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Hi - I am one year post-op tomorrow. What a difference a year can make! I thought I would respond to some of your worries. They are all very legitimate worries. I am the Queen of worrying, so I had an even longer list one year ago today! 1. Hair loss. This happened. I thought I was going to get away without it happening, but between 4-5 months it began. I lost a lot of hair. It is now growing back. 2. Blood thinners. Didn't need them or clinic didn't prescribe them. But I do have MS and have had to give myself injections over the years for that. It really is amazing how fast you get the hang of it. 3. Gas. They do pump you full of gas. The best way to get rid of it is to walk as much as possible as soon as possible. Walking will help with every part of your recovery. I was up the evening following my surgery and walked every few hours all night (they are coming in and waking you up anyway!), 4. Catheter. I had a catheter. It was inserted after they put me out and it was removed before I regained consciousness. No memory of that at all. No infection. 5. Complications. I had NONE! I worried I would have them all, but I sailed right through. I could have gone back to work after a week off I felt so good - I work in an office. I am 49 years old, so I am not a kid saying this either. Being active makes all the difference. 6. Family / Friends / Coworkers. My family have all been terrific - I could not have done this without them. Friends and coworkers, some have been great, others not so much. I have taken a lot of support right here. It is one of the things I love so much about this site. 7. Dehydration. For the first week you full time job is to drink. It is very possible to get it all in and be fine. Just think of it as the number one thing you have to do in those first days. 8. Stomach. This one I can't speak to. I have not had any problems now or in the past. But this surgery has been around for decades. I am sure they know how to scope and look for problems post RNY. It is one of the advantages I think of having this surgery over some of the other choices. 9. Dumping. This has never happened to me. I have been very careful to follow my clinic's plan and have not had any dumping symptoms at all. As time has passed I have tried sweets, even a few M & M candies or a bit or cake or pie. For many people, as long as you follow the rules, it doesn't happen. 10. Lose skin. I wish I had a more positive response to this one, but this is a big problem for me. I have lost 198 pounds in the last year. I was 331 when I began this journey and am now 133. My arms are the worst. I had HUGE arms. I also have lose skin on my legs and stomach. I was never big breasted, but now am probably an A-B cup. I work out every day. I don't think there is much you can do about this one. They say age and genetics and how much you lose will tell the tale. I wish there was a magic answer for this one. Best of luck to you! Even with the down stuff, I wouldn't go back to where I was a year ago for all the money in the world. I love my new healthy life! Carol

There is a lot of misunderstanding about telogen effluvium (post-surgery hair loss), so I thought I would post about it. Even bariatric clinics sometimes don’t understand or explain this condition adequately. “It is normal to lose up to about 100 hairs a day on one's comb, brush, in the sink or on the pillow. This is the result of the normal hair growth cycle. Hairs will grow for a few years, then rest for a few months, shed, and regrow. Telogen is the name for the resting stage of the hair growth cycle. A telogen effluvium is when some stress causes hair roots to be pushed prematurely into the resting state.” ”If there is some ‘shock to the system,’ as many as 70% of the scalp hairs are then shed in large numbers about 2 months after the ‘shock.’ This sudden increase in hair loss, usually described as the hair coming out in handfuls, is acute telogen effluvium.” “Among the common causes are high fevers, childbirth, severe infections, severe chronic illness, severe psychological stress, major surgery or illnesses, over or under active thyroid gland, crash diets with inadequate Protein, and a variety of medications.” [Quotes from “Biotin and someone else didn’t doesn’t necessary have anything to do with respective amounts of hair loss. Which leads to… 3. You don’t need to do anything other than get enough protein. “No treatment is needed for most cases of telogen effluvium. Remember that the hairs fall out when a new hair growing beneath it pushes it out. Thus with this type of hair loss, hair falling out is a sign of hair regrowth” [Telogen Effluvium Hair Loss]. You don’t need to take biotin. However, failing to meet your prescribed protein goals can also trigger this condition (see quote above about causes: “crash diets with inadequate protein”). 4. You can’t prevent it. Even if you get adequate protein, major surgery is still a shock to your body. Almost everyone who has bariatric surgery gets some degree of telogen effluvium afterwards. Someone who has lower surgery stress and thick and/or short hair might not even notice telogen effluvium. As someone who has been through this several times, I can reassure everyone worried about it that the effects are temporary and don’t do any long-term damage! Cheers

My hair started shedding about 2wks after the surgery. I am now about 3 mos post op and at the "height". I hope it will taper off soon. I'm convinced it's from the anesthesia. I've gotten plenty of Protein, Vitamins and Biotin daily. Biotin is supposed to help w/ hair loss. Who knows if my hair loss would have been worse if I weren't taking it. No one except me has noticed yet. My recommendation is get enough protein, take your vitamins and try not to worry. Stress could make it worse. Good luck!

Mine started coming out about 3 months after surgery. My hair stylist said that it is common...she sees it a lot with patients who have had weight loss surgery. She also reassured me that it would grow back. I'm trying not to worry abou ti ttoo much. After all, I'm losing weight, and I would go back and do it all again. But, I know it's really hard. My hair has always been what people have commented on. It's definitely been my thing!

