confused about restriction

[Oregondaisy 2,020]

Syrah, is there any way you can use a larger font? I like this thread because I am trying to decide if I need to get a fill or not. I am really having trouble reading your posts.

I can't decide if I can handle another fill. I wish I knew the answer. It scares me so much after reading what happens when we are too tight. Sometimes I think I need one, and when food gets stuck I think I will never get another one.

[Syrah 0]

Sorry Denise! Is this better? It looks fine on my screen. What browser are you using? Try Internet Explorer...

I am probably not a great person to answer questions about fills. I've only had one and have not had a lot of restriction, but others here may have some great advice.

[anonemouse 1]

The procedure may be becoming quite common, but that doesn't mean that all surgeons are equally experienced with it. Seriously, if you were having heart surgery, would you rather have a surgeon that's done 15 of the procedures, or one that's done 1500?

[Oregondaisy 2,020]

Yes Syrah, that's so much better! I use firefox. My son always tells me it has built in spy ware protection and that I should use it.

I really want to lose weight, but when I hear about all the trouble people have, it makes me think I should wait. The band is supposed to get looser as we lose. At the same time, if I am not losing, how is that supposed to happen. What a dilemma.

[anonemouse 1]

Yes Syrah, that's so much better! I use firefox. My son always tells me it has built in spy ware protection and that I should use it.

Firefox rocks! Seriously, I love it. It seems to load a lot faster than IE, also.

[Syrah 0]

I guess I don't put heart surgery and lap band on the same playing field. To be brutally honest, the most crucial person in the room for any surgery is your anesthesiologist. :eek:

[Syrah 0]

I like Firefox for Macs and IE for PCs.

LaurenD, I guess I am just more laid back than some people. Where I live, I have access to a giant university hospital with world-reknowned doctors. It is one of the largest public teaching hospitals. You want to be there if you have something really dire going on, like a heart transplant or cancer. I also have access to a smaller hospital with lesser-known doctors, but who trained at the university hospital. For surgeries my kids have undergone, I've used the smaller hospital. Why? Because I don't want half-day pre-op appointments. I don't want to schedule something like a tonsillectomy 4-6 months out, when my kid is suffering. I don't want the hassle of students and residents messing with my kid for pre-op vitals, etc. Getting the best care possible is not always the best option for people for a variety of reasons, and it is certainly not universally affordable for everyone.

I wonder how many people go straight to Mexico because they assume they won't get approved? For example, Furellie weighed 206, pre-banding. Unless she's really short or has a serious co-morbidity, she probably wouldn't have been approved by insurance anyway, based on BMI.

[Syrah 0]

Denise, question for you. Are you having trouble losing, or are you just getting impatient? :eek: If you are losing 5-8 lbs / month, you're doing great.

[anonemouse 1]

I guess I don't put heart surgery and lap band on the same playing field. To be brutally honest, the most crucial person in the room for any surgery is your anesthesiologist.

But they are both surgeries. With ANY surgery, you have to balance several factors. Cost, surgeon's experience, convenience, etc. For many people, the experience of the surgeon wins out. Not everyone lives close to a world-class hospital. Many people probably figure that if they are having to travel to get to an experienced surgeon anyway, they might as well travel to Mexico and use the most experienced surgeons in North America.

Yes, cost is a factor. The fact is, some people either can't get approved by their insurance company, or their insurance company will only partially cover the surgery (as in my case), or they have an exclusion. And, some people just don't want to take the time to fight for approval. Some people decide that they are willing to pay for the most experienced surgeon available. You'll find, though, that many people took out loans, borrowed money from relatives, or saved for years to go to Mexico.

When someone is messing around with your internal organs, you don't want it to be someone that, based on the band manufacturer's policies, is barely qualified to do the surgery. Believe me, I am very laid back, but not when it comes to my health. I don't want to put my life in the hands of a surgeon that has a high complication rate and I don't want to put it in the hands of one that isn't that experienced. To me, it would be like asking an eye surgeon to perform a heart surgery on me.

[mabunga24 2]

Back to the original frustrations about lack of restriction, maybe this will help.

