faithmd

Found some links to threads about it from 1 year ago, it was done away with then secondary to problems, I dunno why it's back. The first thread is a GREAT explanation Wheetsin gave for it: http://www.lapbandtalk.com/f5/wheetsin-s-definitive-thread-reputation-rep-power-34072/index2.html http://www.lapbandtalk.com/f5/rep-power-33719/ http://www.lapbandtalk.com/f80/rep-power-33786/

Here's some links to threads about it about 1 year ago, it was done away with, I dunno why it's back. The first thread is a GREAT explanation Wheetsin gave for it: http://www.lapbandtalk.com/f5/wheetsin-s-definitive-thread-reputation-rep-power-34072/index2.html http://www.lapbandtalk.com/f5/rep-power-33719/ http://www.lapbandtalk.com/f80/rep-power-33786/

Wait, I thought it was decided a few months back that "Rep Power" was not a desired feature to have here. Many felt it was almost like having a popularity contest and it was getting out of hand in the short time we had it. I see no point to it, I feel it is a very bad thing to have, especially on a site like this where so often people are already often emotional or on an emotional roller coaster with what is happening in their lives. If I have a higher "rep" is someone more likely to believe me (even if I may be wrong) than someone with low or no rep (who may be correct)? I'd like to see it go away (again) and this time NEVER come back. I thought it was a buried idea LONG AGO.

Ooooo, I don't like apples, either. Ate too many of them as a kid. I do like Yellow Delicious, but no other ones than that. Oh, Apple-as in Mac? I love them, or I used to, but we are currently a Mac-free house.

I went yesterday for my first fill (after ten months) and they were unable to fill in the office secondary to it being too deep as well. My next step is fluoro, hopefully next week. If they can't get it there, I'm not having it moved, I'll struggle and buckle back down and lose some weight. It hurt too much having it placed the first time to have it moved...

Meanie, meanie, meanie! :scared2::boink::thumbup: (just kidding, let's have a big: :redface: )

Sadly your experience is not completely unusual. There are quite a few practices that have outdated beliefs that LapBand is not a good choice for someone with an over 40 BMI. Which to me is funny because almos all insurances REQUIRE a BMI of 40 to approve bariatric surgery (35 with two co-morbidities). I think there are very few people out there with an exactly 40 BMI who are at that office asking for LapBand. I know it has been a very frustrating road for you already. I too had a long journey to banding and I know it really does make you want to give up and toss up your hands at the whole thing, but I implore you that if you felt banding was right for you, to please try again. I agree that I do not think I'd want to go back to this hospital again. If you go to www . lapband . com (here's a link, it says "Home" in the text) Home they do have a searchable database where you can find the closest provider to you that does banding. Unfortunately that does not guarantee they accept Medicare, but at least you'd have a starting point. I understand that traveling long distances for banding and all the appointments is a pain, but I have to tell you, if I had to travel six hours to get to see a surgeon I was comfortable with and who I trusted, I'd do it in a minute. Fortunately I only have to travel about 75 minutes on a good traffic day, but many of us here travel hours and hours, some actually have to fly to see their surgeon, but do it because that's what works for them. I do encourgae you to try again, with a different surgeon. You should not have to start all over. You have logged your food, you should have medical records from your visits already and you have already had a psych eval with an MMPI-2 (the long test you took). Once you choose a surgeon you should be able to ask for a transfer of your records to the new surgeon (it might cost you a few dollars-many doctors charge some copying fees). You have already been pre-auth'd by Medicare so they know you've completed their requirements. And now you know of some of the stumbling blocks to look out for (like asking any new surgeon what their banding BMI is and if you know you want LapBand will they fight you for RNY)? You have done well with your weightloss and that shows you have the ability to stick to a plan and would very likely do well with a band. I do wish you luck and I hope you are able to find someone you are comfortable with.

Some bandsters find it very difficult in the immediate post-op phase to reach around and wipe their backsides. Next time you go to the bathroom, reach around and then pay attention to just how much of a stretch and twist it is on your abdomen to do that reach. Some folks find it more comfortable to wrap TP and moist wpies on the end of the tongs so they can clean well. Some very supersized folks simply cannot reach back there and actually use bathroom tongs specially made for this purpose: Self Wipe Toilet Aid - Allegro Medical Supplies Long Tong Toilet Aid, Bathroom Assists - Allegro Medical Supplies

So I fully explained the why. Ad nauseum. And it doesn't seem to make a darned bit of difference. What can ya do? Nada. Just hope that we will all be okay and every one of us will be successful and none of us will lose our bands. That's what I want.

