GeezerSue

According to the research, the magic number is 50. When a surgeon has done more than 50 LapBands (not just more than 50 bariatric surgeries and not just more than 50 laporoscopic surgeries, but more than 50 LapBands), the patients have fewer complications.

Oh...I thought I was at a South American soccer game. Never Mind. Gooooooooooooooooooooooooooooooooooooooooooooal! Sue (good work!)

Jean, Can we look at your menu in terms of what I can eat when I have any restriction at all? I'm stuck on a "chicken tender." But if it's breaded and/or white meat, I would be unable to eat it. Two TABLESPOONS of rice? I wouldn't be able to eat two GRAINS of rice. Hummous can plug me up a little, the way a banana would, if I were tight. Tabouleh? I'm okay on the parsely, but the barley (or whatever the white stuff is) would plug me up. As would any cold Cereal. A couple bites of very-well-chewed DARK meat chicken. A piece of mushed-up, well-roasted carrot or sweet potato, some well-cooked Beans (navy, kidney, pinto, small white, lentils, butter beans, etc.). The nicer you are to your stoma, the fewer Prilosec/Nexium/Aciphex you will buy/take, and the better you will sleep. Take it easy, Sue

Almost thirty years ago (back when they kept people in the hospital for long times), I had cancer and had to have a hysterectomy. Since I was a whopping twenty pounds overweight, I figured that the "silver lining" on the whole surgery cloud was that at least I'd lose a little weight through the whole surgery process. At discharge, after over a week on nothing and then mostly broth and Jello, I weighed five pounds more than I had at admission. I asked my surgeon what the hell he had put in my IV. He said 4400 calories per day. Seems he didn't want me to get weak. Sue

I don't know...but do you really want to be one of his first patients? The complication rate is far lower when the doctor has done 50 lap bands or more. (All lap band doctors are experienced lap surgeons. The difference is how many lap bands they've done. And the less experienced guys don't routinely make mistakes, either. It's just that when you look at the big picture, there are half the problems with more experienced doctors that there are with the less experienced doctors.) Maybe you can find an experienced guy who does take your insurance. Good luck, Sue

Just my humble opinion, but I'm convinced that surgeons who want patients to lose weight before surgery are assholes. (Am I allowed to say "assholes" here? NO? Okay.) I think doctors who insist on patients losing weight before surgery are exactly the same jerks who will be berating you for gaining (or not losing "enough") weight during the post-op phase and will have you begging for adjustments. AND, any moron knows that weight lost with those drugs is regained about 97% of the time, so what's the point? I know you have the national health service to deal with, but can you find another surgeon? Sue

I have heard: a) from many, many Rodriguez patients who are thrilled with him; and, from two Mexican doctors who say that Rodriguez has had emergencies his little clinic was not prepared to handle. (Truth? Gossip? Who knows?) I can tell you that IF there is an emergency, once you cross the border and get on the US side, it's a 150 mile drive to San Antonio for a big city hospital. Rumbaut practices in a large, state-of-the-art teaching hospital, which has plenty of doctors of various specialites there, just as you'd expect in a medium-size city here. His follow-up has been wonderful for me, although I'd avoid e-mail as a way to reach him. He answers his own cell phone (even when he's on a stage in Chicago getting ready to deliver a lecture) and returns calls placed to him when he's unavailable (on a plane.) The only charge related to post-op service is for the flouroscopy. If I had it to do over, the only change I might make is paying him and the hospital separately, as that might have saved me a few hundred bucks. (He has an all-inclusive price, which covers everything, no matter what...and then a pay-doctor-and-hospital-separately-price which save money, but if you need an extra day or extra services, you're on your own price.) Sanchez is also in Monterrey and has thousands of happy patients. Kuri, in Tijuana, is very experienced, does repairs for Inamed problem cases and is almost always available by phone. He has two facilities--the bargain place for $8500 and the oceanside place for $10,000. Have you checked out Cirangle in San Francisco? Rumbaut recommended him to me as a US doctor for adjustments. I've heard their price is closer to $12,000 and that it includes a few post-op adjustments (fills/unfills). If I were self-pay (which I was) in AK (I'm in CA), I think I'd check out Cirangle and whatever group Jessie Ahroni is involved with in Washington state. If they came within a thousand or two of the Mexican price, I might stay closer to home...not because anything is wrong with Mexico, but because when you need a tweak to an adjustment, you'll probably delay needed visits, and that's not good. Good luck, Sue

Marsha, If things, overall, are getting better, relax. If things, overall, are getting worse, call Dr. Kuri. Have you had general anesthesia before? Do you know how you respond to it? Our daughter had breast reduction surgery last summer and the third week post-op was her week from hell. There was nothing that was really wrong, but not enough was right, if you follow the theme here. We all react so differently to the anesthesia, that we have to be prepared to feel like hell just on general principles. BUT, if you are sure that something is getting worse, call Kuri.