After I was banded, I wondered what restriction would be like. I didn't feel it after I was banded. I didn't feel it after my first fill...or my second. I was so down on myself about my bad behaviors with food. Then I got my third fill, and my food seeking behaviors just stopped. My cravings just stopped. I was free. I found my sweet spot. It happens. But you have to keep pushing for fills until you find it.

But I also had another experience in my journey. There came a time when I thought I needed another fill. I went and the fluoroscope said my pouch was dilated. So I was feeling like I could eat anything again! Pouch dlation happens, often without it being your fault. Well, I thought I had ruined the surgery! The fill center said to go back on liquids for 3 days to give the pouch time to shrink. And to do a few minor changes in behavior. And if that didn't work, they'd do a bit of an unfill to let it go back to the right size. But it worked. 3 days later I was feeling good restriction and my food seeking behaviors went away.

So here's my third story. Now as an old bandster of 6 months, I have some food seeking behaviors and have had some of my old bad habits reappear. But now, I have tools. I have restriction. I have 6 months of experience with the band. I know that when it happens, I need to go back to basics. I write down everything I eat, how I eat, my exercise...for a few days, and I'm back on track. Or I up the exercise, change the food, slow way down while eating....anyway, change is possible now and never before in my life. I'm becoming a mature bandster.

All of this is to say that it is a lifelong journey and very individualized. If it isn't working, don't be passive. Work it and fight being dicouraged. That discouraged feeling is just a leftover from the old days of feeling hopeless. It doesn't apply now. go after answers. And know that the answers next month may be different from the answers this month. Go for it.

Betsyjane- Thank you for your post and sharing your experience. I do feel like I am where you used to be...I have had my second fill and don't feel any restiction. I will go in for my third in a couple of weeks. I do have a question though about the dialated pouch that you mentioned. This happened AFTER you found you sweet spot? Do you know what caused your pouch to dialate? Besides 3 days of liquids...what other behaviors did you change?

Thanks!

[Syrah 0]

But who is "barely qualified," in your opinion? Is that a common problem among people who are banded in the US? Because if so, I am not aware of that. Is there some evidence that all US surgeons have high complication rates and lack the basic skills? Again, I am not aware of this problem on a large scale, based on my research and on my reading here.

My understanding is that there is a very rigorous training period (and required certification) for lap band surgeons, and that several prominent Mexican surgeons have been very involved in training their US counterparts.

Again, I compare this to hauling your kid to Johns Hopkins for a tonsillectomy. Not gonna happen, lol!

[Syrah 0]

<p>By the way, I do live near an excellent hospital, but I actually had the surgery 60 miles away in a regional, rural hospital that has a long-time niche for performing bariatric surgeries on people from around the midwest. Ths place only recently started lap bands, as my state's BC / BS did not routinely cover it, but the lap band surgeon has done tons of such bands on patients in another state, where he practiced with a surgeon friend. </p> <p> </p> <p>The large tertiary care hospital in my town only does the RNY surgery.</p>

[anonemouse 1]

But who is "barely qualified," in your opinion?

Barely qualified is, to me, anything less than 100 surgeries. Even Inamed doesn't consider surgeons that have performed under that number to be "experts."

My understanding is that there is a very rigorous training period (and required certification) for lap band surgeons, and that several prominent Mexican surgeons have been very involved in training their US counterparts.

According to Inamed, surgeons only have to perform 3 band surgeries before they are certified.

[Syrah 0]

Why on earth is Inamed certifying surgeons who they don't consider to be experts?

[anonemouse 1]

Why on earth is Inamed certifying surgeons who they don't consider to be experts?

Because all surgeons have to start somewhere. To me, it is like a doctor learning a a teaching hospital. When they leave that hospital, they may be rudimentally qualified to perform any number of surgeries, but that doesn't mean that they are the surgeon you would want operating on you. Or you can think of it along the terms of a nurse. When a nurse passes her qualifying exam, she's a nurse. She's as much a nurse as someone who's been a nurse for 20 years. But there is a massive difference in the amount of experience. Would you really, truly want a brand new nurse treating you, one that hasn't necessarily learned all the little tricks, rather than a nurse that's been in the business for 20 years?