Well, no first fill. After about 20 minutes of pushing and prodding and two bent needles later, I have to have fluoro... I was well numbed, and the NP really tried hard, and was wonderful, but my port is a low profile that is attached to my (apparently very flat and tight) abdominal muscles really well, and it is about 4-5 inches below my skin due to my large spare tire...She just couldn't reach it... DAMN

Awww, thanks, Steph! You're quite the muffin, too! Trystelle, good post! (and you are ROCKING!!! WOOHOO on the lbs gone!)

I had almost forgotten about that post. It was one of my better rants, wasn't it? Thanks for your support, C!

First and foremost, I want to apologize if I inadvertantly hurt your feelings. I did not bash you, I merely provided your post and highlighted what you said to show how destructive we can all be to ourselves (I'm including myself in this). I beg to differ that this is getting out of hand, this is what many people need to hear and read. See the post above yours. I know when someone esle wrote things similar to what we are writing, it helped me stay on my post-op diet. It helps to know why and sometimes it helps to have the point driven home time and time again. This is serious business, it could be your band. I know no one would EVER wish harm to another person here. And we who have been there do not wish harm to any of you, either. That is why we take the time (and believe me, it takes a lot of time for me to type what I do-I'm not that fast, nor am I very accurate) to write these things and point out the things that are said to you. We all want you to be successful. I want ME to be successful, I'm not right now and I could use a swift kick in the pants re: my simple carb intake but that's for another thread I'm sure I'll start soon. It is soooo easy to fall into the trap of complacency we were all in that made us fat. Simply put we didn't have to work at it. It was easy. We sat on our butts for the most part and we ate what we should not have (there are rare cases where it is something endocrine, but that is VERY infrequent). Lets face it, it is HARD to lose weight, even with this band. It is ESPECIALLY hard to be in Bandster Hell. Everyone of us who is posting about why you shouldn't ramp up your post-op diet has been there. We DO know what it feels like, we know what it's like to be all emotional and wonky and depressed. I know that it was very hard, I cried some days because I couldn't figure out why I wanted this band that I worked so hard to get, out of me. I was desperate to chew, I wanted something of substance, I am addicted to food. I am an addict. But I had to control that addiction for a few weeks to allow this tool that I now have to heal so that it can help me overcome this addiction. Like alcoholics or drug abusers, we will always have this addiction, we need to learn how to overcome it and use the tools we have to get a handle on it. One of those tools is the band and we all want new bandsters to keep theirs for as long as possible. That is why we will always speak out on threads like this. I know no one is saying to the OP to eat steak or taffy (thanks, Wasa), but a lot less can be just as destructive.

I've never been filled (ten months out) and soda is VERY painful for me. I just avoid it completely. If I have to have the "sparkling sensation" I'll swish my mouth with some, but if I swallow-OUCH!

My loss stopped about a month after I stopped losing weight. I get 80+ grams of protein a day, take supplements galore, biotin, etc. Does not make an iota of difference. It's gonna fall out if it decides it wants to. It will stop when it wants to.

Double snort-charcoal panties! Yep, I know they exist, and sometimes I think they'd make my husband's life nicer if I wore a pair...my farts can be AWFUL.

Wait, but you did advise the OP they'd be "just fine"-see below: And others also said the OP would be fine to not follow their doc's advice, this one below specifically did it because they read it here that it was okay for others, so they decided it was okay for them! : Another who said "didn't kill me" and advised "portion size" and to "chew" : ---------- Do you know that for sure, that they all "lived just fine"? How many have slipped or eroded? Do we really know? Absolutely follow your OWN docs advice, but as we have said many times before, people come here to try to get someone to validate bad behavior so they feel "okay" about going against their doc's orders. You know what, I'm not at all comfortable with eating the day after surgery, but again, I'm not a band surgeon. So I cannot comment officially one way or the other. I can only say it doesn't hurt to go longer on liquids or mushies. re: "you should have a program you will be able to do comfortably" sorry, but I gotta say that's a load of hooie. This is HARD, it is NOT EASY, and we should not give up safety and proper healing for our own "comfort." If we wanted the "easy" way out, I think we would have gotten the DS or RNY (though that's not a cakewalk, either). Actually we all didn't have the same surgery. We may have all had some sort of adjustable gastric band placed, but we all didn't have the same surgery, there are more factors here than merely a surgeon's preference for diet. It may be different patient to patient based on factors like what kind of band was placed, scar tissue s/he had to go through to get in, hiatal hernias that had to be repaired, etc... I really am not trying to start a fight with you, I (we) have seen this too many times and it is getting more and more frequent where folks are trying to validate their poor post-op compliance. It is not as simple as saying, "here's what I did and why, but do it your doc's way" because people like StarbuxQueen above will still take others' experiences and use them to make it acceptable to break their own doc's orders. Often I think surgeon's do not explain WHY we need to follow a certain diet, they just say to do it and expect us to follow blindly. I personally need reasoning behind it and so I explain it to others thinking it may help them, too. I just feel the need to impress upon all of us that it is important to remember we are all different and we do have to be very careful of how we respond when folks seem to want to "break the rules" in their post-op diets. We cannot say anything that will validate them, or we risk them misunderstanding us and not following their surgeon's advice. And that is the reason for this post.

