WASaBubbleButt

How much are you exercising?

I have hypothyroidism and it didn't affect my weight loss. I am a rare one that was able to stop taking it at goal.

Keep dreaming. ;o) The port isn't going anywhere and the more you lose the more it sticks out. Think of a turkey timer, that red thing that pops out of a turkey when it's done cooking. When yours pops out you'll be done losing. ;o)))) You'll get used to it.

Your stomach was made extra small knowing it is going to stretch out a bit by 4-6 months. In a few months it should be the size and shape of a small banana. Right now it's about half that. So if you take full advantage of the itty bitty sleeve you have now it just gets you to goal faster. It's not going to get easier to lose weight, it's going to get harder. Your metabolism will naturally slow down a bit. You WILL lose muscle mass, it's a natural part of losing a massive amount of weight. They key is to maintain as much muscle mass as possible and you do that through Protein and weight training. You'll be able to eat a little more at 6 months. It's not like bypass that things kinda come to a dead stop at 18 months but with us it slows down at about 6 months and it isn't the breeze it is today. You'll have to put a bit more effort into it just like any WLS type. Take FULL advantage of the easy weight loss and depending on how much you have to lose you might get to goal by 6 months. Exercise, do it every single day. Limit white carbs to 20gms daily. Not all carbs, just WHITE carbs.

I've wondered the same thing. It *seems* like Mom's heart is in this more than the daughter. Just hearing what she is eating is making me think her entire diet needs to be overhauled. But I considered the relationship Mom and daughter have so I responded according to how things are instead of perhaps how it should be. If the daughter isn't going to put 100% effort into this, I'd be giving the daughter jobs to earn money to pay Mom back for the band.

Whoa... wait a minute. Do you hear yourself? The fat mentality is screaming and you can't hear it. You are losing weight. Tell these people your health is an issue and you cannot gorge yourself. If they demand that you eat, gorge yourself, and they demand you do this in spite of your health it is YOU that should be insulted. Com'on... let's get real here. It's time to change our relationship with food. I believe that YOU believe they would be insulted but we all know that if they want you to harm yourself then that isn't realistic.

