GeezerSue

Should YOU have the band surgery? Only you--if honest with yourself--will be able to figure that out. Do you eat "too much" at three meals a day...or do you graze and eat most of the time? What is your relationship with sweets? Those things may impact how successful banding would be for you. The surgery itself is a relative piece-of-cake. The immediate post-op time can require numerous band adjustments or may require NO band adjustments. People can move along with no problems and their friends can have real issues. Read what others have been through, good and bad, and choose what's best for you. Oh...one other thing. Do you have the resources for the required follow-up for whatever wls you choose? I'm picky and spend a good deal on Vitamins and supplements because I had the band removed and now have the DS. DS people HAVE TO HAVE special vitamins and supplements. Band people HAVE TO HAVE adjustments and they CAN cost quite a bit. (Up to $800-1000 per adjustment at the big city hospitals with fluroscopy.) If you haven't factored in the aftercare costs, it would be a good idea to do so. Again...a few people need NO adjustments. But in the first two years I had my band, I had about a dozen. Ka-CHING!!! Good luck!

I'm just going to pop in and say that SOME of the posters haven't been banded long enough to say they've really tried. (It SEEMS like a long time, but a few months isn't enough time, really.) HOWEVER, I want to add for those who HAVE been banded a long time and are getting nowhere, that the band isn't for everyone. It's where most European surgeons START...but they have a brisk business in removing bands and moving patients to different options. There is a "right surgery" for each of us, and no surgery being performed today is "wrong" for everyone. Far too many people explain whay they've chosen the surgery they've chosen by mentioning what they think is WRONG with the other surgeries. (I did it, too. But I was wrong.) And it's bullshit. If you haven't give the band a chance, slow down and listen to the good advice proffered here and give it your all. BUT, if you've already done that, and are sure you don't want to go back to "flying solo," talk to some of us who have moved on to other surgeries. So far, we sound like a fairly satisfied group to me! Sue (Eight months post-op from DS, BMI moved from about 48 to <34.) (And, yes, my poop stinks, but it never was an olfactory delight.)

Several (many?) of us have had our bands removed due to complications...erosion, slippage and other problems. Some of us have moved on to other procedures, namely the RnY or the DS (Duodenal Switch.) Others are just "flying solo," without any other surgical intervention. Sue

Okay...on the whole "overeating" thing. When your esophagus malfunctions, you can eat a teensy, tiny bit of food and--because the food doesn't move to the stomach--it will STILL get stuck in the esophagus and STILL might cause dilatation. Are you "overeating," as in "eating more food than you should?" Absolutely not. Are you "overeating," as in "taking in more food than your damaged esophagus can handle?" Maybe. I'm grasping at straws for examples, but...imagine two identical balloons, only one of them has a defect where there's a little weak bubble. You go to blow them up and one pops, even though you have MORE air in the other balloon and it's fine. What's up with that? The damaged balloon cannot hold as much air as the good one. When your esophagus isn't working, even a very small amount of food can be too much food. I think that any medical professional who calls that "overeating" knowing how the rest of the world defines "overeating" is not being very helpful.

This might help: http://lapbandtalk.com/showthread.php?p=264744#post264744

Logic would dictate that since the (insurance) requirements in the US* are generally that the patient have a BMI or 40+ (or a BMI of 35+ with comorbidities), then ALL OF THE PEOPLE who qualify for ANY wls have collectively sunk to exactly the same "terrible low." The only difference is which solutions(s) are attempted. In Rachele's case and mine, we first tried the band. Then we moved on. (*In other countries or for self-pays, YMMV.)

Might they have said, "esophageal dysmotility?" See, when we eat something, the esophagus--unlike the pictures we see in cartoons--isn't just a tube the food drops through. The esophagus massages the food on down to the stomach, where it can be digested. When the esophagus doesn't massage the food correctly, it's call "esophageal dysmotility." (There's a test for this...manometry.) In my case, the band CAUSED esophageal dysmotility. Food and beverages just sat, trapped in the esophagus, moving up a little...moving down a little, until the esophagus FINALLY moved them through. Meanwhile, my trainer was going insane because I could not get in a reasonable position for most exercises. And we'd go out to dinner and the ONE-THIRD of a cup of Soup would get jammed in there and then I couldn't eat dinner. It was miserable and the band caused it. When I had the band removed and was revised to the DS, the situation changed and all was well. So...most GOOD band doctors will not band someone who, going out the gate, already has this condition because it will probably only get worse. The manufacturer of the band says it's not a good idea. Scroll down to #6 at the bottom. http://www.allerganandinamed.com/products/obesity/us/clinician/lapband/risk.html

http://www.duodenalswitch.com

Those from the "medical field" show up not only as "alarmists" but as "defenders" as well. So, applying the same logic, just because someone who is in the field says it's a good idea, doesn't make it so, either. (BTW, that link I provided eventually leads to some of the letters sent by the FDA to some of the "colon cleanse" gurus regarding their false claims, false advertising, etc. Usually, they STOP, but then immediately start up with some other enterprise of similar dubious veracity.)

