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Thanks Alex! You and I are old school bandsters so I am sure you know what I am talking about. I am eagerly awaiting for the new changes!

Well if you plan on "abusing" your band and keeping it dangerously too tight, and intend to lose weight by vomiting all your food daily and have no respect for how the band is supposed to work, I would seriously advise you to NOT get the band. The band can be very safe if it is installed properly, and you follow safety fill protocols. Vomiting with the band should be a VERY RARE mistake. Some people will get the band and use vomiting as a "sport" and Pb on purpose, and disregard eating rules with the band since you can easily bring up food once the band gets tighten to the green zone, if you don't chew well, or eat too much. You can DAMAGE the band by not chewing your food well and vomiting daily, or keeping it too tight, it's just that simple, YOU choose your destiny with the band in most cases, REAL complications are rare and preventative complications are HIGH. Please take the time and read this article on how the band SHOULD work, and you don't have to worry about anyone else's band problems as long as you do what you are supposed to do and your surgeon installed it properly. This is the best article yet on how to live with your band and how to avoid complications, read it well and follow it and you will do well. Good luck http://bariatrictime...1/#comment-2133 Gastric Banding and the Fine Art of Eating

Hi Alex, Thanks for the exciting news! However, I have some serious concerns. Combining ALL surgical types can backfire. The reasons many lap banders come here now is that they feel this is a 'safe haven' from Lap Band bashing. The Lap Band forum on Obesity Help has been destroyed by "The Other Type" of surgeries and those who've had complications or their bands removed and "moved on" to "other weight loss surgical types.. And sadly NO ONE goes to the lap band forum on Obesity Help any longer due to all the negativity and if this new venture is not planned out carefully and there is not "heavy" moderating, it may turn into the same thing. I know you mean well, and ideally if everyone CAN GET ALONG, this will be a wonderful idea. But again, I've seen Lap banders bullied for years and while I am hopeful, I am concerned about lap banders getting the support they need without constant bickering. I try to come here to bring "value" and get support and try to stay on track with my weight loss and help newbies, I don't have time to come here and bicker about I am stupid for getting the band and it will be soon to be removed..just saying An excited, but concerned member

Also...will the new site have the following functionality?: 1. A Block button that actually works where the person that you've blocked can no longer see your posts or respond to your posts. 2. The capability to make your profile private 3. The capability to upload pictures "privately" Thanks

Your welcome ! And congrats on the green zone! And happy losing.

I agree with ButterFly -- YOU are in control of how tight your band should be, always remember that, they work for you. You should let them know how tight you want your band, when they are filling your band under Flouro -- you can still let them know if they should back off the saline, or add more.

There is really no need to see your surgeon after the first year especially if you are in the Green Zone and KNOW what danger signs to look for. Many band patients are not skilled enough to know "warning" signs with the band or many band patients IGNORE them. But if you are on TOP of lap band warnings, such as "able to eat too much", OR the band gets extremely tight with no recent fill adjustment, frequent vomiting, frequent reflux at night, and a dry frequent cough, -- you really don't need to see your lap band surgeon but once per year, or six months. I agree if it ain't broke don't fix it, congrats on your success!

