Many Questions

[ouroborous 519]

Hi, first of all, thanks to anyone who takes the time to read this post. I have many, many questions.

First of all is the biggest one. Why WLS? I have been obese almost my entire life. There was one time period when I was not obese; I was a young man working at a very physically strenuous job (unloading semi trailers for UPS). Now, I'm a middle-aged man working at a desk job (computer programmer), and all of my efforts to lose significant weight have either failed or yo-yo'ed (which I'm sure everyone here is familiar with).

I've read about the restrictions after lap band, and some of them are simply the restrictions that any diet should have: avoid sweets, avoid white, bready foods, chew slowly, stop when you're full, control portion size, exercise lots, and so on. Additionally, there are some WLS-specific restrictions: NO (?) carbonated beverages (there goes my love of Diet Coke), NO alcohol (I'm not a lush, but I love a summer beer or vodka cocktail), NO (?) caffeine (so I can't even have coffee?), plus a lot of scary things about how for instance taking a whole pill can lead to chain vomiting.

So what it seems like to me is that WLS requires the same degree of willpower -- which I've failed to demonstrate -- that a successful diet requires. Which begs the question; if I'm going to have to do all the "work" of a diet anyway, and stick with it if I want to see progress, why not skip the surgery and just do the diet? Either I'll succeed or fail (with or without WLS), but if I don't get the surgery, at least I don't risk surgical complications, and can drink a beer, and am (probably) tens of thousands of dollars better off.

Second question, what are the real limitations? I have read so much, conflicting stuff. I know you can't shouldn't eat, for instance, Snickers' bars (and why would I want to sabotage myself that way), but what about coffee? Carbonated beverages? Alcohol? Do I have to give up all of life's little pleasurable vices for this goal?

Also, I've read a lot about things getting "stuck" in the stomach pouch if you eat to fast, or if you swallow a large pill, or something. What does this mean? Vomiting? Discomfort? A stomach pump? Along with being obese (BMI of 41) and having sleep apnea (a comorbidity; if insurance companies weren't so difficult, I'd be a shoo-in for the surgery), I'm a hypochondriac. What are the real RISKS post lap-band, versus just discomforts. Discomforts I can live with (assuming, of course, the benefit is worth it -- see my first question).

Finally, some health-related stuff. I know most/all here aren't doctors, but I have a fatty liver (diagnosed w/ultrasound) and quite possibly a duodenal (not gastric, that's important) ulcer. Am I disqualified from the surgery on medical grounds?

Again, sorry for the book-length post, but I have a lot of questions and am still very unsure about whether the surgery is really a good choice (remember, I'm only 39, given my family's long life-span, this is something I'll need to live with for another 40 years or more), whether I -- weak-willed as I am -- can live with the limitations, what the risks are, and so forth.

I'd love to hear advice, answers, and opinions on the subject. My girlfriend is also contemplating lap-banding (although she's much more enthused about it than I am) and I'm trying to find the right balance between skepticism towards any "magic wand" weight loss cure, and real optimism at the possibility of, for the first time in my life (barring the six months I worked for UPS) really being closer to my ideal weight.

Thanks in advance for any information or answers!

[BillOh 13]

Everybody is different, but I'll take a stab at one part.

Second question, what are the real limitations? I have read so much, conflicting stuff. I know you can't shouldn't eat, for instance, Snickers' bars (and why would I want to sabotage myself that way), but what about coffee? Carbonated beverages? Alcohol? Do I have to give up all of life's little pleasurable vices for this goal?

The band is just a tool like any other diet, but it makes eating less easier and helps you slow down your eating. Now that I am at my goal, there is nothing I have to give up. I can eat anything, I just cant eat 48 chicken wings in 12 minutes any more, but now that the band helped me get where I wanted to be, I can do what I want, I just keep an eye on my weight and compensate for any bad days. (like holidays, or I gained 3 pounds because of a funeral.

Also, I've read a lot about things getting "stuck" in the stomach pouch if you eat to fast, or if you swallow a large pill, or something. What does this mean? Vomiting? Discomfort? A stomach pump? Along with being obese (BMI of 41) and having sleep apnea (a comorbidity; if insurance companies weren't so difficult, I'd be a shoo-in for the surgery),

Large pills aren't a problem fro me. It is pretty uncomfortable when you do get stuck, sometimes painful. We don't usually vomit, people where call it PB or productive burping sometimes along with sliming. Only once have I had to vomit up a piece of chicken breasts. You learn quickly to avoid it. My sleep apnea and blood pressure are cured, so it was worth it for me.

Edited September 17, 2009 by BillOh

[ouroborous 519]

Interesting, thanks for that. With the amount of acid reflux I have, I suspect that I have "PB" quite a bit already.

[RestlessMonkey 7]

You answered WHY WLS in your sentence "I've been obese almost my entire life". Why haven't you just dieted and exercised? Huh? Or have you, and then you relax and it comes back? WLS because for over 90% of the overweight population, diet and exercise doesn't work.

If you needed a pacemaker for your heart would you get it? Or would you think "no, that's too easy that's the chicken's way. It should beat fine on it's own".

