BetsyB

Yes, there is capacity for more than the 11 cc. BUT, you might be surprised at how, toward the end, even the tiniest of fills can make a huge difference.

If they did not have a day surgery room for you to return to so that you could be evaluated for a period of time before discharge, and their policy is not to discharge from recovery, it may not be an issue that you need to be concerned about. If your stay was less than 23 hours, there's a good chance it will be billed as a day surgery, anyway. My doctor always keeps patients overnight--and my surgery was still billed as a day surgery; a 23-hour admission is considered observation, whether you're in a recovery room, day surgery bed, or on an inpatient unit. So, there's hope. Give the hospital a call---at this point, I'd be optimistic that there will be no issue at all.

I didn't have restriction at 8.5 ccs, either. Tiny fills from that point on have gotten me there--so don't be discouraged about fill amount. There's still plenty of room for fine tuning. Secondly, the day-to-day fluctuations in weight are meaningless. A cookie really doesn't cause a gain of a pound. The body--especially the female body--does weird things, weight-wise. If you can't take the daily ups and downs in stride, it might be a good idea to weigh less frequently. All that aside, yes--I really do need to pay very, very close attention to what and how much I eat, even though I have restriction and the band is doing its job very well. I was banded because I have ridiculously low caloric needs. And even with a band, I still have those ridiculously low needs. I lose best when I eat 800-900 calories, get 80-100 g protein/day, and stay <50 g net carbs/day. EXERCISE IS CRUCIAL for me--I cannot lose without it, even at my very low caloric intake. I exercise every single day, at least once--and often twice. Your needs might be very different. If you're not losing, it'd be a good idea to start tracking what your taking in (and putting out in the form of exercise) on a site like fitday.com. (No, I don't count my cinnamon!) Once you get a concrete idea of what's not working all that well, you can tweak things, one at a time, to see what does work. If you're not already doing it, the first change I'd make is exercise. The next would be addressing calories; do you lose better if you knock off 100 a day? If you add 100 a day? How about if you bump up Protein? Or pare down a little on refined carbs? If you add a bit of heart-healthy fat? There are so many variables--and you really might have to do some work to figure out what does the trick for you. Once the ball gets rolling, you won't have to devote so much attention to it---but if you're not getting results, it really is worth the analysis.

If I had trouble with my band, I'd consider revision to the sleeve. Elfie, I wonder about your experience. You are still seeking the elusive restriction, but I wonder where you are now, in terms of the sensations you're experiencing before, during, and after eating. How do they compare with preoperatively? I know you've made big changes in the way you eat. How different is it from the way you ate preoperatively? I'm not being condescending or argumentative; I'm trying to get info to figure out where you are and where you are headed. What are your expectations for "restriction"? How do you envision that being different from where you are now? I know you're very, very frustrated....just trying to think of things to help.

Is your company doctor's referral required for you to have the surgery? If not, take her opinion for what it is worth: exactly the same as anyone else's opinion. Not everyone--even a physician who should be--is well-versed in obesity, its causes, and its treatments. It's an emotionally charged topic, and everyone has an opinion. Just because a person is a doctor doesn't mean the opinion is well-informed. My PCP was lukewarm about banding at best. He has one other patient who's banded, who's had dismal failure. Know what? Since seeing my success, he asks me a thousand questions each time I see him: what has made it work for me, how I eat, what I do, how I supplement....he's taking in all this information, and learning. His other patient is now doing much better because he's better able to give him guidance. And he's recommending banding to other patients. If you don't need your company doctor's approval, consider filing the opinion away, and proceeding with what you have determined is best for you.

No, not everyone who's banded has an eating disorder. Obesity is caused by as many things as cancer is. There is no single cause, and we don't all fit under the same umbrella. (I suppose the argument could be made that eating more than the body requires is disordered eating. I don't think this is always the case.) To the original poster, yes--eating disorders DO play in to the determination of whether a person is a suitable candidate for banding (or any weight loss surgery). The psych evaluation will explore your disorder(s). In general, they prefer that patients have at least a year of active recovery under their belts before consideration for bariatric surgery.

