faithmd

I second the kudos for sticking with it! But if the point is to shrink the liver, am I correct in assuming that you can only have sugar free/low fat yogurt and low fat cottage cheese? The sugar and the fat content is what makes the liver "fatty."

There is a lot of research out there about these pre-op diets and shrinking the liver. The majority of it was done relating to RNY, specifically in the days when most RNY or other WLS was done open versus lap. Though it doesn't really make a huge difference when you are talking about grasping the liver and retracting it whether you are open or not. Suffice it to say, the research was done to see if shrinking the liver (so that the operative field was easier to visualize and the liver was less likely to receive a traumatic injury from the instruments and manipulation) was beneficial. It was, but the majority of the studies (not a ton of them out there, but the data is solid) showed the longer, the better. Suggesting a four, or six week diet pre-operatively was the "ideal" but who can realistically do that? So I think the surgeons decided that two weeks was acceptable (there is a little data sbout some shrinkage with two weeks). Still, there are some docs who require three weeks, and occasionally four pre-op if they believe their patient to have a very fatty liver. I'm not sure if this is ALWAYS diagnosed with an abdominal ultrasound, but I know some folks get them. Some surgeons don't subscribe to it, some do. That's why you get differences. Also, there is the fact that the research was more geared towards a longer and more involved operation that requires more manipulation of the liver (RNY) than what is usually required in AGB (LapBand). I think that's another reason why quite a few of the band surgeons in Mexico (using them as an example) don't require it. They are highly skilled and many of them have exclusively done the band. Their table times are far shorter than a surgeon who has done say, 30 bands. The shorter on the table, the less time in the abdomen, the shorter time the liver needs to be retracted. Some doctors may also use the pre-op diet as a way to psychologically prepare you for the long time post op that you will be without solid food. There is also some credence to resting the stomach a bit pre-op. Though I still don't understand why some docs require a bowel prep for the Band! Here's a link where you can go watch the actual OR, the surgeons doing it explain the whole procedure VERY well. You'll see what I mean by retracting the liver: http://www.or-live.com/tgh/1593 Hope that helps!

It's like contact paper for the skin, like thin cellophane wrap that sticks to you.

I was thin until I started into early puberty at about 9 years old. I have no idea what I will look like, and I'm not sure I care all that much (okay, maybe a little). I don't think I have a very good perception of what I look like now. Photos always shock me. I'm not sure why this is, but maybe I'll be more self-aware down the road when some of the weight is off? I think this will be a fascinating journey, can't wait to reach my first stop (banding). Great topic, BTW!

Julie, I've been reading your thread and following it for some time now. I just wanted to chime in and say how inspiring you are. I hope to be banded soon and have been a couch potato most of my life (other than camping, hunting, fishing, etc...I was never a runner or aerobic fan) and I'll be starting at a weight similar to your starting weight. I hope that I can even enjoy half the success you have in your (a little less than) first year out. I wish you the best with your surgery, I am certain you are in very good hands, both with your father, and your stepmother. It's wonderful to have those resources! One of the surgeons I work with has put the offer on the table for a TT down the road, I'd just have to pay anesthesia costs. I was very hesitant to accept because of similar reasons to those you laid out earlier. We've known one another for a very looong time and I thought I would feel "funny." Your very articulate response on the previous page was such an eye-opener to me. Thank you for posting your thoughts and conclusions. It was MOST helpful! I will continue to follow this thread closely, I can't wait for the next chapter in your story. Thank you again!