Hi, Sam....I have met other AK banded, but you are the first here! One went to Mexico, but I think you can get pretty experienced LapBand surgeons in Washington state these days. And there are excellent follow-up people in Washington, as well.

I know you probably hate this kind of answer, but one of my doctors said, "No eating before fills," one said, "Liquids only before fills," and my surgeon said, "Come into the office after Breakfast." And they think it's the obese who are a little crazy.

Okay, fills... Some of us have surgeons who want to approach the adjustment (what a fill is really called) in a Let's-Get-This-Show-on-the-Road kind of way. They tend to be foreign and/or very experienced LapBand (not just experienced at lap surgery or experienced at bariatric surgery) surgeons. Other of us have the "Let's-Be-Very-Careful-and-Do-This-Slowly surgeons, who tend to be located in the US and/or kind of new at the band. So, what that means is how many fills one has had is completely irrelevant. And, IMHO, the whole little-by-little approach is silly. Because let's say that YOUR ideal fill is 2.3cc's. Dr. Little-by-Little puts in 0.5 at adjustment #1, then moves it up to 1.0cc's at adjustment #2 and so on. When the patient gets to adjustment #4 (2.0cc's), it still isn't enough and then at adjustment #5 (2.5cc's) it's too much and whatever the doctor was worried about in regard to an overfill is going to happen anyway. AND, some of thee surgeons only do fills once or twice a month. So the patient is six months post-op until he/she gets the needed restriction. And we all know how WE deal with that kind of frustration and "failure." And then they say the band doesn't work. Right. Figure out what your doctor is doing. Explain whay YOU don't want to wait six months for restriction. See if you can get the adjustment YOU need. Sue My experience with fills is almost all outside the US. Those doctors used flouroscopy and most got the restriction as tight as they thought I could reasonably handle, and didn't even look at the syringe until I asked them how much saline we were talking about.

I hate when they say "Do not open oven door while baking." I want them to say, "If you open the oven door while baking, the souffle will be flat as a pancake and you'll have to feed your boyfriend's mom a Peanut Butter sandwich, you moron." THEN, I'm more likely to follow directions. Jean, do you have the Inamed bookelt? It is not as informative as it should be, but it's a start. http://inamed.com/products/obesity/us/patient/lapband/information.html Then, some of the stuff you learn/make up as you go along. Here's one I finally wrote about, a year or so ago on another board, since I hadn't seen it anywhere...the saliva (also called "slime") thing. One of the things that is probably happening--or will happen once you start eating--is the saliva thing. In a normal, healthy, unbanded stomach, the food just moves on through the esophagus to the stomach. In a banded stomach, the food can move only so far before it gets to the band and the whole process gets hung up. The brain (which has not read the band owner's manual) interprets the "hang up" as food that's stuck and needs to be moved to save your life. So it sends a little saliva to move things along. Then it sends more. Then it sends gallons (or so it seems) of thick, gooey, saliva to really make it move. When that doesn't work (which it can't because of the band being in place) it all (everything north of the band, so to speak) has to come up. So...my advice to newly banded folks is to head for the bathroom the minute the saliva starts...and start spitting. It may take five minutes or twenty minutes or longer. (And the getting up and walking to the bathroom helps, too.) That saliva has nowhere to go except into your esophagus, which is already blocked at the bottom. So, IMHO, trying to keep it all down is a waste of time. MY goal is to get rid of the extra saliva until the "blockage" has had time to work its way through. The "cure," which I hope to learn pretty soon, as I have been banded for almost a year and a half, is to eat less, chew better and WAIT between bites. I'm an older patient...I was 55 when I was banded. And I had to get unfilled due to reflux, and kind of start all over. But I apparently STILL haven't figured out that the way my system works, it takes several minutes for the signal that it's time to stop eating gets to my brain. If I keep eating during those several minutes, I am inevitably sorry just a few minutes later. AND, I need to negotiate with myself before I eat (I'm often in restaurants) regarding how much of what is being served I'm actually going to eat. Today, I'm going out to lunch with a slew of other old farts and fart-ettes. I have already gone online and checked out the menu. Then I called to see what Soups were being served today. Next, I'm going to call to see if I can order a Breakfast at lunch, because that would be easiest and best for me. If not, I'll have a lunch choice and a SECOND choice, because I don't want to spend the time in the restroom. Right now, I'm thinking that the cup of Soup and half a sandwich sounds good...except I'm concerned about celery in the tuna and about chewing everything else well enough. I'm working on this band thing. I'm obviously a slow learner. This is another reason I'm glad I opted for the band, instead of the bypass. If I had had the bypass, I'd be my thin ideal self by now, but I'd still be just as dysfunctional about food as I am right now. So, after the two year "honeymoon," I'd be one of those bypass people who gains it all back. WITH THE BAND, WHAT YOU LEARN SHOWS, AS YOU LEARN IT. I've learned a little. I'm still learning. Good luck on your journey, Sue