One thing I am going to suggest is changing her diet a bit. Those frozen burritos are complete garbage. They are loaded with fat, sodium, carbs, and calories. A better bet would be overly steamed veggies chewed well. Instead of eggs with fake cheese (eggs are very hard for many bandsters) if it is the AM what about a Protein shake? I'm assuming this was breakfast? It's normal to be tighter in the AMs. If she eats carbs in the AMs she is going to be hungry all day. Save the carbs for evening. Stick to protein earlier in the day. Have her count her WHITE carbs, not veggie carbs but WHITE carbs. Limit those to 20gms daily. Unlimited veggie carbs. No flour or sugar AT ALL. This is all about a lifestyle change, not eating the same bad foods in smaller quantities. I fully understand you are trying to save money, that's more than reasonable. But buying overly processed foods that have more fat grams than nutrition is not the way to go. Steamed veggies... buy a microwavable steamer bag. Cut up yellow squash, zucchini, broccoli, caulaflower, veggies other than potatoes, corn, peas, and carrots. Steam them, drain, add soy sauce and sesame oil if she likes Chinese flavors. Very little reason why she couldn't eat this. The veggies can be steamed to a mush if need be. She's getting Vitamins, Fiber... basic nutrition. No more than a dollar per serving. Does she like Mexican? Buy a bag of pinto Beans, 1# is less than a dollar and makes a ton of food. Wash, soak overnight in Water. Put in crock pot for 8 hours or so. Drain 90% of liquid, mash. Add spices to taste such as salt, pepper, garlic, onion powder, and a bit of EVOO, not garbage oil, quality oil. Just a teaspoon or two. Now you have refried beans without the lard and garbage from the store and cheaper than canned. Get some tostadas. Watch brands, don't get the cheap ones because it's loaded with carbs and calories. A bag of quality tostadas is about $3.00 and has 20 servings or so. Put refried beans on tostada, a bit of real cheese, place in oven to melt cheese and heat beans. Top with your own pico de gullo and add taco sauce. Pico de gullo (my way and I'm not Mexican so this might not be REAL PDG. Heh...) Tomatillo (med) Tomato (lg, verrrrrry firm) Serrono (sp?) if she likes heat, if not other type of pepper Onion (small) Cilantro (I like a lot, add to taste) Salt Lime juice to keep it fresh so it will last a few days Dice Tomatillo, tomato, onion, pepper. Chop cilantro, add salt to taste. It will make the tomatos drain, keep the juice or not, your choice. Sprinkle lime juice on top of the whole thing. It will last about 4 days as will the beans. You have a meal that is loaded with protein, tastes good, has GOOD carbs, fiber, and nutrition. No way is that going to be more than a dollar a meal. Do the same thing as above but instead of a tostada just make it in a small bowl. Use the PDG on top of salads, in Soups, be creative and put it in anything you want. It's great! ~~~~~~~~~~~~~~~~~~~~~~~~~~ Lentil Soup... Lentils are a complete protein chain unlike pinto beans so you don't need cheese (complete protein chain). A bag of lentils is about a dollar and makes a TON of food. A bag is 1#, use 1/2 bag. Wash and soak in water for 8 hours or over night. Get a large crock pot, add lentils, dice onions, broccoli, cauliflower, celery (diced small... strings!), zucchini, yellow squash.. just clean out the produce drawer of your frig and add anything you want except potatoes, carrots, peas, or corn. They are starchy and high in unnecessary carbs). Add chicken broth, spices such as salt, pepper, garlic, crushed rosemary, whatever you like. Cook in crock pot all day. You have a hearty soup, loaded with good carbs, low cal, high fiber, excellent nutrition and for about $0.50/serving. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Twice baked Zucchini or Yellow Squash Use either or both. Slice in half the long way, scoop out the middle like you would a twice baked potato. Bake shells to desired tenderness if you want or do it all and bake at the end. Dice onion, celery, bacon bits, chicken bits, be creative. Put anything you want in there. I use onion, celery, and Canadian Bacon. Just clean out your frig when you do this. Leftovers, anything you want. Use a small bit of EVOO and cook the mixture you come up with. Sprinkle parmesan cheese on the zucchini or yellow squash, add mixture to hollowed out shells (don't hollow them out too much), overstuff them with whatever concoction you make. Sprinkle with more parmesan cheese or romano cheese. Try to stay away from the oily type cheese. Bake to desired tenderness. Since she should only be able to eat one you have a meal for certainly less than a dollar. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In your grocery store you should have a section for bagged beans. Don't buy canned, they are expensive and processed. Buy a bag of every bean they have and play around with them. Make soups, stews, invent your own recipes. These recipes do not take a long time to prepare. Washing and soaking... 3 minutes. Dicing veggies and adding to a crock pot.. 20 minutes at best. Never add salt to beans until after they are cooked, they'll be tough if you do. Add it after they are cooked. If she doesn't like veggies and healthier foods tell her tough. You don't care, that's what she gets. Make her eat it anyway. She's not a little child, she needs to learn to like these foods and with eating them daily she will learn to like them and she'll begin to crave them. When you are thinking about food and cost... get down to basics. We don't need ANYTHING with flour or sugar, that is what got us fat. We didn't get fat from eating broccoli we got fat from eating processed foods loaded with bad carbs and sodium. Taking them out of the diet gets us thin. Fresh veggies are not expensive, fresh fruit is expensive. But our quantities are limited with good restriction so it's not expensive. Beans, wild rice, fresh veggies... this can be cheaper than the processed, lacking in nutrition, hard to eat stuff she's consuming now. Remember, this is not a diet of eating crap but less of it. This is a lifestyle change. She can do it or not, it's her choice. But if she wants to lose weight she's going to have to overhaul her diet. Don't even buy the crap foods, nobody needs them. You can have healthy meals that are less expensive than the stuff she's eating now. Money just isn't a reason not to eat well. How many hours a day is she exercising? She should be working up to an hour a day. If she's not then get on her about this. Make her do it. You paid for this surgery you have some rights here to make sure she is trying. The band isn't going to do it for her, it's a tool she she can change the way she moves her body, the foods she eats, and the way she thinks about food. It sounds to me like she's eating the same foods she probably was before surgery but less of it. That's not how this works. Is she posting here? What is her ID? We all need to work with her and get this kid going in the right direction.

