BetsyB

Eh, it doesn't matter what people say. Easy way out, hard way out---it's the way out. Some people find a different way. That's fine. We are using this way. In many regards, you'll find that it is easier. In others, it's not. No one who has not experienced it will understand or appreciate your rationale; no sense in arguing the point or becoming aggravated.

as long as you're not experiencing discomfort, there is no cause for concern. You're simply taking in so little that there's less moving through your body. Anesthesia and pain meds contribute to the slowdown. Don't be alarmed if you experience diarrhea when things do start moving; it's very common.

No one has ever died from the preop diet--you'll make it through. It's good prep for bandster hell <evil grin>. Seriously, it's just a matter of time before food assumes a much less important role in your life. Right now, it's really rough--and it will be for a while. But in the end, it's very freeing to lose the attachment to eating. Food is still wonderful--things taste good. But the relationship really changes.

Well, the good news is that you chose Protein and fat--so your decarbing wasn't disturbed. The purpose of the preop diet is to reduce the glycogen (carbohydrate) stores in the liver. This reduces the liver's size, making it easier for the surgeon to maneuver during surgery. No harm, no foul. (In fact, some surgeons--like mine--permit one protein + leafy meal/day during the preop diet.) Hop back on the wagon. You're almost there, and it will be worth the ride.

Smoking hugely increases the surgical risks. Factor in obesity, and the risk of serious surgical complications such as blood clots, pneumonia and circulatory problems skyrocket. Wound healing is delayed by smoking, as well. In the long term, smoking increases the risk of stomach ulceration. But even things like a smoker's cough can ultimately be problematic as related to the band. I'm a former smoker, and quitting was the best thing I ever did. Even better than the band---and I think everyone knows how much I love my band. It's an incredibly difficult addiction to kick. But it's so worth the effort.

I love soup. It was one of my favorite meals preop, and remains so now. Not everyone is satisfied with it--but it always does the trick for me. (I think it's psychological as much as anything else. There's nothing as therapeutic, to me, as a good bowl of homemade soup.)

A serving of Protein is usually 3 ounces; if diced and measured, that often comes to about a cup, but of course there is variance. (I have a set of Mario Batali measuring bowls--you can get them from Entertaining at Home or Target online--that are handy; I eat from them rather than measure with them.) You can't convert "a cup" to 8 ounces when talking about solids. You have to weigh or measure. My doctor's guidelines had me focusing on protein at 5 weeks; a 3 ounce serving was recommended. (Now it's 3-5 ounces; I usually get full on just under 3.) A couple of weeks later, nonstarchy veggies were added. A bit later, fruit. All doctors/nutritionists/dietitians seem to have different recommendations; mine does not advocate reintroducing starches/grains until 75% of excess body weight is lost. ETA: Honk's "sandwiches" are one of my favorite lunches. A couple of romaine leaves, each with an ounce of protein (turkey, chicken, fish, whatever...) and a half ounce of cheese.

My doc's rule of thumb is that it's okay to wait it out--to give time for swelling to subside--as long as you can tolerate liquids. Keep sipping! And be really cautious as you reintroduce food over the next several days. Take it slow. I find that liquid Benadryl helps with the inflammation post-banding.

Nah--it's not made of anything that would set it off.

I've steadily lost weight at the same rate since banding--but I still am fine-tuning adjustment at 8 months. I felt some restriction with my 3rd or 4th fill--and have been tweaking it since. (I think I'm there--but the beauty of it is that it can always be adjusted, forever.) My doctor's eating regimen is stringent, but was really great for promoting loss even without good restriction. Yes, I was hungry---but that was time-limited :thumbup:

Anesthesia and surgery interrupt your hair growth cycle. Mostly, it's just a matter of time. But you can increase your odds by making sure you get enough protein, taking a good-quality bariatric multivitamin, biotin and zinc and using a hair-loss shampoo/conditioner such as Nioxin.

So the alternative is staying fat, and remaining exposed to the attendant health risks? Sagging skin isn't the prettiest thing in the world. It looks a heck of a lot better than skin stretched beyond capacity with fat. Obese boobs and bellies sag, too. But obese bellies pose a huge health risk. Losing weight by any means can result in sagging or loose skin. It's not a given, however. It's dependent on genetics, age, smoking status, how long you've been overweight, how many times you've gained and lost, past pregnancies, and so on. It is NOT affected by rate of loss (not that banding provides ultra-rapid loss, anyway) or by anything you apply to the skin. Staying fat to avoid skin issues is like continuing to smoke so you don't gain weight--it doesn't make sense. Tell your friend to have her doctor document all health issues relating to her hanging skin (skin rashes, and so on). Her insurance may not cover abdominoplasty (tummy tuck), but it is likely to cover panniculectomy (removal of the hanging skin). No rose-colored glasses here--just almost 100 pounds down from my highest weight. At 48, after 3 pregnancies and plenty of yo-yoing, I look pretty damn good. Will I have surgery? Maybe. I am not sure how I will look when I hit my goal, but the way things are going, I might (and in fact have a consult scheduled for May, when I will be in the surgeon's city, anyway)---but it looks like I will need far less than I originally had feared.