I wanted to join the conversation and share my story with anyone banded that's wondering "can I get mine out and be okay?" There isn't enough out there in terms of stories of people who've done it and done it successfully - and we need a better, more public conversation about this. Tonight, in the wee hours of my bed as I type this, I am 14 hours post op. I had my band removed today (well, yesterday), on Saturday June 25, 2016 somewhere between 11am and noon EST. I was banded for nearly thirteen years, since December 22, 2003. Imagine, I went into the OR to get my band having just turned 25 a few months earlier. Today I had it removed, at 37 and a couple months away from turning 38. I have had the lap band for more than ONE THIRD OF MY ENTIRE LIFE. Today is truly a new chapter for me. I sit here without my band, post-op, feeling many complex feelings but with ultimately a layer of hope and relief and some joy on top. Through it all, I feel gratitude. The uncertainty and worry and anger that I also feel will dissipate. I want my story to be out there. I wrote practically a novel this evening- not originally intended for this website, but for me, to help myself clarify my journey and feelings. I am considering if I will edit it and submit it anywhere for publication or just on a blog, somewhere that maybe if even a couple other people stumble upon it, who are banded and wondering if they can/should have their band out, it will help. Or if someone who has had their band out, can relate to it, then that too would make it all worth it. This is a VERY long essay. Like, probably a solid 20 minute read. It is the first time in 13 years I have ever really put pen to paper on my story or attempted to articulate it aloud. I understand if you scroll down and go "Lord! I am not reading all that!" But, if you have the 15-20 minutes (depending on how fast you read!) and feel this may be helpful, my story is here to share with you and hopefully provide some measure of inspiration, comfort, perspective. I wish all of you, in various stages of your journey, the very best. Whether you are considering a lap band or other weight loss surgery, currently have the band, are thinking about having it removed or already have done so - my best wishes for whatever your future has in store for you. Sitting here tonight, freshly de-banded, I cannot tell you enough how long I have waited for this, and yet, until for how recently I worried and was uncertain if I would ever see this day. It has finally arrived. This is my story of the 13 years that lead to this very evening: -PG, Brooklyn, NY, June 26, 2016 --------------------------------------------------------------------------------------------------------------------------------------------------------- When I was young(er) In the summer of 2003, I was 24 going on 25. A trim kid but chubby teen, I had climbed up above 200 lbs in high school (though wasn't fat, just "thick") and then in college really put the pounds on. Instead of the Freshman 30, I did the Freshman 50. I followed that up with the sophomore 20, the junior 20 and the senior 20. I took a year off between graduating high school and starting university, and I took five years to graduate once I started, so by the time I graduated college in May 2002, I was tipping the scales at close to 300 lbs. By then, I was 6'2 (I topped out at 6'3 when I was about 24) and so while I looked heavy like a linebacker, I could lie to myself and others about how truly big I'd gotten. But inside I was miserable. Nobody wanted to date to me, I didn't find myself attractive, I felt huge, I smoked, so between that and my weight, I was not in great shape. I wasn't one of those "housebound" obese people at 80-90 lbs overweight and certainly my youth, some good genes and a fairly active disposition helped. But ultimately I was deeply discontent and unhappy. My overeating was turning to a binge eating disorder. In college, I developed some hair raising eating habits. It started with stuffing myself in the all you can eat residence hall dorms. I would eat an enormous fast food based lunch on campus most days and found myself going with friends to Chinese buffets and American home cooking style buffets and while my other friends had a plate of food, I squeezed out two packed plates and maybe on a special day a third. After play rehearsal and social plans with friends I would stop at 2-3 fast food drive thru's on my way home and have a "feast" for dinner of 2 to 2.5 meals. Hmm, how about a few tacos from Taco Bell, ooh, but I also need some Chili from this pace, or some wings or maybe a bacon cheese burger to go with those tacos and let's get some fries and a frosty while at it. I told myself it was because I needed "options" and "variety." Because I "loved food." I did want options and variety and I do love food. But I also was compulsively overeating and nurturing my very broken spirit with food. I hung out at a dear friend's house who lived at home with her salt of the earth family that had tons of food packed in the cupboards and home cooked leftovers. I can remember eating plate after plate of their food and to this day it's a wonder they never told me to get lost and never come back for literally eating them out of house and home. I was binging and while I sort of knew that I was, like many others with eating disorders, I got really good at lying to myself. I rationalized it any which way I could: I'm stressed, I am sad, I am gay and boys don't like me. Or I am still growing (yes, I sure was). And besides: I didn't binge every day. I learned to reserve the big binges, the ones that made me sick to my stomach, for a couple times a week and justified the rest of my unhealthy eating by telling myself that it was okay since I rarely ate Breakfast and most days had "smaller" dinners and lunches - meaning, one large meal at a time instead of two. The beginning of the 13 year saga After I graduated college, I moved to NYC to pursue graduate school. In the fall of 2002 I arrived nearly obese, lonely and, coupled with the stress of starting life in a new huge city on my own and adapting to the demands of a rigorous graduate program, I coped by eating even more than in college while trying to find workouts to do and researching different popular diets but regularly starting or staying on them. Talk about cognitive dissonance. I told myself "if I were just thin, I would have a boyfriend, be so happy and successful." The more I thought that (which turned out by the way NOT to be true), the more I found myself ordering $20 Chinese, Indian, Thai, diner, Mexican, BBQ style delivery dinners. I ate all the time between the fall of 2002 and fall of 2003 in NYC. I made briskets, pastas, even my salads were ridiculous, loaded with cheeses, meats, croutons, and large amounts of full fat salad dressings. I hit my diner across the street late night and had chicken fingers, club sandwiches, fries, milkshakes. NY pizza was a regular treat. And of course I went in on Cookies, cakes, ice cream, you name it, on the regular. No control. By the time summer of 2003 rolled around I was 24 and had gained over 50 lbs in my first year in NYC. I was hanging out right around 355 and at 6'3, that put me at between 130-150 lbs overweight. I could no longer pretend I was just "heavy" or "thick." I was now obese and very large. Working out became less viable, my stomach was stretched, I was constantly physically and emotionally hungry. And then that summer I learned about the lap band. I had tried everything else, most diets whether sound or scams, didn't last for more than a few weeks before I gained back the 15 I'd lose + an additional 10 for good measure. The band seemed different. I read as much as I could online and began researching. I knew quickly it was right for me. In the fall of 2003, I went to a weekday evening seminar given by Dr. Christine Ren who ran the Bariatric Weight Loss Program at NYU Medical Center. It was filled with other large people like myself and we all seemed to share one thing in common - we were at our wits end and most of us were ready. I began the process. I filled out paperwork, I met with Dr. Ren's team of specialists, and I eventually qualified. I found out that my health insurance would not cover the procedure (this was 2003 after all, long before most insurance companies had their act together and saw it as a preemptive measure) and so the only way to have the several thousand dollar procedure would be to pay out of pocket. I had a trust fund set up, not a huge one - I'm not from that kind of money - but a modest one left by my grandparents. I think they imagined it would be used to start a life with a spouse, buy a house, maybe help with future post graduate education costs. But it was enough that I could pay for the band and have a fair amount left over and so I decided to go for it. I started attending support groups, and as my day of banding surgery drew closer, 12/22/03, I grew excited, nervous, but excited for the "new me." I was TERRIFIED at the prospect of general anesthesia and being put to sleep - not sure why - I'd never had surgery before other than my wisdom teeth. But I decided it was worth it. I did the pre-op diet and liquid fasts exactly as I was supposed to. I dropped 8 pounds before and the day before I weighed myself at home naked and I was something like 345. But on the scale the next morning at the hospital (still in my clothes), I tapped out at 349. Guess I was wearing a heavy sweater and jeans. That was what my documented day of surgery weight came in at. I rounded it up a pound to 350 ever since. I mean, heck, that was the basic reality. Joining the band The surgery was terrifying. I had to sign a release that basically said if I had any complications, including death, I would not hold the hospital liable. I was amped up and worried that I would go into cardiac arrest on the table. Can you imagine? At 25, and in otherwise perfect health, I was having such thoughts. And yet, I knew this is what I needed to do. It was the only tool or pathway that seemed at all possible to help me achieve my true inner trim self. And so I did it. I climbed up on that table and felt like I was having a panic attack and had my first surgery / anesthesia experience (of many to come). It was rough. When I came to, I was very out of it and in pain in the recovery room. I can't remember if I was held overnight. It's been many years and I have had so many other hospital stays since, it all blends together. When I did get home, I followed the post-op diet near perfectly. Clear liquids for a few days. Thicker liquids for the second part of the first week or so. Then soft foods like mashed potatoes, purees, soft boiled eggs, etc. The weight began to slip off like warm butter. When I moved into regular foods, and began the getting my band tightened phase, now into early 2004, I noticed at first blush how sensitive my lap band was, or should I say, how sensitive my body was to it. The smallest tightening and food would get stuck so easily, I would vomit at nothing. It was rough. And still - it was a novelty then which made it do-able. Plus, the weight was literally pouring off without much effort. I mean, the effort of being careful with what and how and when I ate and drank. But without having to worry about being starving - and knowing that if I overate, I would throw up and be miserable. So it sort of took care of itself. Over the next 15 months, I lost over 140 pounds. I hit 208 lbs. in March of 2005 and I was slender. Not just thinner. I was legitimately a tall, slender man. Clothes shopping became a dream come true, catching my reflection in a plate glass window sideways became a joy for the first time and wearing my shirts tucked in with belts - what a dream. But with the joy, relief and new happy discoveries, came other obstacles unforeseen. More surgeries and a little reality ahead One of these obstacles unforeseen was the large amounts of sagging skin on my stomach and even what were formerly (the ever dreaded) male breasts. By November 2004, it was clear how much skin remained and that quickly became my new preoccupation - getting rid of it. I was referred to a reputable plastic surgeon on Long Island who had done numerous tummy tucks and gynecomastia procedures on men who'd lost substantial weight. The surgery was to include both the tummy tuck procedure and gynecomastia at the same time, on March 17, 2005. I was 26 years old and I was thrilled - thought I was going to now finally at last, after just a little over a year ago obese, and now slender, going to have the body I had dreamed of. I was scared though, even more so than with the band surgery, because while the band placement took about an hour under anesthesia, this was going to take SIX to SEVEN hours under anesthesia. And - guess what? It wasn't covered by insurance - no surprise there - but I had to have it. So I ponied up that fee, several several thousand dollars - out of my trust. It didn't matter. This was my life, my body, my self-esteem. I had "worked hard" and "deserved it." And so when the day arrived, I climbed on yet another operating table, counted backwards and went under the knife. Oh my God. There aren't words to describe how much I was not prepared physically or emotionally for that type of operation. This was an operation. Not a "surgery" or a "procedure." A full scale operation. When I woke, if you want to call it "waking," my initial jumbled, drugged thoughts were that something had gone terribly wrong and that I was dying in the recovery room. Shouts of nurses telling me "Breathe, take a DEEP breath! C'mon!" along with a myriad of other calling my name over and over again, trying to get me to stay awake. I felt like I couldn't breathe, couldn't open my eyes, couldn't think properly - it felt like I'd been literally hit by a semi truck and was fighting to live. Guess what? I wasn't fighting for my life - this was normal. I was just in a lot of pain and under the effects of a TON of anesthesia and drugs. Recovery took weeks of wearing bandages and compression suits. Dealing with pains and drains. Meds. And constant check ups. About 6 weeks after, I had all the gauze, bandages and compression suit off, I stepped on the scale and weighed myself: 199.2 pounds. A buck ninety nine and 6'3. I was 26 years old and thin. Literally thin. Gaunt. Friends commented: "Yo, buddy, you look great, but maybe that's enough. Eat a sandwich, okay?" (Which of course, with how tight my band was in those days, was not a possibility, bread in fact, was something I stopped eating altogether and still to this day, though I have resumed eating it on occasion, really don't mess so much with). My friends were right. I look at pictures of myself then and I was thin, but indeed gaunt. The loose skin being removed caused me to lose an additional 6-8 pounds and I'd dropped a couple more yet still from how tight my band was at that time. For a few weeks, I hung out under and at around 200 lbs. I was so sick. I thought "I like the way that SOUNDS. I think I want to get down to 195, to have a BUFFER, to make sure I stay UNDER 200." For what? Because it was an abstract number that appealed to me? Another consequence unintended by the band - my perceptions of reality versus the reality of health or reality of other people's perspectives came into clash. They don't talk to you about this in lap band training. Not really. They might throw around a few catch phrases, but that work is up to you. And rightfully so. It wasn't easy though. And to this day, while "better," I still have to challenge my perceptions - frequently. Within weeks, I had climbed up to 205 and hung out there for a while. Eventually: 209. 210. And then a period of time where my body seemed to settle between 212 and 215. Which in retrospect was a healthy, nice weight for that time of my life. The novelty of the band, however, began to taper in the coming months and years. I turned 27, looked "good." 28, 29 brought more of the "I look good and I like what the band had done/does for me, but I'm also starting to hate the band and the lack of normalcy I realize I may never fully have" feelings. During these years, the picture I had for myself of myself at that self, often didn't match up with the earlier discussed little issue of reality. I shopped for clothes that were too tight, even though I was now "lean," they were still too small. I tried buying Medium tank tops that didn't fit me. I rationalized that a "large" was too big even though - it wasn't. My view was distorted. Men didn't start tripping over themselves to date me. I thought that would be "solved" and that being thin would get me a boyfriend. But it didn't. Nothing changed and I developed a deep hurt, a deep anger, and an even deep lack of confidence than before. At least when I was fat I had an excuse. It's not me - it's the weight! But trim, why couldn't I get men interested? Was there something fundamentally ugly about me that I was missing? Was this a curse? Why the continued lack of attention, the continued rejection? Oh once in a while I would get a guy interested and we'd date for a while, but it didn't seem to work and I secretly wondered if he was put off by my surgery scars and/or was it something else? Were my facial features not attractive? My hair cut/color? Or maybe, I started to believe that because I didn't have a six pack that was the problem. Even though I was slender, I started to realize that I was actually "skinny fat." No definition, no muscles. Just slender in clothes, lean appearing, but jiggly out of them. My stomach looked good - that came out really nice from the tummy tuck. But the gynecomastia not as much. There were these "divots" or small craters on both sides of my chest, that looked like some flesh had been scraped out with a grapefruit spoon, where the smooth contour of my breast area dipped down below the nipple into a small nook. I didn't realize it but the subcutaneous tissues had collapsed from scar tissue or bad healing or who knows what - I will never know the reason why. I've tried to get my surgeon to explain it to me, to fix it for me, but to this day it's still a mystery and yet one more thing I have come to hate about my body. The irony of finally being slim after so many years of struggle and theoretically ready to be shirtless at the beach but now not ready to be shirtless because of this random issue - of chest "divots." What? How does one even manage or fix that? The only attention that seemed possible to get from men was sexual. You know, a guy online or a guy at a favorite gay bar with friends, noticing me from a few feet away. I was never that promiscuous - and without making this story all about that - let's just say - I became more promiscuous. I wanted love, but was willing to replace love with whatever physical affection opportunities, even if temporary, presented themselves and met with some minimum standard. It's not easy at 29, to realize that being thin was not solving or satisfying all that I thought it would, when it came to attraction and love. I'd had a few boyfriends here and there in life but nothing super long-term or successful in the long run. I believed that the issue must be with my chest and began an arduous process at 27 of under going revision after revision. My plastic surgeon did the same speech and dance each time the revision didn't work as he had predicted it would: subcutaneous tissue this, skin healing that, fat alignment this, don't worry we'll make you happy no matter how long it takes that. I, young, insecure and desperate to achieve what I thought I was owed, lined up willing to under go any hurdle. Even involving anesthesia, a fear so big that I probably qualify for a diagnosis or phobia if there is such a thing. Funny that I stupidly shelled out the "cost" for these revisions, which was a few thousand a pop to factor in a reduced fee for him, surgical costs, anesthesiologist costs, etc. It's now been 11+ years since that original plastic surgery - and I'm still not happy with my chest. After my 6th revision in 10 years, completed last July 2015, one side - the left side - is finally finished to my satisfaction. I was never looking for perfection - just a normal, flat, non-divot appearance. The left part of my chest has finally achieved that. The right side still has some remnant of that divot. The surgeon, who has long ago stopped being sweet and full of promises with me, has now reluctantly agreed to give the right side alone one more go on July 21. This time to my sheer relief, no anesthesia, other than local, will be involved. He thinks it will take 40 minutes and I can be completely awake, with no sensation from the lidocaine and along with a cocktail of Versed to keep me relaxed, it should be a very simple procedure. To the plastic surgeon's credit, the right side, while still after 6 revisions is not fully there, is closer than it has been. The surgeon thinks this will be the last and final time and that it will match the left side after it's done. I know myself that it will be the last and final time because regardless, I'm done after this. I've given it my best try. From here on out, the quality of my chest appearance will have to be derived from as far as his gynecomastia + the revisions has taken it + my future weight lifting and healthier lifestyle can make it. The rest will be what I can do to accept myself and feel sexy and confident with my chest as is. It's not hideous. Some people say it looks good. The trick for me is as I get older, letting go of unrealistic dreams of lovely pecs that may never be. And that is okay. It's becoming more and more okay. ​The in-between years: Slips and sticks Years with the band passed. In 2008, a couple months shy of my 30th birthday, I was now learning to "eat around the band." I had learned some good habits with the band and made some good self discoveries about myself and how and why I ate, triggers, and in general, had begun trying to find healthier ways of eating. But the binging never completely stopped and the emotional urges to eat, triggers, all of that, while maybe slightly diminished, never disappeared. In June 2008, I noticed that I was having tremendous pain in my band and that nothing was staying down, not even Water. It was dire. At some level I knew that this was more than being too tight. In the NYU Medical Center ER, on a Sunday evening, they were initially not sure what the problem was. They admitted me overnight and the next morning I was given an esophgram - which brought about the dreaded results: slipped band AND a hiatal hernia. I was devastated and scared when they said that they were immediately prepping an OR for me and that I would be rushed into emergency surgery. Part of me had had it. I thought "I've lost the weight. I could survive without this band now." But when the bariatric surgeon on call came to speak with me, he said in no uncertain terms when I asked about taking it out and leaving it out: "Foolish. I can take the band out and not fix it, and not re-band you, but you will absolutely gain all the weight you lost back. The results are conclusive. You wouldn't have a chance to keep it off." And I believed him. And who knows, while part of me is angry for not getting another opinion or standing up to him or saying "well, screw that, tell me how I CAN fight this and live without such misery," part of me feels like "okay, maybe I was not ready then. Maybe I still did need the band." I was prepped for surgery, rushed in, quietly crying, convinced I was going to die, my usual surgery/anesthesia phobia in high gear. Final preparation happened as I was brought up on the OR table, IV inserted, versed, anesthesia, darkness, begin. I came to and was told it was all fixed and that I was successfully re-banded. I cracked jokes and way too looped up on pain meds, I told the surgical resident when he came to check on me in the recovery room after, that I loved him. He shook my hand, high tailed it out of there, and it wasn't until later that I felt more than sheepish and cursed this cycle of never ending surgeries, all from a self inflected weight gain from years earlier - that I did. I had caused. I did this to myself. Let's be honest. That is perhaps what hurt most of all. Until 25, I never knew the inside of an OR. After, I knew it frequently and had come to quake in its presence. Life continued as a lap bad patient. Time rolled forward. I tried getting filled a couple more times as my weight in 2008 started to creep up, out of the 210's and into the 220's and 230's. But I couldn't tolerate the tightness. My body was so sensitive and the pain and inability tolerate it grew with each passing month. Any restriction seemed to irritate my pouch and stoma and life became an embarrassing array of me rushing to the mens room at restaurants with friends to go throw up some stuck food, me avoiding certain foods like asparagus or meat that seemed too tough to avoid such embarrassment, me trying to eat healthy but then giving up and eating junk food that I knew would just go down easier. It became an array of pain when something I ate got stuck and it became a constant fear that I would end up having my band slip again. And yet I hung in for the long haul. By 2009, I had had most of my Fluid taken out of the band - all but maybe 0.2 cc's or some symbolic amount like that. And I stopped going into my surgeon's practice. I went on with my life with a nearly deflated band. I went up and down in my weight. By now, my daily eating ritual had devolved to eating what I wanted and especially when I was not trying, I used water or soda or other cold beverages with each meal to push food through my stoma into my pouch until I felt the "ploomp" feeling of the food passing through. That feeling became pure joy. I learned how to manipulate the band and eat around it. I no longer ever ate without pushing food through with liquid. Of course that came to backfire every once in a blue and got me hopelessly stuck. But I would sit out of the game for 12 hour or so and then be back in with full force. The band was not doing so much to stop weight gain anymore. I let it become a useless instrument. In August 2012, at 33 going on 34 and just under 9 years with the band, I was at my heaviest weight since getting it put in. 265. I wanted to be 215. That means I had re-gained about 50 of my original 140 weight loss. To me it seemed like a nightmare, but in retrospect, it was pretty amazing that I had kept the vast majority of my weight loss off for so many years and even at my heaviest, I had only regained about 35-40% of my weight loss. I immediately took action and got on Weight Watchers. I had heard so many good things about it. And now I decided to see, with a deflated band and while still not too big, if I could stop the bleeding without depending on a silicone donut to do it for me. And guess what? Pounds started melting away again but because of ME. I did the work. I started grocery shopping every weekend at Whole Foods or Trader Joe's and menu planning. I cooked healthy meals and weighed and measured my food. I educated myself on eating more whole foods and less processed foods. I still had triggers and mild binges on occasion but now when I did, I COUNTED them and owned up to them and tried to understand at least what was causing them. If I decided to say "the heck with it, I'm getting 3 glazed Krispy Kremes," then I asked myself "what's really going on here and why?" I made myself at least know why I was doing it and even if I still went through with it after- which I often did - I tried to be at least conscious about it. That was something that counted - and tangibly helped me grow further than I had up until this point previously. The very beginning of the end of the band Weight Watchers lasted for about 10 months and saw me lose a total of the 39 of the 50 pounds I had regained. I came within 11 pounds of being back at my goal of 215. Without the band. And then it all went downhill. In 2013, my dog, my beloved best friend, was diagnosed with Cushings disease and if you know what that is and what it means for a pet - the amount of work, the amount of witnessing them suffer, the amount of money spent trying everything - then you know what a toll it takes on you and your pet. Factor in that I was not the happiest in my career and in my life - and I found myself falling off the wagon of Weight Watchers for a couple weeks - which turned into a couple months which turned into I was no longer on Weight Watchers and eating whatever I wanted. Between June 2013 and early 2015, so a solid year and a half, I went down the darkest eating hill I have gone down since having the band. I caved. I ate everything and too much of it and my band didn't stop me. Other than every few weeks stuff getting stuck, causing me to be sidelined from eating for 12 hours, I was able to eat with almost the same gusto as I was before the band. Oh how the mind tricks you on weight gain. Sure, I knew I was putting weight on. But I'd say "hmm, well, it's been 6 months since I've been off WW, and while I feel a little thicker, I am guessing I have probably gained maybe 2-3 pounds a months and have put on somewhere between 15 and 25 pounds. So maybe I'm like between 230 and 240." Then: "hmm, well, it's been a year since I've went off Weight Watchers and I got very involved in the gym and working out with a trainer recently, so I think even though my eating and stress has been a nightmare, I think I've mitigated some of the damage. I am probably at like 250. After all, most of my clothes still 'fit.'" Finally, after two years of fighting to get my dog stabilized and healthy, his health took a huge nose dive in late January 2015 and over the next two weeks a hell on Earth began trying to literally save him. I lost that battle on February 15, 2015 and at a few months shy of his 9th birthday, way too young, my beloved hound mix passed away in my arms on the way to the ER vet. (His third time going there in less than 2 days). There aren't words to describe the devastation. To this day, nearly a year and a half later, it's too much. After he died, for a week, I literally stopped eating. Listen, when I am upset - I eat. But this? This was beyond upset. If I wasn't eating, this was pure devastation. But, as the initial shell shock and utter grief moved into numbness and disassociation, the cravings returned with a vengeance. I am convinced that between late February 2015 and six weeks later, in early April 2015, I put on a good 15 pounds alone. In early April, most of my clothes now didn't fit and I had been telling myself for MONTHS, "you must get back on the horse. You will wind up gaining all your weight back. You cannot let this happen." My dog had died, I was sad, but there was no longer an excuse. And so I returned nervously but full of hope to Weight Watchers and re-joined on April 15, 2015. The weigh in was crushing: 289. Nearly two years of out of control eating and I had gained from my low of 226 on WW, approximately 63 pounds. That's approximately 31.5 pounds a year. That's 2.5 pounds a month. Guess what? I was right at six months. I probably only did weigh around 240 then. It's the fact that for the first time since 2003, I had let myself not get back on the horse and had just nearly given up. I had literally regained 60% of what I lost. I was determined to STOP it now, and I did. One small note to add: in August 2014, I ate something and became so stuck by the band, that I could not eat for 24 hours and the pain became unmanageable. I went to the ER in Methodist Hospital in Brooklyn where I now lived. At 35, going on 36, I was yet again facing another lap band slip and thought "if it is, it's coming out. I will manage. I cannot live like this." They hospitalized me to get fluids in me and examine me. They did an esophogram. It showed no slip but that the band was tight and my stoma and esophagus was very painfully inflamed. An on call bariatric surgeon was paged to meet with me. His message, naturally, was the same as the other on call surgeon back in 2008: "I'll take the band out for you if you want, but just understand you'll regain all the weight." I was livid. "No! I will not! I will not let myself!" He was insistent. "Yup, you will. Not only will you gain it all back, but you'll gain extra too - you'll be bigger than you ever were before and you'll do it very quickly." I argued that a year earlier I had made tremendous progress with Weight Watchers and that my band these days was useless, it was nearly empty. His response? "Doesn't matter, the band sits on your gut and presses on nerves that reduce hunger craving hormones. Once you get that band out, your appetite will be insatiable and all your old habits will come back." Do you know what he said next? "It's your destiny to be obese. You cannot be a healthy weight with out some form of weight loss surgery." I rolled over in my hospital bed and looked at the wall trying not to break down and cry. I felt trapped. He left the room and I never saw him again. The regular doctor withdrew the remaining 0.2 cc's left in my band from years earlier, and I was released the next day after I was able to swallow a cup of water and hold down some Jello. I left that hospital defeated and continued to gain weight. I now had a COMPLETELY empty band. Deflated. Nada. Nothing left but a loose silicone band. Which made my last several months of my eating frenzy even easier. When I finally re-joined Weight Watchers approximately eight months later, for my second time, my life yet again changed drastically. Now I was back on plan with a vengeance. I started where I left off. All the good habits and learning and planning and accountability. Now I did something new: before I used to do meetings but would only attend periodically and then it became online WW until I dropped out. I now attended a meeting every single week that I was in town. I shopped, I cooked, I planned, I allowed myself some flexibility and treats and I discovered that I could really eat a lot of delicious, satisfying foods and actually felt more nourished and satisfied eating this way than I did when I was out of control. I was able to eat out, drink beer, wine, cocktails, have a lot of what I wanted - and I was losing the weight fast. By February this year, about 10 months after I restarted, I had lost 62 lbs through diet and exercise. I weighed 227 and was 2 pounds from my new, more realistic goal of 225. (Which my doctor signed off on and approved since Weight Watchers says your goal weight for lifetime membership must match the approved charts - at 225, I am pretty slender - but according to the charts, for my height and age I am supposed to be between 185 and 195. Ha! My body would never get there and even if it did, I'd look like a famine victim). I got 2 pounds from goal and then I hit a NASTY plateau. I became defeated and started slipping on plan. I gained a few, lost a few, gained a few, maintained a lot of weeks that I worked my ass off and was so frustrated. To taste it - to be that close and just miss it. But something else started happening. I chilled out. I was hanging around my 230's at this time and other than getting off plan and eating whatever I wanted for a week or two, I noticed, I was getting BACK ON PLAN, faster and completely committed. I went to Ohio in late February to visit college friends - that was one time I got way off plan and then within a week, got right back on. In late March, I went with family to the DR to an all inclusive resort. The food was amazing - yes - I got off plan. Within a week after? I was back on plan. And in late April, I went to LA for a week for the Jewish holiday and to spend time with a friend for her 40th birthday. Yes. I got way off plan. And by May, two weeks later? I was back on. Here's what I have learned that I think is crucial for us compulsive overeaters, us emotional eaters, us up and down and life long weight strugglers: We will slip. We will be triggered. Lap band or no band. The key is to try to 1.) Be aware of when you are struggling, why you are struggling, what is causing the overeating, emotional eating, etc. 2.) Challenge that behavior / mitigate that behavior WHEN you can. I have started to do this with myself now and it's new for me - I can talk myself out of a bad eating moment and replace it with healthier behavior - not all the time, not even half the time - maybe 20% of the time. But that's a BIG improvement and important! 3.) This is the most important: if you find yourself slipping, as we all will, acknowledge it and SET A DATE for getting back on the horse. That date could be in one hour, one day or one week. Heck, it could even be a month if that's what it takes. But SET THAT INTENTION and STICK TO IT. Don't let it go 4 months or 9 months or 2 years like I did when I got close last time and it all fell apart. Be accountable and aware and willing to GET UP when you FALL DOWN. I think that right there is the key to winning this weight battle and to maintaining weight loss or taking off weight. Here's where I am grateful to my lap band: I could never have lost 140 pounds on my own. I have lost 62 pounds on WW and though I've been caught in a plateau for the last few months, I'm only ten pounds up from my lowest weight back in February. I have not thrown in the towel and I will not throw in the towel. I will soon engage another weight loss cycle and I will hit my goal of 225. I know I will. And then I will work hard to maintain that on lifetime maintenance with WW as best I can. There will be literal and figurative ups and downs. But none of this, where I am at today, would be possible had it not been for the band. I was not ready for Weight Watchers and that commitment back at 24 years of age. I would have liked to have been, but I wasn't. And even so - me losing 30, 40, 50, 60, even 70 pounds on Weight Watchers is one thing but losing 140, more than twice the amount I set out to lose this past time - is another story entirely. I know I could not have done it then - and I am not sure if I would be able to even do it now, with as far as I have come. Regardless, in 2003, the band was the only tool I could find at that time that allowed me to take that kind of large scale of weight off - and effectively keep it off for a long time after. Eventually, the tool became less effective and I clammed up in seeing it and figuring out what to do about it. But in the end? I am where I am today because of that lap band. Better or worse. And I personally think even though rocky and bumpy as it was, it's better. I am better for having had it as a part of my life. Scars and all. The actual end of the band A few months ago, I started noticing that I was getting tight in my band - that was empty. I started getting stuck on foods I should not have been getting stuck on. When I had my "stuck episodes" the episodes were BAD. Violent. Out of nowhere. Rendered me unable to function. Yes, I was used to the occasional getting stuck because of my complicit misuse of my band. But this was different. This was a new kind of stuck. In addition to a full time professional career, I also teach college as an adjunct professor a couple evenings a week. During one of these classes, in late January of this year, I took a sip of water while I was teaching. Something that had not passed through earlier and was mildly stuck - but not in such a way that it really bothered me - suddenly became VERY stuck, with 20 minutes left of my lecture to go. I should have been given a Tony Award for my acting performance. I think the color drained out of my face, but other than that I managed to be all smiles and on point but inside was DYING. Trying to hold it together. I ended class five minutes early and made a beeline for the bathroom. I threw up but it was not resolved. I could not eat for another 18 hours. Imagine my horror when, in my other class that I teach, a few weeks later in February, during a 5 minute break, I got stuck on trail mix. Badly. Trail