Sara Kelly Keenan LC

Extremely overweight people who become thin very rapidly through surgery can sometimes feel very vulnerable and unprepared to deal with not only their own changing bodies but also the reactions of friends and family to the "new" body. Sometimes they are uncomfortable being the object of sexual desire for the first time in their adult lives. Especially with women, I have also seen that some feel as though they are ostracized by other women because those other women believe that their formerly fat friend has become an attractive threat to their own relationship. Others may feel self-conscious or unattractive because an extreme weight loss leaves them with skin folds or scars. They sometimes feel that surgery did them no good because their bodies still stand-out in public and in private as unusual. One client referred to it as the "Is That All There Is?" syndrome. She said she somehow believed that losing 150 pounds would leave her with a body that society would consider beautiful and what she got was abdominal flesh hanging over her thighs. I notice this is especially true when a person going into the surgical process is focused on getting thin or attractive rather than on getting healthy. There can also be problems in intimate relationships. One woman spoke of her husband's lack of interest in her sexually. In all other ways the relationship was healthy so they were able to talk about it. What she learned was that after the weight loss her husband felt unworthy of her because he was still overweight. He also lost his sexual confidence when his overweight wife, in his words, became "one of the girls in high school who wouldn't give me the time of day." Also, if a WLS patient has early-life traumas unaddressed or not completely addressed prior to surgery the loss of food as a way to placate stress and to reduce anxiety can be a new source of trauma. This leaves many facing a very difficult transition to a life not centered around food. All of these stressors and others are a breeding ground for cross-addictions. It is vital to consider before surgery and in the "thinning" months and years after surgery how you will deal with stress, sadness, fear, loneliness, anxiety, or whatever thoughts and feelings triggered emotional eating in the past. If there is no healthy outlet for these the body and mind will create whatever outlets they can, which most commonly include alcohol, drugs, sex or gambling. The problem of replacing food addiction with alcohol addiction is the one I have personal experience with and have seen the most in people I've encountered. In 2006, three years after LapBand surgery, I developed an addiction to alcohol. I had lost food as my companion, soother of stress, provider of sensual satisfaction and entertainment. I was not able to eat the comfort foods that placated my fears of life prior to WLS and I desperately craved an outlet for uncomfortable emotions and beliefs I took-on and began running from during my childhood in a violent home. So three years after WLS, and after loosing 110 pounds, my dinner every night became a 6-pack of Vodka coolers or more (Sour Apple or Grape) and ironically Healthy Choice low-fat ice cream. At my lowest I was 220 pounds and I felt very uncomfortable and vulnerable in a smaller body. I continued to wear large, baggy clothes because I was afraid to look feminine. Feminine to me then meant I was vulnerable and open to attack. This went on for a year, during which I regained all 110 pounds lost and felt like a failure. Worse, I felt like a public failure because everyone around me knew I'd had LapBand surgery. What I had to do was address the beliefs and fears I had about what it meant to be feminine. I had to come to terms with my past and embrace a future in which it is possible and within reach to be healthy, feminine and safe. To avoid cross-addictions, it is important that individuals considering surgery or those who have had surgery take this very personal, individual journey into the beliefs they hold onto from their pasts. These are the beliefs that caused them to turn to food in an unhealthy way for comfort. It is vitally important to plan what healthy outlets for emotional pain they can create. A therapist or Weight Loss Life Coach can help with this. Dealing with the thoughts and emotions that caused compulsive overeating in the past and forming healthy patterns for working with and releasing fear and anxiety in the future are essential to long-term weight loss and the avoidance of cross-addictions for WLS patients.