Your doctor raises good questions, but sounds as though he was doing a bit of a hard sell. This is likely because he is enthusiastic about an exciting newer procedure that yes, is promising--but also is probably a bit more fun for him, because it's ...well, exciting and newer. There are lots of good reasons to have a sleeve. Similarly, there are lots of good reasons to choose the band. Each has advantages and disadvantages. The long-term information about the sleeve is sparser, though--so you have to take his long-range prognostication with a tiny grain of salt. For me, the decision was based on: a. invasiveness/degree of body modification b. adjustability c. INSURANCE COVERAGE--the sleeve is an absolute no-go, in terms of many insurers' coverage d. potential reversibility/ability to revise Your criteria may be different than mine; you will have to do your own research and determine what is best for you. I am very happy with my band, and would do it again in a New York minute. OTOH, if I were to develop problems and require replacement or revision, I would consider the sleeve, if it were covered by insurance. Just remember that every doctor, like every human, has his own opinions--and that they might not be right for YOU. Only you can determine what will work best in your life.

My doctor uses a modified preop diet. Patients have shakes twice a day, and one meal consisting of lean Protein and nonstarchy veggies. Blood sugar tends to even out after a pretty short time, once the liver starts giving up its glycogen stores. Your doctor will give you specific instructions regarding blood sugar. If you have Type II, the diet probably won't cause issues (other than a desirable lowering of blood sugar). If you have Type I, bottoming out may be more of an issue, and s/he will tell you what to do if your blood glucose does drop precipitously.

I'm sorry you're having a hard time. If you're willing to do a bit of driving, Brian Lahmann and Christopher Joyce at BMI Surgery in Joliet are worth the time it takes to get to their office.

I've been looking forward to this series--thanks for posting. I will watch for you :smile:

Have you discussed the rationale for the overnight stay with your doctor? The first thing I'd want to know is whether there was a reason for the stay that was not shared with you (or was shared, when you were in recovery and not quite "with it"). If there is no real rationale, I would dispute the charges. Chances are there will be no need to involve an attorney--especially if your insurance covered the procedure. (They will cover the stay, as well--and will certainly dispute the charges, and likely win.) As for the liver biopsy, I'd want lots more information about that from the surgeon himself. Yes, labs do make errors. But liver damage can and does occur due to certain meds, and it can occur precipitously. (In other words, things can be fine, and then, quite suddenly, not fine.) As much of a pain as it is, I would want every test recommended done to rule out any possible issue. If you think the labs were mixed up, certainly discuss the biopsy with the surgeon---he's the one who saw the organ, chose to biopsy (and apparently had a reason for that), and can best address your concerns. If you really do not believe that the biopsy results were yours, ask to see the report. While the wrong person's report sometimes winds up in the wrong medical record, it's much less likely that the wrong specimen is mis-labeled. So, if the report has your name on it, along with the results you've discussed, it's fairly likely that the specimen discussed in the report came from your body. A liver biopsy isn't something you want to repeat, so the noninvasive tests recommended really probably are a good idea unless you can really definitively determine that the biopsy results were not yours.

My doctor makes a distinction. Solid Protein is weighed, and some other foods (such as veggies) are measured. I couldn't eat four ounces of protein in a sitting if my life depended on it!

It's hard when you're in the losing phase, because you don't necessarily want to invest a lot of $$ on the higher-quality clothes. I was glad I'd saved good jeans (I like the Talbots basic 5-pocket jeans) from various sizes over the years. It's nice not to have to shell out $$ for new jeans every month or two! Now that I'm nearing goal, and staying in each size for a little while, I'm buying a good pair as I move into each size. For shirts, I've pilfered from my kids--they have nice clothes! As I buy, I'm choosing things like J. Crew, Talbots, places that use nice fabrics and good cuts/tailoring. I am so glad to be free of Lane Bryant and the poor-quality fabrics they use. (I always did like their jeans, though.)

Everyone's body is very different. You can pinpoint what works best for you by journaling your food intake someplace like fitday.com. I lose best in the 800-900 calorie range (with daily exercise)--but I'm not the norm. You may not be the norm--or you may. The only way to figure it out is to keep track of your intake, and take note of what works for you.

I answered yes, but I really don't see the point. Shakes are not low-calorie meal replacements, really. You can increase your satiety for the same number of calories by eating lean and leafy meals. I have 3 meals a day plus 2 shakes, and have consistently lost very well.

