Hello New Friends,

My name is Sara. I got the band in 2003 in Mexico and liked it too tight. I lived on liquids and tiny amounts of food, which caused sliming and puking every day for years. I lost 100 lbs in the first year and slowly regained it all with liquid calories. My band was so tight and I ate a quantity of food that caused esophegial stretching. So my lower esophogus has become a pouch that stores food until it makes its' way through the band. I have now had all fill removed and the gastro surgeon in my doc's medical group wants to remove the band but he says I would not succeed with a sleeve revision because the ways I cheated with the band (liquid calories) I can also cheat with the sleeve-- mochas, wine coolers, ice ream, etc. So he will not approve me for further surgery. Also, of that hundred pounds I've lost 70 lbs again, by using Alli daily for 3 years, so my BMI is too low for insurance to pay for WLS for me.

Do you agree I am not a good candidate for the sleeve? I am having an upper endoscopy in a few weeks to see if there's any tumors or cancerous disease process in the esophagus. Then the surgeon wants to remove the band and thats it. No more surgeries for me, according to the surgeon. Do you agree?

I'm thinking about going back down to Tijuana in 6 months, so my anatomy has time to rest after the band's removal. I'd like to give it another shot to do it right with the sleeve. Eat protien first, then veggies. No abusing liquid calories. I'm ready to try to obey all the sleeve rules for success if my stretched esopgegus can tolerate and not sabotage my new sleeve. What do you think? Please be frank. I need the truth, even if it's ging to sting when I hear it.

Thanks, Sara

Talking from the perspective of a therapist, I would advise that you get some counseling to help with your triggers to cheat on your diet. Our thoughts lie to us and we are our own worst enemy in which I present as evidence you case with the lap-band. This might be a good time to get started on eating healthy by eating a high protein low carb diet to get started. Make this habit along with seeing a therapist for food related issues. We all experience a lot of head hunger but you need different coping skills to deal with these issues. We all have a food addiction that sabotages our efforts at changing our diets and exercising.

Thank you Dorrie. I have begun to do just that. The surgeon who will remove my band has required everything you mentioned and he has personally hooked me up with all these resources in my community and the large medical group he is part of. I would only pursue the sleeve after 6 months of eating healthily in reasonable quantities. Do you know if my stretched esophagus would make a sleeve revision not work for me or is it a potential tool for me in the future?

Thank you,

Sara

Sara - there was a question I wonder if you would answer - were you taking only what you are supposed to of the Alli? Have you developed any eating disorders?

Dorrie had a wonderful answer for you.

I would say a concern for you from me is def the cheating - because that will set you up to fail. Another serious issue. Crossover replacements for your foodstyle...they are known as addictions. Alcohol, smoking, weed, cutting, and replacement "feeling" (I forget that one - help me out Dorryie!).

Going to a counselor is OK - but what then - do you actively work on what you have talked about? Do you read on your own? If you were not taking a diet aid, could you maintain your loss?

The esophogeal stretch may be a way to get some of it covered by insurance, even if they will not approve the sleeve.

Replace the mochas with a coffee, or warm up and froth a glass of hoodia soy milk in chocolate or a spash of coffee. Popscicles are good, Jello too! If you cantr get away from alcohol, make a jello shooters, freeze them, and blend them in a blender with some crystal light you have poured into ice cubes.

Get onto My Fit Pal, get to know the site well, it will help you alot.

If you find yourself off the band, still go to therapy, and prepare yourself to do this old-style until your esophagus and tummy can heal - get the original "eat this, not that" book, and feel free to stick around the forum. There is alot discussed here, not all VGS related, and you can build up a healthy bit of knowledge.

Notice I did not say yay or nay about whether you should get the sleeve...I cant make that decision. Whatever you go, I hope you work through everything and are well.

I talk like I am telling you what to do - it is just my nature, I only intend them as suggestions...

I agree with Dorie that therapy is a great idea, for anyone with food issues, not just you in particular. I also think that you will have a tough road because you did actively cheat the band, BUT, and it's a big one, you were also dealing with too much restriction to be able to eat properly. I "think" there might be a mitigating factor in there because of the tightness of your band. The sleeve would allow you to eat without that over-restriction that the band seems to cause for a lot of people. I think you should discuss that issue with both your surgeon and your nutritionist.

However, I'm still worried by the fact that you were good enough at cheating the band to regain a lot of weight. That says it was a lifestyle choice for you, not just a way of compensating for lack of food. I dont' know whether a sleeve would work for you or not with that history. You're going to have to go to some lengths to convince your surgeon and therapist that you're truly ready.

As you already know, WLS is ONLY a tool. It's not a magic solution, but it is a powerful tool if used correctly. I say it all the time, they don't operate on our heads, just our stomachs. If you're active on the LBT forums, you may recognize that I've stolen and changed Papa Jack's theme!

Good luck! I hope that you do work out the issues so that you can move forward.

Dear Pokieism,

You ask so many good questions that I'm going to cut and past your questions and then give you very honest answers so I can keep it all straight.