When the band is installed, the ring that surrounds the stomach (forming the pouch) is not full. (Some doctors do put a bit of saline in at the time of installation.) Over time, saline is added to the band, via a port that lies under the skin of your abdomen. This adjustment is what we are referring to when we say "fills." Over a period of time--often several months, the band is adjusted until you achieve the appropriate level of restriction. A very, very important consideration, when choosing your surgeon, is preop preparation and aftercare. Some doctors do provide really good preop seminars, nutrition classes, exercise support, and support groups, and so on. Others do not--many patients end up feeling kind of abandoned. My doctor is in the former group--and nutrition courses continue for the first year postop. (I am sure you could attend longer, if you wanted.) It helps a lot. In addition, patients are given a pretty comprehensive "manual" of what to expect, how to advance diet and exercise, the changes to make during maintenance, and so on. When you're choosing your doctor, do ask about the support you'll receive. I never really am aware of the band, unless I've taken one bite too many. I just don't feel it at all. I can, however, feel my port. It doesn't really interfere with exercise, though I am aware of it more when using certain equipment.

Once you achieve restriction, which can take a period of months, you will be left with a pouch (with limited capacity) that slowly empties. This means that hunger is pretty much removed from the equation, making it far easier to sustain the lifestyle needed to lose weight and maintain loss. It depends on your doctor. Many recommend a higher-protein, lower-carb regimen. There is limited pouch space once you achieve restriction, so the most important thing, really, is to choose foods that benefit your body and meet its needs. Well, most of the time; there is room for indulgences and treats. See above; hunger is removed from the equation. If you are a compulsive eater, you will still have to learn new behaviors and coping techniques; the band will not miraculously remove the impulse to eat. But it does provide pretty good negative reinforcement for overeating. This is dependent on your specific policy. Mine does cover band-related complications. I have not heard of any large-scale manufacturing defects. In general, when there are medical device issues, patients (or their insurers) are generally responsible for repairs unless the company is found liable. Your doctor will inform you pretty fully of the potential risks associated with banding, and when you consent to surgery, you accept those risks. It is temporary (and related to anesthesia and surgery itself); most doctors give medication that prevents these from occurring. It depends on your doctor. Most do not recommend drinking alcohol for a period of time after surgery. Mine vetoes it for about a year; the idea is to promote the adoption of new health habits (while maximizing weight loss). Alcohol = liquid calories that are used, by the body, very efficiently (as in, converted to fat very easily). It is also a disinhibitor--making it more likely that you will make inappropriate food choices. That said, occasional drinking usually is not an issue (if you don't have medical issues that preclude it)--you just have to be aware that it can affect the rate of weight loss.

Her surgeon MUST know of her alcoholism prior to surgery. This is potentially a matter of life and death. My mother was not honest with her doctor prior to a surgery near the end of her life. I pulled the anesthesiologist aside and told him---it was imperative. She still experienced delirium tremens--a minor surgery landed her in ICU because of complications due to alcohol withdrawal. Had they not known in advance, they would not have been prepared, would have wasted time trying to determine what was wrong. Alcohol withdrawal is very dangerous--very. It needs to be carefully medically managed. It's utterly immoral to subject a surgeon to her risks without informing him. He puts his license on the line every time he performs a procedure. Knowingly jeopardizing HIM with her actions is pretty heinous. Legal liability aside, living with the knowledge that a patient came to harm on your watch is HORRENDOUS. What a horrible, ill-thought plan.

Yep, we take care of everyone except ourselves.

I don't know agents, but I am a writer/editor (the nature of my writing doesn't require that I be agented); if you find that you need another set of eyes to prepare the manuscript (or receive feedback that this is necessary) let me know--I'll be glad to help you out. Editors can be expensive, and I'd be glad to spare you that expense.

