Hello.

I thought this was probably better placed here since what I this is closer to a Support type of posts. (My previous related thread was in the "General LapBand Discussion" forum under the heading "Oh, no, the dreaded end of the road speech...") but this one is really aimed at those interested in giving/receiving support during the bumpier parts of their band journeys. I'm going to share my story - The Good, The Bad, and The Ugly. It's long but if one is interested in what a long term Lap Bander has seen, then maybe there is something in here to contemplate about.

To summarise: My long-time LapBand surgeon "fired" me last month. He told me he didn't think I should have any more fills (ever) and that the band had done all it could for me as that I'd lost as much weight as I'd ever lose with the Band. As shocked as I was, I was trying to stay positive but my sneaking suspicion was that he viewed me as a LapBand failure and was basically trying to cut his losses. Which would be one thing, but he made no further suggestions about what should be my next step or option for managing my weight for the rest of my life. I'm at about 2.8cc of fill in my 4cc Inamed band.

I've only lost about 51# total (including some weight that bounced back after being ill), and my LapBand surgeon and I initally estimated I'd lose 70-80 lbs. Later I he revised that to an approximately 68 -75 lb loss of my excess weight which was still reasonable I thought. So my current BMI is now firmly stuck at 30 which still makes me technically obese by BMI standards. I stayed in compliance and concentrating on working to lose although I could clearly realize I was in need of a slight fill to continue to see progress.

While I struggled to figure out why he was so adamant on me not being filled anymore and what I should do next, I was shocked speechless (literally) to receive a certified letter that clearly outlined that I was "fired" as a patient. The letter was harsh and I really took it hard. But, I guess I'm taking this so hard for several reasons. It's been a long road.

Bottom line: I have now pulled myself off the floor and have taken a deep breath and started calling other surgeons in the area. Of course I felt my former surgeon was the best but I guess he thinks he's done all he can for me, and I've done all I can to make my band work. So this meant, either I accept his assessment of me as a LapBand failure and live at the same weight (or struggle to stay at that weight) or consider my other options, if I had any. No I haven't spoken with him, but I think his letter said it all. I asked for my medical records and I was justifiably miffed at how coldly I had been dismissed.

As I was waiting to get my records released (I've now gotten part of them) I was concerned about revealing too much information as I feared some sort of backlash. I am no longer afraid, and having read those detailed records have emboldened me to come out of the LapBand Failure Closet and try to 'move on', as so coarsely advised by a surgeon who posts on this forum. I have always tried to stay positive and upbeat on this forum and to try not to beat people over the head with my own band journey. But hey, I feel like I have something to share with those who may also find themselves struggling to meet their own goals or to succeed with the band. Or those who may think they eventually have to face other options to succeed. Nearly every single experience on this board is similar to something I've been through - because I've been banded nearly 5 years.

Here's the back story. Everyone has a different trigger that makes them consider drastic measures to finally lose weight. For me, it was a "self-imposed" set point of a BMI of 40. That was the dividing line I picked to be honest with myself that my years of dieting,weight loss programs and other attempts were failing. After years of yo-yo dieting, when my BMI crossed the line from 38 and approached 39 - I realized it was time to be honest with myself and get some help in fighting obesity. So utilizing my research, I got myself approved (yes, by myself, on the phone with the insurance company) for the gastric bypass. My talent is getting approved, and that's what I did. I made a clear case and received my approval letter.

Although I was definitely obese, I knew that a 70-80 pound loss would get my BMI down to approximately an upper 20's BMI. And I knew that losing that much would get me down to a reasonable, normal weight range, plus I'd look much better. With the RnY bypass, it was estimated (by various surgeons) that I would probably lose another 90-105 lbs. which would put me at the skinnier end of normal. This kind of loss was a bit more than I needed, but it would be worth it to finally have a tool for my weight loss that would finally put me in a normal weight range after a life of obesity.

After my RnY was scheduled, I went in for my PreOp appointment two days before surgery and found out that the surgeon's scheduling error had deleted me from the surgery scheduled and I could not be re-scheduled for 2 months. So I took a deep breath and considered this an omen that maybe I should consider my other options. I did a bit more research and found that a type of Weight Loss Surgery that was very popular in Europe that I knew about (I lived/studied in the U.K. for a bit) was being introduced in the States. It wasn't approved here yet. This was 2001.

There was an FDA trial for this new method, the LapBand, and one of the surgeons who had performed it in abroad in Europe, was now here in my area and doing it as part of the trial. I asked to be considered.

At my initial consult, I listened and learned about the LapBand versus the Gastric Bypass. I understood that the lack of malabsorption often meant much slower, and much less weight loss than bypass patients experience.