Sara - there was a question I wonder if you would answer - were you taking only what you are supposed to of the Alli? I did take more than the recommended doses. I took the dose doctor's prescribe when writing an Orlistat prescription, which is more than the over the counter recommended maximum. Overdoing is a lifetime pattern for me. All things to excess, nothing in moderation.

Have you developed any eating disorders? I am addicted to Frozen pineapple on a stick from Dryers. I credit it with the 30 pound weight loss during the last 2 years. I make my main meal of the day lunch and then replace dinner with Dryer's Pineapple Pops. I stopped keeping ice cream in the house 2 years ago and go through 9 boxes of Pineapple pops a week--that is addictive behavior because many times a day I'm grabbing a Pineapple Pop give give my mouth something to do when the people around me are eating meals or when I'm feeling weak and might eat something with fat calories if I didn't keep the pineapple around.

Dorrie had a wonderful answer for you.

I would say a concern for you from me is def the cheating - because that will set you up to fail. Another serious issue. Crossover replacements for your foodstyle...they are known as addictions. Alcohol, smoking, weed, cutting, and replacement "feeling" (I forget that one - help me out Dorryie!). Yes, in the first 5 years of my band I did develop addictive behavior with wine coolers. The band was tight, and I would skip solid food and drink wine coolers after dinner. I was never a drinker before I got banded and one night I was watching an Oprah after work enjoying my dinner ---a 6-pack of Green Apple Smirnoff's Vodka Coolers. The topic of the show was people who got WLS who developed alcohol, sex, or gambling addictions once food was cut off to them as their go-to addiction. That was probably 2005 and even though I was at my goal weight I knew that Oprah Show was talking about me. I cut myself off from those friendly little bottles cold turkey. Now I may have one or two bottles once a month but that is all.

Going to a counselor is OK - but what then - do you actively work on what you have talked about? Do you read on your own? If you were not taking a diet aid, could you maintain your loss? If I was not taking the Alli I could maintain my weight. I credit the Alli (and walking) for the 30 lbs I've lost in the last 2 years. I did go to a counselor for several intense years and I thought our work together was completed. I am going back to her. My nature is mostly that of a loafer, a lazy person who does the minimum required to get by in the world and I make no apologies for it. I know who I am, I like living a lazy life and I don't have kids so I'm not failing a duty to children to teach them by example to work hard. I will always look for the easy way out. But when I want something I will work. When I lost weight I jogged 5 miles per day 3-4 days per week. When I wasn't jogging I was on bike rides with friends in which 200 miles cycled in a day was not uncommon. I loved it, but then had a nasty bike crash while in a pace-line and that wrecked my right knee and ended my cycling career.

The esophogeal stretch may be a way to get some of it covered by insurance, even if they will not approve the sleeve. My insurance is happy to pay for the band's removal, but with my behavioral patterns and a BMI of 32 I no longer qualify for WLS as a covered medical procedure.

Replace the mochas with a coffee, or warm up and froth a glass of hoodia soy milk in chocolate or a spash of coffee. I go to Peet's Coffee and they make a non-fat, sugar-free mocha that doesn't taste sugar-free. I get a small and that's 250 calories. That is something I enjoy and wil continue to gie myself several times per week. I don't like soy milk, or black coffee, or tea. I have tried and they are not for me.

Popscicles are good (Dryer's Frozen Pineapple Chunks on a stick) , Jello too! If you cant get away from alcohol, make a jello shooters, freeze them, and blend them in a blender with some crystal light you have poured into ice cubes. I stopped alcohol in my life because I knew it was becoming a problem in 2004/2005.

Get onto My Fit Pal, get to know the site well, it will help you alot. Never heard of it. I'll look into it. Thanks!

If you find yourself off the band, still go to therapy, and prepare yourself to do this old-style until your esophagus and tummy can heal - get the original "eat this, not that" book, and feel free to stick around the forum. There is alot discussed here, not all VGS related, and you can build up a healthy bit of knowledge.

Notice I did not say yay or nay about whether you should get the sleeve...I cant make that decision. Whatever you go, I hope you work through everything and are well. You misunderstood me. Sorry my words were unclear. I wasn't asking anyone to make the "sleeve after band with esophageal stretching" decision for me. I know that only I and a willing surgeon can do that. I offered my medical history and was asking if anyone in this forum ever got the sleeve after having a band removed due to esophageal stretching, and did it have the desired outcome.

I talk like I am telling you what to do - it is just my nature, I only intend them as suggestions...

If you don't believe you can find a way out you become the problem.

If you believe you can find a way out you have solved the problem.

I know that ultimately it is up to me to change my love-relationship with the things I put in my mouth and learn to eat for nutrition rather than comfort. I'm working with a dietician now to do that. But I also want to take advantage of the latest medical procedures to build upon my efforts. My knees are shot and my spine is shot in two places so I live in constant pain and on Oxycontin 24/7. I need to keep working at getting the weight off this body sooner rather than later and this time I'm committed to doing it right with my therapist, my dietician and my personal trainer. But I do also want to know if anyone has a medical history similar to my medical history with the band AND has benefited from an additional, newer procedure.