Please read this article of how the band SHOULD WORK. Also you just made a post about "Burping" which indicates you could be too tight. There is sometimes a fine line between the Red zone and Green zone. You should NOT be burping up air and food if you are truly in the Green zone. If you are very excited about your new adjustment and seeing the scale move -- please don't let that excitement overrule your band being too tight. Because that excitement can turn into horror. Remember it's YOUR BAND and YOUR BODY, if you damage your band, you will have to pay for it, or have to eventually get it removed. Being in the Red zone too long comes with horrible consequences and will lead to band damage and removal, please remember that. I have highlighted in RED what a too tight band indicates in this article, and highlighted in GREEN what the green zone feel like. You can IGNORE this article and keep your fill level even if you are in the Red zone, but that will be all on you if you suffer complications, you have been far warned. Also remember constant burping, dry cough, and not able to eat solid Protein without pain an vomiting, and throat irritation, usually are the first sign that you are too tight after a recent fill. But if you are in the Green zone by reading this article, congrats and good luck on losing! Gastric Banding and the Fine Art of Eating BT Online Editor | September 22, 2011 by Paul O’Brien, MD Dr. O’Brien is from the Centre for Obesity Research and Education (CORE), Monash University, Melbourne, Australia. Bariatric Times. 2011;8(9):18–21 Funding: No funding was received for the preparation of this article. Financial Disclosure: Dr. Paul O’Brien is the Emeritus Director of the Centre for Obesity Research and Education (CORE) at Monash University, which receives a grant from Allergan for research support. The grant is not tied to any specified research projects and Allergan has no control of the protocol, analysis and reporting of any studies. CORE also receives a grant from Applied Medical toward educational programs. Dr. O’Brien has written a patient information book entitled The Lap-Band Solution: A Partnership for Weight Loss, which is given to patients without charge, but some are sold to surgeons and others for which he receives a royalty. Dr. O’Brien is employed as the National Medical Director for the American Institute of Gastric Banding, a multicenter facility, based in Dallas, Texas, that treats obesity predominantly by gastric banding. Abstract The author reviews the physiology of eating and what the adjustable gastric band does to the function of the distal esophagus and upper stomach of the patient. The author also provides the “Eight Golden Rules” on proper eating habits for patients of laparoscopic adjustable gastric banding, including what, when, and how they should eat, in order to achieve optimal weight loss results. Introduction Laparoscopic adjustable gastric banding (LAGB) has been shown to enable patients with obesity to achieve substantial, durable, and safe weight loss,[1,2] which can help reduce or resolve multiple diseases,[3] improve quality of life, and prolong survival in patients with obesity.[4] LAGB is a weight loss surgical procedure performed solely for the purpose of affecting a key physiological function in weight loss, appetite control. In 2005, we conducted a randomized, blinded, crossover trial that showed that the LAGB controls the appetite.[5] However, if the LAGB is not placed properly or if the patient does not eat properly, it will not perform at an optimal level. For example, if the band is placed too loosely, then it will not provide the proper level of reduced satiety and appetite, and likely will have little effect on the patient’s weight and health. If the band is placed too tightly or if patient eats too fast or takes large bites of food, slips and enlargements can occur, leading to reflux, heartburn, vomiting, and sometimes the need for revision. Optimally, the band should be adjusted so that it squeezes the stomach at just the right pressure. If the patient eats correctly and the band is placed correctly, the LAGB should adequately control the patient’s appetite, resulting in optimal weight loss. The Physiology of LAGB Dr. Paul Burton, a bariatric surgeon at the Centre for Obesity Research and Education, Melbourne Australia, has studied the physiology and the pathophysiology of the LAGB closely. He used high-resolution video manometry, isotope transit studies, endoscopy, and contrast imaging to understand what happens during eating in normal controls, eating in patients who are doing well after LAGB, and eating in patients who have symptoms of reflux, heartburn, and/or vomiting after LAGB.[7–15] In Burton’s series of articles, he concluded that in LAGB, it is not the band that fails, but rather the patients who receive the band and, more importantly, the doctors who care for them. Many years ago at the Centre for Obesity Research and Education (CORE), my colleagues and I developed the Green Zone chart, a conceptual way of identifying the optimal level of band restriction (Figure 1). When a patient is in the yellow zone, it is an indication that the band is too loose. When in the yellow zone, a patient may be eating too easily, feeling hungry, and not losing weight. When a patient is in the green zone, he or she does not feel hungry, is satisfied with small amounts of food, and is achieving weight loss or maintaining a satisfactory level of reduced weight. When a patient is in the the red zone, it is an indication that the band is too tight. The patient experiences reflux, heartburn, and vomiting. The range of food the patient in the red zone can eat after undergoing LAGB is limited and he or she may start to eat abnormally (so-called maladaptive eating), favoring softer, smoother foods like ice cream and chocolate. While in the red zone, patients will not lose weight as effectively and they may even gain weight. Burton measured the pressure within the upper stomach beneath the band in numerous patients when they were in the green zone. He found the optimal pressure was typically 25 to 30mmHg. The art of adjustment is to find the level of Fluid in the band that achieves that pressure range. That level of pressure generates a background sense of satiety that persists throughout the day. The patient, when correctly adjusted, normally will not feel hungry upon waking in the morning, and throughout the day should feel much less hungry than he or she did before band placement. In my experience, it is common for LAGB patients to have no feeling of hunger in the morning. Then, during the day, a modest level of hunger will develop, which a small meal should satisfy. One of the key lessons learned from Burton’s studies was that each bite of food should pass across the band completely before another bite is swallowed. There is no pouch or small stomach above the band and there should never be food sitting there waiting. The esophagus is a powerful muscular organ that typically generates pressures of 100 to 150mmHg, but it is capable of generating pressures above 200mmHg. Esophageal peristalsis squeezes the bite of food down toward the band and then progressively squeezes that bite across the band. Each bite must be squeezed across the band before the next bite starts to arrive. Figure 2 shows a bite in transit across the band. A single bite of food, chewed well until it is mush, will move down the esophagus by peristalsis. At the level of the band, the esophageal peristalsis will squeeze that bolus of food across the band. It takes multiple squeezes (usually 2–6 squeezes or peristaltic waves) to get that bite of food across in a patient with a well-adjusted band (Figure 2). Those squeezes generate a feeling of not being hungry and stimulate a message that passes to the hypothalamus to indicate that no more food is needed. If a single bite of food is able to generate between two and six waves of signal, a meal of 20 bites may generate 100 or more signals. This is enough to satisfy a person and is enough to signal him or her to stop eating. We recognize two terms for appetite control, satiety and satiation. Satiety refers to the background control of hunger that is present throughout the day regardless of eating. In the LAGB patient, satiety is generated by the band exerting a constant compression on the cardia. Satiation is the early control of hunger that comes with eating. In the LAGB patient, satiation is generated by the squeezing of the bolus of food across the band during a meal. Each squeeze adds to the satiation signal. There are sensors in the cardia of the stomach that detect this squeezing. The exact nature of these sensors is still to be confirmed but they must be either hormonal or neural. We know that satiety and satiation are not mediated by one of the hormones currently known to arise from the upper stomach.[16] Ghrelin is a hormone that stimulates appetite. A number of hormones that can be derived from the cardia of the stomach are known to reduce appetite. None of these hormones are found to be raised in the basal state after gastric banding and none can be shown to rise significantly after each meal.[16] Vagal afferents are plentiful in the cardia, and one group of afferents has a particular structure that lends itself to recognizing the compression of the gastric wall associated with squeezing of the bite of food across the band. In my opinion, the intraganglionic laminar endings, better known as IGLEs, are the most likely candidate as mediator of the background of satiety throughout the day and the early satiation after a meal. The IGLEs lie attached to the sheath of the myenteric ganglia and are known to detect tension within the wall of the stomach. They are low-threshold and slowly adapting sensors and therefore are optimal for detecting continued compression of cardia of the stomach over a 24-hour period. The several squeezes that go with the transit of each bite stimulate the IGLEs further. The signal passes to the arcuate nucleus of the hypothalamus and the drive to eat is reduced. The lower esophageal contractile segment. Burton developed the concept of the lower esophageal contractile segment (LECS). It is made up of four parts: the esophagus, the lower esophageal sphincter, the proximal stomach (including the 1cm or so above the band and the 2cm of stomach behind the band), and the band itself (Figure 3). As the esophagus squeezes the bolus of food down toward the band, the lower esophageal sphincter relaxes as this peristaltic wave approaches. It then generates an after-contraction, which can maintain some of the pressure of the peristaltic wave as a part of the food bolus is squeezed into that small segment of upper stomach. The upper stomach, including the area under the band, is sensitive to these pressures. It generates signals to the hypothalamus. These signals may be hormonal but are more likely to be neural. A correctly adjusted band will generate a basal intraluminal pressure of 25 to 30mmHg, providing a resistance to flow. The segment of the bolus that is squeezed through generates more signals from that area. Keeping the LECS intact is a key requirement for success with the gastric band. Bad eating habits (e.g., insufficient chewing, eating too quickly, taking bites that are too large) hurt the LECS. If those bad habits go on for long enough, stretching occurs and the power of peristalsis is lost, leading to the return of hunger (Figure 4).