mix?? That was usually a no problem food. Not this time. I ran to the bathroom for the remaining three minutes of the break and puked like my life depended on it. I knew I was in rough shape. The waves of pain radiated up my chest into my throat. I could tell that I was so inflamed and tight that I would not even be able to get one drop of water down. I had to return to that class and continue teaching in pure misery. I couldn't stand it. I am not sure how I got through it, but it was a new low point for me. A point of no return. I couldn't live like this. In my 13th year of the band, now at age 37 (imagine, I was 24 when I started this journey!), I was starting to have had enough. And not just thinking "maybe this is enough." The uncontrollable feelings became that it "was enough. Definitely enough. Too much." I started thinking constantly about getting it out. Every time I'd have a stuck episode, and they kept coming, and the pain increased, I fantasized about pulling the plug once and for all, and GETTING IT OUT. I was approximately 120 lbs less than when I was banded, nearly 13 years later, and yes, while I'd gone up and down a few times over 13 years, I had mostly kept the the bulk of the weight off and recently, I was learning to finally be more aware than ever before about my eating and to get back on the horse when I lost my way within a couple of weeks. To hell with what these few weight loss surgeons had said to me about "you will definitely regain all the weight and then some if you take the band out." What? No, I won't. I have learned how to stop myself now. Give me a little credit as a functioning human being - I think I've earned it. Look past your statistical research and numbers and look at the individual patient, doctor. Look at ME. I began to realize that this band has not kept the weight off all these years. It helped me LOSE all the weight and initially helped me maintain it, but it is ME who has done the work to keep it off and try and maintain the bulk of the loss and the band - ? No longer really helps. I am the one, I do the work. I don't need this misery. I had far more control than I had ever previously given myself credit for and dawn was starting to break on me realizing this powerful truth. The problem was my health insurance. I had done a cursory search and had found that in 2016, my union insurance did not cover weight loss surgeries - at all - period. So, not only was I shocked that they were such dinosaurs about it, but figured "well, there goes that, cause I don't have the $8,000 extra right now or whatever it would cost, to have this safely and properly taken out." March and April passed and the episodes continues. In the middle of this past May, just five weeks ago, I had such a bad episode I almost went back to the ER. I could not eat for 24 hours - not even sip water. I was in pain. It was misery. Desperate, I finally called my surgeon's office whom I had not called in YEARS. What was wrong with me that I suffered all this time alone and in silence? I had emotionally moved beyond my band and now even resented it. Is that why I didn't have the clarity to ask for help, instead of holding it in alone? Instead of making assumptions? Was it out of fear of my insurance saying "nope, band removal not covered, you're on your own." Would that anger me so that I feared hearing that and then REALLY feeling stuck (literally and figuratively)? Was I avoiding having one more surgeon tell me "fine, I will take it out but you will regain all the weight and fast." Or was it that deep down, I believed that I wasn't actually capable of keeping the weight off WITHOUT the band? Was that what was holding me back? I suspect there were tomes of all of these thoughts that held me in chains for months and even the last few years that I was ready to take this step. But by May, after that particularly harrowing episode, something instinctively, desperately said "enough. You cannot continue like this. Ask Dr. Ren for help." And so I did. I called up for an appointment and it's like, the easiest answer all along poured out of the skies and my life took a major turn that I am so grateful for. I had an esophogram done the morning of my appointment with Dr. Ren, June 1, 2016. After swallowing the barium, the results were sent to Dr. Ren's office and upstairs to her suite I went. After meeting with the nurse and going over the situation, Dr. Ren came and met me and invited me into her office. She was wonderful in 2003 and she's wonderful today. I really hadn't seen her other than in passing over the years and we sort of both had this moment in the hallway where we realized how long it had been. We joked about how much younger we both were then and marveled at how much life had changed and thriving her practice had become over the years. She sat me down in her office and asked me what was wrong. I told her. Everything that I have written above, in so many words. And what she said astounded me. It went something like this: "You have done such a good job with your band. Some lap bands last longer than others, but many don't last for life. 13 years is a GOOD run with a lap band. That's a long time. In looking at your esophogram results, it's no wonder you're having the problems you are. I see swelling and inflammation on your lower esophagus - and not from a recent episode from the other week. This is more long term inflammation caused by the pumping your esophagus is trying to do with an irritated stoma and possibly too tight of a band. Even though it's empty! It must be so painful. It's time for your band to come out." I felt like I'd won lotto. Like every cloud ever, not just the current clouds, but the past clouds, didn't just clear - but evaporated. I felt heard. I felt vindicated. I knew it. But what about regaining weight? We had a long talk about how she normally always feels in agreement with what the other surgeons had said - that the vast majority of people having their lap bands out regain the weight. Most of it or all of it. But - that a small group does not. Some people have managed to keep the weight off through that hard type of work I have been attempting to do - yes - without much help from the band. And my dogged and determined efforts showed that I was a possible candidate for keeping that weight off. She said that if I could commit to Weight Watchers and if I could stay on it, get to maintenance and get back on that horse quickly after I fall - she didn't see why I couldn't do it. We talked about the sleeve and other newer weight loss surgeries - but I just didn't have it in me and she UNDERSTOOD and RESPECTED it. I was thrilled. Dr. Ren also told me that there was now a non-surgical weight loss doctor in her practice that she recommended I see as well. I agreed to do so. And best of all? She said "of course your insurance will cover your band removal. Your esophagus has some damage - it is reversable but it needs to get out now and that's a medical necessity. She walked me over to her billing specialist who investigated it and she said "what is your insurance? Oh! We've had a few people who have had it out with your insurance. This should not be a problem when we submit it as a medical necessity" (which it was). She said she would presubmit the claim and we would schedule the date. It all happened so fast. Dr. Ren does 1 Saturday morning a month in the OR, the rest of her surgery days are something like Mon and Wed. Monday was not great as I didn't want to have to take a whole week off of work for this or you know, half the week. And Wed sounded good but she was booked through August on Wednesdays (and this was back on June 1). The billing specialist who does her surgery calendar too said "hmm, if you'd want to come in and do it on a Saturday morning, she has her one Saturday a month this month on June 25th. I have one spot left." I scooped it up right there and then. Details got planned. I would need pre-op blood work, an authorization from my doc, she would have to make sure the claim was approved by my surgery. I would need to take the Friday before off from work (for me for self care) and the Monday after off, which was no problem, I would need to pick up some supplies, prep emotionally, arrange a family member to be with me/pick me up day of surgery, and decide who I shared this info with. I scheduled an appointment for Dr. Lofton, the non surgical weight loss doc that Dr. Ren recommended. She was highly booked and hard to get me in. They put me on a cancellation list and on June 10 they called me and said "hey, we have a cancellation on June 13 first thing in the morning, can you be here?" YUP! I made it happen. Dr. Lofton and her PA were great. They looked at my history and ultimately she recommended a medication called Saxenda, formerly used as an insulin controlling daily injectable for diabetic patients, it became marketed in 2014 as a new weight loss medication that has shown to be quite successful in diminishing appetite and feelings of satiety by reducing a hormone in the gut that causes hunger - the same one all of these bariatric surgeons were referring to when telling me "even if your band was deflated, it's been reducing a hunger inducing hormone." Hey! How about that? So - the plan was I would pick up the Rx, if approved by my pesky insurance - and keep until after the band was removed. I would spend a few weeks seeing what it felt like to be "normal" again with no intervention, get familiar with my baseline hunger and if I noticed I was too hungry or eating too much, then I would give the Saxenda a try. I will have to inject myself once daily in my gut, leg or arm and it apparently does not hurt and is easy and no big deal. I am 100% willing to try it if I need it. And after an initial denial from my insurance company citing the need for prior authorization, Dr. Lofton's team was able to get said prior authorization and last week I picked it up and brought it home and have it ready. This month of June flew by. Before long it was the eve of my surgery and I was terrified. And excited. But more terrified. 4,569 Days (12 years, 6 Months, 3 Days) I have been terrified of surgery, since I mentioned before, in 2003 when I first had the band put in. It's something about the combination of worrying irrationally that I will go into cardiac arrest on the table and never awake again - combined with the idea of being cut open, combined with the idea of what it can feel like to wake up throwing up and out of it and having people yelling at you to take a deep breath while being wheeled naked in a gown down a bright hallway to recovery - that has rendered me a frozen five year old being asked to jump off a high dive. I knew I would be terrified but until last night, I didn't realize how much. I managed to get myself into the hospital on time. Upon arriving at 9:30am for my check in this morning, there were several fire trucks parked in front and in the main lobby, the fire alarm lights were flashing while firemen rushed around. They took out all elevators and I was told, "if you want to get to the fourth floor you'll have to wait and it could be a while or you'll have to take the stairs." It's a good thing I'm relatively lean and in shape. And that it was the 4th floor and not the 14th floor. But - I of course internalized this as a sign of "you are being warned, this is an emergency waiting to happen, you are going to crash and die during surgery." I won't belabor the rest of the details of my tremendous fear. During the check in and pre-op holding area where I changed into my gown and was counseled and examined by a lovely nurse - I was practically giving myself a heart attack. I go through this near every time I have surgery now. A lovely small moment that helped was that as I was lead to a curtained cubicle with a recliner chair where I was to change and be examined pre-op, I saw a young man laying the curtained stall across from me. He seemed maybe 17 years old. He was Latino, had braces and was scrubbed up and ready of this own surgery. His parents sat eagerly next to his bedside and held his hands. A Spanish translator was speaking gently in Spanish with them and he, the young man, seemed to not be paying attention too much. He followed me with his eyes as I was seated in my stall and watched me closely. When I finally made eye contact with him, he smiled sheepishly and waved timidly at me. As if to say "I'm scared, are you? We're both about to go through this together." This young man had to see someone much older than him, but perhaps younger than his parents and the closest person who could understand what he was about to go through. I recognized it in his eyes. We kept smiling at each other every so often over the next 30 minutes, while the nurse came in and took my temp and blood pressure, and explained the surgery to me, had me confirm my name and date of birth, while his surgeon, a middle aged white man came and spoke to him and his family and translator - during this whole that they prepped both of us, we searched for each other, 20 years apart in age, but somehow totally intertwined in what we both were preparing for. I tried to send him soothing, reassuring facial expressions. His youth and kindness and desire to have but a small connection in the wake of such a frightening, uncertain trial induced me to put aside my fear for a moment and care for him, instead of perseverate on my impending death. Soon, he was wheeled away by an orderly and his parents walked away, slowly, mother crying, I heard the nurse directing them to the waiting room and saying that he would be okay. As he was wheeled away, he gave me one last glance, as if searching for clarity in what would happen next. My nerves returned, but there was a deeper force in me now, one that was rooting me on and saying "if you just get through to the other side of this procedure, you will find a freedom for which you've searched for not just the last 13 years of this lap-band, but your whole life. For 37 years. It's not that I thought, like when I got the band in, that my life was going to become AMAZING. I was simultaneously having fears about regaining so much weight and knowing how much work was going to be required. But - a feeling that I could now feel healthier, take this step on my own, get the training wheels off after more than a dozen valiantly fought years, some improvements - not perfect - but some - and that gone were the days of getting stuck and maybe now I could eat kale and asparagus and a not worry about the ramifications. Now I could be intimate with a partner and now worry about them feeling my giant port and saying "um, what is that?" Now I could go out to dinner and eat unencumbered - not meaning pig out - but just not worry "ugh, what happens if I get stuck in front of these people who know not of my situation and have to run twice to the bathroom?" After so long, I was going to be at last free of this. One way or another. Soon they came for me and it was my turn. They wheeled me away out of the pre-op staging area and brought me to a patients only elevator. I watched countless doctors and nurses walk past me, register by the look in their eyes that I was on my way to the OR and you could see the curiosity: "hmm, he's young, wonder what he's having done." My surgery nurse met me at the point of no return, double doors where scrubbed up personnel only were permitted to pass. She spoke to me for a while, had me sign some papers again and then wheeled me inside those doors. She parked me outside the OR #4 for while she walked away to find someone. I looked inside the window on the door of the OR trying to see if I could figure out if it was going to be my OR. Inside was a plasma TV screen and on it I saw a long metal wand pointed at what looked like someone's intestines, smoke wisping out of the end of it as it cauterized and made a high pitched sound I could hear through the doors. "Bzzzz." I realized they were in middle of surgery on someone and wondered if it was my 17 year old friend. I thought of his frightened face and thought about how by now he was most certainly unconscious and under way, whichever of these many OR doors he was actually behind. Soon the surgery nurse returned and wheeled me down one more door, to OR #5. I considered whether or not I liked the sound of OR #5, there seemed to be best I could tell up to 12 OR's on this floor and I decided I liked the sound of #5 and its placement, as she parked my wheelchair and motioned that we had arrived. It took all I could get to muster up every last ounce of strength when my moment came, that I had dreaded for the last several days, of climbing up on that operating table this morning. At NYU, they wheel you to the door of your OR and then you get to walk your ass in and climb up on that table. It's so clinical and sterile. No windows, no music, no TV. Just like 6 random scrubbed up people prepping instruments, the plasma screen, your table, etc. They got me on the table, tears streamed down, they tried to soothe me and work quickly. To my nurse anesthetists credit, she got my IV in no longer than 6 or 7 minutes after I got on that table and within another 2 minutes, they'd delivered a strong dose of versed. I thought about my mom who had passed away years ago that I missed and asked her and God to be with me. I asked for forgiveness. I thought of my grandmother who I had loved in her life - and I thought of even my dog! His sweet face and constantly happy disposition. His wagging butt and smiley nature - it actually made me feel better! I thought "whatever happens, God, it's out of my control and in your hands. I am letting go and trusting. And if I make it through, which I am choosing to have faith that I will, the real test will continue after, as I move forward with eating healthy and staying trim WITHOUT these training wheels." Around that moment, I was very loopy and high on versed, sleepy but I remember the anesthesiologist had suddenly appeared and vaguely was aware of him saying it was time to deliver the anesthesia and commenting "ohhh, i think I feel it coming, it feels..." That was all I remember. Like every time before. And like each time before, I was immediately aware of beeping machines and voices and a woman's voice calling my name. No real sight at first, just a strong fatigue and desire to sleep mixed with a desire to be conscious and - the very happy and grateful feelings of "oh my God! Oh my God! I did it! I'm done! I'm on the other side!" Like finishing the dreaded mile I used to run in junior high. Dreading it all day, not because I hated running it but because I hated the feeling of trying to remain in the middle of the pack, the fear of falling behind and coming in last or second to last. Knowing that I had to blend in and fight to keep pace, fight to not be made fun of for failing. At the end of the mile, stepping over the final stride, came always an exuberant elation, not because I had set any records or felt proud of my run necessarily, but joyous that I was FINISHED, it was not me who now had to dread it, it was behind and I had survived and could go on with the next order of business that preferred fare more than that. So is waking up for surgery. I didn't love it. I hated it in fact. But I survived. I was on the other side. And though I was becoming aware of pain and fighting the super high effects of Fentanyl and Dilaudid (simultaneously wonderful and frightening), I felt a constant relief that no matter what I was here now. I slept and woke and in between blurted out crazy comments to my dedicated recovery room nurse about banana pudding, banana cream pie, about how I hoped she was not voting for Donald Trump (which I would never say to a nurse I didn't know under a non-drug induced state and to which she replied "what do you think of me? Of course I would never!" I am still feeling lucky that I wound up with either a polite nurse who lied for my sake or most likely being New York City, a sensible moderate or liberal). I was brought ice

