Elisabethsew

Here's a recent study that I found: Jul 18 (Reuters Health) - Although technically more challenging, laparoscopic Roux-en-Y gastric bypass, a common type of stomach bypass operation, provides greater weight loss in severely obese patients than does placing a plastic band around the stomach to make it smaller, new research shows. Stomach bypass is also more likely than banding to promote the resolution of diseases often seen in obese patients, such as high blood pressure and diabetes. Although multiple trials have compared the two procedures, this is the first study to focus specifically on patients with a BMI greater than 50 -- with super morbid obesity -- Dr. George Ferzli and his associates report in their article, published in the Archives of Surgery. BMI is a measure of body weight for height. Values between 20 and 25 are typically considered normal. Any value of 30 or greater is considered obese. This information is vital for patients considering weight loss surgery, Ferzli told Reuters Health, "because proper patient and procedure selection, proper follow-up, and proper long-term support are quite important in achieving the desired outcome." At the SUNY-Health Science Center of Brooklyn in Staten Island, New York, patients undergoing weight loss surgery decided which procedure would be performed, after receiving extensive counseling. To be eligible, the patients had to complete a supervised dietary and exercise program of 8 to 12 months without maintaining weight loss. Ferzli performed more than 315 weight loss procedures between February 2001 and June 2004. Among 106 super morbidly obese patients, 60 underwent stomach banding and 46 underwent stomach bypass. Stomach bypass took longer perform in the OR than did stomach banding. Moreover, patients treated with stomach bypass were hospitalized for a day or two longer. There were no differences between the operations in the rate of early complications. After 30 days, however, patients treated with stomach bypass had fewer complications than those treated with banding and also lost more weight. "We believe that the band requires significant will and discipline and compliance, otherwise the patient can get things by the restricted area, especially high-calorie liquids," Ferzli noted. Complications are likely to result from patients "not eating properly, trying to force things down by eat rapidly or not chewing properly." "In our experience, laparoscopic Roux-en-Y gastric bypass appears superior to laparoscopic adjustable gastric banding in super morbidly obese patients," Ferzli and his associates conclude in their paper. There is a subset of severely obese patients for whom gastric band would be more appropriate, Ferzli added. "We now reserve gastric banding to patients who cannot have gastric bypass surgery, because of such conditions as liver disease or (stomach disease) and ulceration that require frequent endoscopy." SOURCE: Archives of Surgery, July 2006.

I have never heard of getting a second fill one day after the first. Some people take 1-2 weeks before a fill "kicks in" so you might want to be a little conservative about having a total of 7 cc's added to your band in 2 days. I'm at 6.5 cc's after 3 fills and that seems to be just right for me. Bands can be overfilled if the MD justifies it with Inamed. I believe your band holds 10 cc's.

When I purchased my house, the very next thing I did was to go out and buy 3 air conditioners and I don't regret it one bit. I'm on balanced budget billing with the electric company so I pay about the same each month. This allows me to spread the cost out over the year. Where do you live that nobody has A/C? I'm on Long Island in New York.

I primarily sleep on my left side and that's where my port is. The hardest part, for me, about the banding was NOT being able to sleep on my side. After about 2 weeks I could sleep on my right side but it took a good 4-5 weeks before I could get on my left side. The weird thing is, I STILL sometimes feel pain when I turn on my left side.

I was 306.2 this AM so I'm approaching the border. LOL. The last fill really gave me proper restriction and I'm on vacation this week from work so I'm staying away from food and doing tons of projects in and outside of the house.

I don't think there's consensus on this issue and doubt there ever will be. As an RN, I do know it's dangerous to crush time released, sustained release, enteric coated and extended release medications and that's why I felt I needed to contribute to this thread. Everyone needs to discuss how to take their medications with their MD. Someone posted here that you can NEVER take NSAIDS (motrin, etc.) if you are banded. That's not true. I have severe arthritis and the surgeon simply added Nexium once a day so I could take Aleve twice a day with meals. After 3 fills, I have had no problems with getting medications down and take pills 3 times a day. So, it seems the best advice is the advice of one's individual surgeon. I mean no disrespect when I disagree with someone else's post but as an RN, I feel I have a responsibility to interject when someone gives concrete advice that is not true as in the case of crushing ALL medications. All or nothing rules rarely exist.

I've had 3 fills and have no problems taking my medications. As a general rule of thumb, some surgeons say to crush any pill that's bigger than a dime. It's best to go with what YOUR MD advises.

Congratulations on taking the first step and admitting you're in need of help. Now take the next step and GET the help you need. You're a beautiful person who deserves to live a happy, healthy, drug-free life and needing help to get to that place is nothing to be ashamed about.

ANY drug that says SR (sustained release) or ER (extended release) or time released should NEVER be crushed. Different MD's will advise patients to either crush or swallow their pills. Bottom line? Do what your MD tells you to do and follow the directions on the medication. Also, anything enteric coated is NOT to be crushed as it is meant to dissolve in the small intestine and NOT the stomach.

I find it amazing that my breasts remain huge no matter how much weight I lose. My highest was 440 pounds and I'm the same cup size now as I was then. Glamorisse support bra seems to be the only one that does it for me and no, it's not sexy. Seems there would be a good market in making large cup sizes with sex appeal.