Well, many of us need a pacemaker for our appetites. Simple.

Real limitations vary from person to person. Caffeine is on the do not list for some, not for others. I'm 13 mos postop and drink caffeinated coffee and tea whenever I want it. In fact at 1 year check up doc told me I'd healed and was doing so well that in his opinion as long as it didn't HURT me physically, I could have carbonated beverages. Again, that's individual. I also haven't found ANY food that I can't eat. White bread, dry chicken, whatever. It goes down.

Finally yes you need willpower. If you overeat because your portions are too large the band will help. If you eat for emotional reasons (whatever they are...reward, sad, bored, because you LIKE chips and feel 1 bag a day is a god-given right, whatever) then the band won't help at all.

It helps you feel satisfied with less food. You are not physiologically hungry. For some that's all the assist they need. For others, it does no good.

A good surgeon and seminar will go a long way towards educating you on the basics. I suggest you attend one or two. Mine wasn't hard sell but rather informative and low key.

Risks...there are risks. Acid reflux, a slip, erosion. There are also risks to obesity. You'll have to weigh the odds, look at yourself and your personality, see if it will work for you. It doesn't work for everyone. But for some of us it's nothing short of a miracle.

And as to the fatty liver and ulcer, probably won't disqualify you. Your surgeon can guide you. However if you really ARE a hypochondriac, the band may not be for you. Some see ever little muscular twinge as a slip, some can't even swallow their tiny little pills (I can take my potassium horse pills just fine) because they are worried about being stuck, etc. It takes all kinds but for a person who is more, well, nervous about being well, I'd think the lap band would be almost like signing up for torture. There are probably better options for that type of person. Again, a seminar and a surgeon can help.

Edited September 17, 2009 by RestlessMonkey

[oliviasmommy 0]

Everybody is different, but I'll take a stab at one part.

The band is just a tool like any other diet, but it makes eating less easier and helps you slow down your eating. Now that I am at my goal, there is nothing I have to give up. I can eat anything, I just cant eat 48 chicken wings in 12 minutes any more, but now that the band helped me get where I wanted to be, I can do what I want, I just keep an eye on my weight and compensate for any bad days. (like holidays, or I gained 3 pounds because of a funeral.

Large pills aren't a problem fro me. It is pretty uncomfortable when you do get stuck, sometimes painful. We don't usually vomit, people where call it PB or productive burping sometimes along with sliming. Only once have I had to vomit up a piece of chicken breasts. You learn quickly to avoid it. My sleep apnea and blood pressure are cured, so it was worth it for me.

Ok yes carbonation is bad for the band it can stretch your pouch and what not HOWEVER my hubby has been banded 2 yrs and he has a beer everyonce and awhile and I still enjoy mikes hard. So once in awhile you'll be ok. Caffine me and my hubby drink it and it has not affected our weight loss. Why lap band? Yes lap is a tool so there is work involved but ill tell u this it takes away my hunger I have been overweight since elementry school and have tried every diet I could work out and not lose a pound with lap band I lose weight and exercising just helps lose more! Lapband has given me the hope I lost years ago

[ParrotheadCathy 0]

Why WLS?

You actually answered your own question when you said "all of my efforts to lose significant weight have either failed or yo-yo'ed". The band is a tool to help you avoid that outcome.

I've read about the restrictions after lap band, and some of them are simply the restrictions that any diet should have: avoid sweets, avoid white, bready foods, chew slowly, stop when you're full, control portion size, exercise lots, and so on. Additionally, there are some WLS-specific restrictions: NO (?) carbonated beverages (there goes my love of Diet Coke), NO alcohol (I'm not a lush, but I love a summer beer or vodka cocktail), NO (?) caffeine (so I can't even have coffee?), plus a lot of scary things about how for instance taking a whole pill can lead to chain vomiting.

A lot of docs actually allow carbonated beverages after a period of time with the band. But each doc is different. But soda is bad for you, period, so if you do without it for a period of time, you may not feel compelled to drink it again. I was NEVER told that I could not have alcohol or caffeine. I drink (damn, I'm a PARROT HEAD! Do you think I'd go to a Jimmy Buffett concert and party in the parking lot without a good rum drink?????) and I have caffeine (I love a big steamy mug of hot tea in the morning). I have 5.8ccs in a 10cc band and I can take two Tylenol at once with no problems. All those other meds I was taking for diabetes, high blood pressure and high cholesterol are all things of the past -- which is why I did this in the first place. I have NEVER vomited, post-banding. I've PB'd but it was my fault for eating too fast every single time.

Second question, what are the real limitations? I have read so much, conflicting stuff. I know you can't shouldn't eat, for instance, Snickers' bars (and why would I want to sabotage myself that way), but what about coffee? Carbonated beverages? Alcohol? Do I have to give up all of life's little pleasurable vices for this goal?

