Prior to the making the appointment for the first return visit since I was unfilled, I rummaged through my post lap-band paperwork to call the surgeon's office to find out pricing information and to make an appointment.

What I learned from that phone call is that the surgeon had "divorced" the old the bariatric program group and returned soley to private practice with his comrades. So, now the I was able to afford a visit to see my surgeon, the dietician, behavioral health and have a fill for $70.

Because I was too embarrassed to see my surgeon after regaining all my weight, I decided to email him over the weekend at an address I came across on an old business card. He replied the same day and basically told me he was glad I had contacted him and to make an appointment to see him. He also told me that he felt his team could help me get back on track.

So, I made an appointment first thing Monday morning for Wednesday afternoon of the same week to see my surgeon, the dietician and behavioral health. I knew I need a complete overhaul of mind, body and spirit. I had wasted enough time.

After I checked in, my surgeon's physician assistant (PA) gathered all my history. I still felt uneasy about having regained all the weight, but I was there to come clean and restart my weight loss. So, I just gritted my teeth and beared all the questions and what appeared to be disapproving eyes. At one point in our discussion the question came up about why I had regained all my weight. I asked her honestly if she really wanted to hear all my excuses. She jokingly replied, "No," but I think we both knew nothing I said was going to change my current situation. Since my surgeon was already aware that I had regained the weight, I realized that everyone else was hearing it for the first time and didn't have time to adjust their reactions appropriately. The only reaction I cared about anyway was my surgeon's. He had had time to adjust.

When my surgeon entered the room, I still felt uneasy. I didn't know what he would actually say to me knowing that I had not applied my best effort to lose as much weight as I could after banding, but he handled it well. He basically told me he was not going to beat me up because that wasn't his style. I told him, "I appreciate that." He told me that they were gonna check out my band to see if it was okay, and that he was going to run a series of bloodwork.

I was then sent to the band adjustment room to check my band under flouroscope and to see how much saline was in my band. Fortunately, the band was still exactly where it should be and hadn't slipped, which was a relief. The PA was surprised that there was so much saline in my band. I mumbled something about my aggressive fill schedule, but I don't know whether she understood it or not, and I really didn't care. She also remarked on slowness of my esophageal function to the surgeon when I swallowed the barium, which my sugeon summised was due to swallowing pushing agains the pressure of the band. My surgeon took everything into considertation and decided to have the PA add .04cc to my band. So according to my calculations, I currently have a 3.6cc fill in my band, which breaks down like this:

December 6, 2006/1.0cc

December 13, 2006/0.6cc

December 20, 2006/0.6cc

December 27, 2006/0.6cc

January 17, 2007/1.0cc

January 25, 2007/0.6cc (unfill)

January 23, 2008/0.4cc

When I went to see Behavioral Health as part of my treatment plan, she told me stuff I already knew and wrote it down for me. I'm recording the list of things to do here for future reference. I also plan to enact some if not all of the suggestions. Here the list:

• Visual cues in refrigerator and pantry. Cordon off kitchen area.
  
• Do not go into the kitchen except to prepare meals and eat; have someone to do cleanup after meals
  
• Exercise five times per week; out of house preferably
  
• Plan menus for meals
  
• Journal
  

The dietician visit surprised me because she was very obese. Mentally I questioned how she could advise me when it was so blatantly obvious that she was overweight. I flashed back to a time I considered becoming a dietician. However, I decided that if I couldn't keep my own weight in check, how was I going to help others. So, I braced myself to hear what she had to say and put my biases aside so I could better help me.

As it turned out, she was simply the messenger. There to guide me based soley on published information provided by the surgeon and other sources. She directed me to pages within the guide she handed me so that I could see where I had gone wrong since my surgery. Guess what? I learned the only thing I was doing wrong was EATING! Imagine that. I had gotten so far away from the band rules that I was doing EVERYTHING in excess. I knew then that I was going to have to severly adjust my eating habits or as the saying goes, "If you always do, what you've always done, you'll always get what you've always got." What did I get? No surprise there -- I got FAT!