GeezerSue

Sasser virus? If so, you'll need a patch. http://www.microsoft.com/security/incident/sasser.asp

In the US, which for a while anyway had the worst banding results in the world, the doctors want patients on lengthy, bizarre pre-op diets. A couple of New Zealand doctors also wanted patients on two weeks of pre-op liquids. They were convinced that doing so would "shrink" the fat around the liver. They were running a test, which they said they'd publish, on their theory when one of the doctors wrote back to me. Two years ago. I still haven't seen a word published showing any proof at all that two weeks of liquids does anything other than make patients crazy and stressed and guilt-ridden when they don't follow it. And many US doctors want to adopt a "fill schedule." And they often titrate the patient up to restriction so slowly that s/he gives up long before any restriction is reached. Or they say "lose 10% of your body weight or I won't do the surgery." Why can't these know-it-alls stop assuming that everything American is better just because it is American and look around? There are very expereinced band surgeons all over the world, whose patients do just fine. Do our guys pay attention and follow their lead? No. Makes me so glad I went to Mexico. End of this rant, but I'm sure I have a couple more in me.

Okay, sleep apnea is one comorbidity. Your BMI right now is about 35.6. My guess--but I don't know much because I was self-pay--is that you are very close to the lowest border for approval. That is, they could say, "Well, you're not MO and if you lose ten pounds you won't even have a BMI of 35 and you only have one comorbidity, so before we pay for this we need to see documentation of one year of medically supervised diets. Don't think that this is what they WILL say. But be prepared in case it is what they DO say, because some people have received responses like that. And other insurance companies have approved people with your stats right away. Why you have the surgery is your business, not mine. It's just that I've seen several financially comfortable women who were 50-60 pounds overweight who were banded and/or who were thinking of it. In a way, I get it, to stop them from becoming MO. On the other hand, I'm only half-way to where I want to be and am learning how very difficult the "head work" is. If I had had only 80 pounds to lose and got only half way, I'd be pissed. I guess it's not fair, but from this perspective it's like, "there's SO much learning and rethinking we have to do EVEN WITH THE BAND, that if there's a chance you could do the learning and rethinking without the surgery, it would be a better thing." Does that make sense? I'll be thinking positive thoughts about your insurance, Sue

Are you morbidly obese? I'd guess that you might be close, but only if you are 5'4" or less. Most insurance companies pay for surgery for those who have a BMI of 40 or a BMI of 35 with comorbidities. I don't mean to be cruel (it seems to come naturally) but your post gives me the impression that you want to have surgery to LOOK better. If that's the case, you need to know that the AVERAGE 220 pound person who needs to weigh 140 and has ANY weight loss surgery will, after two years, weigh about 170 pounds. Maybe a less grumpy, non pre-op person will answer better? Sue

Yeah, Kelly. And I'm a "senior citizen." (Which means there are no kids around and we've often got all day to...you know...exercise.) In fact, in discussing plastic surgery, I hesitated about spending money and doing the boobs, as that is purely cosmetic. He asked, "If you have your boobs done, does the possibility that you'd parade around here naked once in a while increase at all?" I admitted that plastic surgery might increase those occasions exponentially. "Well then," he declared, "cheap at twice the price."

Flouro for me. Sue sitting here glowing in the dark

Immediately post-op, the thought of coffee just grossed me out. And I usually like a cup or two of really strong, unsweetened, black coffee. But for a couple of weeks, it didn't sound or smell appealing. Now I drink it again. But I usually have a sugar-free, vanilla powder and about two ounces of milk in it, to get in my morning Protein. That's especially important to me when I'm more restricted in the morning. I drink a silly product called Arrowhead Sparkling Water (I prefer the orange essence), which contains 0% everything, no sweetner (real or artificial), but IS carbonated. But when restricted, I have to let it sit for a while and then I stir it to let most of the carbonation out. IMHO, a day full of diet Coke is not a good idea. Too much everything bad, and nothing of value in it. You might want to learn to love water.