I consult on a Facebook group made up of people who experience very large weight losses through Bariatric surgeries and today I am struck by how they view their slimmer bodies and the BMI chart. What strikes me is that when they get down to within 30-40 pounds of what the BMI chart says is goal for them I notice many deciding they know better than the chart. The phrase, "I feel good at _____ weight" keeps coming up, as though that "feeling" makes irrelevant the BMI chart and scientific data about the dangers of carrying an extra 30-40 pounds on our bodies. Heart disease, diabetes and high blood pressure, as well as other illnesses linked to overweight, don't care when we set an arbitrary number that we "feel good" about. Today I'm wondering if it has more to do with the emotional work left undone when the excitement of the huge weight drop is focused on. It's great to focus on the big drop and enjoy it but it is also important to do the emotional and psychological work to embrace a body without a protective layer that keeps the world at a distance. I wonder if not doing this work accounts for people deciding to hang on to the last 30-40 pounds and deciding the BMI chart doesn't apply to them. Again and again, I see the term, "Everyone is different." While that is true, I see it as an excuse to not face fears about a life without fat and finish the job of making the body as healthy as it can be. I know this pitfall well, which is why I care so much about it and am writing about it now. When I was 333 pounds and got down to 210 in my 30s and 220 in my 40s I said the same thing! "Good enough! I'm big-boned! The BMI-chart doesn't apply to me because I am 6'3" tall. I naturally have a linebacker's body. My body isn't meant to be slim." The thoughts that limited my possibilities seemed to go on and on and they did stop my progress at the exact weights at which I accepted those thoughts as fact. The last and final time I lost weight I decided to allow my team of professionals, my coach and doctor, to decide when the goal had been reached for my body. I decided it was possible that my thinking about my body was limiting my results. Imagine my surprise when a slim, sexy, very un-linebacker's body was waiting for me at 175 pounds and a BMI of 21. Imagine! The BMI chart applied to me too!! I try to gently point this out on the message boards I consult on, but people carefully choose their language with the term "I feel." We are taught to respect "I feel" and hold whatever follows in reverence. The problem is that many couch a thought with "I feel" terminology. They are actually expressing what they THINK and the thought, unexamined, limits their potential. I love to work with people willing to differentiate between what they think and what they feel. These people are willing to examine their thoughts for patterns that limit their possibilities and may even cause a backwards slide into obesity. Really, losing the weight is just the beginning. Working with our thoughts about our weight and almost every aspect of our lives is central to long-term success and health. I expressed thoughts like this on the message boards and within minutes there were multiple comments from people reverting saying "The BMI chart doesn't apply to me because I feel [this and that]." Losing a lot of weight isn't the end of the journey. It is just the beginning. So I believe examining the thought patterns that led to obesity is key in order to not return to obesity. The BMI is not a perfect tool. No tool is perfect and there are some concerns as to its' value in all cases and for all bodies. But why not test it ALL THE WAY in your weight loss journey rather than holding-up short of optimal results? What do you think?

Thanks for all your comments. I appreciate them all. The thing I find interesting in the people I have been interacting with is that they embrace the BMI chart, which I acknowledged is an imperfect tool, until they get close to leaving the "obese" range. Then they abandon the tool and take their weight loss no further. I notice this particularly in WLS patients, who experience dramatic and sometimes shocking (to themselves) weight losses. It's as though perhaps it happens too quickly for them so they "step on the brake." It's my job to help people examine their limiting thoughts and behaviors so I am a student of those behaviors. I notice that many people seem to decide to abandon their weight loss when they are about to leave the "obese" classification and enter the "overweight" classification and I wonder if that has to do with the euphoria of dramatic weight loss being behind them or their lack of comfort in their "new" bodies. Classifications have limited value when talking about the weight ranges of human beings and I wish there were a better way to speak of it . If someone is happy being a particular weight that is their business, of course. But if someone has limiting beliefs that cause them to stop short of their stated goal when they begin working with me then it is my job as their coach to help them flesh-out their motives and reasoning. Goals can change mid-course but it is important for a person to be clear why they are changing their goals mid-course and examine their beliefs. What I have seen is people who lose 100+ pounds, get 30 pounds from what the BMI states is normal weight for their body type and summarily dismiss losing more weight. I am curious about what beliefs may be limiting a client's success. After consideration, if my client wishes to remain at a current weight I support that.