I don't know, to go that low for a sleeve is of concern. The costs to do a sleeve are quite a bit more than most would realize. They have to be seriously hurting for business to be willing to go that low and it does make one wonder where they are cutting corners. The staples alone are amazingly expensive. Surgery in a clinic, recovery in a hotel in Tijuana, dirt cheap surgery... be careful. At least make sure you are getting three leak tests and have access to a hospital and that YOU know how to get there. Since you won't be getting 24/7 medical supervision after major surgery at least don't go by yourself. At least have someone there in case you can't get to a hospital by yourself.

In the beginning I tracked carbs and did keep them under 20. Probably half way to goal I just kept WHITE carbs at 20 and unlimited veggie carbs. I still do that for the most part. I counted Protein, calories and carbs, nothing else.

600 calories a day isn't for everyone but it can be done safely. I did it. I always got at least 60gms of protein in daily which is what my doc suggested, I had plenty of energy, plenty of muscle, no problems. Starvation mode... there isn't any solid science between that concept.

There was a convention of some sort for bariatric surgeons a couple of weeks ago and they discussed repositioning or rebanding.. they claims stats are 70% chance of a future slip with a re-op. I'd really think long and hard about the sleeve. It's easier anyway.

Who is your doctor? I'd be happy to send him basic information on banding. ;o)