Sure they do: Sutures only. And I'm glad to hear you had no problems with your dissolving sutures. I am going to be requesting that along with glue when I see the surgeon tomorrow. I'm crossing my fingers. Second choice would be dissolvable sutures with steri-strips. I'd love just glue, but I think I've got too much belly fat and it would pull alot. I've encountered enough dehisced wounds in my day to know I don't want one! :paranoid Thanks for the responses, don't stop now...:clap2:

You can buy scales that go to 400 and even 500 lbs that are fairly reasonable (under $100) just do a search for bariatric scale or look on Amazon.com, I found some there. I like your idea of going to the dump, though. I may try something like it. I don't want to shell the moola out right now for a home one. My ex would jump on a feed scale they had at the state surplus store whenever we would go. I noticed him out of the corner of my eye one time. I never said anything, but I knew why he did it and I applauded him for wanting to know where he was at weight wise.

No, no, no...do not starve yourself. The scale WILL go down, it takes time. Many folks have posted that post op they gained a bit of weight. Who knows if it's because of the shock your body went through, or if your body is in starvation mode already and is keeping all the calories it can. Have faith and hang on through this, it will come back off. Some folks have suggested upping the calories a tiny tad, and now that you are on soft Protein, your body will react differently. You definitely want to up that protein intake. Tuna fish and cottage cheese are high in protein. Good luck and take care! Remember this is not like the bypass, it does not take the pounds off by malnourishing us, the band is reliant on our food and Fluid choices, it helps us with portion control (eventually ) Now that you are a bit farther out, you can start making some of those choices. I (and I'm sure you probably did, too) have read on here that the first few weeks after banding are NOT for weight loss, they are for healing, so don't worry about a few pounds, it will drop again. Keep us informed, please!

Aprilmarie, I take it you didn't try to give it up pre-op? Don't feel alone, there are tons of folks here who are or have had problems with soda addictions. Take heart, you can get through it. Use the search function and look for threads with carbonation in them, you'll find lots of differening answers and opinions about this. The latest things I've been reading here and on the net say that some carbonation may be possible in moderation, but most agree you should wait six months to a year out before doing it. By then, you've broken yourself of the need, so why bother starting back up again? I caution you that this is not medical advice, and you should go by what your surgeon and nutritionist say, but there is emerging data that once well healed, a little carbonation is fine. Most every doc I think does say it's fine if you let it sit out and get flat, though.

Janine, congrats on being banded, may I ask where you went? And I am not a fan of the artificial stuff, either. I use Stevia a lot.

I third these opinions. jubjub, you really need to think long and hard about why you got the band. If you're not going to follow rules that were set up based on research and success and failure rates, then why bother having surgery? I don't know if you read any posts about how the band is placed, or watched any videos of placements, but I encourage you to go and watch this one, the surgeons doing it explain the whole procedure VERY well. http://www.or-live.com/tgh/1593 Your lower stomach is sutured up over your band and the more you make your stomach digest foods with residue in them, the longer it will take for those sutures to heal. Remember those stitches are in a warm, wet enviroment, anything stitched in conditions like that is going to take much longer to "set" in place. The stomach is very muscular and the contractions you are causing it to do by eating are moving those sutures around and risking popping them. Seriously man, stop and consider what the bleep you are doing and why? We want you to be successful, I would assume you want that, too.

I second wanting that recipe, Jack. Can you post it in the Recipes forum?

Speaking as a Michigander, I think our First Gentleman is quite that, a gentleman. And I've found that he handles it quite well. He was just on the radio discussing his new book and made comments similar to those you posted. And that fact that he is still by her side (whether you like her or not) and IS the cement that holds that family together, speaks volumes about the possibilities of men being able to "switch" roles with their wives. And yes, it's high time this happens! But I'll skip the experiment on a National level using Bill and Hillary, ok? Oops, I mean Hillary and Bill...

Here's a link to a thread here about the materials you should have received when you got your band: http://www.lapbandtalk.com/lap-band-identification-t3771.html

You sure can.

I have my surgical consult tomorrow and if the surgeon I'm seeing does not use pars flaccida, I won't be going to him. Simple as that, the statistics speak for themselves. Since he is who my insurance pays for me to see, I don't know what I'll do if he does not use this technique, but I'll cross that bridge later.