[11,12] The Fine Art of Eating A quality aftercare program is essential to successful weight loss in patients after LAGB. Before making the decision to proceed with LAGB in patients, I promise my patients three things: 1) to place the band in the optimal position safely and securely, 2) that they will have permanent access to a skilled aftercare program, and 3) that I will give them the information they need to obtain the best possible weight loss from the band. In return, I ask for three commitments from my patients: 1) that they follow the rules regarding eating after undergoing the procedure, 2) that they follow the rules regarding exercise and activity, and 3) that they always come back for follow up no matter how many years have passed.[6] The “Eight Golden Rules.” At my facility, we summarized guidelines for eating after LAGB into what we call the “Eight Golden Rules” (Table 1). These rules are included in a book and DVD given to every patient who undergoes LAGB at the facility.[6] The rules are also posted on www.lapbandaustralia.com.au and are reinforced at most aftercare visits. These eight golden rules must become part of each patient’s life. The effect of the LAGB procedure on hunger facilitates a patient’s adherence to the rules, making it more likely that he or she will follow them. However, achieving positive results with LAGB requires a working partnership between the physician and patient. Adhering to these rules is the patient’s part of the partnership, and he or she ultimately is responsible for the success or failure of weight loss following LAGB. What to eat. After undergoing LAGB, patients should eat small amounts of “good food,” meaning food that is protein rich, of high quality, and in solid form. Each meal should consist of 125mL or 125g (i.e., about half of a cup of food). This measure of “half a cup” is a concept rather than a real measure of food, as some foods, such as vegetables and fruit, are composed largely of Water and this has to be allowed for in some way. Thus, I allow exceeding the “half a cup” limit a little for vegetables and fruit. We instruct patients to put each meal on a small plate and to use a small fork or spoon. The patient should not expect to finish all of the food on the plate, but rather he or she should plan to stop when he or she is no longer hungry. Any food left on the plate should be discarded. Protein-rich foods. Protein is the most important macronutrient in the food a LAGB patient eats. At our clinic, we recommend that our patients consume approximately 50g of protein per day. We have measured protein intake of our patients (Table 2) and have monitored their blood levels. We have not seen any protein malnutrition after LAGB, indicating that a daily intake of about 50g a day is sufficient. Table 2 shows the energy and macronutrient intake of 129 consecutive patients measured before and at one year after LAGB. Note the mean energy intake is reduced by approximately 1500kcals.[17] The best source of protein is meat; however, red meats, such as beef and lamb, tend to be difficult to break up with chewing in order to be sufficiently turned into mush. It is much easier to break up fish with chewing, and many fish are high in protein, including shellfish. chicken, duck, quail, and other birds can also be cooked to be easily chewed to mush before being swallowed. eggs and dairy, including cheese and yogurt, are also excellent protein sources. For nonanimal sources of protein, a patient should consider lentils, chickpeas, and Beans. Half of the “half a cup” allotment per meal should comprise protein-rich food. The other half should be made up of vegetables and/or fruits. I recommend to my patients that they eat more vegetables than fruit because vegetables have less sugar. Any space left in the “half a cup” can be used for the starches, (e.g., bread, Pasta, rice, cereals, potatoes), though I recommend to my patients that they eat a minimal amount from this group of foods as they tend to provide no important nutritional benefit. High-quality foods. High-quality food are foods that are minimally processed, natural, and whole. We encourage our patients to look for quality over quantity—for example, they might try sashimi-grade tuna, smoked salmon, duck breast, lobster, or even a simple poached egg. It is also important to remind your patients that there is no limit to the amount of herbs and spices that can be used to enhance the flavors of their foods. Solid foods. The patient should choose solid foods over liquids whenever possible. Liquids pass too quickly across the palate and, more importantly, too quickly across the band. There is no need for the esophagus to squeeze liquid, and without the squeeze, there is no stimulation of the IGLEs and no induction of satiety; therefore, eating calorie-containing liquids may negatively impact a patient’s weight loss. When to eat. After undergoing LAGB, a patient should eat three or less times per day. If the patient is in the green zone, meaning that the band is adjusted correctly, there should be no need for him or her to eat between meals. In fact, even three meals a day may be more than needed for satiety. In my experience, patients have little interest in eating in the morning. By late morning or early afternoon, patients may start to notice some hunger, which indicates that it is time to have a first small meal. In the evening, patients may have another meal. Most importantly, patients should be instructed that a meal missed is not to be replaced later on. The typical human body is satisfied with a maximum of three meals per day but often is happy to accept two or even one meal per day. Patients should be reminded that there should be no snacking between meals. If a patient finds that he or she is hungry by late afternoon, encourage him or her to eat something small and of high quality, such as a piece of fruit or some vegetables, just to tide him or her over until the evening meal. The patient should then visit the clinic to check whether or not he or she is in the Green Zone. It is important that the patient adhere to the aftercare program to monitor whether or not he or she is in the green zone. If not in the green zone, the patient will need to have fluid in the band increased or decreased. How to eat. Take a small bite and chew well. The “half a cup” of food should be placed on a small plate. The patient should use a small fork or a small spoon to eat. A single bite of food should be chewed carefully for 20 seconds. This provides the opportunity to reduce that bite of food to mush. It also provides the important opportunity for the patient to actually enjoy the taste, the texture, and the flavor of the food. Encourage your patients to enjoy eating more than they ever have. After chewing the food until it is mush, the patient should swallow that bite. Swallow, then wait a minute. The patient must wait for that bite to go completely across the band before swallowing another bite. Normally, it will take between two and six peristaltic waves passing down the esophagus, which can take up to one minute. This is probably the biggest challenge of educating the patient who has undergone LAGB. You must instruct the patient to eat slowly—chew well, swallow, and then wait one minute. A meal should not go on for more than 20 minutes. At one bite per minute, that is just 20 small bites. The patient probably will not finish the “half a cup” of food in this time. In this case, the patient should throw away the rest of the food. After undergoing LAGB, the patient should always expect to throw away food and to never eat everything on the plate. If it takes between two and six squeezes to get a single bite of food across the band and each squeeze generates satiety signals, then 20 bites should be generating 40 to 120 signals. The actual number will depend on the consistency of the food, the tightness of the band, and the power of the esophagus. With good eating practices and optimal band adjustments, the patient should not be hungry after 20 bites or less. As soon as the patient is no longer hungry, he or she should stop eating. After undergoing LAGB, the patient should never expect to feel full. Feeling full means stasis of food above the band and distension of that important part of the LECS above the band. This destroys the LECS, the mechanism that enables optimal eating behavior and appetite control. A patient should always keep this process in mind. If the patient finds that after eating the “half a cup” of food he or she is still hungry, he or she should review his or her eating practices, correct the errors, and consider the need for further adjustment of the band. If this is occurring, it is usually an indication that the patient is not in the green zone. Eat a small amount of good food slowly. These eight words are the key to success. Small amount refers to small bites, the small fork (e.g., oyster fork), and a total meal size of half a cup. Good food refers to protein-rich, high-quality, and solid food. Slowly refers to chewing well, swallowing, and waiting a minute. Try to repeat these eight words to every patient every time you see them. Get them to repeat it at every meal. The failure of the gastric band can almost always be traced to failure of this process. Addressing the Challenges The two principal challenges after LAGB are weight loss failure and the need for revisional surgery due to proximal enlargements above the band. Weight loss failure will occur if the band is not placed or adjusted correctly or if the patient does not adhere to the guidelines of proper eating and exercise. When a patient is not achieving results after his or her LAGB operation, the doctor should check to ensure that the band is correctly and safely placed. The most common reason for weight loss failure is poor eating behavior, which leads to enlargement above the band. There are three common eating errors: 1. The patient is not chewing the food adequately. Food must be reduced to mush before swallowing. If it cannot be reduced to mush, it is better for the patient to spit it out (discreetly) than to swallow it. 2. The patient is eating too quickly. Each bite of food should be completely squeezed across the band before the second bite arrives. 3. The patient is taking bites that are too big to pass through the band. Each of these errors leads to a build up of food above the band where there is no existing space to accommodate it (Figure 4). Space is then created by enlargement of the small section of stomach or by enlargement of the distal esophagus, both of which can compromise the elegant structure of the LECS. If the LECS is stretched, it cannot squeeze. Without the squeezing, satiation is not induced. When satiation is not induced, hunger persists, more eating occurs, and stretching continues. If our patient continues this each day for a year, it is inevitable that chronic enlargement will occur, the physiological basis for satiety and satiation is harmed, and stasis, reflux, heartburn, and vomiting supervene. The doctor should continually review the Eight Golden Rules for proper eating and exercise with each patient. For optimal weight loss following LAGB, the patient should have access to a comprehensive long-term aftercare program for clinical support and optimal band adjustments and he or she must follow the guidelines regarding eating and exercising for the rest of his or her life. “Eat a small amount of good food slowly” is the key to optimizing the gastric band.