Today I'm wondering if it has more to do with the emotional work left undone when the excitement of the huge weight drop is focused on. It's great to focus on the big drop and enjoy it but it is also important to do the emotional and psychological work to embrace a body without a protective layer that keeps the world at a distance. I wonder if not doing this work accounts for people deciding to hang on to the last 30-40 pounds and deciding the BMI chart doesn't apply to them. Again and again, I see the term, "Everyone is different." While that is true, I see it as an excuse to not face fears about a life without fat and finish the job of making the body as healthy as it can be. I know this pitfall well, which is why I care so much about it and am writing about it now. When I was 333 pounds and got down to 210 in my 30s and 220 in my 40s I said the same thing! "Good enough! I'm big-boned! The BMI-chart doesn't apply to me because I am 6'3" tall. I naturally have a linebacker's body. My body isn't meant to be slim." The thoughts that limited my possibilities seemed to go on and on and they did stop my progress at the exact weights at which I accepted those thoughts as fact. The last and final time I lost weight I decided to allow my team of professionals, my coach and doctor, to decide when the goal had been reached for my body. I decided it was possible that my thinking about my body was limiting my results. Imagine my surprise when a slim, sexy, very un-linebacker's body was waiting for me at 175 pounds and a BMI of 21. Imagine! The BMI chart applied to me too!! I try to gently point this out on the message boards I consult on, but people carefully choose their language with the term "I feel." We are taught to respect "I feel" and hold whatever follows in reverence. The problem is that many couch a thought with "I feel" terminology. They are actually expressing what they THINK and the thought, unexamined, limits their potential. I love to work with people willing to differentiate between what they think and what they feel. These people are willing to examine their thoughts for patterns that limit their possibilities and may even cause a backwards slide into obesity. Really, losing the weight is just the beginning. Working with our thoughts about our weight and almost every aspect of our lives is central to long-term success and health. I expressed thoughts like this on the message boards and within minutes there were multiple comments from people reverting saying "The BMI chart doesn't apply to me because I feel [this and that]." Losing a lot of weight isn't the end of the journey. It is just the beginning. So I believe examining the thought patterns that led to obesity is key in order to not return to obesity. The BMI is not a perfect tool. No tool is perfect and there are some concerns as to its' value in all cases and for all bodies. But why not test it ALL THE WAY in your weight loss journey rather than holding-up short of optimal results? What do you think?

I was 170 pounds overweight and I thought I had tried everything. I had a LAP-BAND for 11 years, during which I lost and regained 130 pounds. The LAPBAND was ready to do its' job, but I was not ready to do mine. This is the story of how I embraced, life, living, healthy food and exercise, and finally shed 170 pounds 8 years into my LAPBAND journey. From needing a "walker" to climbing America's tallest mountain in 2 years, this is my story. Food was my way of comforting myself and relieving stress for as far back into my childhood as I can remember. There was alcohol and violence in my childhood home and I needed comfort. There was no human source for it so I created a source for it. Food "hugged me" and made me feel safer. In an environment with stressors beyond my control. I had a small something I could easily access to sooth myself. It was my mind deciding what to eat for comfort and it was my hand lifting the food to my mouth. I was in the driver's seat regarding something in my life and body, even if I wasn't safe in my home. Food was my best friend, provided comfort and gave me a way to manage even a small part of my life. By my teens, my chubby appearance morphed into actually being significantly overweight. At the age of 12, I jumped from a women's size 12 to size 18 and never looked back. By the age of 20, soon after my mother's death, I was a size 26 and 330 pounds. In my 30s, I lost 130 pounds too rapidly and much of my hair by binging and purging and in my 40s, I again lost 130 pounds after LAP-BAND Weight Loss Surgery in 2003. But because I had not done the emotional, internal work on my relationship with food and childhood trauma, my food addiction shifted to liquid calories I could easily pass through the LAP-BAND, which is common. At this time, for the first time in my life, I developed an alcohol problem and my dinner each night was a six pack of "vodka coolers" followed by a pint of low-fat ice cream for dessert. Nutrition was the last thought on my mind and my focus was on comfort calories that could pass through "the band." By 2006, all the weight I lost was back. I also continued to eat solid foods that would force me to vomit and caused my esophagus to become distended. When a LAP-BAND patient doesn't respect the "full" signals