Precisely, the dumping effect tends to lessen over time, which means that weight is more easily regained. The RNY is sort of a tool, but only if that pouch stays small, and since it is made from stomach, it has a tendency to stretch easily over time. The things that keep the RNYer's honest in the beginning are basically malapsorption and malnutrition. Your body is a smart machine, it figures this out eventually. And you start utilizing food in a different way, the weight creeps back on. And your are still malnourished in terms of vitamins, etc. You simply cannot absorb them like you did when you had your intestine intact. So eventually many start to regain, but still have vitamin deficiencies, unless they are lucky enough to be able to absorb the supplements and take the B12 shots. If I HAD to lose a large amount of weight FAST because of medical issues, or if I were a lot older, I'd consider RNY (probably DS, actually), but at my age and without any real comorbidities, I'm being banded. If it becomes necessary, I can always have another bariatric procedure later. But if I have the RNY now, I could possibly have it taken down if I develop problems later, but I'll never get that minimum of 22 inches (up to who knows how much) of intestine back, ever. The operative techniques have changed dramatically in the past four years alone with the band. Here's a link to a journal article about the techniques used now (and to those of you being banded, make sure to ask if your surgeon uses this technique, if s/he doesn't, I'd reconsider that surgeon) that Rockn4U posted: http://thinforlife.med.nyu.edu/assets/REN%202.pdf?RCD=J53039 Here's the summation of what the article describes: Excellent results have been achieved outside the United States, with excess weight loss (EWL) averaging 53% to 65% at 3 years and major complication rates of 5%...Interestingly, the initial American experience in the Food and Drug Administration clinical trial resulted in a lower-than-expected rate of EWL (36%) and a higher-than-expected rate of complications (40%). The discrepancy between the results of the Food and Drug Administration trial and the international results may be partially explained by differences in surgical technique. A correlation has been shown between surgical technique and complications, specifically a higher rate of gastric prolapse for the older perigastric technique than for the pars flaccida technique (5.2% vs. 0.6%). Fielding et al. initially described the use of the pars flaccida technique and their subsequent 5-year results of 62% EWL, a 3.5% rate of gastric prolapse, and 0% mortality. Now while the article speaks specifically to US rates, the perigastric technique was not only used in the US, it was used in other countries for years as well. Other countries were just faster at changing their technique to pars flaccida than we were. Remember, our surgeons in the US were trained by Mexican and some European surgeons. US surgeons learned the perigastric technique from them. Then the International surgical community changed their tecnique to pars flaccida at the time that the US was just starting to place bands with more regularity. It always takes time to change surgical techniques, especially when the surgery being done is new to a practitioner.

Congrats on being Banded!!!! And on your excellent loss before banding, that is wonderful, you CAN do it! Welcome to LBT!

From all I've read here and other places, you do not want to be bringing anything back up! Grits might be too tough so soon after a couple of fills. Are you able to get warm liquids through the band? If you are not able to keep things down, you might need a slight unfill. The goal is to be able to eat and feel full after about 1/2-3/4 cup of food. Not to be unable to eat. Too tight bands can cause problems inside as well as slippage from bringing things back up. Hope you feel better soon!

