BetsyB

I was an adult. But I've been "fat in the head" my whole life (thanks, Mom). In other words, I've always seen myself as fat, even when I haven't been. And even as a child, my mother had me on crazy diets---when there was no need. When I began to gain, I did what I suspect you've done---I gave it my ALL to lose. And I really am awesome at losing weight---but as you know, lost weight tends to get found pretty quickly! In the Houston hospital where I worked in the 90s, banding (early-generation---quite different procedure) was routine. I swore I'd NEVER be banded, based on outcomes. I worked with several banded nurses; they were thinner, but malnourished, bald, and ill. Good Vitamin and Protein supplementation was not available, and the nutrition information given to them was quite different than that given today. So banding really didn't become something I considered until very recently. I waited until it came a long, long way. During that time, I had 2 kids, returned to normal weight (without much effort), and went right back up. Much of the gain was very abrupt. No real metabolic cause was identified, but *something* just isn't normal---I think my body just got sick and tired of the yo-yo I was tormenting it with and said, "Uh-uh. No more of that nonsense. I'm not budging!" If a SAFE and EFFECTIVE band had been available, I would have hopped in line for it in the 90s, when it was easily available to me. At the time, I was about 50 pounds overweight. I would NOT choose to do it to keep from becoming overweight (if nothing else, I'd educate myself very well about nutrition and exercise; that knowledge is necessary no matter what course of action you take)---but I do think it's perfectly reasonable to have the surgery to nip a developing problem in the bud. I don't think we're likely to see insurance agreeing with me regarding the importance of nipping it in the bud--so I think people who do so can expect to self-pay. But really--I think most of us, in retrospect, can say we'd love to turn back the clock and halt our gain before it impacted our lives profoundly over time. Before your weight issue gets out of hand, have you tried any of the plans that require real lifestyle change? Programs like Weight Watchers, while not for everyone, can do a really good job of helping you shift your relationship with food and exercise in healthy, positive ways. If you could learn to make the changes without having surgery, that would be really awesome. But I totally get where you're coming from, and think you're smart to be thinking of ways to STOP the gain before it affects you the way it's affected most of us.

For me, this amounted to providing a list, to the surgeon, of past attempts (or even successes---though as we all know, those tend to be followed by regaining) at weight loss. I am sure mine was far less than comprehensive; I couldn't begin to enumerate every attempt I've made! The words sound intimidating, but really---I think you will find very few obstacles to being banded. If you're covered, and meet the BMI (and/or possible comorbidity) criteria, it will be deemed medically necessary. But YES--if your insurance so specifies, you WILL have a period of weight supervision by the surgeon's group. (This is independent of any documentation you provide; my PCP had documentation, and I had documentation from WW memberships--and that didn't matter. What matters is the time frame stipulated by your insurance contract.) My period of supervision was three months--I visited monthly and though I was impatient to get the ball rolling, it really was a great opportunity to get my questions answered, become more comfortable with my doctor and his staff, and so on. Really, they keep you pretty busy with other things during the waiting period---things like clearances by a cardiologist, pulmonologist, and psychologist. You might require a sleep study or cardiac studies beyond an ECG. You might find yourself having pulmonary function tests. You might find yourself in the office of another -ologist. These fill up the waiting time quite a bit. It's frustrating---but the time does pass, and soon you will be banded. By the time you are, you will be confident about what's ahead---and your doctor will be confident that you're a candidate who will do well. I'll be okay :tongue_smilie:

I'm with Elfie--I don't regret it at all. I love to cook & eat--and having a band hasn't changed that OR created any misery. I make different things--but I tend to view it as a challenge to make the things that fit into my new eating plan as wonderful and delicious as possible.

How far postpartum are you? Remember, it takes almost 10 months to make a baby--it's reasonable to expect it to take at least that long to lose the weight you gain. If you're nursing, it can take longer. (For some women, the body clings fiercely to body fat while nursing; others lose easily.) I'd like to address one thing you said: that appetite is cut. Really, it's not. Appetite (that's the part that's in our head telling us we WANT stuff) remains---hunger, too, can remain. Until you achieve restriction, your stomach capacity is limited, but its emptying is as quick as before surgery---so you can only eat a little bit at a time, but become hungry relatively rapidly. Your mind---your appetite---will "tell" you it's time to eat. But if you want to lose, you really, really have to moderate how much you eat. Your BMI likely makes you eligible---but it may or may not be the solution for you. Attending a surgeon's informational seminar can give you good information. Reading here, too, can give you a pretty realistic idea of what to expect.

I understand how someone's thoughtless words can throw you into a tailspin, so please don't think I'm being critical with my response. But do try to put this in perspective: You've lost a HUGE amount of weight in 3 months. Her idiotic comment really doesn't do anything to take away from that amazing accomplishment, does it? A good response might have been? "Pain? What pain? This has been the easiest 38 pounds I've ever lost!" I mean, sure--we all know it's hard work. But b!tch at work doesn't need to know that. You're doing phenomenally well---really, PHENOMENALLY. Don't let a clueless coworker throw you off track. She's totally not worth your angst.