I am a naturally lazy person so I am going to copy/paste what is on my profile for another message board. It was originally a response to another person looking for a butt kicking. ;o) ~~~~~~~~~~~~~~~~~~~~~~~~~ I'm going to get hammered for writing this but that has never stopped me before. ;o) You know these people that eat pizza and tacos a few days after surgery and they come to the boards asking if they just messed up? You know those people that pat them on the head, tell them it's okay, and to "try" to do better tomorrow? Yeah, I'm not one of those people. I tell them to knock it off, they are risking their band and why? For a lousy taco?? Are they serious? I don't suggest they TRY to do better the next day, I tell them to DO better right now. I think we often times don't give ourselves enough credit. We think we are weak willed and powerless over the world. That simply isn't true. We have been living a life of fat for many years. You tell me the weak willed and powerless can do that, I won't believe you. Being fat in today's society is no easy task. It's really damned hard. Yet we survive it and if we can survive that, we can survive passing up a donut. Let's face it, it is much easier to pass up a donut than it is to have to buy two airlines seats because our butts are too big for one seat. It's much easier to pass up a single donut than it is to face ourselves in the mirror of Lane Giant after realizing we are yet... a bigger size than the last time we were there. We face humiliation and embarrassment every single day just due to our size. I think sometimes we tend to get used to it and forget that humiliation and embarrassment are NOT normal and a part of life. We also pretend it does not hurt as much as it does. I'm not trying to be a skank about this but you know, WLS is our last shot at WL. This is a big deal, we have choices and too many times we are all making the wrong ones. I don't eat a lot of junk because I don't need it. Neither do you. I disagree with those that say ANYTHING in moderation is okay. The reason I disagree is because ALL of us did not get fat because we can do moderation well. With a band or any WLS our caloric intake is cut drastically and we need every calorie for food we actually need and use. The only thing cake, Pasta, or crap food will do for your body is make it more plump. This is a lifestyle change and a lifestyle change does not mean eating the same load of crap but just less of it, that means overhauling your diet and eating food that your body needs and does something positive for it. What "value" does chocolate cake have for your body? So does this mean that you can never have a piece of birthday cake again? Of course not. It means that eating junk on a regular basis serves no value. We don't know what moderation is so we have to go searching for it. Moderation does not mean limiting ourselves to crap food just one time daily or one time weekly, it means more along the lines of on birthdays, special occasions. When we "plan" on eating junk weekly, what does that make our thinking? That means we are *still* planning our lives around food and poor choices. Thin people don't set out to plan on when they will eat a load of crap, they don't even think about it until the birthday party or social meeting is there staring them in the face. Yet we fatties actually plan a date and time to eat bad food. See the difference in thinking between a fat person and a normal size person? The lifestyle change is not planning on WHEN we will have loads of crap food, lifestyle change means actually going out there and living what we claim we want. Life as a normal size person. If you can face the humiliation of being obese in society, can you honestly sit there and tell yourself that passing up junk food is harder than being the fat girl walking into a room where being MO is socially unacceptable? I mean, I think there comes a time when we have to put things in their proper perspective and this is one of those times. Next time you want junk food get real and get honest with yourself. Get a photo of that food item and a photo of a person that is the size you want to be. Which do you want more, do you want the cake more than you want to be thin and healthy? Be verrry honest with yourself. If you prefer the cake over thin then just go for it and have the darn band removed. But I'll bet you'd rather have thin over a piece of cake when you really get honest with yourself. It's all about perspective and self awareness of what you want out of this life. We have a choice, and it IS a choice. We can be fat or we can be thin. With a band thin IS within grasp. The thing about us fat folks is that traditional diet and exercise is too hard, we just can't do it. We cannot lose and maintain at a normal size weight. Call it a lack of self control, call it anything you want. I'll cop to it, I'll be one to stand right up there and admit that I can't do it. But with a band it is still hard but it is the kind of hard WE can do, OUR population. Losing weight with a band is the kind of hard we can do but without a band, nope... we can't do it. Sometimes, maybe often times, maybe 20x a day when we are justifying more grazing behaviors and opening the frig to see what unnecessary food is in there, there comes a time when you just have to tell yourself no. We tell our children "no" daily. No, you can't play with razor blades in the middle of a busy street. No, you can't eat rat poison. No, you can't fail to look both ways when crossing a street. No, you can't do drugs. No, you can't go out with that drug abuser who just got out of juvvy. Sometimes we have to tell ourselves no as well. If you are like me, not sure you are, but if you are like me I can't stop at one Frito, or one bite of this or that. For me it is all or none. If I eat white carbs I can't quit. I lose self control. If I stay away from them completely I have no problem. The more I eat the more I crave. I am a person that wanted bread so bad about 3 months after banding I actually broke into the bread crumbs I use for cooking and ate the whole can. Then I started in on dry stuffing mix. It wasn't even something that tasted good (pretty rank, actually) but I couldn't stand the carb cravings anymore. That was my moment when I realized when and how I lose self control. So I avoid those situations. You can come over to my house right now and look through my house. You won't find any flour, pasta, bread, Fritos, or other foods that are my triggers. There are no bread crumbs, stuffing mix, cake mixes, cookie mixes... none of it. I don't even keep it in the house. There is not a person that has ever once been in my home that even needs those foods. My husband doesn't need them and he doesn't get them if he is here. Why would your family NEED cakes, Cookies, etc? We are not punishing our family members by denying them food habits WE have, it really is okay if you don't load your cupboards full of crap your kids do not need. I think that is another mindset we have to change. I've seen people post on these very boards that they can't pass up the cookies in the cupboard but they can't punish their children by not having cookies in the house. Since when it is a punishment to decline to feed a growing child cookies to the point you can't have a day without them in your home? Exercise... you know, we have physical and emotional reasons for overeating. Those issues we have to overcome and find ways to deal with them. But exercise? Nahhh, we have no excuse. That is just plain lazy behavior. You don't like exercise? Neither do I. But it's like cleaning the toilet. Who DOES like to do it? We do it because we have to. It's just a responsibility. We are all great at justifying eating too much and not exercising but the reality comes down to sheer lazy behaviors. If you can't run then power walk. If you can't power walk then walk. If you can't walk then do chair exercises. We have the energy to get up and run to the frig 20 times a day yet we can't find the time nor the motivation to do the SAME walking outside and away from food. How does that work? ;o) There are people who LOVE exercise, zog bless their little hearts! It's like a transfer addiction. They go from eating to exercising. They love it. Personally, I think they are sick and twisted human beings. ;o) I exercise but I hate it. Never have enjoyed it, not even a little. The person who invented weight resistance cannot possibly be anything but a lover of S&M. They should be shot. But you know what? It really really works. The motivation for me was not busting my butt on a treadmill when I would have much preferred doing my nails. The motivation was that the more I exercised the more weight I lost. THAT was my addiction, losing weight and getting thin. The more you lose the more motivation you get. What if you do this, just for ONE week... one week only. Cut out ALL white carbs. Yep, you'll be climbing the walls, you'll be dealing with head hunger full force. Every single TV commercial for food will be calling your name. You'll cus and swear at me and everyone else that is around you in real time or the boards. Start exercising. Even ten minutes of brisk walking. Work up a sweat, bust your butt. Just 10 minutes. That's nothing, that is the same as a couple of TV commercials. That is about the same amount of time to read a single thread on OH. Just take 10 simple minutes and go out for a hard walk. Then you are done exercising for the day. Honestly, 10 minutes is NOTHING. We have 144 10 minute blocks in a day, it really is nothing. Then tomorrow do 11 minutes. And yes, time it from the time your walk is a brisk one, not when you start thinking it's time to go outside for your walk. When your pace is up to brisk then start timing. Daily add a single minute to it. Push yourself to do better each day, just a single minute added. So for a week eat what you want, don't count calories, don't count fat grams. Don't worry about calories in the least. Eat what you want but do limit WHITE carbs to 20 a day. I'm just talking for a week. Do the 10 minutes of exercise while adding one minute daily. See what that does for you. You want 20 chicken breasts? Eat them. You want zucchini, yellow squash, any other carbs except fruit? Eat them. Lots of them. Don't even count carbs from veggies. Just count white carbs and limit those drastically to 20gms daily. The idea here is not to get you into ketosis, the idea is to get you eating the right carbs. Have unlimited VEGGIE carbs. You'll poop like a champ too. ;o) I'll bet you that you lose weight. Then as the motivation kicks in and the stomach hunger dies down you will be able to cut those 20 chicken breasts down to 10. Then 5, then 1 daily. Understand what is head hunger and what is true stomach hunger. Just focus on white carbs and minimal exercise. I'll bet you it works. If you can live the life and frustration as a fat person, you can do this. Being fat is MUCH harder than better food choices. Again, it's all perspective. What about your fill level? Are you at good restricton? If not, get thy butt to the doc and take care of it. There, that's yer' butt kicking. ;o) Just remember, you CAN do this, you have survived much much harder as a fat person and you have survived a life that is no walk in the park. If you can survive fat life you can easily survive the above plan for the next week. And BTW, this means start the whole plan tomorrow, not on Sunday at the beginning of the week. If you have already eaten a load of carbs today you will be hungry for the rest of the day. It's a blood sugar thing. So start tomorrow and keep remembering, you can do this. Good luck to you!