And the answer to Part Two of your question (you haven't asked it yet) is "Yes, there is a chance you could actually gain weight between surgery and the time you have an adjustment that provides real restriction." Back to the first part...immediately post-op, the mucosal lining of your stomach was probably quite swollen. Even Water had to go through slowly. Then, over the past couple of weeks, the swelling has reduced (this is a good thing) and the stoma (the opening between the top and the bottom) is bigger. So now, more stuff goes through more easily. The stoma opening increases as the swelling decreases, and as you slowly add food that will provide some nutrition and satisfaction without moving the band, because you want the scar tissue inside to form around the band, right where the doctor placed it. That's how we get back to Part Two. So, there may come a time, after the first four weeks and before you get a restriction that is just right for you, that you "can eat as much as before" and feel "like I don't even have a band." This is absolutely normal, too. Just wanted people to be prepared. Sue

It is ALL so subjective. I went with a patient who had a port replaced. She chose to have the surgery while awake and then she drove home. Four hours or so. If you were intubated for the surgery (some are, some are not), the "I'm getting a cold and sore throat" feeling is the result of having had a piece of plastic shoved down your throat. It is likely more an irritation than a virus. Sue

Call Don Mills at Inamed. If he can't help, Walt Lindstrom can. They've been through this before. It is NOT investigational, or experimental or unproven. They just don't want to pay.

Call Don Mills at Inamed. If he can't help, Walt Lindstrom can. They've been through this before. It is NOT investigational, or experimental or unproven. They just don't want to pay. I understand Walt writes a pretty effective letter: http://www.obesitylaw.com/

Two different issues are getting confused here. I have no background or training in this area, save many years of dealing with insurance companies. But here goes: 1(a)--Will you be insurable on you new company's group insurance or when your company changes carriers. Yes. That's what group insurance is all about. 1(--Will you be insurable on your own? Depends on the policy and they'll probably exclude any treatment involving the band, routine or emergency, as well as treatment for morbid obesity. 2(a)--Will your new insurance cover adjustments to an existing band? Who knows? But I wouldn't count on it. (If the new insurance policy covers the band surgery, then it should cover adjustments for the "already-banded" who end up being covered on that policy.) 2(--Will your new insurance cover other health issues, including emergencies, involving the band? If it wasn't already "excluded," [see 1( above] I'd fight for coverage if/when the need arose, based on the "like any other implant" position mentioned above. Sue

TOTALLY depends on who and where your doctor is. In Mexico, they just want to know you are okay for the surgery at hand. In the US, they want to make sure you can't sue them for anything afterward. If there's psych testing, they just want to know that you are not likely to be suicidal when your coping mechanism--stuffing food in to deal with life--has been removed.

I did. Didn't take fans. Took husband. Impossible-to-remove-from-hair-goop. Forty thousand electrodes hooked to your body. My experience was that I learned that I had really bad sleep apnea when I was sure I didn't ahve it at all. Go through the testing. You need to know. (My cardiologist gently mentioned that if I didn't have sleep apnea, I'd be the first person with a BMI of about 45+ he'd met who didn't have it.)