I'm screwed, I already had two pieces of Red Velvet Cake. But now I'm done for the day, I'll be on liquids for the rest of it. I'm getting my first fill today, ten months out.

Sharona, While I do really appreciate what you are saying about how the OP was asking about what everyone else has done, you need to understand why we (in my case slightly) more experienced bandsters jump right in and put a stop to the bad behavior with food. We have learned in our months or years here that even though someone may be asking an opinion, they are really testing the waters and seeking validation for "cheating" on their diets. Somehow it makes folks feel better if they can say, "There was this person on LBT whose doctor told her to start soft foods on day two, so I'm okay." But it's not okay. It really isn't and we cannot simply sit back and hold our tongues (or fingers) and let it go by. We know what can happen, we've consoled many of us who have had slips or lost their bands. Do we know why, not usually, but one cannot help but wonder if in some cases it wasn't the post-op diet that did it. I know in a few situations where you can see someone post about a slip and then look at thier previous posts and they were one that cheated one time or ate something and it went down "okay." You can't help but wonder if that's what set them up for the slip. And you are correct, different surgeons have different approaches. I would always ask what that surgeon's slip rate is, and how many bands they have PERSONALLY performed, what their surgical technique is, are they J&J and/or Allergan certified, etc. Perhaps one surgeon might do a few extra stitches in the band that they have found to be helpful in securing it, in that case, perhaps they are comfortable letting thier patients eat a bit earlier, but we don't know the particualrs of each surgeon. I know that you are aware of the different schools of thought out there in the medical world on just about everything. Sometimes those differences are based on experience, sometimes they are based on reading a journal article (it's true), and sometimes they are actually based on inexperience or arrogance. What it all boils down to is that it is never bad to go longer on liquids, it definitely CAN be BAD to advance to food faster and anyone that asks, I'll recommend a longer liquid stage to them any day.