Three WEEKS? Good lord, woman! Get naked and start chasing that man around the house. OTOH, you MAY need to be creative depending on where your port is placed. And who said you're not supposed to exercise? No weight lifting, maybe. But you should (probably) be walking and doing other exercises that don't stress your band or port placement.

Aha...the business center in the Hampton Inn! Memories. There are GREAT juices at the supermarket next door, in varities that are not always available in smaller US grocery stores. And you can always get chicken broth and tea at Sanborn's. The hiking will help with the gas.

Sultana, Even though I don't want to be a smart ass so early in the morning, I'm going to warn about this anyway, even though I know you know. Jessie Ahroni, the noted band guru, says there are only three adjustments we need to worry about: too loose, too tight and just right. I know that a lot of people--usually Americans, we're famous for it--get hung up on the numbers. And I have observed, ususally among the newly banded, that people want "as much of a fill as" someone else has. But the number of cc's of saline we have is essentially irrelevant. What IS relevant to me is how much restriction I have. In my case, with a 9.75cm band, my ideal fill is around 1.4 to 1.6 cc's, right now, subject to change as my weight and fat and anatomy change. I think my band holds around 4.0 cc's, but all I need to focus on is the level of restriction I have. And, IMHO, whether a fill (or adjustment) is conservative or aggressive is not a function of how many cc's of saline we have, even if we have identical bands, but of how much restriction there is. In other words, your 2.0 would have me completely shut down. Given my anatomy and where my band is placed and all that, 2.0 would be so aggressive as to be malpractice! And yet, you may be underfilled. SOOOOO, it sounds to me as though your doctor was trying to give you a lot more restriction than you had as of the second adjustment. Now you may have to wait. Because I've learned that many people become more restricted a week later. (I don't get that, but it happens.)

The Mexican doctors almost always underestimate how difficult it is to get band adjustments on this side of the border. That didn't stop me, but I live close to Mexico and adjustments, while a hassle, are doable. If I want to go to a US facility, and if they don't mind taking me, the cost can run from about $300 to about $1300, per adjustment, in Southern California. And, right now, I'm looking at two adjustments within the next month or two. I want to get unfilled for plastic surgery and then I'll need to get refilled after the surgery. You might want to find out where the Johnson & Johnson SAGB trials are taking place near you. And then find out if those doctors will do adjustments for people banded with the SAGB before it was approved here. But it still could be costly. On the west coast there are experienced US LapBand doctors banding for, I think, as little as $12,500. Have you checked out the east coast? Sue

Depends on your research skills. Right now, except for the FDA trials going on with the Swedish band, the only "legal" band in the US is the Inamed LapBand. For most of us, finding doctors who know about our bands is a challenge. Finding a doctor who knows about the Swedish band will be a BIG challenge. Then, convincing that doctor to service your band which you had implanted elsewhere, instead of with him, is a problem. They are surgeons. They make a living doing surgery. The follow-up is a necessary evil to many of them and many do not want to follow-up on somebody else's project. Right now, I would not go for a Swedish band implanted out of the country, unless I had airline travel priviledges and/or big bags of money for the travel. Just my opinion. Sue

Been out all day. Donali, as usual, was right on.

Never heard of it. (And I've been reading on this topic for a couple of years.)

sleep apnea can strike anyone, but (strangely enough) it often both causes and is caused by obesity. (Lab animals deprived of REM sleep--like apnea patients--eat more.) Anyway, just a word of warning from an old person. And while we're at it, yet another thing that is "easier" with band than with bypass. Fat cells are chock full of hormones. People who rapidly lose a lot of weight get a bit nuts. Sometimes it's mood, sometimes it's even more, such as hot flashes and all. You have lost a LOT of weight in a relatively short period of time. In fact, there are people who have hd bypass surgieries who are not losing as fast as you are. That said, you could be (excuse the unsolicited diagnosis) just a bit nuts right now. Nothing worthy of hospitalization or that sort of thing, But like your worst-ever PMS times 111. THAT kind of nuts. And add to that, that a woman who weighs 220-something presents an entirely different persona than a woman who weighs 330-something. Depending on how long you've been MO, you are dealing with having the world treat you in a way it has not in a long time. That's gotta bring up issues along the lines of, "So what was wrong with me this time last year, Bubba?" Good luck finding you!