Sadly, I have not seen very good outcomes with repeated port infections. Some have to get the port removed, and get on heavy antibiotics for a while, sometimes 6 months or more to try to get rid of all infection, and in most cases does not work out long term. Also you did not mention if you were diabetic or not, but, on Allergan website, diabetics tend to have a hard time with the band, than others, since they are more prone to infections. Infection can spread up the tubing to the band and cause band migration (erosion), if I were you, I'd be looking into eventually removing the band, and possibly looking for alternatives for weight loss. I am wishing you the best.

Another thing, I want to say, NEVER let the scale -- control whether you need some saline removed. This is where many get into trouble, PBing is not painful for most, so many "get rid' of their food daily and don't think twice about it. Until the damage gets done and then REAL vomiting occurs, with awful bile reflux, frothing at the mouth, not being able to sleep without 'stuff' coming back up at night. These things can be prevented with not keeping the band dangerously too tight, taking the time to slowly chew your food, and not purging your food. It's just that simple, you don't have to abuse your band to lose weight, I don't know why so many women do it. She is a very pretty girl, I hope she can get some help, but she should know that it will be VERY HARD to keep her weight down WITHOUT a tool in the long run. This is why I use to warn newbies -- don't abuse your band and lose it, have the band to "help you" and not do all the work, and you can keep it for a long time. Also ButterFly: you are in GOOD hands, you have one of the most experienced lap band surgeons in the US.

Take pea size bites, it could be swelling, if after a week and you are still burping, ALOT...you are too tight and need to go back and get a little out before you damage your band, sometimes if you remove 0.1cc it could keep you out of the red zone. Good luck

This letter is totally uncalled for and inappropriate. This woman has NO idea why these "obese" children are obese. It could be a medical condition, or some other issue that that child is dealing with. I can't believe the thought of some people, I am SURE those kids know they are overweight, they don't need a stranger to tell them that. Let those children enjoy Halloween like other children, I guess this woman feels that Overweight children don't "deserve" treats... Also if they are fat today, does not mean they will be fat in the future, how dare she...this woman would not last in some neighborhoods...LOL.

HotButterfly, Thank you for posting this, unfortunately this happens ALL THE TIME and is NOT RARE. I would say 90 percent of lap band complications, happen like this. I've actually heard a LOT WORSE. This is why I am so cynical on these boards, newbies IGNORE you when you warn them, they think..Oh...it will happen to 'others'.... This girl is telling her story to hopefully help others, but she REALLY abused her band... The lap band is NOT about misery,vomiting, and constant burping up foam and reflux. I honestly can't believe so many live with the lap band this way. This will HAPPEN TO EVERYONE that keeps their bands too tight, NO ONE IS IMMUNE. I am going on 9 years post op and I've seen and heard a lot worse, I've had friends that bands slipped so bad until it strangled most of their stomach and they had to get a force "Sleeve, removal of most of the stomach" . Some think they can get a NEW band or it fixed after a slip....NOPE...once the band has slipped so bad or the esophagus gets dilated from being so tight so long, you can NO LONGER GET A LAP BAND. Many think 'vomiting' is NORMAL...IT'S NOT..NO VOMITING WITH THE BAND IS NORMAL AT ALL. Even if you PB and throw up food, every now and then...--THAT IS ALSO A PROBLEM...ANY FREQUENT VOMITING with the band WILL CAUSE IT TO EVENTUALLY SLIP. -- VOMITING SHOULD BE VERY RARE, like ONCE A YEAR OR SIX MONTHS. And if someone is vomiting daily --- they are in BIG TROUBLE, sometimes it takes a few years before SEVERE slippage occurs where it gets life threatening. Since I've had my new band placed, I have not vomited once and I hope and pray to keep it that way....Vomiting with the band is like "lap band suicide" and SADLY -- MANY THINK it's NORMAL to vomit and purge daily --- This is why MANY SURGEONS are NO LONGER DOING BANDS....DUE TO LAP BAND ABUSE FROM PATIENTS... In Australia...lap band complications are not as common as in the US, they don't tend to abuse their bands as much as Americans do, their slippage rate is low compared to US band patients....MOST of the lap band complications ARE preventable. -- sadly. I hope many on this board listen to this girl....BUT SADLY --- she is among MANY that have lap band complications. Anyway thank you for sharing this important video -- hopefully it will touch others.