the body sends to the brain and continues to eat, the esophagus becomes a storage place for excess food and the esophagus stretches. This made the LAP-BAND useless and while it is still in my body, it no longer functions properly. At the same time, during the last 20 years, I developed back problems from bulging discs related to the weight I was carrying. I began using opiates under a doctor's supervision to combat pain and muscle spasms in my back and in my knees that resulted in five knee surgeries. At first, I viewed the opiates as a wonderful tool as they relieved or masked some of the pain and also provided an emotional high. Soon I was using the opiates for emotional reasons more than for pain and as my tolerance for them grew, I needed larger doses to get the same effect. Then I needed to graduate to a stronger form of opiate and that is when, 10 years ago, I began taking Oxycodone and OxyContin around the clock along with Flexeril for muscle spasms. Sitting for long periods became unbearable and I was forced to leave my career as a Court Paralegal and qualified for "permanent disability." I cried as I left the hearing in which I was declared disabled. I didn't want to be disabled but felt it must be true for a judge to decide it was. It was 2010 and I believed my life was essentially over. At 50 years old I was simply waiting to slowly die. I believed all my happy days were behind me. When my doctor suggested I try yoga before we take the drastic step of implanting electrodes in my spine for the pain, I began attending a very gentle yoga class for people with disabilities. Slowly, over a two year period, I began to build stronger core muscles which made the back spasms less severe and less frequent. But I continued to take the opiates because by then I had an emotional and chemical dependence on them. During this time, I was diagnosed with Sleep Apnea which was caused by the opiates and excess weight. Opiates disrupt the brains signals to the lungs and suppress the respiratory drive. On top of this - physical pain, addiction and emotional unhappiness - I was also caring for my father with Alzheimer's. Although in a safe and loving group home, I still felt responsible for my father's well-being and comfort. I was his only family within 3000 miles. As so often happens when caring for a loved-one, we stop caring for ourselves in every sense. Soon after my father's death in 2012, I developed pneumonia because my breathing became so inconsistent that my lungs filled with fluid. I realized at that point I needed to change everything about my life including losing the weight and decreasing, even eliminating, my use of opiates or else I would die. At that moment, in the hospital in 2012, the desire to live was sparked in me by the threat of death! After leaving the hospital, for 60 days, I detoxed and experienced cold sweats, tremors and anxiety as the opiates slowly left my bloodstream. Once I was drug-free, I began making small, sustainable changes to my diet and gradually increasing amounts of movement. (Yes, that means exercise!) Over the following 18 months, my weight dropped from a high of 333 pounds down to 185. As a 6'3" tall woman this is a healthy, lean weight for me. In 2013, I decided then to give myself the gift of nearly full-body plastic surgery. Since I was already severely overweight in my teens, at a time of life when many young girls look their best and enjoy being pretty, I decided "it is never too late to have a happy childhood." During an 11-hour surgery, 13 pounds of skin was removed from my abdomen, buttocks, back, chest and under arms. For the first time since the age of 12, no part of my belly and buttocks continue to jiggle when I stop walking, no part of me droops and my thighs do not rub together. The Sleep Apnea is gone and I now climb mountains instead of grabbing railings to pull myself up stairs! But the hardest mountain I've ever climbed was a "metaphorical mountain" in those first few weeks of starting to change my relationships with food and drugs, as well as beginning to move. I am enjoying a lovely renaissance in a healthy, lean, strong and coincidentally beautiful body. However, this transformation has not been about beauty. My goals are continued health and a desire to live with passion, and about choosing to do more than survive. I am driven from an internal source to live a vibrant, full life of joy so I can continue to enjoy the love of family and friends and so they needn't lose me to obesity and addiction. This photo (above) was taken on the highest mountain in the 48 contiguous United States, Mount Whitney. After 10 hours of climbing 6,134 feet to an elevation of 14,508 feet covering 11 miles, I summited at 2:00 pm and like every part of my weight-loss, fitness and "reclamation of life" journey, I did it! Yet, like during every aspect of my journey I had partners. My partners knew the lay of the land, my strength and challenges. I surrounded myself with people who knew how to help me get where I wanted to go. Physical and mental health professionals who coached me to express my full potential. What mountains will you climb in your life and who will help you get there? Build your team, including here at BariatricPal, and there is no "mountain" you cannot climb!