I'm one of those post-band reflux people, so I just recently learned how reflux/GERD can impact one's life. I don't want you to think I'm encouraging you to get the band. I was just telling you what it is I had learned about the impact of the band on GERD/reflux. It's ALL a crap shoot and I'm not sure I'd go for it. If you want to ask Don Mills (whose job it is to promote the band so he is going to have primarily positive information), you can reach him at (805)683-6761, and just follow the voice prompts. Now, let me make you just a little crazier. Some doctors who do gastric bypass use a "silastic ring" which is a non-adjustable circle of plastic, placed at the location where the esophagus and stomach meet, to prevent stress on the area. So when you talk to doctors about that, find out the impact of the silastic ring, if they use one. Finally, there is also the DS. That SEEMS to be the bypass surgery of choice for banded people who have done a lot of homework. Again, it's not as popular with doctors. I wish you the best on this. GERD is terrible. I wish you relief.

Okay, I don't want to upset you, but here's where legitimate logic is at odds with the real world. He's right, you're right, I'm right and we all may be a little wrong, too. Here's why: The band can cause reflux in people who have never had it AND CURE REFLUX IN THOSE WHO HAVE IT PRE-OP, DEPENDING ON THE REASON FOR THE REFLUX. As a matter of fact, I had a conversation with Don Mills of Inamed about this topic yesterday. In patients who have GERD or reflux symptoms pre-op, the band provides one more place the stomach acid has to work its way through to get to the espophagus. For many of them, the stomach acid that used to work its way to the esophagus gets kept in the "lower stomach" because of the band. And, because the acid doesn't get to the "malfunctioning flap," it can't get into the esophagus. Those who do not have reflux pre-op and end up with problems after surgery do so because of the band placement and because now the acid gets trapped in the little upper pouch and finds its way to the esophagus. I could be 100% wrong. (Alert the media?) But many, many people who had GERD pre-op have had no symptoms since being banded. Keep checking. You may be giving up on your surgery of choice based on insufficient evidence. Good luck, Sue

Laura, I am older (55 at the time of surgery), have reduced esophogeal motility (which we assumed due to age, again with no pre-op testing and a surgeon who had planned over 1400 bands at that time) and have had (so far) only moderate success with the band...AND I'D DO IT AGAIN TOMORROW BECAUSE I GOT MY LIFE BACK. I went from using a cane to walk and a treadmill speed of 0.6 mph with a physical therapist and an oxygen tank at my side and sleeping or trying to sleep about 18 hours per day due to sleep apnea, and all that stuff. I now do a half hour of cardio on the treadmill at over 3 mph and/or eliptical trainer at about 50% resistance. I lost about 80 pounds, regained 20 when unfilled, lost about 5 of that, and am currently stalled. I'd get an additional tenth of a cc of saline to bump things up, but I'm about to have it unfilled again for plastic surgery. Did you have the test because of pre-existing problems? Is your surgeon one who accepts only "ideal" patients? (I just read a medical journal abstract about which are "better" bariatric patients.) Are there test results which can be interpreted by another doctor, or is this one of those deals that is read on the spot? Good luck on whatever you decide. But, if you have no history of esophageal motility issues (and especially if you're older), I'd wonder if the doctor was just trying to limit his surgical practice to only those patients with ALL of the pre-op predictors of success. Sue