Thanks for your ideas and concerns. I really do appreciate them because you help me develop my own thoughts to a point of greater clarity and you help me see where blind spots in my thinking might cloud my judgement.

Sincerely, Sara

Hi Lissa, Thanks for writing. As you say, "they don't operate on our heads, just our stomachs." They are free to operate on my head too if they think that would work!! :-))

One thing though that people didn't bring up is I was in a presurgery seminar the other day and the lady was discussing the surgery with me another sleever and a banded. She told us we wouldn't be hungry but the banded person would be but just wouldn't be able to eat when hungry. I think that the lack of hunger may help you to succeed where the band failed. But that's just a thought from a pre opper I'm still new on this journey.

Sent from my Kindle Fire using VST

Hi Patrick,

Thanks for your thoughts. That's funny because I've felt like I haven't had physical hunger since 2003. I get tired, which is the symptom that reminds me to fuel the body.

For me, the band did remove the sensation of physical hunger. Prior to banding I felt that the moment I woke up in the morning I had to do battle with an inner demon, demanding that I go to the kitchen and eat huge volumes of food the moment my eyes opened!!! I always lost to the demon. The only question was "how long would it be before I found myself in the kitchen eating huge amounts of food? 9am? 9:30am, 10am, certainly never beyond 10:30 or 11am. Couldn't happen. By then the demon had won and I would spend the rest of the day binging and loathing and fantasizing that tomorrow would be the day I would beat the demon.

Patrick, the demon was gone on August 15th, 2003, when I was banded. Even with no Fluid in my band whatever restriction is there is enough so that I don't wake up craving huge piles of food before I'm even out of bed. My husband jut walked into the room and said, "Do you wanna do anything for lunch?" I thought a moment, felt no hunger desire and said, "Nah!" And that's what I say every day. I don't feel hunger ad I couldn't care less when or where my next meal is. But don't get between me and my 3:00 mocha, usually my third mocha of the day........which takes us back to those damn liquid calories that pass through bands and sleeves and bypasses with complete freedom.

No matter which WLS we chose there's no escaping personal responsibility for every caloric solid or liquid we allow to slide dow our throats.

What is the sensation with the sleeve? Is there the sensation of physical hunger? With the band if you take one bite too many it results in puking everything. And you can only know in hind-site which bite was one bite too many. With the sleeve what sensation occurs and tells you it's time to stop eating?

For me, "full" is a pressure feeling. I imagine it as being like a balloon that is over-filled. Sleevers can still slime or puke, but it seems to be rarer with us than with those who are banded. I try to eat until I'm satisfied, not until I'm full. One of the best things I learned from my nut is to measure my food. I know that I can do about 3-4 oz of a dense Protein (chicken, beef, pork), so I'll measure out that amount. It doesn't leave me "full", but I'm not hungry. If I have room, meaning that I don't feel satisfied, I'll add in a little veggie. I rarely eat carbs because they are sliders for me.

I've actually puked twice in 9 months, both times were related to eating carbs and drinking too soon after a meal. I've, luckily, never slimed. And, even when I threw up, it wasn't like it ever was pre-op, it was more like my stomach ejected it's contents and that was it.

What is the sensation with the sleeve? Is there the sensation of physical hunger? With the band if you take one bite too many it results in puking everything. And you can only know in hind-site which bite was one bite too many. With the sleeve what sensation occurs and tells you it's time to stop eating?

There can definitely be the sensation of physical hunger. I woke up this morning just 4 days post-op and my new gogo gadget tummy was angry at me because it was hungry.

Hi Lissa,

What is sliming and what are sliders. There's a band term called "PBing--Productive Burping"---which means puking the contents of an entire meal when to much food is eaten and as you say it is "more like my stomach ejected it's contents."

I'm not sleeved yet but wanted to add that you seem really open and honest with yourself. You know what your issues are and are dealing with them. I wish you the best of luck.

Sliming is more like foaming at the mouth, from what I understand. You definitely know it when it happens. Sliders are foods that you can eat without restriction because they don't fill you up. They just "slide" right on through your sleeve.

What I did wasn't productive burping, I don't think. Both times that I got sick, I had eaten bread and then took a drink too soon after eating. The liquid made the bread swell up and the contents of my stomach just came back up. There was no burping and no real drama to it... more like my sleeve hit the eject button.

To Everyone with Tijuana Sleeve doc knowledge........

Thank you Lissa and Sleeve Guru. From hearing people share their surgical sleeve experiences in the Tijuana area, who would you say are the 2 or 3 sleeve surgeons many different people have gone to for surgery and were happy with the experience AND the price? My band doc, Dr. Ariel Ortiz charges $10k for the sleeve surgery and some surgeons I don't know price it for under $5000. Who are the currently "hot" sleeve surgeons offering good service for a good price?