I'm almost four months post op. I have thin hair and was worried about hair loss. I've been using Nioxin shampoo and conditioner since I had the surgery and have had no hair loss. Getting in protein helps too!

I've been on Bariatric Pal for a few months now and I'm a week away from surgery. I've read countless posts around fears about surgery, complications, losing hair, loose skin but my biggest fear is something that I rarely see mentioned. What if I fail at this too? Does anyone else worry about that or just me? I did okay going through an 8 week pre-op diet/skills class and lost around 15 pounds. But as soon as my 2 week pre-op diet started, I have lost my mind and haven't been able to stick to it. Which leads me to wonder if the same thing will happen afterwards. I really want to be successful but knowing that soon I won't be able to eat make me feel compelled to eat while I can. It probably doesn't help that my doctor's office told us that we have already shrunk our liver with the weight loss we have already had and they only expect us to lose another 2 lbs on the pre-op diet. I took that as permission to eat three meals a day versus 1 meal and 2 shakes a day.

Agree you're still very fresh out to worry too much about getting all the Protein in, just do the best you can and focus on fluids, preferably with some type of protein to combine them. You may also want to try some protein powders, like the unjury, comes in various flavors. The chicken flavor is very tasty and comforting on a fresh post op tummy, and it's 20 or 21gr of protein. That combined with 1 Premiere Protein shake (30 grams of protein) would get you almost to 60 with just those 2 things. And I agree with suzzzzz....there isn't too much you can do to avoid hair loss, you either get it or you don't, and odds are higher you'll experience hair loss to some degree regardless of getting in all protein/vitamins or not. Be well! Sent from my SM-G928V using the BariatricPal App

I was worried about hair loss before I had my surgery. Not long after my surgery, I talked to my cosmetologist about it. Before surgery, I had very thick hair. I started noticing excessive loss when I was about 3 months out from surgery. To be proactive, I talked to my stylist about the best cut to minimize hair loss (or the appearance of it). I normally get my hair thinned, but I stopped that for a while too. I also quit coloring my hair for about the first 10 months. I didn't want to weaken anything further than surgery already did. I cut back on how often I washed my hair (every other day instead of daily), and I took Biotin and listened to my stylist. My stylist was also able to recommend products that would help. I was glad I talked to her and teamed up with her on the issue. She was also able to reassure me that my loss wasn't drastic.