LJM, Susan, Wasa, Denise and Steph-good posts, ladies. I agree, I think the fresh bandsters are getting less and less tolerant of our advice and wisdom. Not all of them, but I've been gone for a couple of months, at least, and I see the difference. The oversensitivity is exponentially worse than even in January or February as is the bad advice from one to another. Newer bandsters: There is sound reasoning behind the liquid diet, I'll explain below. I know it's AWFUL not to be able to chew, it stinks! If we weren't addicted to food, we wouldn't have needed surgery in the first place, but you just have to suck it up and do what your doctor says. Loads of us have had to do FOUR and SIX weeks of liquids. It is a few WEEKS out of your lives, how long have you been fat? I've been fat a crapload longer than four or six weeks. That's all it is, folks. And those of you being banded now are getting WAAAAAY more relaxed dietary guidelines than those of us who were banded even less than a year ago. Do I agree with that? No, but I'm not a band surgeon, so it is not for me to agree or disagree with. I can only explain my point and let you decide for yourselves. I really, really wonder about the slip rate we'll soon see in the next year or two with these changes in the post-op diets. I think they'll shoot up. We have more and more providers banding people and they simply do not have the experience behind them to say to their patients "You need to be on liquids for four weeks." They are going by what they are learning from other docs and they are getting deluged with phone calls from us patients who are whining and crying and begging for food because we can't seem to handle a few weeks of our lives without chewing something. So they throw up their hands and tell us if it doesn't hurt when we eat it, go ahead. That is bad, we do not know what it will hurt in terms of internal healing and what that will mean for us LATER. Those of you who advanced earlier (even if your doc said it was okay): If you slip down the line, I want you to think back to this thread and these posts and maybe, just maybe you'll understand why we "oldies" (and I'm not even a year post-op, so I'm not that experienced at all) were so emphatic about our beliefs in following your doctors advice and that IT IS NEVER BAD TO GO SLOWER AND STAY ON LIQUIDS LONGER. (Let the flaming of me begin for saying that.) I am a person who wants data to back up most things a health care provider is doing to/for me. The Allergan website (the folks who MAKE the LapBand) says this about food stages: Dietary Guidelines After surgery, you'll need a new nutrition plan. You'll learn about the positive changes you can and need to make in your diet and lifestyle from your surgeon and/or dietitian. It's very important to follow your new eating and drinking instructions beginning immediately after the surgery. In the first few weeks after your LAP-BAND® System surgery, you will be on a liquid diet since only thin liquids will be tolerated by your stomach at that time. As you heal, you will gradually progress to pureed foods (three to four weeks post-op) and then soft foods (five weeks post-op). Finally, after about six weeks, you will be able to eat solid foods. Here's what J & J (Realize) has to say: Recovery at One to Two Weeks Progress from a clear liquid diet to a full liquid diet as the healing from surgery progresses. Your healthcare team will provide advice on the quantity and types of liquids that are right for you at this stage They do not suggest starting soft foods until Three Weeks out. Granted perhaps there is new research that says prolonged periods on liquid diets are not necessary and the Allergan site just hasn't been updated yet. However, I want the data to back up why it's okay to introduce foods with more substance earlier. Even J&J's site suggests soft foods at week Three and I've love to see their slip rates. Wait, they don't really have any data yet, they are too new in the US. I would also ask your surgeon about what her/his complication rate is and more specifically what their SLIP rates are (and how many bands have they PERSONALLY done and how long have they BEEN BANDING-not doing lap surgeries). Are they making post op diet guidlelines because of the increased width of the AP and Realize bands and the selling point that it's less likely to slip *because of* said width? Is there a study they can show you to support the fairly quick move to pureed and soft foods? Has surgical technique changed and is there a way now to access the back of the stomach (not previously accessed because of it's proximity to the spinal nerves) and suture the band (I haven't heard of it and cannot find it in any videos)? Time for a lesson in digestion and anatomy: The reason for the liquid diet is because the band gets "seated" on the stomach and held in place by scar tissue in the back and a sort of "rut" or "groove" in the front that forms during the weeks we are taking in liquids. The stomach is a muscle, and that muscle has to churn and undulate to digest and move food through. Liquid requires little stomach movement to process. When we start to chew something, or ingest something with residue in it like purees, etc, that lets our digestive system know that food is coming down, fluids begin to be secreted to aid in digestion and the stomach starts moving in preparation to start the breakdown of food. The band is held in place on the front of the stomach by sutures in the stomach where it is pulled up and over the top of the band (called the pars flaccida technique), then sutured to itself (Allergan bands-can't find anything re: surgical technique for Realize band, by their animation, there is no suturing on the front, which leaves it MORE susceptible to slippage, but perhaps they just didn't include that in the video). There is nothing holding the back in place, the surgeon tunnels behind the stomach to pull the band around and then scar tissue forms to hold it. That scar tissue can't form properly or as well if the stomach is churning and moving to digest. The "rut" or "groove" can't form well around your stomach with the churning and movement, either. The more your stomach moves, the wider that groove will be, and you want it small and form fitting, not big so the band can slide around. On the back you want the scar tissue to heal and form itself tight around the band to hold it securely in position, it's kind of like getting a paper cut on a joint, everytime you move it even slightly, it pulls apart. At least that's what the band folks have said for years that is how it all happens. Perhaps someone somewhere has done a new study and what we've always believed is actually not right. It's possible. Do you see now why I'd be hesitant to do much of anything but liquids very early on? Of course, if someone can show me concrete good data from a few years post-banding showing no increase in slips (not just a study with a sample of a few patients) with the shorter time on liquids showing the longer liquid diet is not necessary, then I'll be happy to change my thought process. One last thing if you've actually read through all of this, but something tells me most "newbs" won't: We are not trying to be rude, and we will not hold your hand and stroke you and say, "It's alright, go ahead, do it because Becky said she could." We will also not sit and say (or at least I won't) "We all make mistakes, it's okay, you'll be fine," because you know what? Maybe you won't. I would never support a newly banded person's "testing" their limits or their "messing up a few times" because that would be irresponsible of me. I do not know the inside of your body and I do not know what your healing will be like. I do not know if eating those few bites of "really soft chicken" has done anything to your band and I won't tell you it's alright. This will be a little extreme of an example, but I think it will drive home my point: If you were pregnant (or your wife/SO were pregnant) and the OB told you you had to be on a certain diet to protect your fetus for X amount of weeks, I'm guessing you'd be on that diet for EXTRA time just to be sure, wouldn't you? Why do we not protect our own bodies in the same way?

