SkinnyKathy

Update: As of this week I have lost 200 pounds! Only 34 more to go to get to my goal weight! YAY!

I was banded a little over two years ago and have lost 200 pounds. At least in my case, for the first 50 pounds, I was wearing nominally the same size. This was principally because I was in denial about what size I actually wore. My clothes were all too tight, plus I had clothes in my closet that no longer fit but that I considered part of my wardrobe, that I was wearing 50 pounds later. Well, that was the case with me and certainly may not be for anyone else. But the other thing I have noticed as I have lost weight is that certain sizes seem to be "sticky" for me. I'm not sure if its a psychological issue or a body size issue or a combination of both but it is at least partly psychological. But there have been certain sizes that I stick with for a lot longer than others. And I'm not just talking about a weight loss plateau. I did hit a stubborn weight loss plateau about 25 pounds ago, but I seemed to be stuck on that size for a lot longer. I recently let go of that size and bought jeans a size smaller, and they are already too big. Recently, I got out a skirt given to me by my sister two sizes smaller, and it is too big. Just last week I bought a new skirt, three sizes smaller. All of this in a short period of time. Was I really stuck at the same size for three months and then lost three sizes in a month? No. But looking at somewhat recently pictures of me there is a noticeable change recently. The truth is somewhere in between. I'm not sure and since it's all going in the same direction, I'm not sure it matters. The main point I wanted to make in the ramble above is that there are many ways to measure progress in our journey. Losing pounds on the scale is one way, a different feel and fit to our clothes is another way. And they may not always go together, and that's still progress. Keep it up! Kathy

I say BS. I have lost 200 pounds with the lap band. Started at almost the same BMI as you. It can be done. Your doctor is right that you have to stay away from liquid calories. The thing about the lap band vs. bypass is that you do have to manage the band in order for it to work, whereas once you have the bypass surgery that's it. I like the adjustability of the band. But I think there is an assumption on the part of some (but not all) doctors that anyone who is morbidly obese, who has 200+ pounds to lose, cannot possibly be capable of actively managing their band, and therefore must have the more idiot-proof bypass surgery. And to that, I say: BS! I'm proof that you can lose 200 or more pounds from the lap band. As long as you are willing to actively manage the band and follow the eating rules, it is a wonderful tool and has given me my life back. Kathy

Fellow bandsters, This week I have hit the 200 pounds lost milestone. Yay me! I have 34 more to go to meet my current goal, but I really see the end in sight now. I am starting to think of and see myself as an almost-normal weight person. Well, at least not morbidly obese any longer! I am really happy with my decision to get the lap band. It was truly the best decision I have ever made. As my reward for hitting this milestone, I am treating myself to permanent makeup: eyebrow and upper/lower eyeliner. Basically it's tattooing on the face. I think I'm almost as scared of this as I was of the lap band surgery! But I am looking forward to it. AlmostSkinnyKathy (wonder if I need to change my id on this site...)

Ladies, I am seriously interested in getting a breast lift as the girls really need it, but one thing I am concerned about is losing sensation in the nipples. I don't really care too much about sensation in the rest of the breast, just the nipples. Hubby and I enjoy that! So my question, for those of you who have had a breast lift or similar invasive breast surgery, how has it affected your nipple sensitivity?

I have lost 200 pounds with the lap band, 34 more to go to get to my current goal weight. I am starting to look into plastic surgery options. I had a panniculectomy after I lost 80 pounds because I had such a severe pannus. This helped quite a lot as I had constant rashes and exercise was difficult. I am pretty sure that I will need a full lower-body lift with a T-incision, probably a inner-thigh lift, maybe brachioplasty although I can probably live with my arms. But probably the procedure I need more than anything is a breast lift. My boobs are in very sorry shape, ladies. They were pretty saggy when I was at 433 pounds, and now that I have lost weight I have gone from a G or H cup to barely a D, sometimes a C cup. And they hang down almost to my waist. My nipples point straight down. It is not a pretty sight! And a lot of that C/D cup is skin. I literally have skin on skin inside my bra, as I practically fold my boobs into my bra. So I am trying to figure out if there is any chance of getting insurance to cover a breast lift. I might also want implants, which I figure there is no chance of insurance covering, but I wonder if I can make any argument that this is reconstructive surgery rather than cosmetic surgery? I have Anthem Blue Cross PPO for insurance. Any insight or advice would be most appreciated.