Parrothead... this is not accurate. The lap band does not offer 0.01% complications. Erosion: 1.3% Slips: Over 7% Infections: <1% at the time of surgery, but the risk remains with each fill. Then there is band intolerance, pouch dilation, esophageal dilation, stoma spasms, and many other possible issues. There IS a chance for death with Lap Band surgery, there is a chance of death for ANY surgical procedure. It's low with band/sleeve but it's still a possibility. Hair loss happens all the time with all WLS types. Have you seen the many posts here on hair loss? I think it's really important to provide good, solid information so that people can make the choice that is right for them. The doctors and band makers do not support your 0.01% stat in the least.

Yeah, and that's the best way I know to get a dilated pouch which can potentially lead to another surgery. With all due respect, this is the dumbest post I have seen in a long time. Why not tell people to dig their eye out with a rusty nail while they are at it? Some people get mega stuck when trying to force that "water slide". It can also lead to pouch dilation which can lead to a stuck episode and then the vomiting can easily cause a slip. You are clearly free to do this all you want but please don't give such horrible advice to newbies, they might actually do this. Don't drink after meals.

He doesn't know if you have a hernia? Why in the world didn't he look? That's standard for any WLS, look for/fix hiatal hernias and do WLS.

Lots of thoughts here.... It's normal to be tight in the AMs.. There are different opinions on how to resolve the "can only get soft foods down in the AMs, can eat anything in the PMs." Some doctors tell you to white knuckle it. Dr. Curry on OH suggests doing your fill at 5PM so you have good restriction in the evenings yet you cannot eat at all in the mornings. Getting full... this is the fat mentality rearing it's ugly head. Did you know that naturally thin people don't like the full feeling? They eat until they are no longer hungry. WE eat until we are stuffed full. A good guide would be this, while you are eating really think about your hunger level: If you are hungry eat two more bites, If you are satisfied stop eating, If you are full you ate too much. When your restriction is not great drink ice Water before eating. Cold usually tightens people up a bit. I am sleeved now (revision from band to sleeve) and even with a sleeve that's about the only thing that affects my restriction. If I drink something hot/warm I see no difference. But if I drink something ice cold before a meal I can only eat about half of what I usually do. My food quantity is already very limited so I don't drink anything cold before a meal. But if I was trying to lose I would.