Food was my way of comforting myself and relieving stress for as far back into my childhood as I can remember. There was alcohol and violence in my childhood home and I needed comfort. There was no human source for it so I created a source for it. Food "hugged me" and made me feel safer. In an environment with stressors beyond my control. I had a small something I could easily access to sooth myself. It was my mind deciding what to eat for comfort and it was my hand lifting the food to my mouth. I was in the driver's seat regarding something in my life and body, even if I wasn't safe in my home. Food was my best friend, provided comfort and gave me a way to manage even a small part of my life. By my teens, my chubby appearance morphed into actually being significantly overweight. At the age of 12, I jumped from a women's size 12 to size 18 and never looked back. By the age of 20, soon after my mother's death, I was a size 26 and 330 pounds. In my 30s, I lost 130 pounds too rapidly and much of my hair by binging and purging and in my 40s, I again lost 130 pounds after LAP-BAND Weight Loss Surgery in 2003. But because I had not done the emotional, internal work on my relationship with food and childhood trauma, my food addiction shifted to liquid calories I could easily pass through the LAP-BAND, which is common. At this time, for the first time in my life, I developed an alcohol problem and my dinner each night was a six pack of "vodka coolers" followed by a pint of low-fat ice cream for dessert. Nutrition was the last thought on my mind and my focus was on comfort calories that could pass through "the band." By 2006, all the weight I lost was back. I also continued to eat solid foods that would force me to vomit and caused my esophagus to become distended. When a LAP-BAND patient doesn't respect the "full" signals the body sends to the brain and continues to eat, the esophagus becomes a storage place for excess food and the esophagus stretches. This made the LAP-BAND useless and while it is still in my body, it no longer functions properly. At the same time, during the last 20 years, I developed back problems from bulging discs related to the weight I was carrying. I began using opiates under a doctor's supervision to combat pain and muscle spasms in my back and in my knees that resulted in five knee surgeries. At first, I viewed the opiates as a wonderful tool as they relieved or masked some of the pain and also provided an emotional high. Soon I was using the opiates for emotional reasons more than for pain and as my tolerance for them grew, I needed larger doses to get the same effect. Then I needed to graduate to a stronger form of opiate and that is when, 10 years ago, I began taking Oxycodone and OxyContin around the clock along with Flexeril for muscle spasms. Sitting for long periods became unbearable and I was forced to leave my career as a Court Paralegal and qualified for "permanent disability." I cried as I left the hearing in which I was declared disabled. I didn't want to be disabled but felt it must be true for a judge to decide it was. It was 2010 and I believed my life was essentially over. At 50 years old I was simply waiting to slowly die. I believed all my happy days were behind me. When my doctor suggested I try yoga before we take the drastic step of implanting electrodes in my spine for the pain, I began attending a very gentle yoga class for people with disabilities. Slowly, over a two year period, I began to build stronger core muscles which made the back spasms less severe and less frequent. But I continued to take the opiates because by then I had an emotional and chemical dependence on them. During this time, I was diagnosed with Sleep Apnea which was caused by the opiates and excess weight. Opiates disrupt the brains signals to the lungs and suppress the respiratory drive. On top of this - physical pain, addiction and emotional unhappiness - I was also caring for my father with Alzheimer's. Although in a safe and loving group home, I still felt responsible for my father's well-being and comfort. I was his only family within 3000 miles. As so often happens when caring for a loved-one, we stop caring for ourselves in every sense. Soon after my father's death in 2012, I developed pneumonia because my breathing became so inconsistent that my lungs filled with fluid. I realized at that point I needed to change everything about my life including losing the weight and decreasing, even eliminating, my use of opiates or else I would die. At that moment, in the hospital in 2012, the desire to live was sparked in me by the threat of death! After leaving the hospital, for 60 days, I detoxed and experienced cold sweats, tremors and anxiety as the opiates slowly left my bloodstream. Once I was drug-free, I began making small, sustainable changes to my diet and gradually increasing amounts of movement. (Yes, that means exercise!) Over the following 18 months, my weight dropped from a high of 333 pounds down to 185. As a 6'3" tall woman this is a healthy, lean weight for me. In 2013, I decided then to give myself the gift of nearly full-body plastic surgery. Since I was already severely overweight in my teens, at a time of life when many young girls look their best and enjoy being pretty, I decided "it is never too late to have a happy childhood." During an 11-hour surgery, 13 pounds of skin was removed from my abdomen, buttocks, back, chest and under arms. For the first time since the age of 12, no part of my belly and buttocks continue to jiggle when I stop walking, no part of me droops and my thighs do not rub together. The Sleep Apnea is gone and I now climb mountains instead of grabbing railings to pull myself up stairs! But the hardest mountain I've ever climbed was a "metaphorical mountain" in those first few weeks of starting to change my relationships with food and drugs, as well as beginning to move. I am enjoying a lovely renaissance in a healthy, lean, strong and coincidentally beautiful body. However, this transformation has not been about beauty. My goals are continued health and a desire to live with passion, and about choosing to do more than survive. I am driven from an internal source to live a vibrant, full life of joy so I can continue to enjoy the love of family and friends and so they needn't lose me to obesity and addiction. This photo (above) was taken on the highest mountain in the 48 contiguous United States, Mount Whitney. After 10 hours of climbing 6,134 feet to an elevation of 14,508 feet covering 11 miles, I summited at 2:00 pm and like every part of my weight-loss, fitness and "reclamation of life" journey, I did it! Yet, like during every aspect of my journey I had partners. My partners knew the lay of the land, my strength and challenges. I surrounded myself with people who knew how to help me get where I wanted to go. Physical and mental health professionals who coached me to express my full potential. What mountains will you climb in your life and who will help you get there? Build your team, including here at BariatricPal, and there is no "mountain" you cannot climb!