These sound great! I'm not ready for rice and tortillas yet--but yum. I bet with a little tweaking, the bean recipe could be made into patties for grilling, a la veggie burger. Thanks for posting!

How miserable! Sinus drainage made me so sick preop that I hate to contemplate how it will affect me postop! In the past, the things that have helped me the most, in terms of mobilizing and loosening secretions have been Mucinex (not Mucinex D, just plain), TONS of Fluid, a good decongestant, and saline nasal spray. (I know many swear by neti pots, but just read a report that suggested they remove too many flora and ultimately may reduce resistance to infection, so I stick with use of saline and only while infected.) That, and antibiotics, of course! Did your doctor prescribe a decongestant along with your antibiotic? If not, you can get one OTC---but ask the pharmacist (or your doc) which s/he'd recommend. Some contain antihistamines, as well---which can gunk things up a little.

I have a Realize band, too. My surgeon also uses the Lap-band, but told me he usually reserves that for patients with higher BMIs than I had, going in.

I'm right there with Elfie---Protein comes first, always. This is what my doctor recommends, and in fact, he doesn't recommend adding grains and other carby foods back in until 75 percent of excess weight is lost. I am not sure I'll always stick by that directive, but I can tell you that when I eat adequate protein, then there's no room for the carbier stuff. If you have difficulty with meat, try preparing it in ways that keep it moist---braising, crockpot, and so on. Experiment with different cuts, add a little sauce, and so on. You have to make sure you don't dry it out; rare is better than well done for band purposes. chicken tends to dry out easily; using dark meat helps avoid this. I've found that fish is very easy for me to tolerate---I liked it (but didn't love it and didn't often cook it) preop, but now I really love it---and rely on it a lot. Beans are a good meat alternative; they are carbier than meat, but the "good" kind with low glycemic impact. They also have good staying power. Yogurt (maybe even with a bit of Protein powder added) is good in a pinch. I also continue to use protein shakes. I like the Inspire brand from Bariatric Eating. I have 1-2/day depending on how I've met my protein needs.

It's totally normal! Weight loss doesn't occur in a straight downward line---there are often little plateaus. Immediately postop, your body's still going through lots of changes---be patient & keep working it, and you'll see the loss :frown:

I'm so glad you're doing so well! I've just emailed my doctor's office, asking for a fill earlier than currently scheduled. I'm ready, and as long as there are no medical contraindications, want to move ahead. We have to be proactive!

If it were at all serious, it would be frustrating. But even the phrasing of the poll makes it evident it's completely tongue-in-cheek. And sometimes, funny is a good thing.

You're doing it right! I couldn't feel my port until the swelling receded and I'd lost a bit of weight. It's becoming more prominent with time. I had--and still have, after one fill--NO problem drinking liquids as I always have, and was just fine with pureed Proteins on Day Three after surgery. We're just the lucky ones! It's a good thing :frown:

My doctor recommends three meals a day. It's not doable for me. I add two Protein Snacks. I really think it's important to fuel the fire at regular intervals, and waiting until mealtime not only doesn't do that, but it results in hunger that makes me more vulnerable to making bad choices.

Whey, by far. First, it's more bioavailable. Secondly, it doesn't affect thyroid function (soy can be a problem for many), and finally, it does not present the same high risk of allergy issues.

Well, I'm not going to say you're nuts for wanting it, because really---I think the band will be of far more use to me in maintaining weight than losing. I totally understand your desire to keep your weight at a healthy level by addressing a problem before it really becomes a big one. That said, the band doesn't work on its own. Doctors look for patients who ARE able to lose---because that means they can comply with the band's requirements. Limiting your portion size is critical--banded or no. It usually takes a period of months before restriction is achieved; during that time---and even after, if you eat the wrong foods--it's more than possible to gain. The band is good "insurance" for many of us, but not well-suited for all. That doesn't mean you won't find a doctor to band you, or that it would be the wrong thing to do. But you're going to be expected to do some REAL work on yourself before anyone will go forward. I also think you can expect a great deal of resistance from surgeons you see; most have a particular BMI in mind when assessing patients, and if you fall below it, you'll have to be prepared to put on a pretty strong case. Most want their patients to demonstrate a history of loss and regain. (I am NOT advocating you do this! It would be so much better if you just got a handle on portion control.) You say your mother and aunts gave up. You don't have to. Banded or no, there is HUGE personal responsibility for outcome; if you are not able to exercise portion control now, then that won't magically change with a band----you will still have to use your own judgment to limit portions. Please don't let your thinking about banding be magical thinking. Do your BEST with eating and exercise. Nip the gain in the bud. You might want to attend a surgeon's free seminar to hear more about what banding involves, as well. Lastly, you can definitely expect to self-pay. Unless you have significant weight-related health issues, insurance will not cover banding for people whose BMIs are, generally, less than 40 or so. Good luck---and good for you, wanting to get the better of a weight issue before it's overwhelming.