You also can't take grapefruit juice is you're taking a statin such as Lipitor. Many drugs interfere with one another. You can't take iron with calcium is a common one.

You don't need to buy an incentive spirometer. Post-op it's used to assist with deep breathing. When you're in surgery, you're lying flat, getting anesthesia and on a ventilator. Therefore, you need to expand your lungs by taking it deep breaths through your nose and slowly exhaling through your mouth. This opens the tiny breathing pathways (alveoli) and prevents pneumonia or other respiratory associated problems.

LOL, I'm not as creative as you are. I plan to joyfully chuck it in the trash as I make my way into the lower (and sexier) sizes.

Medications prescribed for hypertention usually do NOT cause weight gain. If you think the weight gain IS truly related to the medication, call your MD. He/she might elect to switch you to a medication that also contains a diuretic such as hydrodiuril. Have you noticed increased shortness of breath, swollen feet/ankles, etc.? If so, call your MD ASAP.

Non-scale goals: - fit into ANY chair ANYWHERE comfortably - shop in normal size stores - wear a bathing suit with NO skirt - make love in ANY position - travel! - walk into a gym with confidence - get to a weight where it will be the optimal time to have my knee replacement surgery and recover like any other person of "normal" size (This is my ultimate goal... no more pain).

After post-op day 5, the only way I knew I had a band was the scars. Because of severe arthritis, I was placed on Nexium so I could continue to Aleve (one pill only twice a day with meals). My surgeon does not do a first fill for a full 8 weeks so it was a struggle to maintain my weight loss. Fill number one did nothing but the second did yield SOME restriction with hard proteins such as chicken and firm fish. I had fill #3 last Thursday and NOW I really know what restriction is. I can eat the portion sizes I am supposed to and feel full when I am nearly done... not too tight and not too loose. If you're feeling hungry, call the dietician associated with your surgeon. I did that and she allowed me to add a few soft foods like lite ricotta cheese to the full fluid phase. That was enough to get me through until I could begin solids. Also, I take quite a few pills everyday and I DON'T have to crush them. I chew a small pretzel until it's really mushy, put the pill in, and down it goes. This was a technique the dietician suggested and it works great. Concentrate on healing and you'll start "feeling" the band after a fill or 2-3.

One of the things that you might want to consider before you decide is, What type of eater are you? This was the frist question the surgeon asked me. Because simple carbohydrates begin digestion in the mouth, people who are sweet eaters and junk food eaters might want to consider Roux-n-y surgery. Do you thrive on chips, chocolate, candy, yodels, cupcakes, cakes, icecream, french fries, pretzels and the like? Or, are you a relatively healthy eater who can't control portion sizes and is prone to binging? As my surgeon told me, It IS easy to "cheat" the band or "beat" the band by eating foods that can easily slip by the band despite band inflation to restriction levels. I have a lot more than 100 pounds to lose but I'm not a junk food eater. I just received proper restriction on my third fill (last Thursday) so you have to be patient with the healing process as well as the fill process and can't expect the weight will fall off a few weeks after surgery. After a lot of research and talking with my surgeon, I opted for the band and have no regrets. As long as you follow the guidelines, there is no reason to expect you can ONLY lose 100 pounds. As you lose, you pick up healthy eating habits and start to lose bad habits. If you're unsure of which surgery is right for you, DON'T schedule ANY surgery until your doubts are satisfied.

I got my third fill on Thursday and it seems to be just what I needed. I'm down to 307.4 and hope to be out of the 3's in another few weeks. My all time high was 440 and I LOVE the feeling of being able to see that scale leave high numbers. Keep up the great work everyone.

The heat is one thing but, when you toss in the awful humidity, it's horrible. I keep the shades down, the A/C and fans on and have focused on getting the inside of the house in shape. Today, I'm cleaning windows and hanging new curtains. Frequent showers also help.

I consider myself an average loser but what you're experiencing is perfectly NORMAL! I lost all restriction at 5 days post-op and really struggled to maintain my weight loss until I had my first fill at 8 weeks. Since then, I had 2 additional fills and this last one did the trick. I am now eating within the lapband guidelines so hang in there... restriction will happen with your fills. Until then, make good choices and stay within the calorie limits.

Most people lose a ton of Water weight on the pre-op diet. It's not natural to continue that rate of weight loss. After banding, you lose the fluids from the surgery and, by the second week, start losing fat. This trend continues for most people at the rate of 1-2 pounds a week. You're right on track and won't feel restriction until you have a fill or 2-3. Toss the scale in the closet and weight once a week at most. You're doing fine and did not "waste" your money.

I love cashews but it's one of those foods that, once I start, I have a hard time controlling. Consequently, I keep them out of the house.

The port site pain was the worst for me and it was several weeks before I could sleep on my left side. As you heal, you're feel less pain so get plenty of rest, stay hydrated and get your required protein in.

Losing weight comes from the motivation to WANT to be healthier. If you are setting yourself up for failure before you're banded, your negative thoughts will become a reality. You have to be patient in healing, getting the right amount of fill, and committing yourself to a healthy way of eating and living. If you're up to the challenge, the band will work with you.

It's natural to be nervous about your surgery and it's good you're having someone stay with you. I did the surgery alone, got a ride home the morning after the surgery and would have loved to have someone stay with me the first night. You're sore for 5-6 days and then start feeling human again so try and not worry too much.