HA! True. Stick to the thicker Protein shakes like whey Gourmet Choco/PB. They are more satisfying. Avoid carbs like the plague because they will just cause blood sugar spikes and make you hungry. High protein, verrrry low carb. Thick shakes, lots of them! Drink them before you even get hungry. Turn the TV off, commercials are not your friend now.

That one would be pretty easy to disprove.

It depends on your insurance and which doctors contract with them. Your best bet is to get a list of doctors contracted with your insurance company and then start researching them each.

I would have to disagree that there is only a 0.01% complication stat. That isn't even close to accurate. Erosion happens 1.3% of the time, slips are still on the rise per Inamed at over 7%. Infections... less than 1%. Then there is pouch/esophageal dilation/damage. Band intolerance is on the rise, port infections are a risk with every fill. Slips... there was a conference in the US recently for bariatric surgeons and if you slip and require surgical repositioning there is a 70% chance for another slip within 5 years. Re-ops are 30-50% within the first five years of surgery. That's not all of the stats, just some. No way are risks and complications for banding 0.01%.

About three of the doctors there are more experienced than a majority of US surgeons. Their experience is greater, their stats are better, they keep you in the hospital for 3 nights following surgery instead of outpatient or one night in the hospital in the US, and they are about half the price. That's the only place I wanted to go for my revision. We just don't have great revision surgeons in my state so for me, MX was a better option. I think Susan's thinking is similar but I'm sure she'll correct me if I am wrong. When it comes to a revision you can't just go to anyone. Leak risks triple with a revision instead of a straight sleeve so you really have to go to someone mega experienced.

Please know, you are not alone in revision surgery! My suggestion... after your stomach has healed go to a surgeon that does ALL major procedure types, band, sleeve, and bypass. If restriction is all you need and you don't need malabsorption, get a sleeve! They ROCK! I love mine, it is so much easier than banding. No slips, erosion, stomas, getting stuck, none of it. Just a tiny little stomach. Weight loss is faster, better, easier, and far fewer long term complications. They also remove Ghrelin, a hunger causing hormone produced mostly by the stomach. So hunger is not the same as before surgery. Here is a link to find out more: Vertical Sleeve Gastrectomy Surgery (VSG) AKA Gastric Sleeve (NEW!) - Lap Band Surgery and Lap Band Discussion Forum If you go to someone who only does bands and bypass they aren't going to push the sleeve. It would be like a toyota dealer talking you into a ford. It isn't going to happen. That's why I suggest going to someone who does all the major procedures, you get a more balanced opinion. But no worries! There are options and they might just be better than the band!

Raising hand. As explained above mine was repaired at the time of banding, I never had a dilated pouch, dilated esophagus, or a slip. But I sure had reflux. Never had problems before banding but I did after. I could either eat a huge quantity of food or nothing at all. It was one extreme or another depending on the day. I hated that band.

My surgeon (in Mexico) and I discussed this at length before my band and he explained that it is well known that Hiatal hernias cause all kinds of problems with banding. He has always repaired them with all WLS types. I had one and he did repair it at the time of my band. When I had mega band problems and was on liquids the last four months of banding I revised to a sleeve. I've seen the CD of the surgery and there was no hernia as it was repaired during banding yet I experienced the same as Elisabeth. I had no reflux before banding, I had mega reflux with banding. It wasn't a hernia. The band causes a lot of problems. Look at the boards, people have problems non stop. Newbies love the band, actually it goes like this from my experience. Those banded: 0-6 months love their band and their surgeon 6-12 months they love their band, they figured out they are the ones doing the work and not their surgeon. 12-18 months they are having problems but the scale is moving so they'll deal with it. 18-24 months they are sick of the problems and are considering their options. 24 months on they are getting revisions if they can afford it. I'm not claiming this is a hard and fast rule, just my experience on various band boards. I haven't had a single day since my own revision that I haven't had someone asking for help to get insurance to cover a revision. They often times can't get ins to cover due to no longer being a high BMI. Ins will pay to remove the band but not revise to another procedure type. If they don't want ins help they want help finding a procedure type for them. I think that these band factories that doctors have created are not great. If the surgeon can only do banding and not the more complicated procedures they aren't telling people all their options such as the sleeve. They are just telling them about bands and suggesting they get bands only. That's not right... kind of unethical if you think about it.