Were you discharged the same day? If so, I think your experience is typical. You have discharge instructions, and will follow up soon with an office visit. If you stayed overnight, I would have expected a visit from the doctor or his PA prior to discharge---since he'd have to visit the unit to write discharge orders, anyway. Bariatric surgeons form longer-lasting relationships with their patients than many surgeons, so they do tend to be a warmer bunch, IMO. But it doesn't sound as though your experience was atypical :redface: (It's also really normal to feel a little abandoned after surgery--there is such a buildup of anticipation, and then it's a bit anticlimactic.)

What percentage of American physicians are represented in the files you see? Not a very big one. You see the worst of the profession; that does not mean the remainder bears any resemblance to that. Yes, there are a-holes in every walk of life. Most who enter the field of medicine do not do so to make money. There are far better ways of doing that! And let's not forget: each and every one of us who is banded--or will be---ASKED for the elective surgery. No one is inflicting anything on us. While it's wise to educate ourselves to ensure that standards of practice are adhered to, it's important to remember that we are forming LIFELONG relationships with our bariatric surgeons. If you have a surgeon whose judgment you question---find another surgeon. But keeping a jaundiced eye turned toward the profession is only going to serve as a barrier to a good working relationship. And the person whose butt it's going to bite is the patient's.

You're not being scammed. I posted to your other thread, so I won't go into detail here--but there are legitimate reasons for his recommendation. That does not mean his approach is the only one--or that you should blindly agree. It simply means there's no "gall" involved (except as in gall bladder). Not every recommendation made by a physician is money-motivated. Most really do care about their patients' well-being and make recommendations based on that. Remember, you've asked to have this procedure (banding) done. Along with that will come doctor recommendations. You might not like them all--or follow them. But when you seek medical care, you do, in fact, place yourself directly in position to get a doctor's medical opinion. His is one that is common, and commonly accepted.

I try to find things I LIKE to do--so housework? Not one of them! I don't want to feel doubly-punished! Usually, I submerge myself in a good book, work, or exercise.

That's exactly the problem with soda--it HURTS. Not as in causing lasting damage, but the carbon dioxide bubbles just cause PAIN. So yes--literally. It will hurt.

Some coughs just linger. The anesthesiologist will listen to your lungs and make a determination. Chances are, surgery will go forward. The anesthesiologist may administer bronchodilators or other meds to improve airway function for the immediate postop period---but unless you're really battling an active infection, he will likely be okay with moving forward. What kind of cough is it? If it's productive, make sure you're drinking plenty of fluid--combined with the Robitussin, that will help loosen secretions. If it's dry and hacky, fluids help, too---and an antitussive might help. (Check with your doc.) I hope you feel better fast! I know it'd be SO frustrating--but if surgery does have to be postponed, it is to protect your safety.

I disagree. Insurers are, but doctors, for the most part, really aren't.

The biggest don't I can think of is choosing a psych who's not among those recommended by your surgeon. I chose one closer to home--and while he is probably a good enough therapist, he went really far afield in my evaluation. He did approve me, but my anxiety was quadrupled by the extra hoops he had me jump through. Otherwise, don't worry about it too much---even if you DO have some emotional issues (because who doesn't?), they will not likely stand in your way. The point is to identify people for whom psychopathology is a real obstacle to compliance. You'll do fine :redface:

It used to be common to remove the gall bladder at the same time as banding---and some doctors did this whether the gall bladder was diseased or not, because the loss precipitated by WLS very often does trigger the formation of gallstones that necessitate removal. They found that postop infections increased when the two procedures were done at the same time. You already have an identified gall stone. Chances are, you will genuinely require gall bladder removal. The question is whether it must be now, or whether you can wait and see whether it becomes necessary. The problem with the latter approach is that, if you become ill, it can really make recovery from banding --- or getting used to a new band--difficult. Many people do live with gall stones that never become symptomatic. It's very difficult to predict whether you will be among them. So the short answer is no, your doctor is not a scam artist. It sounds like he has genuine concerns about your well-being, and wishes to tackle a problem before it causes you distress. OTOH, it's an approach that might not be necessary. Is he approachable, in terms of discussing the pros and cons of moving forward? If I were in your shoes and did not want to have the cholecystectomy before banding, I think I would let my own doctor know that I was aware that WLS ups the odds of gall bladder disease, and that I knew that intervention might be necessary down the road---but would prefer to approach it more conservatively. If you're well-informed, and know the signs & symptoms to look for, a wait-and-watch approach really may be appropriate (even if it's not your doctor's first choice). OTOH, if he is insistent, I would not feel as though I were being scammed. I might get a second opinion (from another bariatric surgeon), but I would accept it simply as his (acceptable) medical opinion.