There really is a period of mourning for food. It occurs at a time when we are very vulnerable--our bodies and minds are in upheaval from anesthesia, meds, the trauma of surgery, hormone fluctuations. Throw in the I-can't-have-that line of thinking and genuine hunger, and it's a recipe for meltdown. It gets so so so much better. First, you'll just get on a more even keel as you recover from surgery. You'll feel better, both physically and emotionally, as you heal. The grief for the old friend, food, can be helped, I found, by adopting a slightly different was of thinking about the restrictions the band (or your doctor's prescribed eating regimen) place on you. Just reframing the way you think about the I-can'ts can help tremendously. Instead of saying, "I can't have that," focus on what you can have. Try to reframe your thinking so that you don't tell yourself, "I'm not allowed..." but instead think, "I choose...." Honestly, making it about choice is very empowering; it effects a shift in thinking that results in far less of a sense of deprivation than occurs when you feel as though your actions are driven by rules imposed by others. (I hope that made sense!)

Isn't it interesting how many of us have nursing backgrounds? My therapist has pointed out more than once that those of us who are caretakers often care for others at our own expense....I know that definitely factored into my own obesity.

My first recommendation would have been to focus on Protein and nonstarchy veggies--but you're already doing that! Is it possible, do you think, that your rate has simply slowed because you are now at the point where you need to lose less? A pound a week after an 87-pound loss--when you are so close to your goal--may be a realistic expectation. That said, are you exercising regularly? For me, exercise is absolutely critical. I'm at 83 pounds down, and was slowing down a lot---and bumping up my exercise just a bit got things rolling a little faster for me again.

I never have in the past. When I worked in neuro, I had a patient who experienced Guillain-Barre syndrome after a flu shot. The first time, it was chalked up to unlikely coincidence. The second time it became pretty darn evident that it was a response to the vax. Since then, I've read about quite a few cases of GBS related to flu vaccination. Ordinarily I am VERY pro-vaccination. But because I was a young, robust woman who bounced back easily from illnesses, I chose not to take the risk. (My husband, OTOH, is in a high-risk group, and has always been vaccinated; for him, the risk of flu has always outweighed the risk of the shot.) This year, I will be vaccinated. I got pneumonia the last time I got flu--and while I'm still relatively young and resilient, I am for the first time facing being a single parent---and want to reduce the chances of becoming ill. I have a child who relies on me, and as I stare down the barrel of having no one to help me pick up the slack if I'm ill, I need to protect myself as much as possible so that I can be the best parent possible. But I will cringe as I get the shot, and worry that I will end up like Mr. B--on a ventilator for months due to vaccination-induced Guillain-Barre syndrome (fully realizing that the odds are very, very, very slight that I will be adversely affected). ETA: And thank you for the reminder; I will make an appointment today.

What about it makes you nervous, do you think? There are certain milestones that are prominent in our minds, but really, it's not the number that carries great meaning. It's the big changes going on in our bodies and minds. I remember getting on and off the scale several times when I went below 200. I wanted to make sure that 199.4 was real--and then I took a picture of the number (and my ugly winter feet). It was a milestone. But it was also anticlimactic. There wasn't a huge change from the day before---I was the same person who needed to do the same things to stay healthy. I guess I'm saying that it's not something to fear. It is a milestone, but it doesn't create changes that are daunting. If you're stalled because your body is simply regrouping after losing a lot, the loss will resume, and you'll just slide into the 190s. If you're stalled because you are subconsciously self-sabotaging a little bit, you'll reach the point where you are comfortable moving on in your weight loss journey. There is nothing wrong with you. You are just engaged in a process that involves a great deal of emotional letting go. You will do it when you are ready. Just know that there's no need for fear.

I'm in a suburb of Chicago, and am an RN turned science/health writer. I am working toward certification as a nutrition and wellness counselor.

It is completely out of a nutritionist's scope of practice to form a professional opinion regarding the suitability of a particular procedure. What you are receiving from her is purely a personal opinion---and you will get many of those from people who are equally as unqualified to give them. Put it in perspective. She has a personal bias; she does not have the professional expertise to form a professional opinion regarding whether surgery is appropriate. Her role is to impart the information you will require in order to be successful with loss once your banded. That's it. Ideally, she should be on the same page as the physician who referred you to her. She should provide information that supports the stated goal--which is eating/weight loss success with an adjustable gastric band. It sounds as though you just got a vibe from her. Even if she didn't actively discourage surgery, I think this is worth mentioning to the surgeon who referred you.

I tell myself, "Self, you're playing mind games that drive you nuts. Knock it off." Seriously, I've been working on my internal narrative, and it has helped a lot. I experience very little head hunger now--and what I do experience, I can now get past by telling myself, "I can choose to eat that. But--nah, I choose not to." (There's something about it being a conscious choice, rather than a rule imposed by a doctor or diet, that makes a difference for me, in terms of emotional response.)