FYI...for those who are not clear on exactly what ObamaCare means. http://obamacarefacts.com/obamacare-myths.php ObamaCare: Myths About Health Care Reform Separating the ObamaCare Facts from the ObamaCare Myths 2013 and Beyond The ObamaCare Myths about health care aren't just confusing, they are wrong. ObamaCare myths range from premium increases to ObamaCare implanting RFID chips in all Americans. ObamaCare Facts aims find out the truth behind the myths about ObamaCare. When it comes to the well being of Americans, there is no room for opinions and rhetoric. The Following Are Some Common Myths About Obama's Health Care Reform New ObamaCare myths are coming out every day. Keep checking back as we fact check the rhetoric. ObamaCare Myth: ObamaCare Creates Health Insurance ObamaCare does’t create health insurance, it regulates the health insurance industry and helps to increase quality, affordability and availability of private insurance. The law does this by creating new rules for insurers, expanding Medicaid to tens of millions of more Americans and by implementing a Health Insurance Marketplace where Americans can buy subsidized, regulated health insurance in a competitive private market. ObamaCare doesn’t create a government-run healthcare system or Government insurance. It greatly expands business for the private for-profit health insurance industry, creating about 12 million new customers. In other words ObamaCare regulates the free market, it doesn't replace it. It does however expand and improve Medicare, Medicaid and CHIP which are types of Government health insurance. It also expands private employer based insurance. ObamaCare Myth: You Have to Use the Health Insurance Marketplace No one has to use the marketplace. Anyone who likes there current insurance can keep it. If you have Government based insurance like Medicare, Medicaid, or CHIP then you are covered. If you like your work based insurance, you can keep that too. The marketplace is for uninsured Americans and those who don't like their current plan. Those making under 400% of the Federal Poverty Level may get help with monthly premium costs and reduced out-of-pocket costs on insurance purchased through the marketplace. Please be aware that if you have access to affordable employer based coverage that provides at least the coverage of a "bronze" plan sold on the marketplace, you won't be able to get cost assistance on the exchange. ObamaCare Myth: My Employer Has to Cover Me The employer mandate has been pushed back to 2015. Employers with more than 50 full-time equivalent employees will have to cover their employees come 2015. Small businesses don't have to insure employees but can get tax breaks of up to 50% of their employee premium costs via the health insurance marketplaces. Learn more aboutObamacare and small business. ObamaCare Myth: Congress is Exempt from ObamaCare Congress isn't exempt from ObamaCare. Congress and their staff have work based insurance, thus they should be able to stay on their current plan. However an amendment to bill before it became law said they must use health insurance marketplace. They will use the marketplace, but since their staffers, making as little as $30,000 can't get subsidies through the marketplace (they have access to employer based coverage) their employer (the Government) is allowed to cover part of the cost of their premiums. Since all members of Congress have been well aware of this since 2010, any other claim is a willful misrepresentation of the truth. ObamaCare Myth: ObamaCare Takes Sides "ObamaCare", officially titled the Affordable Care Act, was originally meant as a pejorative term to equate the bill with the current president in order to play politics U.S. health care reform. The truth is the Affordable Care Act is the result of a joint effort between both sides of the isle, health insurance companies and law makers and has been being worked on for decades. The law itself is based on "RomneyCare", The Massachusetts health care insurance reform law, St. 2006, c.58. "RomneyCare" was based on the individual mandate which was proposed by the Heritage Foundation in 1989. The individual mandate was championed by Republicans as alternative to single payer as it put individual responsibility at the forefront of health care reform. ObamaCare Myth: ObamaCare Only Helps X People The truth is ObamaCare helps everyone. Some of us might pay more, but everyone will be able to enjoy better quality health insurance and more rights and protections in regards to healthcare. When it comes to cost the rule of thumb is that the less you make the more the law helps you. Those who may pay more include individuals and families making over 400% of the poverty level and businesses with over 50 full-time employees making over $250,000. ObamaCare Myth: Obamacare Means Higher Premiums One of the most wide spread ObamaCare myths is that ObamaCare increases insurance premiums. While many Americans have seen their health insurance premiums rise since the passing of the new health care law, blaming "ObamaCare" is an over simplification of the truth. The truth is insurance premiums have been growing faster than the rate of growth in income for well over a decade. Today there are more rules and regulations aimed at reducing the growth in premium rates like the rate review provision that stops insurance companies from unjustified rate hikes and the medical loss ratio provision that stops insurance companies from spending your premium dollars on non-health care related expenses. This isn't to say that the Affordable Care Act hasn't indirectly affected some premium increases. ObamaCare stops insurance companies from raising premiums due to health status and gender or denying coverage based on pre-existing conditions. Every plan must offer more essential health benefits and preventive services at no out-of-pocket costs and much more. In some cases insurance companies have raised rates on existing plans in response to your new health care benefits, rights and protections. Luckily ObamaCare does a lot to mitigate this affect, aside from the consumer protections mentioned above, ObamaCare creates a Health Insurance Exchange Pool known as the Health Insurance Marketplace. Today low-to-middle income Americans (and small businesses) can shop for subsidized, regulated health insurance from competing health care providers using their State's online marketplace. Cost assistance offered through the marketplace greatly reduces premium costs of those making less than 400% of the Federal poverty level. (400% of the Federal Poverty level equates to individuals making less than $46,021 or a family of four making less than $93,700 a year). Learn more about the Health Insurance Marketplace. ObamaCare Myth: Obamacare Means Higher Taxes Many Americans will save on medical costs and taxes because of ObamaCare, many more won't pay a dime more than they do now as far is taxes go. Higher-earners and large employers will be responsible for more taxes, but the group who will pay more almost universally profits off of the new law. The fact is ObamaCare includes the biggest middle class tax cut to health insurance in our nation's history due to providing tax credits to millions of Americans to lower their premium costs. The only tax that impacts the average American directly is the "individual mandate". The mandate says: If you don’t obtain coverage or an exemption by January 1st, 2014 you must pay a per-month fee on your federal income tax return for every month you are without health insurance. In 2014 the fee is $95 per adult ($47.50 per child) or 1% of income, whichever is higher. The family max is $285. The "employer mandate" for large employers to cover their workers did lead to some employees being cut back to part-time, but it also led to many more being moved from part-time to full-time in order to provide them with health benefits. Small businesses won't have to insurance their employees, but if they choose to they may be eligible for tax breaks of up to 50% of the cost of their employee's premium costs. The only people who are affected by most of the other taxes you hear about are about are the 3% of businesses and 2% of Americas richest families with incomes of over $250k and capital gains over $250k. - See ObamaCare Taxes for More info and Myth debunking on taxes. ObamaCare doesn't raise your premium and doesn't mean higher taxes for the most part, but it does limit some tax breaks and tax deductions like HSA caps. ObamaCare Myth: ObamaCare Means Lower Wage and Fewer Jobs The biggest job creators are small businesses with under 10 employees, next is under 20, next is under 30 employees (it goes on from there). These businesses can receive tax credits through the marketplace to help ease the burden of providing health insurance to their employees. Small businesses have historically had the hardest time providing quality coverage to themselves or their employees. Come 2015 only businesses with over 50 full-time employees who don't already provide health benefits to their full-timers will be affected by the "employer mandate". These businesses account for .2% of all firms in America. While employees of some of those companies may have their hours cut to part time in order for employers to avoid paying a penalty, ObamaCare actually creates millions of jobs, including tens of thousands of new health care jobs, 16,000 new IRS jobs as well as many more private-sector jobs (especially in small businesses with under 25 employees) and other government jobs. Most of the top 3% of small businesses polled said that the idea that ObamaCare would affect their job growth or hiring process was an "ObamaCare myth". Although ObamaCare doesn't directly result in job loss, companies are cutting back hours of full-time workers to below 27 hours in order to avoid providing them with healthcare has been one of the nastier side effects of the bill. Ironically the requirement to provide insurance has been pushed back to 2015. ObamaCare Myth: The ObamaCare Death Panels The concept of death panels, panels that provision health care and decide if you will live or die, is an ObamaCare myth. There is, however, a financial advisory panel that study treatments to keep health care costs down. There was a provision in the health care bill that had to be removed due to the rumor of death panels. The provision would have paid doctors for providing voluntary counseling to Medicare patients about wills and end-of-life care options. Removing the provision did, ironically, hurt seniors. That fact is, your health care is in the hands of you and your doctor. ObamaCare regulates insurance not health care. ObamaCare Myth: Obamacare Comfort Care There has been an ObamaCare myth going around since 2011 when a "brain surgeon" called up the Mark Levin show to let him know that patients over 70 years old could be given "comfort care" instead of brain surgery depending on the decision of a panel. This "neurosurgeon's" claim has since been debunked by both the AANS (American Association of Neurological Surgeons and the CNS (Congress of Neurological Surgeons). We have also checked out the ObamaCare bill itself and can confirm this is an ObamaCare myth. The AANS stated that the man was most likely not a neurosurgeon and was rather pretending to be. The bottom line is that ObamaCare doesn't ration health care, it helps protect consumers against the health care rationing insurance companies have been doing for years. ObamaCare Myth: Standard of Living Will Decrease Since your taxes probably won't be affected, your health care costs will go down and your health care