Yes, I get tighter, too. Meds with guaifenesin (Mucinex, Robitussin, or their generic equivalents) help to loosen secretions a lot, and help with the problem.

I just nod & smile, or give a thumbs-up. There's no obligation to swallow! I'm not wild about public vomiting, but have always made it to a bathroom (I find out where they are before starting to eat). I guess I've been lucky; if I've gotten stuck or had an issue, it's been easily and quickly (and quietly) resolved, with no one the wiser.

No regrets here--It was the best thing I've ever done for myself.

I aim for 800-900 calories, 80-100 g protein/day (now that I have good restriction, it's usually around 80), <50 net grams of carb/day (from veggie and legume--and occasional fruit--sources only), and --and this is really the most important part, IMO--exercise every single day, often twice. I really think that exercise is the most crucial aspect, if you want to know the truth. Re: fat intake. Yes, some Protein sources provide a wallop of fat. But when your caloric intake is so low, and you focus primarily on lean sources, there's plenty of leeway, fat-wise. I don't choose lowfat cheeses; I simply don't eat enough of any single food to be concerned about fat. I keep an eye on it (I journal on fitday.com), but never exceed the AHA's guidelines for fat intake. Getting adequate fat is important for satiety, and paring down too far can cause other problems. I have lost consistently well. I suspect that you would not think the rate particularly fast, but 2.5 pounds/week over 8 months--well, look at my signature.

It depends on how you approach things. If you wait to reach restriction before modifying your eating, you won't lose until you hit your sweet spot. OTOH, you can eat as though you have restriction from Day One, and lose steadily throughout your journey. That's the approach I've taken. I've consistently lost about 2.5 pounds/week from the beginning. ETA: I have to agree that exercise is a critical, critical part of the equation for me, as well.

I'm not sure I'd be comfortable with a doctor who uses the same band, always, for everyone. My surgeon was reasonably certain he would use an 11 cc Realize band on me, but told me he couldn't be positive until he was inside me, and could assess my stomach. For what it's worth, though, he never uses the 4 cc bands any more--for anyone. I would want to know more about the doctor's rationale for band selection.

It's normal to feel little or no restriction until you've had a series of adjustments (fills). However, just because you can eat anything doesn't mean you should. Use this time, as you work toward restriction, to learn and practice the good habits you'll need when you do have restriction--you'll be glad that you did when you see the results. What sort of eating regimen does your doctor recommend?

I've reviewed doctors on Angie's List--and I know they learned of the feedback, because their approach changed dramatically. It's not a bad place to leave a review. I hope you know I wasn't asking about hunger and satiety condescendingly--just trying to get an idea of what is going on with you. It sounds like a tremendously frustrating situation, and I think there are tons of us who'd love to see you happier and losing the weight you want to lose. I agree that for some people, carbs are important for satiety. I'm unfortunately not one who can lose weight well while incorporating them to any significant degree. (I fought this like hell, and look where I ended up!) I have been unusually fortunate with my band, though. I am one of the lucky ones for whom satiety occurs with a small volume of food, and lasts for a handful of hours. Not everyone is like me--not everyone starts out from the same place or with the same needs. (I just needed to get my caloric intake way down; I have freakishly slow metabolism.) I'm sorry you're having such a difficult time. I do think in your shoes I'd try tiny incremental fills to see if they do help with the hunger. In the hands of a skilled doctor, you might fare so much better than you initially did. I'd also try different combos of food--switching the protein/fat/carb ratio (or making sure all carbs are complex, or whatever...just mixing something up). You never know what might trip the switch and get the weight loss ball moving again. Still, it is a very discouraging situation, and I understand your feelings---I would be so disappointed in your shoes.

You've got a great attitude. The ability to love and accept yourself no matter what will take you very, very far.

I think it's probably a good idea to talk with your doctor about this. Though the pain of gall bladder disease generally is located in the center of the abdomen or off to the right a bit, it's not terribly uncommon for it to occur the way you describe. After 10 months of loss, gall bladder disease is often the culprit for abdominal pain. But it's important to let your doctor know what's going on so that s/he can do a full assessment. Chances are, it's nothing that is of enormous concern. But it's always better safe than sorry.