My surgeon advised me that although there were no guarantees, that in his estimated with the LapBand, with compliance I'd lose approx. 70-80 lbs. in 12 to 18 months after surgery. As that was closer to the weight loss target I thought was best for me, this seemed like serendipity. My surgeon also advised me that he thought I was an excellent candidate for the band and the FDA trial so I said I'd consider it.

After doing some additional research I thought this might be a good match for me, and I thought this surgeon was absolutely focused and laid out my options. I liked the fact that he had an impressive record, was well regarded in the bariatric field, and the fact that he performed both LapBand and Lap RnY bypass surgeries. I also read some then-unfinished research that said current American patients were only losing about 50% of their excess weight. This was a concern for me because with my lower weight/BMI (by weight loss surgery standards) then if I fell into that group I'd only lose approx. 40 lbs - which would be hardly worth it for such an expensive and life-changing surgery. I expressed my concerns to my doctor and he reiterated that while there were no guarantees that his own patients generally saw success closer to 75% or more of their excess weight. He agreed that a 40# loss would be disappointing and he sincerely felt I could more than that, and perhaps twice that amount. I was comfortable with his longer track record with the LapBand (he'd done more than many of the American surgeons who were learning the surgeries as they did the trial, and it was supposed that their inexperience also contributed to the slightly less successful results the study showed so far.)

After some consideration, I decided the LapBand sounded like the right tool for me. I was accepted into the FDA trial in 2001. I was determined to make this work especially since some of the other surgeon's offices I had previously consulted with for RnY - all cautioned that the LapBand was newer, experimental and would probably not help me get the weight off. I appreciated their concern but decided I'd be happier going with LapBand and just doing my darndest to make it work. And so I did.

Well I was banded and the surgery went fine. I had never had any type of surgery other than getting my tonsils out as a child so I had no idea what to expect. My recovery went well, and I resumed normal activity after a while. The FDA trial set very narrow perimeters for the surgeons working on it, but I kept as compliant as possible and was very focused. My band was completely empty (that was protocol then) and no matter how you did on the liquid/soft diet phase, you never got your first fill until you absolutely stopped losing weight. I didn't want to stop losing so I worked hard to lose weight with my limited restriction. I lost more than 40% of my excess weight and was very much on track to be a success. I watched what I ate, did not eat when I wasn't hungry, exercised and really worked hard to succeed. My post op tests showed that both the band and me were doing fine.

Within 10 weeks of my intial surgery however things took an unfortunate turn and I began complaining of what I thought was flu and muscle ache. I went to my local doctors clinic but instead I ended up being transferred within hours at the hospital's ICU department and was extremely ill. To make an already long story short, all the available tests showed my band was in perfect position, no signs of any wear or damage but yet I was getting sicker with every passing hour. I was hospitalized for weeks while a huge team of doctors attempted to figure out what was wrong with me. I got sicker and sicker and was not able to keep down any food or even Water or juice - I could only tolerate Gatorade, and tonic waters of various sorts. I had upper GIs, esophograms, and every test you can think of to have.

My LapBand surgeon was thoroughly distressed but extremely supportive and went above and beyond to help them find out what could have caused me to become so ill. He sought information from every possible source. Because of the trial, there was limited information on possible side effects of the band so eventually after much examination, a surgical reason was eliminated for the illness. (I was told I had been too sick to undergo emergency surgery to remove the band anyway, so it was left in.) I eventually got better and a very long hard recovery.

As I had been hospitalized for so long, I was unable to work and lost my $84,000 a year I.T. job and lost my medical insurance. I realized I had no choice but to get better because I couldn't afford not to do so. It was very hard to keep my spirits up but I really tried. I was told that since I recovered with the band still in, then I should probably just keep it in and try to continue to work with it unless I saw any tiny signs of recurrence of illness.

The months passed and I got back to full strength. My band was given further testing, but showed no signs of making me ill. I went for more than a year without ever having the band filled as we were all cautious about doing anything to upset my incredible recovery.

As part of the life-saving treatment I was given prescription cortisteroids medication (known to cause weight gain) which later starting reversing my impressive weight loss. Despite my best efforts and even after working so hard, I saw slow weight gain. This really got me down. I tried to be very compliant yet I saw steroid weight gain and ended up heavier then when I was before I had surgery - this was really difficult to deal with. My surgeon (and other doctors) felt my distress, and suggested that I remove my scale and focus on getting well versus losing weight - which I did.

After months turned into years of exhaustive testing, lab work, and follow ups I was given a full clean bill of health and was told I could restart my weight loss process. After so much time, I was finally allowed to have my first fill. I saw a bit of restriction but not much. I wasn't able to do very strenous exercise so I watched my calories closely. The doctors and my surgeons watched me closely but my symptoms never reappeared and I seemed to be in full recovery. My weight was a real concern for me, and the one small fill didn't seem to be doing much to help with restriction.