It sounds to me that you are not at your sweet spot. Do you still have restrictions? Are you thinking about food all the time? To me, those are key signals that it's time for another fill. Best of luck! Kathy

You've only had two fills ever? It took me 3 or 4 fills before I got to the "sweet spot" for the first time. Then for a while I needed fills every month or so to stay at the sweet spot. I once went 6 months between fills but that was the longest. The trickiest thing is getting to and staying at that sweet spot. It sounds from your description that you have never gotten to your sweet spot. Keep at it! The band only works for you if you work to manage it. But since you had the band put in you should follow-through with the rest of your investment and get the fills you need to get to the sweet spot. The feeling of something stuck in the throat can happen at various times but for me at least, it is always associated with eating too fast. Slow down, take small bites, chew well, and check in with your body frequently as you eat. The real signal you are looking for is a feeling of fullness and the cessation of hunger. I won't say I NEVER drink when I'm eating, but really I can't take more than a single sip of liquids when I'm eating or there just isn't any room for food. If you're not feeling that way, if you're able to eat and drink at the same time, is another strong indication that you haven't even reached the sweet spot yet. It also sounds like you are struggling with head hunger quite a lot. That's the other thing I love about the band, when it's adjusted right, head hunger gets cut way back. The band pinches the vegas (sp?) nerve, which sends hunger signals to your brain. That's one way I can tell that it's time for another fill - when my head hunger starts to resume. (Slowed weight loss would be another sure-fire indicator.) Please do get another fill and let me know how it goes! Yes, fills can get pricey but if you don't get fills then you are not getting the value out of the band, the investment you have made in the surgery and recover time to actually lose the weight you set out to lose. Good luck! Kathy

Cool, do you know the answer to the question about whether the scar has to go all the way to the elbow? Is there a chat feature on here?

I am starting to think about the next step in plastic surgery for me. I have lost 184 pounds, want to lose another ~50 to get me around 200 pounds before I go under the knife again. I say "again" because I had a panniculectomy about 100 pounds ago. My pannus was such a problem that I had it removed when I was only partially down, knowing that I would still need a full lower body lift when I get to goal weight. Now looking at my body, I know I will need a lower body lift, inner thigh lift, breast lift with probable implants, and possible brachioplasty. And lipo in various spots for sure. I know this is two operations, possibly three. So since I know it will be complicated and expensive I want to start researching options now. Obviously I can go back to the doctor who did my panni (which was covered by insurance), but I am hesitating for two reasons. First, I was not 100% pleased with the results. In the end it turned out OK but not great. Second, he is expensive. As is virtually any plastic surgeon in the San Francisco Bay Area. So I'm hoping any of you regulars on this forum can give me any links or advice on having plastic surgery done outside the US, or other options for less expensive surgery when you have to pay out of pocket. Thank you!

Dr. S: I have a quick question about brachioplasty (armlift). Does the incision have to go all the way to the elbow? If most of your hanging skin is in the upper half of the upper arm, can you get an incision that only goes that far? Or is there any other way to avoid a scar all the way to the elbow if you don't have full-on bat wings, only partial bat wings?

Hi everyone, I wanted to shout to the rooftops that as of today, I have met my original (although not my current) weight loss goal! My starting weight was 433 lbs. And as of today I am at 249 lbs, for a cumulative weight loss of 184 lbs. Actually, my original weight loss goal was more nebulous than this. Originally I could only vaguely visualize a conceptual goal of maybe, possibly, someday, if I'm lucky, getting into the low 200's. Later, as I started losing weight, believing that I might be able to do this, and realizing that I needed a more concrete goal to work towards, I decreed that goal to be 249 pounds, as that is the first number I could hit that would round down to 200 rather than round up to 300, LOL. However, quite some time ago I modified my goal to be 199 pounds. That is my current goal. But if I get down that far I may try to reach my next goal, which is 179 pounds. My lowest weight as an adult is 169 pounds, and that is my fantasy goal. But 179 pounds will get me into the top of the normal, healthy weight range for my height and age. But for now I just wanted to say yay me! And thank you to my LAP-BAND® which has made it all possible. Oh, I should mention that I was banded September 9, 2008, so it has been almost 2 years. I know I won't win any medals for fastest weight loss, but a steady weight loss of about 2 pounds a week is most healthy anyway. For me, the most important success factor has been actively managing the band - specifically getting to and maintaining that "sweet spot" where hunger and cravings are much more manageable but I can still get plenty of liquids down. I find that if I am too loose or too tight, even by a small margin, my weight loss slows down dramatically. Well, I think I am going to take myself shopping and buy myself some new sexy underthings to celebrate! Kathy