See my comments above. Getting a band is NOT going to prison. You are still able and supposed to enjoy life. The only beer I really like, I can't buy in the States (Belikin, which is brewed in Belize) so no beer is not a question I've ever really had to address except when I was in Belize just over a month after surgery. Yeah, I had one but I had to drink it slowly. I've eaten birthday, a few M&Ms, I don't like coffee but I LOVE hot tea and I drink it. I don't miss Diet Coke. I stopped cold turkey and never looked back -- except that I mix it with rum, which pretty much takes the fizz right out of it. But, I reiterate, it is ALL THINGS IN MODERATION. If you pig out on anything, your band will stop you from going too far. If nothing else, no more food can get into the pouch and you will feel very uncomfortably stuffed and will have to stop. Believe me, you only have to experience that too-full feeling once and you'll remember you want to avoid it. It's like you ate 3 plates of food at Thanksgiving dinner and one of every dessert. Ugghhhhh.

I've read a lot about things getting "stuck" in the stomach pouch if you eat to fast, or if you swallow a large pill, or something. What does this mean? Vomiting? Discomfort? A stomach pump? Along with being obese (BMI of 41) and having sleep apnea (a comorbidity; if insurance companies weren't so difficult, I'd be a shoo-in for the surgery), I'm a hypochondriac. What are the real RISKS post lap-band, versus just discomforts. Discomforts I can live with (assuming, of course, the benefit is worth it -- see my first question).

Stuck is exactly that...it sits in one place and you wish it would move. Occasionally, you will cough the stuck bite back up (productive burp or "PB") and when that happens, if's actually a relief. But it IS NOT VOMITING. It is regurgitation of that stuck bite or two. Vomiting is when your stomach muscles force all the contents of your stomach back out. Two very different things. Lose the weight and all your aches and pains will disappear and you won't want to be a hypchondriac any more...you'll be too busy enjoying life.

The risks are somewhat minimal. Slippage can occur, though not often, and many, many docs actually stitch the band into place to prevent that (mine did). If your band gets too much fill, you can develop a night cough and acid reflux, all of which is easily remedied by you admitting you have the problem and getting a slight unfill of even as little as .2 cc. I remember some posts from a man who turned out to be allergic to one of the components of his band and had to have hit removed. That was one person. Risks of anesthesia and surgery itself are separate things and your docs should advise you of those risks, but they are pretty small percentage risks.

Finally, some health-related stuff. I know most/all here aren't doctors, but I have a fatty liver (diagnosed w/ultrasound) and quite possibly a duodenal (not gastric, that's important) ulcer. Am I disqualified from the surgery on medical grounds?

Fatty liver ... the pre-op diet is designed to reduce your fatty liver. Stick to the pre-op diet and you'll be fine. A duodenal ulcer needs to be treated but shouldn't keep you from surgery unless it's not responsive to treatment.

I will say unequivocally that getting the band has not compromised my quality of life in any way or amount. On the contrary, it has improved my life immeasurably. I think most people here would agree with me.

Go to a seminar and ask the presenters your questions, too. (Many seminars have a patient or two there you can talk to as well. i've done this for my surgeon.)

[ouroborous 519]

Thanks all for the responses.

On the hypochondriac front, I'm a "rational hypochondriac" -- like any hypochondriac, I fear every health-related thing that goes "bump in the night," but I also know the actual likelihood of various bad things. Also, a LOT of my hypochondria is weight-related; my father had a serious heart attack when I was 6, and I think that ever since then I've been terrified that just like him, my heart will just "stop" one day. Add that to what I know about diabetes, sleep apnea, and so forth, and you see that the majority of my hypochondria is related to my weight.

As to the "willpower" thing, I think that the realization that I'm coming to is that it's BECAUSE I have poor willpower that this might be right for me. I tend to overeat (and drink, I even drink Water in huge quantities with giant gulps, and I eat like a starving wolf), and something that literally *forces* me to slow down and eat less might just be the best thing. It would mean that I didn't have to rely upon willpower alone; there would be (to an extent) a "hard limit" on how much I could eat or drink at once.

Part of the reason that I have so many doubts/questions is that, due to having had some elective surgeries that were worse than useless (RF tongue ablation for sleep apnea, for instance), I'm leery of the risks and costs of surgery if the likely benefit is little to nil. But I've also had some surgeries that dramatically improved my quality of life (LASIK surgery to get me to 20/20 vision, nasal surgery to repair a deviated septum), so I'm trying to keep an open mind.

Again thank you very much for your input. I'm going to see if my insurer -- Aetna -- will even cover a part of my costs. I'm not SUPER hopeful on that front, but it might be worth the fight. I don't mind if I have to go on a six month medically-supervised diet first, since that would help me learn "how to eat" and quite possibly shave 10-20 pounds off my current 330 (I'm 6'1 and very heavily built, but still 330 is very obese for me).

[RestlessMonkey 7]

It sounds like you're on the road then. That's great! Lap band may or may not be for you but until you check it out, you'll never know. And I hope I didn't insult about the hypochondria; it does take all kinds to make the world go round. I just think for some people the band would be more of a worry than a help. In other words, it isn't psychologically suited to everyone. Thank God we're all different. I, for instance, can't imagine ever having the fortitude to get bypass surgery because the thought of having my stomach cut up, sewn up, but left in place, closed and making gastric juices, gives me the heebie jeebies! :thumbup:

Best of luck to you!