The following year I went in for follow up and was fully discouraged. Not only was I back to square one with my weight loss but I had another 11# to lose from the steroid meds and treatment. I debated whether I'd ever see real weight loss with the Band and whether I should be revised to another form of Weight Loss Surgery. My doctor reminded me that I'd managed to navigate the difficult road I'd been on, and suggested that I not give up on the Band yet as I hadn't had a chance to give it a normal run. Since I found it nearly impossible to get medical insurance after my illness, I only saw my doctors on a cash basis. I received no more fills.

The following year - I worked hard to lose the extra weight from the illness but still struggled. I felt virtually no restriction. I'd only had the one previous fill but the restriction I had seemed gone. I did follow ups with my WLS surgeon and he admitted he suspected there was a small defect with my band (since defects were now turning up at the 2 and 3-year point after having the LapBand surgery). It was like my weight had stabilized (with little overall loss) and this made my surgeon think that something else might be the cause of my lack of restriction. We discussed options of dealing with handling it, but I needed to get full medical coverage before we could proceed with any additional surgery. There were now newer techniques for band placement, and newer types of tubes & ports, the band was now seeing more overall success. After having been through all I'd been through, the worst part was having people look at me like "all that and she's still fat?" And I was.

It was a crushing blow to not get to see even a bit of weight loss success.

Finally it was discovered that my Band had a leak/break between the access point and tubing. Options for dealing with it were discussed and I wondered if I should just opt for a revision to an RnY bypass. No, I wasn't looking forward to getting a more severe surgery, but I was absolutely exhausted with trying to see weight loss with a nonfunctioning tool. I was still trying to lose weight, and was fighting with gaining/losing the same pounds again, just like before I ever had the LapBand. My surgeon maintained that if I'd get the repairs, he was sure I could still succeed with the Band and see the weight loss that had eluded me so far. My total net loss was almost negated - I even had to take off another 11 lbs I had gained from the steroids, so I was practically at my start point again.

Early in 2005, my access port and tubing were surgically replaced (the band itself was still in 'perfect' condition) - and my surgeon suggested I should reconsider this as a "new banding" and not just reflect on my overall distressingly long band journey. His idea was that I treat this as if I was a new post op. And to be honest, it really felt that way. I decided to try to make a fresh start and with the new restriction I felt, and I fully rededicated myself to making the band work out for me. I finally saw slow but steady progress. My post op tests and labs looked good, too. I was healthy and immersed myself in making this newer tool really work. My surgeon reiterated that he thought that 66#-70# loss was possible if we were able to keep me healthy and I revised my weight loss goal. I thought it was more important that I keep my loss steady even if it was slow. After months I saw a 20# total weight loss - it was slowly working. What relief!

The key word was slowly. The pounds peeled off at ridiculously slow speeds. At my surgeon's suggestion to better monitor my progress I stayed in constant touch with the office - and even did my bi-weekly/monthly weight ins at the surgeons office and kept them appraised (at his insistence) of any or every major change or any LapBand-related symptom or occurrence. Although my weight loss was not as fast as when I was originally banded, I decided that I would still continue to believe in the band. I was allowed to get regular fills for the first time ever and slowly my weight loss began to approach the 30# loss rate.

So after years of Band living, I was filled around the 2.5 rate and enjoyed real restriction for the first time in years. I worked with it, and even saw my BMI further down. Over time my restriction seem to cease especially as I lost a bit more weight. I had my band filled a bit more to 2.8 which did well for months, but as happens, eventually seemed to lessen. It seemed the smaller I got, the more restriction I required (I've heard some other long term veteran Bandsters talk about this and it's not that uncommon on long term banded folks.

So after struggling with the band for years I finally got some months of consecutive but very slow loss. I made incremental progress and was excited to finally see the success that others had enjoyed. I saw the loss stabilizing, my appetite and food intake capacity increasing, so I realized it was time for another fill. I contacted my doctor and scheduled an appointment as normal. He did this fill under flouro and absolutely shut me down totally. He told me that the 40# (plus the extra 11# I had to lose after my illness) that I've lost after getting the band is probably all that I'll ever lose. He insisted I looked fine the way I was (at 30 BMI? Come on...) that if I'd lost 1/2 of my excess weight then the band had done all it could do.

He no longer believes in filling bands more than 2/3 full and that's where I am. (For a person banded 5 years, being at 2.8 is not considered that radical, but that's his current belief now and he's not yielding. Even though I'm only down 40# and although we'd both said that was hardly a satisfying result, then he's now willing to cut his losses and just leave me hanging.