Careful what you ask for... National Institutes of Health National Heart, Lung, and Blood Institute Facts About sleep Apnea WHAT IS SLEEP APNEA? Sleep apnea is a serious, potentially life-threatening condition that is far more common than generally understood. First described in 1965, sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep. It owes its name to a Greek word, apnea, meaning "want of breath." There are two types of sleep apnea: central and obstructive. Central sleep apnea, which is less common, occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respirations. Obstructive sleep apnea is far more common and occurs when air cannot flow into or out of the person's nose or mouth although efforts to breathe continue. In a given night, the number of involuntary breathing pauses or "apneic events" may be as high as 20 to 30 or more per hour. These breathing pauses are almost always accompanied by snoring between apnea episodes, although not everyone who snores has this condition. Sleep apnea can also be characterized by choking sensations. The frequent interruptions of deep, restorative sleep often lead to early morning headaches and excessive daytime sleepiness. Early recognition and treatment of sleep apnea is important because it may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke. WHO GETS SLEEP APNEA? Sleep apnea occurs in all age groups and both sexes but is more common in men (it may be underdiagnosed in women) and possibly young African Americans. It has been estimated that as many as 18 million Americans have sleep apnea. Four percent of middle-aged men and 2 percent of middle-aged women have sleep apnea along with excessive daytime sleepiness. People most likely to have or develop sleep apnea include those who snore loudly and also are overweight, or have high blood pressure, or have some physical abnormality in the nose, throat, or other parts of the upper airway. Sleep apnea seems to run in some families, suggesting a possible genetic basis. WHAT CAUSES SLEEP APNEA? Certain mechanical and structural problems in the airway cause the interruptions in breathing during sleep. In some people, apnea occurs when the throat muscles and tongue relax during sleep and partially block the opening of the airway. When the muscles of the soft palate at the base of the tongue and the uvula (the small fleshy tissue hanging from the center of the back of the throat) relax and sag, the airway becomes blocked, making breathing labored and noisy and even stopping it altogether. Sleep apnea also can occur in obese people when an excess amount of tissue in the airway causes it to be narrowed. With a narrowed airway, the person continues his or her efforts to breathe, but air cannot easily flow into or out of the nose or mouth. Unknown to the person, this results in heavy snoring, periods of no breathing, and frequent arousals (causing abrupt changes from deep sleep to light sleep). Ingestion of alcohol and sleeping pills increases the frequency and duration of breathing pauses in people with sleep apnea. HOW IS NORMAL BREATHING RESTORED DURING SLEEP? During the apneic event, the person is unable to breathe in oxygen and to exhale carbon dioxide, resulting in low levels of oxygen and increased levels of carbon dioxide in the blood. The reduction in oxygen and increase in carbon dioxide alert the brain to resume breathing and cause an arousal. With each arousal, a signal is sent from the brain to the upper airway muscles to open the airway; breathing is resumed, often with a loud snort or gasp. Frequent arousals, although necessary for breathing to restart, prevent the patient from getting enough restorative, deep sleep. WHAT ARE THE EFFECTS OF SLEEP APNEA? Because of the serious disturbances in their normal sleep patterns, people with sleep apnea often feel very sleepy during the day and their concentration and daytime performance suffer. The consequences of sleep apnea range from annoying to life-threatening. They include depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. It has been estimated that up to 50 percent of sleep apnea patients have high blood pressure. Although it is not known with certainty if there is a cause and effect relationship, it appears that sleep apnea contributes to high blood pressure. Risk for heart attack and stroke may also increase in those with sleep apnea. In addition, sleep apnea is sometimes implicated in sudden infant death syndrome. WHEN SHOULD SLEEP APNEA BE SUSPECTED? For many sleep apnea patients, their spouses are the first ones to suspect that something is wrong, usually from their heavy snoring and apparent struggle to breathe. Coworkers or friends of the sleep apnea victim may notice that the individual falls asleep during the day at inappropriate times (such as while driving a car, working, or talking). The patient often does not know he or she has a problem and may not believe it when told. It is important that the person see a doctor for evaluation of the sleep problem. HOW IS SLEEP APNEA DIAGNOSED? In addition to the primary care physician, pulmonologists, neurologists, or other physicians with specialty training in sleep disorders may be involved in making a definitive diagnosis and initiating treatment. Diagnosis of sleep apnea is not simple because there can be many different reasons for disturbed sleep. Several tests are available for evaluating a person for sleep apnea. Polysomnography is a test that records a variety of body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels. These tests are used both to diagnose sleep apnea and to determine its severity. The Multiple Sleep Latency Test (MSLT) measures the speed of falling asleep. In this test, patients are given several opportunities to fall asleep during the course of a day when they would normally be awake. For each opportunity, time to fall asleep is measured. People without sleep problems usually take an average of 10 to 20 minutes to fall asleep. Individuals who fall asleep in less than 5 minutes are likely to require some treatment for sleep disorders. The MSLT may be useful to measure the degree of excessive daytime sleepiness and to rule out other types of sleep disorders. Diagnostic tests usually are performed in a sleep center, but new technology may allow some sleep studies to be conducted in the patient's home. HOW IS SLEEP APNEA TREATED? The specific therapy for sleep apnea is tailored to the individual patient based on medical history, physical examination, and the results of polysomnography. Medications are generally not effective in the treatment of sleep apnea. Oxygen administration may safely benefit certain patients but does not eliminate sleep apnea or prevent daytime sleepiness. Thus, the role of oxygen in the treatment of sleep apnea is controversial, and it is difficult to predict which patients will respond well. It is important that the effectiveness of the selected treatment be verified; this is usually accomplished by polysomnography. Behavioral Therapy Behavioral changes are an important part of the treatment program, and in mild cases behavioral therapy may be all that is needed. The individual should avoid the use of alcohol, tobacco, and sleeping pills, which make the airway more likely to collapse during sleep and prolong the apneic periods. Overweight persons can benefit from losing weight. Even a 10 percent weight loss can reduce the number of apneic events for most patients. In some patients with mild sleep apnea, breathing pauses occur only when they sleep on their backs. In such cases, using pillows and other devices that help them sleep in a side position is often helpful. Physical or Mechanical Therapy Nasal continuous positive airway pressure (CPAP) is the most common effective treatment for sleep apnea. In this procedure, the patient wears a mask over the nose during sleep, and pressure from an air blower forces air through the nasal passages. The air pressure is adjusted so that it is just enough to prevent the throat from collapsing during sleep. The pressure is constant and continuous. Nasal CPAP prevents airway closure while in use, but apnea episodes return when CPAP is stopped or used improperly. Variations of the CPAP device attempt to minimize side effects that sometimes occur, such as nasal irritation and drying, facial skin irritation, abdominal bloating, mask leaks, sore eyes, and headaches. Some versions of CPAP vary the pressure to coincide with the person's breathing pattern, and others start with low pressure, slowly increasing it to allow the person to fall asleep before the full prescribed pressure is applied. Dental appliances that reposition the lower jaw and the tongue have been helpful to some patients with mild sleep apnea or who snore but do not have apnea. Possible side effects include damage to teeth, soft tissues, and the jaw joint. A dentist or orthodontist is often the one to fit the patient with such a device. Surgery Some patients with sleep apnea may need surgery. Although several surgical procedures are used to increase the size of the airway, none of them is completely successful or without risks. More than one procedure may need to be tried before the patient realizes any benefits. Some of the more common procedures include removal of adenoids and tonsils (especially in children), nasal polyps or other growths, or other tissue in the airway and correction of structural deformities. Younger patients seem to benefit from these surgical procedures more than older patients. Uvulopalatopharyngoplasty (UPPP) is a procedure used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate). The success of this technique may range from 30 to 50 percent. The long-term side effects and benefits are not known, and it is difficult to predict which patients will do well with this procedure. Laser-assisted uvulopalatoplasty (LAUP) is done to eliminate snoring but has not been shown to be effective in treating sleep apnea. This procedure involves using a laser device to eliminate tissue in the back of the throat. Like UPPP, LAUP may decrease or eliminate snoring but not sleep apnea itself. Elimination of snoring, the primary symptom of sleep apnea, without influencing the condition may carry the risk of delaying the diagnosis and possible treatment of sleep apnea in patients who elect LAUP. To identify possible underlying sleep apnea, sleep studies are usually required before LAUP is performed. Tracheostomy is used in persons with severe, life- threatening sleep apnea. In this procedure, a small hole is made in the windpipe and a tube is inserted into the opening. This tube stays closed during waking hours, and the person breathes and speaks normally. It is opened for sleep so that air flows directly into the lungs, bypassing any upper airway obstruction. Although this procedure is highly effective, it is an extreme measure that is poorly tolerated by patients and rarely used. Other procedures. Patients in whom sleep apnea is due to deformities of the lower jaw may benefit from surgical reconstruction. Finally, surgical procedures to treat obesity are sometimes recommended for sleep apnea patients who are morbidly obese. NATIONAL CENTER ON SLEEP DISORDERS RESEARCH (NCSDR) The mission of the NCSDR is to support research, training, and education about sleep disorders. The center is located within the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. The NHLBI supports a variety of research and training programs focusing on cardiopulmonary disorders in sleep, designed to fill critical gaps in the understanding of the causes, diagnosis, treatment, and prevention of sleep-disordered breathing. FOR MORE INFORMATION Information about sleep disorders research can be obtained from the NCSDR. In addition, the NHLBI Information Center can provide you with sleep education materials as well as other publications relating to heart, lung, and blood diseases. National Center on Sleep Disorders Research Two Rockledge Centre Suite 7024 6701 Rockledge Drive MSC 7920 Bethesda, MD 20892-7920 (301) 435-0199 (301) 480-3451 (fax) NHLBI Information Center P.O. Box 30105 Bethesda, MD 20824-0105 (301) 592-8573 (301) 592-8563 (fax) U.S. Department of Health and Human Services Public Health Service National Institutes of Health National Heart, Lung, and Blood Institute NIH Publication No. 95-3798 September 1995 .