What is/was your lowest POST-banding BMI? This is totally anonymous, so please feel free to tell the truth!

Those colon-cleanse schemers are more full of $h!t than John Wayne and Elvis's colons ever were. http://www.quackwatch.org/01QuackeryRelatedTopics/detox.html

After we went out to dinner, a friend's husband (a rather quiet 70-year-old man) asked her if I wasn't starving since I couldn't eat anything. I was surprised HE noticed. Ther RnY DOES have malabsorption...that's why the dumping. But it primarily restrictive in nature. So it has more in common with the band than one might imagine. Even similar "end results."

On another board, a frequent traveler has spent more time in ER's than in vacation hot spots. For any other lurkers...a willing radiologist (so there's an MD on board and for fluorscopy if needed), AN ONCOLOGY NURSE (because more than any of our doctors SHE can find the port) and noncoring Huber needle are your best bets for getting a well-executed unfill.

Just adding that the DS does not cause dumping. More poop every morning, for sure...but not dumping.

Melanie...let me rant for a moment about RnY. It is--after the first year or so--mostly a restrictive surgery, just like the band. I decided that since the most I ever lost with the band was about 35% of my excess weight, it would be the very definition of insanity (FOR ME) to do essentially the same thing and expect different results. That's why I went for DS (FOR ME). I know that Jossart is listed as a DS surgeon in SF, but so is Kaufmann in LA. Yet, Kaufmann essentially ignored my requests for the DS (and was a rude and arrogrant little twit in addition.) He said that banded with a BMI of 48, I "wasn't heavy enough" for the DS and tried to get me on board for the RnY. I am SO glad I went elsewhere. I am seven months post-op...I'm a "slow loser" because I'm not particularly compliant (revisons can be that way since we go into surgery #2 with attitude) and I'm down somewhere around 86 pounds, WHICH IS ABOUT 60% OF MY EXCESS WEIGHT!! I was back into 2X's and 3X's pre-op. I'm losing all over, but my belly was the biggest, so right now I fit best in maternity pants for the extra room at the waist. I wore a pair of Gap size 14 maternity shorts to go to an activity at the beach last week. So I have CLOSE TO a size 14 ass and thighs. Good luck on YOUR decision, but don't go for any surgery YOU are not convinced is right for YOU.

I've had most of them...at least the band and esophagus parts. But I regained my way back to MO. So, I had problems secondary to the band, which meant that the band had to go...and I qualified for wls. (My band had been self-pay in Mexico.) I think that you need to at least find out about the entire appeal process available to you...how it works and how to make it work to your advantage.

You go, Penni.

Jack, the RnY leaves about a 1-2 ounce stomach...a shotglass, more or less. RnY depends on SOME malabsorption even though with that tiny stomach it is a primarily restrictive procedure. The DS leaves a 4-6 ounce stomach, so it depends on SOME restriction, but is a primarily malabsorbtive procedure. (Both of those stomachs stretch over time, leaving the RnY person more dependant upon the good habits s/he will have formed during the first 18 months or so. The DS person will have lifelong malabsorption--and all the related plusses and minuses...she says as she swallows Calcium tablet #2 of the FOUR she should have taken today.)