Hi, I am not sure where you are going to have your surgery. No, you will not fail at this--we all think this and that is a normal feeling and statement. Just follow the rules they give you. You can't imagine what it will be like to NOT feel hunger. After the WLS you eat because you need to eat. There will no longer be a feelings of hunger--I know that is a strange thought but a true one. You will have to deal with what we call "head hunger." The "old thinking brain" has been in charge for your entire life. NOW YOU have to be in charge I will send you something I wrote about a few things and they should help you quite a bit. You honestly should not require little of any after care. I had complete blood panels run because I felt pretty weak and I found out that my potassium level was low, they gave me medication for it and that resolved that issue. If you have a Highly Qualified Doctor for a surgeon you should never have to think about or worry about a leak. I had Dr. Aceves in Mexicali, Mexico and he is one of the top Weight Loss Surgeons in the world. So I knew this going into my surgery and had NO worries about any kind of a leak. I had NO pain when I got home. I went shopping 3 days after I got home for groceries. They sent pain meds home with me, but I did not need any. I think you will do fine. The first month after the surgery will be the hardest month that you will ever have to do. It is only for 30 days and you can do this--it isn't a lifetime. I am always here if you need help or have any questions. Here are the things that I wrote about and you might find them useful. Sorry if I sent you too much information, but you might find this helpful. Print them out so that you can read them later. Hugs, Suzanne *********************************************************************************** Volume 1 I decided that I would make a list of things for new people who are thinking about having WLS that might be helpful to them. This is long so please PRINT THIS OUT TO READ if you don’t want to read it all at one time. First thing is to start asking people on the board you are on all kinds of questions—make of list of things you want to ask and keep coming back and ask more questions as time goes on. The more questions that ask the more you educate yourself about WLS and the process and what doctor they liked. Don’t rely on just one source of information. It is really normal to have all kind of feeling and emotions when trying to decide if you want to have Weight Loss Surgery. I must have talked myself in and out of doing this at least 50 times during my 6 months of research. My only regret is that I didn't’t do it sooner. This is a big step. But if diet and exercise worked for us then we still wouldn't’t be fat and would have lost the weight a long time ago and never regained it. It takes a lot of courage to have Weight Loss Surgery. I am very proud of you for looking into this. Don’t give any more days of your life being overweight, and your body hurting along with being unhealthy. WLS really is your answer. How do you select your surgeon? First of all this is NOT a time to price shop for the cheapest doctor to do your WLS—that is just the wrong way to go at this. There are a lot of doctors who advertise on the Internet doing sleeve surgery for a lot less than some other doctors. I found one posting from a person who had the following concerns after having surgery in Tijuana, Mexico. (a) They put NO name band on her to be able to ID her when giving medications or anything else. ( NO one asked if she had any allergies to foods or medications—thank goodness this person didn't’t have any. ( The lab did NOT label tubes of blood with the person’s name on it—very dangerous. © Day after surgery they gave this person ice chips, tea and apple juice. The next day (day 2) they gave this person NOTHING so this person asked why and the nurse said this person wasn't’t allowed to eat anything. Well, this person then said I had Clear liquids the day before and they wanted to know WHO gave it to this person?? (d) This person was told that they would get a copy of the operative report on their discharge to take home with them—This person has not received it yet and that was about 2 weeks ago. So make sure have positive feedback about the Surgeon and Staff and Hospital that you choose. My choice after 6 months of research was Dr. Aceves in Mexicali, Mexico. What I can tell you in my opinion is that he is the very best you will ever find to do your surgery. I can only speak about my experience and my research that I did before I made him my choice for a surgeon. Pack lightly for your WLS. So many of us have gone to Mexico, so you want a small suitcase with wheels, a laptop & a cell phone. The clothing that you wear to Mexico are the same ones you can wear home—slip on shoes work great too. Make sure that the clothing is loose fitting. Something just comfortable for your ride home. While in Mexico—that is if you go to Mexico for WLS make sure you take GAS-X. They have nothing in Mexico that they give your for gas, and the use gas in your abdominal area during surgery. It is painful after the surgery, so GAS-X STRIPS are easy to use by just placing them on your tongue. Take a couple of boxes with you—you will be glad you did. If you are going to use a credit card make sure you tell your credit card company and your Bank if you use your debit card or credit card. Sometimes if you DO NOT let these companies know you are outside of the US they block your charges. Use a credit card or debit card vs cash it is much easier to use. Take small amounts of cash for tips—I took $45.00 in 1’s for tip money for various things. If you go to any hospital anywhere leave ALL jewelry at home –just a watch and no rings or other jewelry. I never had any problems at all leaving my purse and computer& cell phone in my room while I was in surgery, but they recommend that you leave all jewelry at home. If you are a lady please remove all nail polish—they need it removed to see your nail beds during surgery. The first month you do after surgery is the HARDEST month you will ever have to do. You do 10 days of nothing but clear liquids to start with—that means you have to be able to see through the liquid. Do not panic if you can not get the Protein they want you to have the 1st 10 days—I couldn't’t find anything I liked that was clear during the 1st 10 days. They want you to try to drink 64 oz each day, and I don’t think I could ever get that much Water drank—just do the best you can. Your new stomach has just had major surgery and it is swollen and will only hold something about the size of your thumb. The next 10 days gets much better—you are now on creamy liquids for these 10 days. You can now have some creamy Soups, yogurt, and pudding—sugar free and find a Protein Drink that you like. For me it is Premier Protein Drink and I get mine at costco. When looking for a protein drink, make sure they are low in calories, high in Protein—Premier has 30 grams of protein in each drink box and make sure you have low carbs too. I know there are a lot of other Protein drinks out there that people like. When it comes to carbs I tried to keep mine at no more than 20 carbs per day. Ask others what kind of Protein drinks they liked and where they get them. The last 10 days are mushy foods. So this is a bit of a challenge. How many foods can I make mushy? I even considered using some baby foods. Start thinking about what will work as mushy foods for you. Starting the 2nd month is quite an adventure. You can eat regular food. Here is where the relearning process takes place. You now will take tiny BABY BITES of food and chew each bit about 30 times or until it is like a liquid. From here on out you will need to take small bites of food and chew and chew and chew. I found out that chicken and fish were a lot easier to chew up. I don’t eat much red meat—your tastes will change and things you didn’t like a lot might taste good and something that you used to love don’t taste that great anymore. Keep track of what you are eating and keep your calories at about 800 calories per day and no more than 20 carbs per day—whole grain carbs are the best to have—NO white or refined carbs. I highly suggest that you keep track by writing them down or using some of the Internet sites that offers you this. I suggest this site it works great there are other sites to use this is just a suggestion. http://www.livestrong.com/thedailyplate/ It really is good to write down and track everything you put in your mouth to start with—that is how you know that you have not had more than 800 calories per day. I want you to understand weight loss surgery is just a tool. The fat does not just melt off of you—they is NO miracle cure. Now you have to put a lot of effort into eating healthy and starting to exercise. Everyone has some kind of exercise that works for them. I love walking and try to walk about 5 days a week. For many of us we started to lose some of our hair 3 or 4 months after having WLS. I would find a lot of hair in the shower after washing my hair. That is pretty normal for a lot of us—this does not happen to everyone. There is no magical cure for hair loss—some people use different shampoo’s or take Biotin. It happens and you live with it. YES, it will grow back. For me I had pencil straight hair and mine grew back natural curly and I love it now. I already had thin hair so for me, I got some cute wigs and wore them for about 9 months until my hair looked a lot better. It was worth the hair loss to lose 105 pounds. Because we eat a lot of protein we suffer from constipation. You need to have at least 70 grams of protein EACH day. So I mix my protein drink each morning with MIRALAX. It is NOT habit forming and is tasteless and it is just a good way to start off the day. I put the protein and a cap full of Miralax in the blender with about 5 small ice cubes and that is my Breakfast. 3 years later I still have this for breakfast and nothing else, it just works for me. You may have periods where you have what we call STALLS. You may be doing everything right and eating and exercising and you have NO weight loss for a week or more. This is normal—mine lasted 9 days. Don’t panic the weight loss will start up again, just keep doing what you are doing. Our heads play games with us sometimes it is ugly what our brain tried to convince us of—We call these “Head Games” and they really are tough times to work though, but you can do it. Your head is still thinking with your old brain and way of thinking that you have been doing for most of your life. You now are eating VERY small amount of food, but your head is used to you eating LARGE amounts of food and that is what your brain wants—so it tries to tell you the you should be eating more—NOT true at all. So you need to have a talk with yourself. Do I just WAN T to eat or do I really NEED to eat? You are not on a diet, but you are making a LIFESTYLE change and that is good because you can do this for the rest of your life. You will NEVER be able to eat like you used to. That is good because that is how we got fat. You will morn the loss of food—you will look around and see others inhaling all this food and you think to yourself—I used to eat like that. You will notice how fast people eat and inhale their food and talk and hardly chew what they are eating. That is pretty normal feeling to have—because you are now eating such small amounts of food and chewing and chewing. You will never be able to guzzle a bottle of water again—that is OK too. These are all good things. In time you will look at all the food people are eating and thinking to yourself oh my gosh I could never eat that much again—it is way too much food. When you have issues or problems come back to the board and ask others who have already done this. We are here to help and support you. Give or exchange all your fat clothes away. You will never need them again after they become too big for you. This weight loss is something you will be able to maintain for the rest of your life. You have earned the right to have new clothes. Make sure you have the VERY best doctor that has had a lot of experience with sleeve surgery and check his success rates out. Check the doctor for HIGH patient reviews from the people who have gone to him or her. I can NOT STRESSS this enough. Make sure that your surgery is being done in a hospital NOT a Clinic. One clue that it is a clinic is if they send you to a hotel room to recover—that is why they cost less, this is also dangerous too. YOU are worth the extra money that it cost to have this WLS in a Hospital and by the best Doctor you can have. You want to have a happy and GREAT life and having the RIGHT Doctor and Hospital are the key to this. Sorry if this is long, but it is intended to have as a reference and answer a lot of your questions that you might have. For some of you, you are very lucky because your health insurance is now starting to pay for Weight Loss Surgery. For many of this, we did not have your luck, so we are self pay patients. There are companies that loan money for this surgery—be aware that their interest rate is high. Once you pick your doctor ask them about these companies that give loans for surgery if you are a self pay patient. You know we never think twice about making car payments. If you have to borrow the money for this surgery just look at this as “body payment.” It will be the best money you have ever borrowed. Please PRINT this out to read later. If you have any questions for me please feel free to contact me. I had surgery almost 3 years ago, so I do have quite a bit of experience. I really am here to help you along your journey. It took me 14 months to lose this weight and I was 63 when I had the surgery, so it is NEVER too late in life to do this. ************************************************************************************ Volume 2 Here are some more things I want you to know about if you are thinking about having WLS and you are having the “Sleeve.” We have talked a little or a lot about “slimming or Fleming” In case you missed it, when you first start eating regular food you have to re-learn how to eat again and chew. With your new stomach you will need to take small tiny bites and chew until the food in your mouth is almost liquid like. This is nothing like what you had been doing your entire life. In the past you eat and talk and put big bite in your mouth along with a few chews and then swallowing—this will NO LONGER WORK FOR YOU. This is a very difficult thing to change. So with your new stomach and just having surgery you may experience slimming or Fleming. First you will feel like the food is stuck, then it comes back up in a clear liquid –your saliva. It isn’t vomit, so that is why it is called slimming or Fleming. It’s a wakeup call to slow down you eating and chew, and chew and chew some more. Just go to the bathroom or have a napkin ready for the slimming or Fleming if you are eating out. If you try to overeat—which is bad you may experience this too sometimes. For me it was always about not chewing enough. What are some signs that you are full? At first I wasn’t sure, but sometimes I just got tired of all the chewing, so I stopped eating. I now get the hiccups or my noise will start to run when I am full. I know that other people have said they experienced this too. It does take some time to retain yourself on how to eating and I know that the first month it is such a process just trying to get all the food in that you need to get in because of your new restrictions. In time it does get a lot easier. Some people actually mourn the loss of food, because you will NEVER EAT the quantity of food that we used to eat---YEAH that is how we are going to lose the fat and maintain that goal weight that we want to have for the rest of our lives. If you think you are hungry and you are positive that you are having physical symptoms of hunger this is YOUR OLD thinking brain playing those tricks we have talked about. You now have to start learning to educate this OLD brain into being your NEW thinking brain. Ask yourself do you just "want to eat" or do you really "need to eat" because it has been 3 or 4 hours since you have eaten anything. It is amazing what our brains can and will do to sabotage our way of thinking. You may be challenged by this OLD brains way of thinking for many years. For me I just have to have some self-talks with myself. We have an addiction to food. There is no way around avoiding food, so we need to find the set of skills that will allow us to change our lifestyle. I eat to live, I NO LONGER live to eat! Food is not my main focus in life. I have seen so many times where people are going along and doing great with their weight loss. Then all of a sudden they are NOT losing anything—they panic—I did when it happened to me. We call these “Stalls.” We have stalled and are not losing anything. Most of the time you are eating all the same and correct things that you have in the past when you were losing weight. Our body just does this naturally--stalls. Mine lasted 9 days one time. This is really normal. I have a few suggestions. Use this site or something like it to track everything you are putting in your mouth. http://www.livestrong.com/thedailyplate/ You might be surprised at what you are eating—that is why I say track it. Remember keep your total calories at 800 per day—if you exercise then you can eat more. This site will help you figure that out how much more you can it by what kind of exercise you did. You also need to make sure that you are not eating more than 20 carbs per day. No white or refined carbs. They should ONLY be whole grain carbs—not whole wheat, BUT Whole Grain carbs—do the best you can when it comes to carbs. If you are having problems with the weight loss you can kick up the amount of exercise you are doing too. The weight loss will start back up again, so don’t panic. We all stumble and fall along the way, don’t beat yourself up over it. Move on and have a better day the next day. Be aware that your friends and family may not be supportive of you having WLS. For your family, first they really may NOT understand it and they are scared for you. This is pretty normal. You have been on the Internet, and been educating yourself and doing a lot of reading—you know much more than they do about weight loss surgery and your choice is the sleeve. They have only heard the horror stories that the media puts out there or one of their uneducated family or friends have told them. Your friends are scared they may lose you as a friend because you are going to lose the weight and they will remain fat—yes I call it fat. I know there are a lot of politically correct terms to use, but if I can say I was fat you will one day too. Some of your friends will be jealous. My suggestion is that you can try to educate them some, but take your time and effort right now and use it for yourself. After you have had WLS and they see you are becoming healthy and you are alive and well they may come around. I want you to put yourself FIRST, for the very first time. If they are truly your friends they will be there when you are skinny. The first month will be the hardest month you will have to do. You are changing everything about how you eat. I want you to keep saying to yourself that it is ONLY 30 days and I can do ANYTHING for 30 days. Once you start the 2nd month and can have regular food, it gets easier. What do you do about getting smaller clothes? One of my adventures used to be to go to Resale clothing places and sell or trade my larger clothing to them, and then finding some smaller sizes. Just buy what you need to get by for a while until you need a smaller size. It was like a treasure hunt or an adventure for me. I found some places like Goodwill that had brand name label NEW clothing that the local stores gave them. I found some great deals at these places. So consider doing something like this or getting together with some of your friends and trading clothing. I also donated a lot of mine for a tax deduction to nonprofit organizations that give tax receipts—it is really great when it is tax time rolls around and I had all these deductions. I would make a list of everything I was going to donate and how much weight I had lost. I kept that all together in case the IRS asked why I gave away 20 some dress and 10 pair of pants, and 30 tops! Make sure that you go see your Primary Care Doctor when you have had WLS if you have gone outside of the US for your surgery. I went to see my PCP before I went to let her know what I was doing—I wanted a doctor who would support me in my efforts. I had to do a bit of education and after she had time to read all of the information I left her, she was behind me all the way. She said come back in to see her after being home for 2 weeks and she would check me over and run a blood panel to see how I was doing. She did this every month for a while and started taking me of meds that I no longer needed. I did need to start taking potassium—mine was low after having WLS and I knew this when I left Dr. Aceves—they had run a blood panel after I had my “Sleeve surgery.” I loved the fact that my PCP took me off 4 of my other medications within 3months of me having WLS. Exercise is important for you in a lot of ways. Walking and swimming are the ones that work best for me. I know that there have been a few people who said they did nothing. Walking helped me lose a little faster and was good cardio too. I try to walk at least 4 or 5 times a week. When I can I try to swim on the days I don’t walk. I know at first it is difficult to start to exercise, but walk around your home then, down the block a little. When the weather is bad—I live in Oregon and we have a lot of rain, we walk inside the Mall during those times. They open up the Mall at 6:00 am where I live, so you can start early. Buy a used treadmill and see if you like walking on it. My last words of wisdom are the following Saying yes means you will do something new, meet someone new most likely and make a difference in your life. Be true to yourself. It is you, your authentic self, the one you were in the first grade, before you leaned to massage your personality into a form that would suit others. Sometimes it is hard to hear the message because of all the external voices and they are so loud. Voices that are loud are always meant to bully. DO NOT BE BULLIED. So carry your courage in an easily accessible place. Be your OWN authentic person when it comes to Weight Loss Surgery. This is ALL about you and NO one else. Last you don’t need the approval of the Bully. You know what is right for you, follow your heart and go for it. I am always here if you want to ask me more questions, or I didn’t cover something that you are thinking about.I read my E-mail daily. I know it is a BIG step to take and there are a lot of things to think about, you can and will be success.