will improve the chances of it affecting your standard of living negatively is unlikely. ObamaCare ultimately decreases the deficit by over $200 billion dollars helping our collective standard of living as well. Most importantly new benefits, rights and protections will lead to better quality healthcare for all Americans with health insurance. Obamacare cuts premiums for for millions of American Families and Small Businesses resulting in the biggest tax cut for the middle class in history! ObamaCare Myth: Cheapest ObamaCare Plan Will Be $20,000 per Family or "Average Family Will Pay $20,000 for Insurance" This ObamaCare myth is a misleading quote from an IRS report on what Americans will pay for a Bronze plan in 2016. For some reason reports labeled a family of 5 making $120,000 in taxable income as an average American family making it seem like rates would go up. $20,000 is what a family of 5 making $120,000 is projected to pay in 2016. Actual costs of that same family range from around $7,000 to over $30,000 depending on regional cost factors, age and smoking status alone. Truly finding an average cost for health insurance is next to impossible. In truth every family is different and will pay rates specific to the plan they chose, their financial status, location, age, family size and smoking status. (Gender and health status are no longer factors in health insurance costs). The report actually does display the disparity in cost, showing most individuals and families will pay 8% of their income or less while families with older heads of the household, located in States with high regional cost, making around and over the 400% FPL mark will pay more. PLEASE NOTE: Now that the marketplaces are opening up it's being reported that the average cost of health insurance on the marketplace is $249 a month before cost-assistance. 6 in 10 Americans without health coverage could get coverage for $100 a month or less on the marketplace with cost-assistance. And large percentage of Americans will be able to get free health insurance due to the expansion of Medicaid. ObamaCare Myth: ObamaCare Hurts Seniors and Medicare ObamaCare reforms Medicare and offers a ton of new benefits, rights and protections for Seniors. There are a number of reformations to Medicare such as closing the "donut hole" for prescription meds, providing better health services and reforming Medicare Advantage (a private Medicare option that lets Medicare be traded on the market, despite taxpayer funding. It currently costs tax payers more than Medicare and Medicaid combined). Large portions of ObamaCare address improving and expanding Medicare for seniors. Get the truth behindObamaCare and Medicare. ObamaCare Myth: Medicaid Isn't Good or People Don't Want Medicaid or Medicaid is too expensive Medicaid is the only option for many low-income Americans. The idea that there is something wrong with Medicaid is a myth spread by those who don't want to use tax dollars to care for those who cannot afford insurance. Millions of low-income Americans including women and children will go without health care because of the politicians refusing to allow Medicaid funding. ObamaCare expands Medicaid to 15 million low-income Americans. Many State's opted out of supporting the expansion due to cost, even though the federal Government provided 100% of funding for the first 3 years. The truth is millions of Americans will go without any type of health care because of the myth that Medicaid isn't quality insurance. Get the full story on Medicaid and ObamaCare. Today tax payers are responsible for tens of millions of dollars in unpaid medical bills because those who cannot afford insurance turn to emergency rooms for care because they have been left with no other option. Expanding Medicaid is shown to actually save State's money. ObamaCare Myth: ObamaCare implants a "CHIP" in you when you get health care... The Mark of the Beast. We have received multiple letters from concerned readers who believe that they will have a mandatory RFID chip planted in them do to ObamaCare. While RFID chips are a real thing and ObamaCare does pave the way to integrate RIFD chips as a way to provide better medical treatment, there is no mandate. The disinformation is causing a panic and taking away the true debate about RFID chips and the implications of their use. The following is an example of the ObamaCare implant myth (and is left grammatically intact the way we found it): "I don't think it is right for president to decide to put chips in the citizens of American hands or anybody else we as Americans have the right to decided if we want the chip its the mark of the BEAST People wake up its in the bible" The idea that ObamaCare will force Americans to be implanted with RFID chips is a myth. We read the bill and did a search for (this part of the chain email): The Obama Health care bill under Class II (Paragraph 1, Section specifically includes ‘‘(ii) a class II device that is implantable." Then on page 1004 it describes what the term "data" means in paragraph 1, section B: 14 ‘‘( In this paragraph, the term ‘data’ refers to in 15 formation respecting a device described in paragraph (1), 16 including claims data, patient survey data, standardized 17 analytic files that allow for the pooling and analysis of 18 data from disparate data environments, electronic health 19 records, and any other data deemed appropriate by the 20 Secretary" The Facts on the ObamaCare Chip Myth The quoted part of the law is about better data collecting for medical records, to reform the way which data is collected to better treat patients. The devices described in paragraph (1) are referring to class II devices which include both life support devices as well as RFID chips. There is no mandate about the insertion of any type of class II device. The only time "CHIP" in mentioned in the 2,000 plus page bill is as an acronym for "Children's Health Insurance Plan". CHIP provides funds to states in order to cover children in families that do not qualify for Medicaid, but still have modest incomes. CHIP provides insurance to more than 5 million kids. It's part of ObamaCare helping to ensure that all Children have health coverage. The debate about centralized data collection, RFID chips and how it relates to the affordable care act will become more important as we move into the next decade. Learn more about RFID chips and the ObamaCare Micro Chip Implant Rumor. ObamaCare Myth: ObamaCare Forces Abortions and Contraceptives ObamaCare gives religious institutions an opt-out for providing specific women's health services (it has also granted waivers to some businesses). Also, contraception coverage is not required by health care companies or exchange commissioners. Although federal funding does go towards women's services and education, it doesn't force anyone to do anything in regards to these services. ObamaCare Myth: ObamaCare Rations Health Care This is an ObamaCare myth. The new health care law doesn't ration health care, but insurance companies do. ObamaCare actually funds research, establishes committees and enacts a number of provisions that protect consumers from the health care rationing insurance companies have been doing for ages. ObamaCare Myth: ObamaCare is Socialist ObamaCare is a program that everyone pays into (taxes) in order to ensure that all Americans have access to affordable quality healthcare (protections and services). Medicare / Medicaid / Social Security are all programs that work like this. ObamaCare allows us all to purchase our own private insurance in a regulated market place. This embraces the ideas of capitalism, regulated free market and freedom of choice, along with the government's protection of your new health care related rights. It's not a widely known fact, but hospitals are almost exempt from the economy and free market due to their ability to set and control prices. Also many medical device manufactures and drug innovators have such a tight control on necessary drugs and treatments that they, in a way, control their own prices as well. Simply calling ObamaCare a redistribution of the wealth or socialism is a very broad and inaccurate generalization of the law. Plus, there is a high chance that wealth is being "redistributed" to your family and / or small business providing better coverage, bigger tax breaks and putting money back in your pocket while improving the quality of your health care. ObamaCare Myth: We Need Less Government Your preference as to whether or not you appreciate the need for the Government that our founding fathers saw a need for is irrelevant when discussing ObamaCare. This is an issue of "do we need healthcare reform?" not "do we need more government?". At this point in history, less government would mean undoing hundreds of years of progress and handing our country over to corporations. Regulations, laws and taxes are all very important to our every day lives. There is always room for reform and that is exactly what ObamaCare does. ObamaCare Myth: Privacy / Freedom Will Be Jeopardized The idea that ObamaCare takes away your freedom is a myth. It doesn't make you do much of anything in regards to health care. The only example of freedom being restricted is the mandate to purchase insurance or pay a tax. Despite these facts, at the end of the day, ObamaCare costing you your freedom is a Myth. You will most likely save money and have access to better regulated Affordable Healthcare. We will all have better preventive services and the security in knowing we won't be dropped when we are sick or denied for a preexisting condition. ObamaCare Fact: 1 in 2 Americans technically has a pre-existing condition. ObamaCare Myth: ObamaCare is Unconstitutional Not only is ObamaCare constitutional, it has been a law since 2010. The supreme court upheld the law, reaffirming that that ObamaCare isn't unconstitutional. ObamaCare Myth: ObamaCare "Culling" Seniors: ObamaCare does nothing but help seniors, it is certainly not "culling" seniors. In fact much of the new health care law focuses on improving care for Seniors via Medicare reforms. Didn't find the ObamaCare Myth you are looking for? Check out this official doc from the American Nurses Associationon Health Care Reform Myths More ObamaCare Myths Are We Missing Any Myths? Let us know and we will add them to the list. Here are some of the Obamacare myths that we haven't covered in detail. ObamaCare Myth: Shutting Down Government Over Obamacare Funding Will Stop Health Care Law. ObamaCare Myth: People Will Be Able To Commit Subsidy Fraud On The Exchanges. ObamaCare Myth: Obamacare "Narrow Networks" Will Constrain Health Choices. ObamaCare Myth: Obamacare Is Bad For Women. ObamaCare Myth: With Full Access To Medical Records, The IRS Will Discriminate Against Conservatives. ObamaCare Myth: Navigators Will Abuse Private Information. ObamaCare Myth: Obamacare Mandates Doctors To Ask Patients About Sexual History. ObamaCare Myth: Obamacare's Medicaid Expansion Will Force Doctors To Turn Away Patients. ObamaCare Myth: Obamacare Is To Blame For A Projected 30 Million People Who Will Remain Uninsured. Finding Out More About ObamaCare Myths These are just some of the ObamaCare myths. Is ObamaCare perfect? Probably not, but if you don't like it you need to base your opinion on facts and not the ObamaCare Myths we just debunked. None of them are even remotely true. If you don't believe this article, that's OK. You can check out our Affordable Care Act Summary or Even the Full Affordable Care Act Bill and do all the research you want. Don't believe the ObamaCare Myths, The Obama Care Facts speak for themselves.