OLD (previously-)banded person here. When I first started looking, Quebbeman had done about 30 bands and Cedars was the only other local option. To me, everyone else is still a "newbie" at this. Even other surgeons mention that Quebbeman is arrogant...pot-kettle? (I haven't met him, but I even found his office staff to be arrogant. And I'm USED TO Newport-Beach-caliber-arrogance, where he used to do all his surgeries.) I have found Cedars to be a monumental bureaucracy but once you get through the phone games and the who-calls-whom-back BS, the people have been very nice. I've never met Dr. Billy, but he is the MOST responsive US doctor I have encountered locally (although--obviously--Pleatman and Curry are responsive, even to the patients of other surgeons and pre-ops), and Billy's staff is very kind, as well. Like most wls practitioners, most of the locals do more than one procedure. LET ME OPINE HERE, BASED ON YEARS OF EXPERIENCE. Yes, you need a skilled surgeon, no doubt about it. Fifty band placements would be my absolute low-end cut-off. However, the band--unlike the other WLS-types--is mostly about the aftercare. (I'm currently seven months out from the "huge, life-threatening, organ-rearranging" DS surgery. I've seen my surgeon maybe three times since he pulled the drains a week post-op. With the band, by seven months out, I had already had about five adjustments and I had many more after that.) SOME people get the band and walk away, needing nothing more. MOST need several adjustments. SOME need many adjustments. A good surgeon can figure out which is which, so it's all about the aftercare. There are many surgeons who can properly place the band...but then they have NO IDEA what to do with the patient and her problems post-op. (Also, just my personal observation, but I think surgeons go into to a surgical specialty because they like doing their magic on people who leave them alone while they do it, having a follow-up to make sure it worked, and then moving on. At the risk of being rude to any surgeon reading this, I suspect that having the patient out cold is a job perq... The "counseling" part of LapBand follow up is NOT something most surgeons have trained in...probably because it just doesn't appeal to most of them. Submarine captains and aircraft fighter squadron leaders are good at what THEY do but would probably not do well exchanging jobs.) Now, about hospitals. Yes, both Kuri and Ortiz NOW practice in lovely hospitals...or so I'm told and I believe the people who are telling me. But, from what I've read, there is NOTHING in Tijuana that even vaguely resembles the many teaching--and other--hospitals we have at our disposal here. (That is why I went to Monterrey. I got Rumbaut's experience and a teaching hospital. Someone wrote that the hospital Rumbaut uses is where a US president who became ill or injured in that part of the world would be taken. But I haven't checked out that claim.) I had one guy in Brea who wouldn't do an adjustment without endoscopy. (ka-CHING.) At UC Irvine, the surgeon and staff were very comprehensive in everything but what I needed. That is, as I described the difficulty and the weird sensations, all they offered was that I come to a support group meeting so that I could hear from others how the living with the band felt. (This was after I'd HAD the band for three years and had been "successful" and then started having strange sensations and regaining all the weight. I KNEW how the band was supposed to feel. It HAD felt that way and then it started feeling DIFFERENT than that...and they--except for an on-the-ball-radiologist--could not diagnose the esophageal dysmotility I was having. Ya know...if I were doing this again (which I would not, but that's not what you asked)...and if I lived where you do...I'd probably go to Rumbaut (in Monterrey) again for his experience and the quality of the hospital and to Kuri (in Tijuana) for follow-up. The back and forth across the border is a PITA, but from your location, it's do-able. And Kuri almost never leaves town, so he is available for your emergencies. But I would call Dr. Billy first and see what the price difference would REALLY be. Good luck, Sue

Because I didn't want to go from one bunch of rules about what I "could" or "couldn't" eat to another, and because of other issues, I opted for the DS surgery instead of RnY. So did Rachele. Others have had RnY and VG. Learn all about ALL of the surgeries, pick the one that's right for YOU and fight for it if need be. Good luck, Sue

I live in Southern California and have been on several boards for about four years and was unfamiliar with Callery's name. So I looked him up on OH. Do you know how many lap bands he has actually done? That is a VERY important to your future success with the band. It's all about follow-up and and RnY surgeons tend to become a little frustrated with band patients who need far more ongoing support than bypass patients. It's a whole different ball game than the bypass and a surgeon who is used to bypass patients may find a band patient to be far too time-consuming. Also, I asked because the comment about not leading a food-centered-life kind of concerns me. It isn't about the food. Not really. It's about self-soothing and self-medicating and taking care of ourselves in the best way we could at the time...which was food. It's no longer a good way to get through the day, but it did serve a purpose. People often THINK it's about the food and stop with compulsive eating...and take up compulsive gambling or excessive drinking or compulsive shopping or way-too-may-sex-partners...or they even become trainers and start exercising in a compulsive way. Don't misunderstand, I'm not saying anything negative about his skills...I have no idea what they may be. But surgeons in general tend to have a "let's fix it and get out of here" kind of approach as opposed to...say...psychologists, who want to talk about everything. And the band is all about follow-up and our eating problems aren't really about food. They're more about dealing with life. I've corresponded with hundreds and hundreds--maybe more--of banded people over the years and I don't think I've heard of more than one or two who had a "losing too much" problem. And THEY simply substituted one eating disorder (compulsive eating) for another (bulemia.)

I had relfux with the band and I had my gallbladder. When I had the band out and got revised to the DS, the gall bladder was removed as a routine procedure. I had a few weeks of reflux but then it went away. So I had reflux WITH a gall bladder and a band and no reflux WITHOUT a gall bladder and band.

Don said that the cure part was a kind of easy guess. The band provided one more "hoop" for the acid to "jump through" on its way to the esophagus where it causes trouble. As far as the cause part of the equation, there was no generally accepted reason. Maybe there is now. Sorry!

The Centers of Excellence thing can be a real rip off. And far from excellent in some cases. For comparison purposes though, I thought you might enjoy the following billling I received for a fill for in 2004: They billed a total of $1573.07 I paid $251.30 (but they later refunded me $42.96) Insurance paid $637.54 So, some of the prices in this thread sound like a real bargain to me.

Generally speaking, the band can CURE reflux (GERD) for those who had it pre-op and CAUSE the problem in those who did not. (That info was from Don Mills about 3.5 years ago, when I suddenly started having reflux, about six months post-op.)