I've read so many times in various threads about people eating super low calories, and it always worries me. And also high fat, high Protein, low carb diets... I wanted to post about the dangers of very low calorie diets and of high fat/protein low carb diets, so here is some info and the sources it comes from: "When you want to lose weight, a very low-calorie diet can seem attractive. After all, the sooner you lose weight the better, right? Well...no, that's not right. Eating fewer than 1000 calories a day can, at best be a short-lived attempt at dieting, at worst it could be a recipe for long term health problems. Your body is not designed to function well on a very low calorie diet. In fact, it goes into starvation or famine mode and tries to preserve essential functions at the expense of the less essential ones. So what happens to your body on fewer than 1000 calories a day? Your metabolism slows down to conserve energy. Your body uses blood sugar, made from carbohydrates, for fuel just as a car uses gas (petrol). Without blood sugar, the brain and central nervous system, as well as other bodily systems, will cease to work efficiently. To try to counteract the lack of blood sugar from carbohydrates in the diet, your body will break down fat, which is what you want, but it will also breakdown muscle and other lean body tissue. Losing lean body tissue can be very dangerous. Even organs can be broken down to use as fuel. Losing lean body tissue can also be counter-productive. Muscle tissue increases the resting metabolic rate. With reduced amounts of muscle, your metabolism will slow. When you come off the diet, increased fat cells will form because your metabolism is slow and so your body needs less blood sugar for fuel. It is also a survival mechanism in case of another 'famine'. With very low calorie diets, an imbalance in minerals and electrolytes can occur, which can be dangerous. These govern the balance of fluids in the body allowing nerves and muscles to function. Osteoporosis can be another danger, especially for women. Often dairy products like eggs, milk and cheese are cut out of a very low calorie diet so cutting out a major source of Calcium leading to loss of bone mass. Anaemia (a lack of Iron in the blood) can also be another risk. If taken to extremes, women can find that menstruation (periods) becomes irregular or stops altogether. A lack of serotonin in the brain can be another problem which leads to clinical depression. You might find that the lack of essential nutrients on a very low calorie diet leads to a deterioration in the condition of your hair and nails. One of the great dangers of this kind of dieting is that you can become acclimatised to it. As your body reduces some of its functions, including those of the brain and nerves, and as depression takes hold due to a lack of serotonin, you can slip into anorexia nervosa - a truly life threatening condition. As mentioned above, when you finally come off this diet, you will almost certainly regain all the weight you have lost plus more leading to yoyo dieting, now believed to be dangerous. Altogether, very low calorie diets are a danger to physical and mental health. They are counter-productive and can lead to long term problems as well as a lifetime of yoyo dieting. It is far better to lose weight safely and slowly on a sensible diet." (source reference: http://www.allinfoaboutdietsnutrition.com/index.php?page=21 ) "Low-carb/high-fat diets pose dangerous health risks and may increase the risk of contracting serious chronic diseases. Studies have linked extreme low-carb/high-fat diets to an increased risk of developing certain disease states, including: • Alzheimer disease • blindness and macular degeneration • some forms of cancer • cardiovascular and heart disease • c-reactive protein/inflammation • metabolic syndrome and insulin resistance • osteoporosis • kidney stones This is due to increased levels of saturated fat and dietary protein in the diet, with inadequate nutrition coming from plant-based phyto-chemicals. [/url]Low-carb diets may increase the risk of birth defects and childhood cancers. Bread, Pasta, Breakfast cereals and orange juice — foods that are “off-limits” in a low-carb diet — are fortified with folic acid, a micronutrient essential to the neurological development of fetuses. The U.S. food and Drug Administration currently requires that enriched grain products be fortified with the essential Vitamin folic acid (the synthetic form of naturally occurring folate, or vitamin B-9, found in many leafy green vegetables, fruits and legumes). Since the fortification of grain-based foods with higher levels of folic acid, beginning in 1999, there has been a remarkable 19 percent drop in neural tube birth defects in the United States. Followers of a low-carb diet do not receive the benefits of folic acid fortification. Low-carb/high-fat diets are not more effective for weight loss. According to studies published in the New England Journal of Medicine and the Journal of the American Medical Association, there are no significant differences in weight loss between low-carbohydrate diets and conventional weight-loss plans. The study published in the Journal of the American Medical Association (April 9, 2003) reviewed studies of low-fat diets conducted between 1966 and 2003, and found that weight loss from low-carbohydrate diets was associated with length of diet, pre-diet weight, and the number of calories consumed, but not reduced carbohydrate content. The study published in the New England Journal of Medicine (May 22, 2003) found greater weight loss with a low-carbohydrate diet than a conventional diet during the first six months, but no significant differences in weight were observed after one year.1 Low-carb diets are perceived to be effective because of the rapid, initial weight loss. However, the weight loss is primarily due to the loss of muscle glycogen and Water — not body fat. Loss of muscle glycogen can result in lethargy and fatigue.1 Foods high in carbohydrates, such as fruits and vegetables, are generally more filling — more “bulky” — than foods high in fat, and less prone to overeating. Foods high in fat can increase energy intake (calories) because they are more energy dense, not as “bulky,” and taste good, leaving eaters desiring more and making it easy to over-consume them. A lifestyle that is high in high-fat foods and low in exercise can lead to weight gain. Carbohydrates, such as pasta, do not make you fat. Consistently overeating calories— whether they’re from carbohydrates, fat, or protein — will make you fat. The only genuine, time-tested principle of healthy, long-term weight loss is to take in fewer calories than your body burns. Low-carb diets may cause cognitive difficulties. Carbohydrates are the only source of fuel that the human brain — the most energy-demanding organ in the body — can use. Muscle cells can burn both fat and carbohydrates, but the brain does not have the “machinery” to burn fat. Depriving the brain of carbs means depriving it of energy — and the shortfall can affect intellectual performance, such as memory and cognitive processing.1 Once the body’s glycogen reserve is exhausted, the brain ends up using ketones, a by-product of the breakdown of fat. Ketones are not the optimal energy source for the brain, and their increase in the body has been shown to impair mental judgment.2 Low-carb diets can make people — especially women — short-tempered. A new study at the Massachusetts Institute of Technology found that the brain produces serotonin — which regulates moods and emotions — only after a person consumes sweet or starchy carbohydrates, in combination with very little or no protein. A shortage of serotonin can lead to mood swings and depression. Eating a healthy pasta meal encourages the brain to make serotonin; eating a steak actually stops it from being produced.3 A Healthier Choice According to the American Dietetic Association, the voice of nutrition in America, there are no good or bad foods — only good or bad diets. At “Healthy Pasta Meals,” a recent Barilla-sponsored conference in Rome, Italy, a team of 38 nutrition scientists from around the world concluded that the “Mediterranean diet” is an excellent choice for maintaining overall health. The Mediterranean diet includes abundant plant foods (such as vegetables and pasta); olive oil; dairy products; fewer than four eggs weekly; fish and poultry in low-to-moderate amounts; red meat in low amounts; and wine with meals, in low-to-moderate amounts. A 2003 study in the New England Journal of Medicine found that the Mediterranean diet reduces the risk of death from heart disease and cancer.4" Low-carb/high-fat diets pose dangerous health risks and may increase the risk of contracting serious chronic diseases. Studies have linked extreme low-carb/high-fat diets to an increased risk of developing certain disease states, including: • Alzheimer disease • blindness and macular degeneration • some forms of cancer • cardiovascular and heart disease • c-reactive protein/inflammation • metabolic syndrome and insulin resistance • osteoporosis • kidney stones This is due to increased levels of saturated fat and dietary protein in the diet, with inadequate nutrition coming from plant-based phyto-chemicals. Low-carb diets may increase the risk of birth defects and childhood cancers. Bread, pasta, breakfast cereals and orange juice — foods that are “off-limits” in a low-carb diet — are fortified with folic acid, a micronutrient essential to the neurological development of fetuses. The U.S. Food and Drug Administration currently requires that enriched grain products be fortified with the essential vitamin folic acid (the synthetic form of naturally occurring folate, or vitamin B-9, found in many leafy green vegetables, fruits and legumes). Since the fortification of grain-based foods with higher levels of folic acid, beginning in 1999, there has been a remarkable 19 percent drop in neural tube birth defects in the United States. Followers of a low-carb diet do not receive the benefits of folic acid fortification. Low-carb/high-fat diets are not more effective for weight loss. According to studies published in the New England Journal of Medicine and the Journal of the American Medical Association, there are no significant differences in weight loss between low-carbohydrate diets and conventional weight-loss plans. The study published in the Journal of the American Medical Association (April 9, 2003) reviewed studies of low-fat diets conducted between 1966 and 2003, and found that weight loss from low-carbohydrate diets was associated with length of diet, pre-diet weight, and the number of calories consumed, but not reduced carbohydrate content. The study published in the New England Journal of Medicine (May 22, 2003) found greater weight loss with a low-carbohydrate diet than a conventional diet during the first six months, but no significant differences in weight were observed after one year.1 Low-carb diets are perceived to be effective because of the rapid, initial weight loss. However, the weight loss is primarily due to the loss of muscle glycogen and water — not body fat. Loss of muscle glycogen can result in lethargy and fatigue.1 Foods high in carbohydrates, such as fruits and vegetables, are generally more filling — more “bulky” — than foods high in fat, and less prone to overeating. Foods high in fat can increase energy intake (calories) because they are more energy dense, not as “bulky,” and taste good, leaving eaters desiring more and making it easy to over-consume them. A lifestyle that is high in high-fat foods and low in exercise can lead to weight gain. Carbohydrates, such as pasta, do not make you fat. Consistently overeating calories— whether they’re from carbohydrates, fat, or protein — will make you fat. The only genuine, time-tested principle of healthy, long-term weight loss is to take in fewer calories than your body burns. Low-carb diets may cause cognitive difficulties. Carbohydrates are the only source of fuel that the human brain — the most energy-demanding organ in the body — can use. Muscle cells can burn both fat and carbohydrates, but the brain does not have the “machinery” to burn fat. Depriving the brain of carbs means depriving it of energy — and the shortfall can affect intellectual performance, such as memory and cognitive processing.1 Once the body’s glycogen reserve is exhausted, the brain ends up using ketones, a by-product of the breakdown of fat. Ketones are not the optimal energy source for the brain, and their increase in the body has been shown to impair mental judgment.2 Low-carb diets can make people — especially women — short-tempered. A new study at the Massachusetts Institute of Technology found that the brain produces serotonin — which regulates moods and emotions — only after a person consumes sweet or starchy carbohydrates, in combination with very little or no protein. A shortage of serotonin can lead to mood swings and depression. Eating a healthy pasta meal encourages the brain to make serotonin; eating a steak actually stops it from being produced.3 A Healthier Choice According to the American Dietetic Association, the voice of nutrition in America, there are no good or bad foods — only good or bad diets. At “Healthy Pasta Meals,” a recent Barilla-sponsored conference in Rome, Italy, a team of 38 nutrition scientists from around the world concluded that the “Mediterranean diet” is an excellent choice for maintaining overall health. The Mediterranean diet includes abundant plant foods (such as vegetables and pasta); olive oil; dairy products; fewer than four eggs weekly; fish and poultry in low-to-moderate amounts; red meat in low amounts; and wine with meals, in low-to-moderate amounts. A 2003 study in the New England Journal of Medicine found that the Mediterranean diet reduces the risk of death from heart disease and cancer.4" (source: http://www.barillaus.com/Dangers_of_LowCarb_Diets.aspx ) Take care of yourselves! and research the effects of your choices!!! XO Leila