Actually I may Ping Alex to have that very important article as a pinned article because it is very critical to any one seeking a band and all lap banders, this information was not available to me over 8 years ago when i first got my band. Newbies today are lucky they have this information. I will paste a link again to it, in the event someone missed it. http://www.lapbandta...-zone-in-fills/

If you are getting food stuck with an 'empty band' you really need to see your surgeon ASAP....this IS different than someone WITH saline in their band.

A good reference is that if you don't chew your food properly and get food "stuck: frequently and vomit often, this behavior will eventually cause band slippage. If you did not read this VERY important post that I posted today on how the band works, it is good reading as a newbie, and is critical to your band's health long and short term. http://www.lapbandtalk.com/topic/177913-must-read-how-the-lap-band-should-work-green-zone-in-fills/

Wow, that sounds horrific, sorry you experienced this. Complications from ANY weight loss surgery whether it be band, bypass, sleeve or ds can be horrible. Also, they can get very expensive too, again sorry this happened to you.

I posted a MUST read article today on how the lap band works, you should really read it, it will help give you some perspective on to live with your band and if you are in the green zone. http://www.lapbandtalk.com/topic/177913-must-read-how-the-lap-band-should-work-green-zone-in-fills/

This trend has been going on for the last 3-4 years, it's not new. MANY surgeons are moving away from the band, NOT because the band is a bad procedure, but because they just do NOT like the AFTERCARE that the band REQUIRES. Surgeons are 'cutters' and lap band aftercare has become a "hassle" for many US lap band surgeons. It's just that simple. Many have been pushing the Sleeve for the last few years, even if the patient REALLY wants the band. Part of it is IGNORANCE from the patient, of not knowing how to live with their bands, and surgeons got tired of lap band 'complications, many patients keep their bands too tight, never follow up and only return to their surgeons when their bands has slipped, so many surgeons were removing more bands than what they were putting in. You have newbies here IGNORE how the band works, they really don't care, all they want is the "tightest fill possible" so this TREND WILL CONTINUE...UNTIL more and more surgeons get sick and tired of removing bands. Part of it is surgeons NOT educating patients on how the BAND REALLY works, and being honest UPFRONT with patient on what it takes to be successful and complication free. Also, with the Sleeve and Bypass once the surgery is DONE, they really don't have to see the patient AGAIN...FOREVER...most patients with the Bypass and Sleeve probably only need to see their surgeon for a few times after surgery and that's it. It does NOT mean Sleeve and Bypass patients don't have complications, because they have MANY..the thing is Sleeve and Bypass patients gets dumped off to their PCP's. internist, hematologists, and other specialists to 'deal' with their long term complications, Vitamin deficiencies, and other aliments. But with the lap band ONLY lap band surgeons can deal with reflux and other lap band long term problems, with filling/unfilling the band, and reading Upper Gi's , endocospies...etc, or removing the band. Also you CANNOT convince MANY lap band patients that a "tighter" band is not better, so unfortunately after a few years, MANY have to get their bands removed... Also MANY do not care if their bands are too tight, they just deal with it until their bands eventually slips...and I guess many surgeons are getting tired of removing bands. I think what will eventually happen is that ALL compliant people and those who keep moderate fills will be the only people to remain with bands, and ALL others will eventually get them removed...I guess you can think of it as a "weeding out process". The lap band will ALWAYS be available on the market, (probably in large urban areas, and decline in small rural areas) for those who can afford good aftercare and followups, but the trend of surgeons performing bands will continue to decline -- sadly due to bad surgeons and bad patients.

I agree with Missy, it depends on the condition of your stomach and the level of complication you have and how experienced your surgeon plays a role as well. Having a band removed and Sleeved in one surgery requires a highly skilled revision surgeon. Leaks are at a greater risk with Band to Sleeve revisions moreso than with virgin Sleeves. Also, BE AWARE that Band to Sleeve revisions have a LOWER success rate than virgin Sleeves, so before you remove your stomach for nothing, make SURE you research the Sleeve in its entirety before you get it done and once you get your stomach removed you can't turn back regardless if you like it or not.

I guess it depends on the surgeon, however my port is a low profile port, very small and not visible at all and it is located a few inches to the right above my belly button and I would not want to have it anywhere else. I have never had port pain, right after surgery I made sure I did not lift anything over 5-10 pound for about 2 months post op and I did not anything touch or hit my port area and I wore loose cloths for about 3 months after surgery.