When our daughter was 15, her German teacher called me to complain that "she looked at me as though she hated me!" At the conference (to which Frau Whoozits brough her union rep, because she KNEW she had stepped over the line on a number of other issues), I laughed and said, "She's 15. Her job description is to be difficult. She doesn't drink or smoke or do drugs or have carnal knowledge of the football team. If she says anything she shouldn't say, or does anything she shouldn't do, let me know right away and I'll handle it. But I'm pretty sure a professional with credentials such as yours can deal with the irate glare of a 15-year-old." Then I took the kid aside and said, "That woman is a nut case. I don't really care whether you hate her or even what you do. But I don't ever want to deal with her again. Be sweet, be a jerk, I don't care. But if you ever do anything that makes her want another parent conference, I'll make your life a living hell." We had no more problems. Don't let this phase of parenting get you down. What kept me from getting nuts was the realization that I had already done all the foundation work, and any "control" I thought I could gather was merely an illusion. I had been the coach. I had called all the plays. At fifteen, I was demoted to cheerleader. Two years later, I tried to butt-in regarding prom arrangements. Finally, she took me aside and said, "Look. I appreciate that you have friends whose kids I know. You need to appreciate that I don't want someone I KNOW is planning on getting drunk barfing all over me and my prom dress. So could you back off, please, and let me continue to plan an evening with MY sober friends, instead of kids I don't hang with because they've got issues?" Ooooo.