Oh, and here are my "before" and "current" pictures. I'm proud of me! Kathy

Hi everyone, I wanted to shout to the rooftops that as of today, I have met my original (although not my current) weight loss goal! My starting weight was 433 lbs. And as of today I am at 249 lbs, for a cumulative weight loss of 184 lbs. Actually, my original weight loss goal was more nebulous than this. Originally I could only vaguely visualize a conceptual goal of maybe, possibly, someday, if I'm lucky, getting into the low 200's. Later, as I started losing weight, believing that I might be able to do this, and realizing that I needed a more concrete goal to work towards, I decreed that goal to be 249 pounds, as that is the first number I could hit that would round down to 200 rather than round up to 300, LOL. However, quite some time ago I modified my goal to be 199 pounds. That is my current goal. But if I get down that far I may try to reach my next goal, which is 179 pounds. My lowest weight as an adult is 169 pounds, and that is my fantasy goal. But 179 pounds will get me into the top of the normal, healthy weight range for my height and age. But for now I just wanted to say yay me! And thank you to my lap band which has made it all possible. Oh, I should mention that I was banded September 9, 2008, so it has been almost 2 years. I know I won't win any medals for fastest weight loss, but a steady weight loss of about 2 pounds a week is most healthy anyway. For me, the most important success factor has been actively managing the band - specifically getting to and maintaining that "sweet spot" where hunger and cravings are much more manageable but I can still get plenty of liquids down. I find that if I am too loose or too tight, even by a small margin, my weight loss slows down dramatically. Well, I think I am going to take myself shopping and buy myself some new sexy underthings to celebrate! Kathy

Pegge, It sounds like you haven't reached your sweet spot yet. It takes time after surgery to get there, but my experience is that once I got there, the weight came off much easier. When I'm at my sweet spot I rarely get hungry and I do lose weight unless I make bad choices (chips, ice cream). I take a Protein powder shake for Breakfast every morning and that really helps me also. Have you ever had a feeling of "tightness" since your surgery? Like you were full without eating very much? If so, it sounds like you haven't reached your sweet spot yet. It took me 4 fills to get there, and the 5th to really stay there for a while. It was longer than I expected and I got discouraged, too. But now I have lost 172 pounds, and stil losing about 2-3 pounds a week. But getting to, and then maintaining myself at, that sweet spot is critical. if I get too loose or even too tight my weight loss slows way down. You do have to manage a lap band, it doesn't do everything for you. But if you manage it well, it will make things much easier for you. Right now I'm only 12 pounds away from my first (initial) non-stretch goal, which was 250 pounds. That sounds really high, but keep in mind I started at 433 pounds and I am 5' 9.5". So I honestly wasn't sure I would even be able to get to 250. But my current goal is to get to 199. When I get there, or when I get close, I will evaluate whether I want to try to go lower. The lowest weight I have been as an adult is 169.5. I would love to get back down to that point, but I would honestly be thrilled with 199, too. Good luck! Kathy

Thanks, everyone, for the kudos and encouragement. And, I have now officially entered Twoderville! In fact, my weight did what it is often apt to do... I plateau for a couple of weeks and then quickly drop 4-6 lbs in a couple of days, then settle out there again. Well, as of this morning I am at 297, for a loss of 4 lbs since I wrote this post only a few days ago. (Unfortunately I can't sustain that rate of weight loss, wouldn't that be wonderful!) But I am definitely now in Twoderville! Kathy

I started this journey at 433 lbs in September 2009 and as of this morning I have lost 132 lbs for a current weight of 301 lbs. I'm so happy to be almost at Twoderville! I'm really starting to feel like a normal person again. I can do almost anything, sit in any chair, fly (sometimes) without a seatbelt extender, buy clothes retail, and I feel sexy and desirable for the first time in a long time. (Ok, not as much when the clothes come off... after losing 132 lbs, Spanx is my friend!) But I do look cute in my clothes, and even though I want to lose another 100 lbs, I already feel like I have my life back. I've lost my weight slower than a lot of you, but I've kept my sanity and I've continued to lose steadily, so I'm not fretting about that. I do need to exercise more to keep up my rate of weight loss and tone up my muscles more. So that is my goal moving forward. Kathy:thumbup:

Dr. JLo, can you tell me more about lymphatic massage? I am the original poster on this thread. I had a panniculectomy on October 8, and here it is almost 3 months later, and I am still dealing with quite a lot of swelling, especially on the side where my original drain fell out soon after surgery. I have been trying to keep my sodium intake down, although I have been getting lazy about wearing a compression garment (Spanx one size too small) every day, so maybe I should get more serious about that. I had to have a drain put back in me one month after surgery and they took about a liter of fluid out of me and then I drained some more over the next few days but this drain, too, fell out sooner than we had hoped. My doctor doesn't think I have any more seromas but rather just very swollen tissues. I have also taken a lot of antibiotics, but the healing is quite slow. I have not heard about lymphatic massage before and I wondered if that is something that one can do at home or do you need to see some kind of professional to do that? Thanks in advance for any advice. Kathy