Lol i think we all worry about hair loss..im only 12 days out and doing great with no hair loss yet but they say you dont really start to loss it unitl between 3 and 6 month mark..great right in time for summer ill be bold lmao! And as far as the pain goes (for me anyway) was less then a 3 on a scale of 1 to 10..i was shocked when i woke up from surgery and only felt a little sore since im a big wennie and hate anything that has to do with pain lol. I think you will do fine. Good luck

Wow! Thanks for this thread; I haven't experienced any hair loss, but I've been worried that I might. Honestly, I'm fairly vain about my hair. I have almost buttlength red hair that I take very good care of. To be honest, it's been a little fear in the back of my mind... of course I'd be bald if it meant infinite health forever, so if it does happen I'm willing to deal with it. Thanks for the information about GENESIS, I am going to look it up.

This has been one of my big worries - I have thin hair to begin with! I did start taking 10,000 IUs of dissolving Bioten every day about 2 months ago, and I've already seen a change and I don't have surgery until Dec. 2nd! I don't see hair loss other than a couple of strands daily, and my hair actually started growing new strands and the worse part is I fight the 'fuzzies' constantly...but I'm ok with that CJ

I am a year out from being banded I did experience hair loss and I don't have a lot to lose! lol It was about 5 months out. My Dr. said it was a reaction to my weight loss and body changed taking place as a result of losing weight. I take hair vitamins and make sure I get my protein in no less that 60 more like 80 gms a day. Do ot worry, it is worth it in the end. My hair is coming back and is thicker than it has been since I had my children a long time ago. I am 59 and don't hav those hormones anymore. Relax and enjoy this new adventure!

I read it as you’ll need to take the multi vitamin & also take the calcium (because of the plus sign) but you don’t need additional B12 as it is included in these meds (the recommended multi). The bad news is if you are one of those who will lose extra hair after surgery, you can’t do anything to stop it. Worrying about it will likely only make it worse - you don’t need additional stress. Remember we naturally regularly shed hair. After the stress of the surgery & the dramatic change to our diet, our natural hair loss cycle is accelerated. So the additional hair you lose was always going to be shed. Your new growth is still occurring but just at its usual rate. The hair on your head is dead & nothing can save that. All those vitamins & supplements that promise hair growth may do is help your new hair growth. Just like fertiliser won’t stop dead leaves falling off a plant but may help with new growth. Same with your nails. Once you get to your maintenance point & you’re eating larger portions & a more balanced diet, everything settles again. Even your face, which may look more drawn for a while, settles too. Your healthier diet will bring a lot of benefits to the quality of your skin, hair & nails in time too. Vitamins can be very expensive but it may be better to start with the higher quality recommended ones to begin while your diet is most restricted. My surgeon, dietician & pharmacist all told me that the vitamins kept behind the counter at the pharmacy are always the best quality in purity & quantity of ingredients. Apparently this applies to all over the counter meds. If they keep certain meds behind the counter buy those. All the best with your surgery & recovery.

Ok so im worried about this whole hair loss thing. I dont know what Id do if I lost my hair call me vain. Id freak out. My nut says if you get your protein in I should be fine. Anybody have any expierence with this, advice, comments?

Oh my...I feel for you Sarah! I'm having the same problem. I had thinner hair to begin with so every time I shower and comb my hair and see those hundreds of strands of hair, I get worried. I'm trying to increase my Protein but it's hard. I'm going to look into Biotin (I'd also heard about that from someone else) and protein "bullets." ?? Off to do some Google research. Funny note - back when I did the Atkins diet - High Protein - I also had hair loss like this. So I'm not convinced it's b/c of lack of Protein. As I understood it it's a reaction to weight loss in general not a specific lack of nutrients. I'll have to read about it again. I need to do something - I really should be wearing a hair-net in my own kitchen - I'm shedding like crazy!

Hi all, I had my first fill today as the topic title states lol It was on Wimpole Road, London... by Fredrick, one of the consultants when I had my operation. Surprisingly it was not as uncomfortable/painful as I thought it would be... i was bracing myself for pain! I even tied my hair up........ but by the time I could complain about him pushing my belly to find the port it was done! I then had to drink a cup and a half of Water and was fine, and off I went back to Moorgate for work (I went during my lunch break). I must say I am really exciting for the future even more, the weight seems to be coming off pretty sharp... people are starting to notice it and I am slowely starting to notice my face and in general my back and stuff getting smaller.... Still a long way to go... but no where near what I was 4/5 weeks ago.... Soooo back on the liquids for two days... hooray soups! (not!) I totally hate Soups... BUT it is just for two days and at least it will kick start some more weight loss... I am a bit worried to eat after my first fill... because this morning before my first fill I got slightly brave and decided to eat a bacon roll from PRET! Never will I do that again, I have never felt such panic in my life... my chest went tight and everything! (I wasnt sick!) but it did take ages to go down and I was thinking this is what that 'i-didnt-chew-my-food-properly' feeling must be. I will not be eating that bacon roll again! lol In regards to gym... June 2013 banders, have you started yet? The aim is to start on this coming Monday... What are you finding works for you, what type of cardio? I was thinking of signing up to the race in Hyde Park in Octover for the British Heart Foundation.... Anyone doing any sports charity events this summer in London? Love Elisa x p.s. sorry about the awful punctuation, grammar etc.

Whether to tell or not is personal decision, just like the decision to have WLS. Do what feels best for you. I was a teller, because I'm comfortable with that, wanted to share the word about WLS, and worried my friends and family would think I had a terminal disease when I started dropping weight rapidly and my hair thinned. But that's me! If you decide to not tell, think of contingency plan for how to handle direct questions after weight loss begins and if someone you did tell blabs to others. If you decide to tell, think of responses for those that make comments about your choice, from those you care about most to near strangers. Be prepared, some comments will be nice and come from a caring place and it will vary from that to downright mean for some. Best wishes on your journey, Lynda Lynda

Okay I met my surgeon in June and told I should lose about fifteen to 20 pounds. However I been told that around four month out you can experience hair loss. I was thinking about getting a weave since I am worried about using heat and chemicals. I was thinking about getting it prior to surgery. I got keratin treatment done in now but I won't get it back in at least maybe next year since it a chemical. I thinking telling my stylist not make the braids too tight. What do you think or do any suggestion? I won't look right with a afro. I was thinking getting a weave anyway

I had the band placed in Sept. and have been really worried about how much hair I have been losing. to the point where I would go 3 days without shampooing because I couldn't deal with the clogged drain and the hair that I pulled from my brush. And if I ran my hands through my hair I would get 10-20 strands each time, all day long. and my pillowcase would be covered when I woke up. I do have to say that it is slowing down. Yesterday when I washed it I only had 3 strands come out and about 20 in the brush. When I run my hands through now I get maybe 2, sometimes none, and no hair on my pillowcase for the past few nights. I have always gotten enough protein and the Dr said it might have been my gallbladder which could have caused some of the loss but since my surgery last week I see a great improvement. I always had thin hair, but alot of it, now I have 1/2 of what I had before and it is thinner. I don't see the new short growth yet but it's early. I do have to say, that no matter how many people on these boards reassured me that it would grow back, I was still not a believer and it really was worrisome.

One thing that has really surprised me with my weight loss are the responses from other people. I don't expect compliments from anyone, as a matter of fact I feel a little uncomfortable when all eyes are on me! However, I have noticed that when people have noticed you are losing weight they are one of 2 things: 1)They go OVERBOARD with compliments . 2)They say NOTHING AT ALL & kindof act uncomfortable around you. My hairstylist is a beautiful, large woman. I've been going to her for over 2 years. We have become good friends. When I originally told her I was having WLS, she seemed pretty supportive & asked lots of questions. However, as I've successfully lost the weight, she has been different. She's just kindof stand-of-ish. This last time I got my hair cut, a woman came up to me & went on & on about how much weight I'd lost & how "great" I looked.....etc. She said to my hairstylist - "Doesn't she look good?" My hair lady responded with a shrug & said- "Oh yeah, I noticed." When I went to the front to pay my bill, the front desk lady whispered to me - "I think she's a little jealous of you. I wouldn't worry about it." Now that I think back, I have had several people who have responded to me in a similar fashion. One of my sisters does not say a word about my weight loss while my other sister can't stop with the compliments. I teach piano lessons & see the students mothers once a week. Some of them hug me & tell me how proud they are of me & others are so quiet. These are all people that I knew very well & had good relationships with. What responses have you noticed from others?

@@April4 good news bud many people feel miserable, have problems lots of people post that they feel terrible, miserable with problems posts about vomiting, gas, being very tired, no energy, constipation, diarrhea, neck hurting, hair loss, Protein shakes, not losing enough weight in a quick period of time, other people doing better than they are plus many other things people (me) ;)also enjoy talking about their NSVS's (non sleeve victory) health tremendously improving no need for certain meds like diabetes, high blood pressure, CPAP getting on an air plane not needing a seat belt extender feeling like the airplane seats have gotten bigger truth is you've gotten smaller being able to sit in between 2 other people on the plane being able to walk better fitting into smaller size clothes (clothes shopping is a frequent wonderful discusssion) being able to walk past a long mirror at Kohl's and not cringing being able to sit at a booth sitting at that booth with room between your stomach and the booth not worrying that you might break a chair putting your seat forward in a car - because you don't need as much room crossing your legs tying your shoes feet getting smaller realizing you have a collar bone confidence going through the roof being able to go out amongst people not feeling self conscious more things i can't think of my memory didn't improve with weight loss people (me) feeling happy what is wrong very with that guess who have enjoyed the above happening them just a few things that you can look forward to as far as the good we have found - we need to talk about that too but that is more fun!! i'm reallllly glad you like the sleeve you are losing weight you will continue to lose more weight for the rest of your healthier, happier, longer, life who deserves it more you will like experiencing the above too bad stuff does happen that we need to talk about but the good - is very good i might have made my point much earlier and kept talking sorry, don't know when to shut up sometimes still friends hugggggs good luck kathy

My suggestion would be to just buy the wigs and don't worry about it. It will come back. I did the whole Biotin thing big time starting about 3 months out. At the 6 month mark, it started coming out crazy. My solution was to basically shave my head. It has since come back fine and dandy just like it was pre-op. So, the hair loss is a temporary thing and you will stress yourself out (causing hair loss) if you think you can change it.