Hi there, Hi Anyone on the board here have been diagnosed with sleep apnea? Me I am trying to learn more and more about it! More of expeirences then facts, I have read a lot about it, but would like to hear the experience of someone who has it. I have questions like: How many times total did you stop breathing during the test? Enough that we didn't even have to do the whole test. The diagnosis was a given, the issue then became WHICH machine. How many times in 1 hour? I know it was over 30. How far did your blood ox level drop? I have no idea. What device are you using?? My numbers indicated that I needed a Bi-Pap. One level of pressure inhaling, a different level exhaling. Any experiences like that would be really helpful! Once I lost about 10% of my total body weight, I was able to stop using it. MOST IMPORTANT PART...I WAS ABSOLUTELY SURE I DID NOT HAVE SLEEP APNEA. Duh. Thank you! Baileym You're welcome, Sue

I used to live in Boulder City. (I used to live almost everywhere.)

Darcy, When my favorite fish restaurant brings the freshly baked little round loaf of sour dough bread, I immediately grab it and start searching for the very brown, slightly overcooked parts of the crust. (The part I used to hate.) I can have A LITTLE, with a lot of butter. But the doughy stuff just kills me. Sue

Bob, the foreign doctors almost always make individual decisions about how much saline each patient needs. Many US doctors have decided to go by a fill schedule. I think it's stupid. Here's why: Let's say, that when it's all said and done, you're someone who will need 2.2 cc's of saline. The Mexican and European and I think Austrailian doctors do the fill under flouroscopy and get you as close to restricted as they can. They may need to tweak it once or twice. But, you'll be pretty close and need only tiny adjustments wheich they do "as needed." Meanwhile, the "schedule" guys will put in 1 cc, then titrate you up 0.5 cc's at a time. That means it will take you three fills to get to 2.0, which won't be enough. And then, at the fourth fill, you'll get to 2.5, which will be too much. That will probably take about six months and it tends to drive the patients who do need over 2 cc's completely mad. The doctors get frustrated and claim that the patient isn't trying and the patients get depressed and give up. I wish the schedule guys would convert to doing what their patients need and not going by some artifcial chart. Excuse my rant. But now yu know that IN CASE this happens to you, to either get yourself to a doctor who isn't afraid to provide some restriction (which is how the flippin' band works) or to cut yourself some slck and not get depressed when it isn't your fault. Sue *a mom who nursed the baby when she was HUNGRY, not when the clock hit a certain time. (Because boobs have been around a lot longer than clocks, go figure.)

The ones I have found will cost you about $1300 per adjustment, IF they decide to accept you. (They have to be in the mood.) I also have a calll in to Dr. Billy, in Ventura County, but no response yet. After that, Tijuana--as inconvenient as it is--is the least inconvenient. I think that, for REAL emergencies, Quebbemann in Newport/Huntington might be available to other doctors, but last I checked he didn't do routine stuff for other doctors' patients. I think Inamed needs to recruit a radiologist in Southern California who could just do adjustments all day. But I think they would still charge quite a bit. (Up north, Cirangle's office adjusts for others, I think. But I think that was about $1000, plus travel up to San Francisco...WAY over an hour away.

Finally, something I THINK I know a little about! I happened to be nearby when someone went through something like this, and I am very observant. This is what I THINK I figured out. Inamed wants to make good on any defective product. If you/they know what's happening in advance, they will get involved and and work out the doctor's fees and arrange for the doctor to bill them. And they provide the replacement materials at no charge. I don't know exactly how they work out the hospital, as this event was out of country. And, I'm pretty sure they even reimbursed for mileage and hotel. SO, if all someone wants to do is have it made right and not get paid for pain and suffering and mess with lawyers, Inamed seems to be right there. HOWEVER, I believe there is also a non-disclosure agreement to sign and that nobody who was involved in one of these deals can actually comment on it.

The opposite of Laporoscopic Surgery is not Major Surgery. The opposite of Lap Surgery is Open Surgery. You can have really major surgery that (like the RnY, for example) done either laporoscopically or open. The LapBand is, as was stated, designed for laporoscopic placement.