Nah, I wasn't involved. Robin was just in my neighborhood.

Yes. I did several months of reflux and then decided to get an unfill. I felt IMMEDIATE relief. Dr. Kuri (if I recall) suggested wating around three weeks, but I waited over two months. I gained weight. I didn't/don't care. I was no longer creating a situation in which esophageal irritation/cancer cold get a foothold. I've been refilled (a smaller amount than my first fill) for about three weeks. I've lost five pounds (I had gained about twenty in two months). I need to reread Donali's post of Polar Bear Mike's post of Dr. Kuri's advice about eating earlier in the day. I think anyone with even minor sensitivity issues needs to do that. And I need to remember that I have restriciton now, and stop eating "just one more bite" as I was able to do during my unfilled months. Other than those things, I'm a fervent supporter of "theraputic unfills." Good luck on your decision.

First, get a good lie ready, just in case, and stick to it! "Gall bladder surgery" seems to be well accepted. So does "hernia repair." I'd go with the hernia story, because you can do that more than once and even if you've already had gall bladder surgery. And it's very believable, as the obese have a higher incidence of hernias. (Just read up on them first.) Then, be prepared to be flexible. Some people (ask Jimmy C.) have VERY sensitive stomachs for a couple of weeks post-op, and end up in the hospital and even on an IV while the stomach heals. Other people (mostly mid-banders, I think) have lunch the day of surgery. But, if you have a problem swallowing your own saliva, you are going to be spending a lot of time spitting. (If/when this happens, it just means that your brain thinks the band is blockage and it's sending gallons of slimy saliva down to clear the blockage.) But spitting looks pretty gross. And it could goop up the foils in a weave, ya know. If you REALLY don't want people to be suspicious, be prepared to be able to hide while your body gets used to the band. Sue *who was out shopping a couple of days post c-section; needed several-hour-long-naps every day for a year post-hysterectomy, just two years later; and was having root canal less than two days post-band, twenty-seven years later*