I really can't give you any advice except to say ask your plastic surgeon what he thinks your chances are of getting insurance to cover it. One thing I would recommend you do is every time you see your primary care doctor make sure you mention problems with rashes and get him/her to make notations about this in their notes. Because that is a key part of the documentation. If you are quietly taking care of it yourself, then you won't have the documentation you need. On ther other hand, it could be argued that a rash which you can quiety take care of yourself does not need surgery to correct it. I know I had to submit photos of my rash and the pannus from various angles so insurance could judge for themselves how serious it was. Part of the criteria is how low the pannus hangs also. Your plastic surgeon is your best resource on this. Kathy

Yes, I have tried Protein bullets a few times, but the ones I tried tasted nasty and were really hard for me to get down. I prefer the milkshake-y type Protein drinks, although I am picky about the brand. I just choked down a Protein shake with a non-preferred Protein powder, and I would almost prefer a really nasty protein bullet, at least I could get that down more quickly, LOL! But I love my Champion Nutrition Pro-Score 100 chocolate flavor, yummy! Do you have any brands of protein bullet that you would recommend? Kathy

There was more swelling on the side where the drain fell out, but it is clear that there is/was swelling on both sides.... ... Well the saga continues... I went back to the doctor today and he took 8 more syringes of Fluid out of me, until he couldn't get any more, but it was clear that there was still fluid in there. He thinks there may be multiple pockets, and he is not able to fully drain me without any visual indicator of where the fluid is. So long story short, I am going back to the hospital on Friday, and will go under fluorosocopy (like x-ray) so they will be able to visualize the fluid, suck me dry, and then put in a new drain that is able to drain any future accumulation from any and all fluid pockets. The other thing my doctor asked me is about my Protein intake. Now normally I am very good about that because I eat a Protein shake for Breakfast every day. But lately I ran out of my favorite Protein powder (which I order online from vitalady) and so I had been getting sloppy about protein intake. He says that even if you are feeling fine on an overall level, the cells may be struggling to rebuild without sufficient protein. So I wonder if that has contributed to my problem. Anyway, I have bought some protein powder from a local retail store and will order my favorite today so it should arrive soon. Anyway, that's the latest.

Well, I didn't want to get to pointing fingers really, but I do think that there was somewhat of a failure on the doctor's part. I am now convinced that I had the beginnings of this seroma three weeks ago at my last appointment, but he didn't catch it because it was underneath all my fatty peaks and valleys. It was only plainly noticeable to him (and me) once it got so severe. Even today when he looked at my belly before he started he said something like, oh yes, this is looking much better, not much Fluid in there now, probably just 2 or 3 syringes, this will be your last seroma visit... Then even he was surprised as the fluid kept coming and coming and coming... We haven't hit bottom yet because 16 syringes (2 oz each, 1 quart total) is the most he will take out at a time. So the saga continues. But it is causing me no lasting ill health effects, no lasting skin damage, no pain, very little discomfort (now), and only a moderate level of inconvenience, so it isn't too hard to laugh in the face of this one of life's little trials... Kathy

Mimilou, to more directly answer your question, I don't think it is necessary to replace the fluids lost, per se. This is Fluid that the body no longer needed, it just had no way to get rid of it. It would be the same as if I had been able to keep my drains in longer. Instead of draining out of me, the fluid built up inside me. My doctor didn't give me any special instructions about drinking liquids, but he did tell me to stay on a very low-sodium diet for the next few weeks. However, any and all prayers are always gratefully appreciated. Kathy

No, no IV fluids to replace the Fluid taken out. He took another 16 syringes out today. That's another full quart. So far he has taken out almost three quarts of fluid from my belly, not to mention the extra fluid that I have peed out from the dieuretic. But my lower belly is starting to look again like I remember it looking right after the surgery, almost sort of flat-ish (not to be confused with the flatlands, these are still wildly rolling hills by comparison, just not rugged Alpine peaks any longer, LOL) I go back next Wednesday for another withdrawal. Thank goodness my plastic surgeon's office is only a 10 minute drive away. And as a bonus, I have had lots of free consult time. It takes quite a while to suck a quart of liquid through a 12 guage needle! So I have been able to pepper him with lots of plastic surgery questions, LOL!

Sorry to those who asked for pictures that I haven't sent them yet. I ended up with really bad swelling, which turned out to be a rather severe seroma, a pocket of fluid under my skin. My doctor took out a full QUART of fluid on Monday, and another 3/4 of a quart on Wednesday, and I am going back today and probably a few times next week. Plus I am on a dieuretic and antibiotics. So I thought it would make more sense to wait until after the swelling settles down to take my official "after" picture. So I will probably take a picture this weekend or next week and then send them to you. Kathy