Yes it does happen to MANY lap banders, we traveled to Lake Tahoe, California a few months ago and I could feel my band tighten as we traveled up the mountain. However, I've had my band tighten during plane flights, but not always, I guess it depends on the ebb flow of the band.

Congrats!! Your success is a job well done,you look great!!

I made this post about 5 years ago on another site a few years ago and it was very helpful to newbies so I thought I would post it here "Disclaimer, this is from my OWN journey and also seeing thousands of other lap banders journeys over the years" 1. If you drink COLD liquids or cold things the band will tighten up. 2. If you drink hot liquids the band will loosen up. 3. Most women that have menstrual cycles tissues around the band will tighten therefore causing the band to tighten up while menstruating and then loosen up right before or after a cycle. 4. The band will tighten if you get stressed about something, always leave a little wiggle room for unexpected tightness of the band, otherwise those who are very tight may find themselves not able to swallow their spit and cause irritation. 5. For many people the band will tighten during flying or even high elevation, those who live in mountainous terrains above sea level may experience a tighter band than those who live in flatter areas. 6. The band is tighter for most in the mornings, when you lie down this cause it to tighten further, something about how the saline moves around in the band which causes it to get tighter when you lie down. 7. When you have a GOOD FILL level you will notice you can't eat as much while sitting down, so don't cheat and stand up and eat! 8. When you have a GOOD FILL level, you will NOT be able to eat and drink at the same time, trust me, this will cause PBing and vomiting and cause the food and liquid to stack up and there is no where to go but back up. (This is an update to this one, many people can eat and drink at the same time, so this may be on an individual level). 9. When you are tightly restricted avoid, grilled chicken IN PUBLIC, make sure your meat are moist, example when I eat salads I add lots of dressing in order to eat this at work without getting stuck, but salad dressing is fattening, but it' not fattening only if you are only able to eat about 5 bites of it and get full/satisfied. 10. To avoid slimming and frequent vomiting (which may cause slippage or a stretched pouch if done daily) make sure you take pea size bites and chew and wait until you feel the food go through, the food IS SUPPOSED to gently ease down your esophagus slowly without PAIN, if you are having painful eating, you are not eating properly OR you are way too tight. Also if you are in public and eating at a restaurant you may want to order a hot tea or Soup to prevent first bite syndrome, typically the first bite is the toughest. Some people disregard this and they may vomit and if this is done regularly you will be on your way to become a revision patient. 11. Eating with the band will become very easy when you learn your band and signals of how tight you might be, your restriction WILL NEVER BE THE SAME EVERY DAY, you will have some days a little bit looser than others, THIS IS WITH ANY RESTRICTIVE SURGERY INCLUDING RNY OR THE SLEEVE, but the band is a bit more finicky since it is filled with saline so you have to eat accordingly based on how tight you are, However,...restriction should NOT vary a great deal, meaning one day soup and one day 2 whole Big Macs...lol, if your restriction varies that much you got a problem and need to see your doctor to make sure you are properly restricted or if you have a stretched pouch. 12. Clearing the pouch out daily -- THIS IS VERY IMPORTANT FOR LIVING with your band in peace! this is what I do to clear my pouch out daily, I make sure I drink Water after I eat before I go to bed, also chew about 2 papaya tablet from (GNC) this also helps clear my pouch out and avoid any indigestion while I lay down at night and I have a good night’s sleep even if I eat very close to bed time. But this will NOT work if you have a slipped band or esophageal issues or band damage. 13. Some foods may irritate you more such as spicy foods, fried foods, chocolate, mints, onions, coffee, these things may cause heartburn in some and may not in others, I can tolerate them as long as I don't overdo it, but taking a pepcid or other heartburn meds will help. 14. Getting food stuck - I've been stuck several times and it is not a good feeling so I try to avoid it as much as I can, the first thing I would do if I get stuck is excuse myself in go somewhere private and raise my arms and take deep breaths and message the middle of my chest this has helped me many times to prevent vomiting and when I message my sternum between the breast this will help move the food down, the food will either slide down or you will throw it up. 15. If you are truly stuck you may have to see your surgeon for an emergency unfill, you will know if you are truly stuck, this may cause breathing problems and can be quite scary and repeated vomiting, but as soon as the food becomes unstuck, most of the time you will feel better immediately. 16. You should ALWAYS be able to eat solid food, even if it's only 5 bites at a time you should be able to eat solid food with your band, if you get a fill and you have trouble with liquids, you are too tight and this will eventually cause problems. 17. It usually takes about 3-7 fills until you reach your sweet spot safely, If you can never get a good fill level, sweet spot, meaning too tight or too looseyou may want to change surgeons and seek a band surgeon only -- your fill giver may not be filling you properly, it should not take that much time to reach your sweet spot, your sweet spot should not be painful or have nightly reflux or pain or vomiting, the sweet spot should allow you to eat a few bites of solid food and you get a signal to stop eating like a hiccup, burp, sneeze, runny nose, and you may feel like you have eaten a thanksgiving dinner on about 4-5 oz of food. 18. The band will restrict dense solid foods better than soup or liquids, you will get fuller on these foods quicker, the band is designed to restrict solid foods, if you are too tight you may not be able to eat healthy foods that are required, which may result in no weight loss. 19. How to know if you are in trouble (deep do do) with your band, Reflux is that slippery slope type issue and should ALWAYS be of concern to lap banders, any time you get a new fill and if you experience reflux that is frequent, you should see your surgeon immediately, there are two types of refux with the band that needs to be CLARIFIED. 20. If you plan on going VERY tight with your band use common sense and puree your food, because eating solids on a too tight band will be a nightmare and you will eventually slip your band, if you don't want to remove saline, puree! and drink Protein drinks and when you lose the weight you want, reduce saline, because you will surely cause band slippage if you attempt to eat "regular solid food" on a too tight band for long periods of time (but word of caution, this may not work for everyone and can be very dangerous to some). How can you tell if your band is about to slip? 1. The dangerous reflux that indicates band slippage or (pouch dilation) is when it awakes you from your sleep and vomit and nasty liquid starts to shoot up into your nose and mouth, or a constant dry cough that is not associated with a cold. THIS REFLUX REQUIRES IMMEDIATE ATTENTION from your surgeon and possible saline reduced and Upper Gi to check your band. 2. The not so dangerous reflux is when you are in the green zone and you ate too close to bedtime and you wake up with "stuff" in your mouth and have to spit it out, what I've done to correct this type of reflux is to drink water before bed along with a few Papaya enzymes (from GNC) which helps ease digestion and move food through a tight band from the upper pouch to lower stomach to clear out that food. 3. However, you should NOT get reflux often WHEN YOU ARE TRULY in the Green Zone, if your reflux is every night despite taking the precautions of clearing out your pouch and not eating too close to bedtime, you are probably in the Red Zone and need some saline out or you may have other issues that needs to be followed up by your band surgeon. What to eat and how much should be discussed with your Nutritionist, but most who have success with their bands walk or exercise DAILY, eat lean Proteins first and veggies and drink water, it's just that simple.