the past few months? Or what? If I were you, I'd mention this when you go for your fill and ask the doc to check your fill level before adding anything more, to make sure you don't have a leak. And please remember that just because you can overeat doesn't mean it's OK to do. Consistent overeating can stretch your esophagus and/or pouch and contribute to a band slip. Also, it's not a good idea to go on eating after you've PB'd or puked. Doing that irritates an already irritated esophagus, so you can get into an endless cycle of eat-puke-eat-puke.

Don't be discouraged when you learn that lap band patients "only lose 40-60% of their excess weight" because there is plenty of evidence here that shows otherwise! According to my surgeon, that "only lose 40-60%" business has been widely misunderstood. What docs mean when they quote the 40-60% is that if the patient loses "only" 40-60% of their excess weight, their WLS is considered successful. It doesn't mean that the most you'll lose is 40-60%. Anyway, I lost 100% of my excess weight.

Please don't call yourself a failure. With no fill in it, your band isn't even working yet. All you can do until you get optimal restriction is to keep on keeping on and do the best you can in the circumstances.

I hope it wasn't me you were calling "a little judgy." I was just giving the OP some important information about eating with the band that can help her avoid complications. My eating history is just as full of poor choices and bad habits as everyone else on this forum!

Before my banding I would eat like it was my job. LOL! Me too! And I was very, very good at my job!