I was crushed (still am) but even more so when I received that certified letter. I felt like I hung in there facing things that NO ONE Banded or not, should ever have to face. When I was considering a revision, he told me I had a chance to succeed with the band. Now I'm a considered Band Failure - and it bugs the heck out of me. So although I'm not near goal, I'm basically told to "suck it up" and move on.

So for all those well meaning but unintentionally smug Bandsters who think that eroded patients or those who have suffered other complications are whiners - Wake Up! No one thinks they will be one of the ones who suffer complications, but it happens. Maybe we shouldn't collectively be quick to judge. I've seen all kinds of comments here (and other forums) and my advice is "you never know where this band journey will take you." It sounds easy to say "oh I'd never consider an RnY or VGSleeve" or whatever the Surgery of the moment is... but you don't know until it happens. I don't want an RnY now any more than I did five years ago, but although I do not believe the band has "done all it can for me" if other qualified surgeons concur with that then I'll consider what my next step will be.

I have done more to deal with, learn about and live with this band than anyone that I know. For that reason after everything I've experienced, having to both find a new surgeon and possibly embark upon a new procedure is overwhelming. It doesn't mean I'm not compliant, it doesn't mean I haven't given this tool my best shot. I deserve and hope to achieve a normal weight and normal BMI - but I do need a surgeon who believes this is a reasonable goal.

Hopefully I'll get there on the next parts of my journey - with perhaps a new surgeon and a new approach - it might happen for me too. I hope so!

But don't be so quick to judge those whose journeys are not smooth - it's not all calorie counting that makes the different in band success, as after five years I've seen and heard things that give me a different perspective.

Wish me luck - and wish luck to others who have been dealt a difficult hand. With is why I always wish Happy Band Journeys to everyone. We all know these journeys are not guaranteed, but although happy ones don't always happen, there are enough of them to make the journey seem worthwhile.

Happy Band Journeys to all.

Wow Sho, amazing journey you've had.

I know you've been through hell and back, but I would strongly recommend that you get your body fat percentaged measured.

My goal weight is 190 to 170, and I will look damn fine at 180, if I ever make it. (stupid Cushing's) But at 180, I'll have a BMI of 30 as well. But at a BMI of 30, I'll have a body fat percentage of close to 30%, which is right where it should be for a woman of my age. RIGHT THERE.

If you need help figuring out your FFM, please drop me a PM and I'll help you figure it out.

Best of luck to you Sho.

I always find it extraordinarily frightening, depressing, and disturbing when doctors give that speech (I've only had it happen once so far, knock wood!). The time it happened to me, it was because the doctor (really she was a nurse practitioner) had absolutely no idea what she was doing, and after a year a half, decided to give up instead of learning something and figuring out what was going on. I subsequently went to a different doctor who took one look at me, diagnosed me within a minute, and prescribed medicine which got me 95% better with three months, as opposed to getting NO better under the care of the NP who gave me the "end of the road" speech. Personally, I do not believe that anyone ever really comes to the "end of the road", because medical science is rapidly evolving every day. Therefor, there is no "end of the road" for any patient. Rather, the "real" definition of "end of the road" is that the doctor is lazy, unenthused, ignorant, and/or unqualified. No doctor should ever give up on or abandon a patient. The very idea is really scary. Why can't doctors just do a little bit of research, or consult with their colleagues, or look up things online? It's not that difficult! I know doctors are short on time, but damn it, we patients are worth it! I know the end of the road speech is a horrible, horrible thing to hear. But when it comes, it really just means it's time to find a different doctor. There is a doctor out there who knows what he/she is doing and can help you. It might take some searching, but there is someone out there who can solve your issues. It's so disheartening, I know, but start looking and you can find someone better. Keep us posted.

Just curious -- you seem to be focused on what the surgeon "did to you." I know I would be too, after five years. At the same time, I also know that I have issues related to rejection, as do many people who have struggled with weight. So, perhaps this experience is activating some issues for you....that are clouding the main thing you should focus on: yourself! There are so many more great band docs out there now than when you first started your journey -- and you deserve a great one!

I've had complications with my band and totally understand the frustration/anger and wide range of emotions experienced with problems. I've gone to not just one band surgeon, but three. And I "fired" my original surgeon -- with a letter, no less -- who I loved, in part because he was price gouging on fills. It was a matter of principal...and my expectations of what I deserved from someone that I am paying. WE are the customers!

Honestly, had I been as sick as you were at one point, I would have cut myself open and taken the band out myself! That you pressed on is a testimony to your great strength.

So, FORGET the surgeon. He's O-V-E-R. The why's are irrelevant. (I'm with Amy -- send him a nice note or something showing you've risen above his actions!)

Good luck and God bless.