While it is technically reversible (i.e. they can reconnect the disconnected part of the stomach and short leg of intestine to what you have left), it is not truly totally reversible. The intestine that was removed has gone to the incinerator long ago. So depending on how much your surgeon removes, that affects your absorption ability forever. Laurend is correct, the complication rate is pretty high. To the OP: Welcome to LBT! You are right, there are MANY MANY threads about this very topic. You may not have noticed, but there is a "Search" function in the blue bar about 1/3 of the way down from the top of the screen. I know it took me a while to find it, myself. I found 3 pages of threads using the advanced search and asking for titles of threads only with the word "bypass" in them. I did not search for RNY yet. I'll post the list of some from the results (first page). I am posting these because it's kind of nice to be able go and read other's responses to your question as well. Some folks who have responded in the past may not be around now. Happy reading and again, welcome, post, ask, enjoy!! http://www.lapbandtalk.com/gastric-bypass-vrs-t30997.html?t=30997 http://www.lapbandtalk.com/advantages-bypass-t31341.html?t=31341 http://www.lapbandtalk.com/band-vs-bypass-t28724.html?t=28724 http://www.lapbandtalk.com/getting-pressured-do-t28690.html?t=28690 http://www.lapbandtalk.com/lap-band-vs-t27483.html?t=27483 http://www.lapbandtalk.com/discussion-why-people-t26103.html?t=26103 http://www.lapbandtalk.com/lap-vs-bypass-t25642.html?t=25642 http://www.lapbandtalk.com/considering-band-but-t25042.html?t=25042 http://www.lapbandtalk.com/lapband-bypass-t25022.html?t=25022 http://www.lapbandtalk.com/band-vs-gastric-t23454.html?t=23454 http://www.lapbandtalk.com/showthread.php?t=23760 And even a poll about it, too: http://www.lapbandtalk.com/lap-band-bypass-t15886.html?t=15886

I'm making note of that one! And I'll alos be remembering Jack's-for those older folks that I feel the need to not swear around.

Great question, and I'm glad Mark has reassured me that I'm pretty well prepared (I've been reading here and other places a lot). Thanks for the tip on the Neosporin!

I cannot speak for Dr. Kuri's reasoning, but there is a lot of research out these pre-op diets and shrinking the liver. The majority of it was done relating to RNY, specifically in the days when most RNY or other WLS was done open versus lap. Though it doesn't really make a huge difference when you are talking about grasping the liver and retracting it whether you are open or not. Suffice it to say, the research was done to see if shrinking the liver (so that the operative field was easier to visualize and the liver was less likely to receive a traumatic injury from the instruments and manipulation) was beneficial. It was, but the majority of the studies (not a ton of them out there, but the data is solid) showed the longer, the better. Suggesting a four, or six week diet pre-operatively was the "ideal" but who can realistically do that? So I think the surgeons decided that two weeks was acceptable. Still, there are some docs who require three weeks, and occasionally four pre-op if they believe their patient to have a very fatty liver. I'm not sure if this is ALWAYS diagnosed with an abdominal ultrasound, but I know some folks get them. Some surgeons don't subscribe to it, some do. That's why you get differences. Also, there is the fact that the research was more geared towards a longer and more involved operation that requires more manipulation of the liver (RNY) than what is usually required in AGB (LapBand). I think that's another reason why quite a few of the band surgeons in Mexico (using them as an example) don't require it. They are highly skilled and many of them have exclusively done the band. Their table times are far shorter than a surgeon who has done say, 30 bands. The shorter on the table, the less time in the abdomen, the shorter time the liver needs to be retracted. Some doctors may also use the pre-op diet as a way to psychologically prepare you for the long time post op that you will be without solid food. There is also some credence to resting the stomach a bit pre-op. Though I still don't understand why some docs require a bowel prep for the Band! Here's a link where you can go watch the actual OR, the surgeons doing it explain the whole procedure VERY well. You'll see what I mean by retracting the liver: http://www.or-live.com/tgh/1593 Hope that helps!

Brandy, what an awfully insensitive thing for your mother to say. I'm sorry that you had to endure that after such a wonderfully cathartic day (and I'm thinking it was probably a great NSV for you, too). My mother would probably say something similar, but I do know that in her case, it would be because she doesn't throw a darned thing away and she's from the Depression Era. Even if it doesn't fit or is out of style, it stays because it cost money. Unfortunately I have gotten that packrat mentality and I've got to get control. I hope to be able to do what you did today and clear stuff out. Good for you for doing that.

Ooooo, there's a Mango Gatorade now? I love mango! Maybe I'll break down and have a touch of it to taste