There is an APS or Advanced Platform Small which is 10 cc/mL and an APL or Advanced Platform Large which is 14cc/mL

I completely understand. It would have been a deal breaker for many of us.

Here's the second list, some are duplicates: Questions to ask during consultation: Research the doctor. What kind of follow up care is provided? (ie: fills, unfills, endoscopies, fluroscopies, port revisions, removal, etc). Ask to speak to about 5 or 6 of his patients before you make a decision (this one os tricky with HIPAA, but usually at the pre-op seminars there are at least one or two patients there-or some have indicated they'd be willing to talk with prospective patients). Ask those people if they have any complaints or issues with their care before, during and after the procedure. How many of the procedures has he done? What types of complications can occur from this procedure and how frequently do they happen? (ie: perforations, etc) What types of complications has he personally ran into doing this procedure? What is his policy when a complication occurs during a procedure? (ie: does he discuss options with family or immediately convert to bypass or other WLS). Is he Inamed/J&J approved for the procedure? If not then who qualified him to perform the procedure and can you have literature to verify this? Research the procedure. How is the procedure performed? Will you use the Pars Flaccida approach? What type of sutures do you use? Can I request glue and not staples? Will I have a catheter placed? If I am on my menses, can I wear a tampon? What will I need to have prepared when I get home in way of food items? What are the short term issues? What are the long term issues? How will I be able to take my pills? Will you write today for liquid pain meds? Do you want me to take antibiotics post-op? If so, will you write for Diflucan (if get yeast infections when on antibiotics)? Follow up care. What is the schedule for fills? When can I get my first fill? How is the fill procedure performed? (ie: with or without fluroscopy) What is the cost for fills? (under fluro and not) How often will I need to be seen? Will I have access to a Nutritionist? How do you handle unfills? Is there a direct line in case of Emergencies? Does your doctor have email address? What Vitamins should I be taking? Will I need to crush my pills? If so then for how long? Are there any pills that cannot be crushed? If so then how will I be able to take them?

Here's one list: PROCEDURE How many lapbands has the surgeon performed? What types of complications have you personally ran into doing this procedure? What is your policy when a complication occurs during a procedure? What kind of band will be used? What size-or will you determine once you are in there? Are you Inamed/J & J approved for the procedure? If not then who qualified you to perform the procedure and can you have literature to verify this? What are the chances of infection? Does an occurrence of infection always mean the band must be removed? How often do your patients need their band removed (or any other additional surgical procedures)? Since I carry a lot of weight in my abdomen, does that increase the complexity or risk of complications with a laparoscopic procedure? Does my abdominal fat increase my chance of needing fat pads removed from my stomach? Does that have any risks associated with it? What are the chances I will need my gall bladder removed? Is there anything I can do dietary-wise to reduce the risk of gall stones? Are sutures always used to place the band? Is there any complications that arise from the "stomach wrap" around the band? Is it true that the sutures are permanent and do not dissolve? AFTER CARE / RECOVERY What should I expect during the recovery period? What is normal? What kinds of self-care could I be doing to help my recovery? Will my activities be limited during the recovery period? If so, which activities and for how long? When can I return to work? What help might I need while I recover? (driving, lifting, etc.) What symptoms should you call a doctor about? What programs do you have pre- and post- surgery to help me succeed? How much support do you provide during the insurance approval process? FILLS What is your fill schedule? When can I get my first fill? How is the fill procedure performed? (ie: with or without fluroscopy) What is the cost for fills? (under fluro and not) How often will I need to be seen? Will I have access to a Nutritionist? How do you handle unfills? Is there a direct line in case of Emergencies? Does your doctor have email address? What Vitamins should I be taking? How will I take my birth control pills, HTN pills, etc? Are they crushable? Will I need to crush my pills? If so then for how long? Are there any pills that cannot be crushed? If so then how will I be able to take them? PREGNANCY Once pregnant, will I have to get a partial unfill or be completely unfilled? Should I expect any issues/complications with a pregnancy after being banded? If there are any what could they be and how will they be addressed? After being banded, are most babies delivered via c-section or can they be delivered naturally? If my baby needs to be delivered via c-section could that damage the port and tubing? Are there additional vitamins I should take while pregnant?

There used to be a great thread here with a list of questions to ask. Since the forum has been updated, it's gone, WAAAAAA!!!! So I'll see if I can retrieve my list for you.