Money is real tight for me so I want to get the least expensive revision of band to sleeve that I can SAFELY get. Who are the lowest price surgeons that you've used and had a great experience with? You can respond here or to my private email, whichever you prefer. Thank you all, Sara keenanbeagles@att.net

As a fellow Newby was anything Newby wrote inaccurate? She wrote: "[i don't want to] have my sleeve surgery done in a Strip Mall clinic (like Alamanza and Jerusalem Hospital)" Are Alamanza and Jerusalem in Strip Malls? "[i don't want to] use a surgeon that doesn't have a lot of experience (like Garcia and Lopez.)]" How many procedures have the "named practices" performed compared to the 3 most experiences Sleeve docs in Mexico? Have Garcia and Lopez performed even nearly as many as the 3 docs with the most # of successful procedures? Here I will define success as "less than 2% bad outcomes or complications per 1000 sleeves performed. Newby also wrote "My life is definitely very valuable to me and I'm not willing to risk it!" She's not telling anyone else what to do. She didn't say that if you chose a doc with less experience you value your life less than hers. I think anyone who read that into her words is allowing their own insecurities to pop-out. She's just stating for herself that she wants one of those docs with the greatest # of successes. I don't see anything wrong with that. Thanks, Newby, for putting forward your personal list in which you speak for no one except yourself. I too don't want to get surgery in a Strip Mall or receive aftercare in a recovery center that was robbed. I also don't want surgery by a surgeon with less experience compared to others. I don't think the way you wrote your email was insensitive at all and I glad to have the information you wrote as it is information I was unaware of and NO ONE says what you wrote was inaccurate. Mark Twain: "Insensitive is what they call you when they can't call you a liar." PS: My LapBand was done by Dr Ariel Ortiz in 2003 when he was one of the priciest. I got good surgery and free fills for a few years, which was good. But his office kept no charts and it was up to me to remember the dates and fill amounts of my adjustments and to report them to the doctor at fill-times. They had no records and no idea! Also, I was in a hospital room in August with no air conditioning. That's what top-dollar bought and that's why I'm doing quality-hunting AND bargain-hunting for my sleeve. Thank you for your original post.

The Rugged news is that today I had a camera put down my esophaghus (don't gasp! I doctor did it!!) The good news is that my 9 year old band has slipped so surgery will pay for it's removal. But I will need to go back to Mexico for the Sleeve because my BMI is too low! The better news is that I have the money!! Cool. Yippeee !!! Sara

Hi Thin Soon, No, I haven't yet decided where and when to be sleeved but I have decided to be sleeved in TJ. I had pneumonia last month that was a severe case requiring hospital time and the doc says it will take 6 months for my lungs to recover. My insurance will pay for the band removal, probably in the Fall, Then I'll rest my stretched esophagus for 3-6 months and then go to TJ for the sleeve. My BMI is 32 so I'm not a candidate for insurance to cover the sleeve in the US. I'm going to spend this 6 months exercising moderately and getting into the habit to eat the way a Bariatric patient should. Protein first, then veggies, fewer mochas and less other liquid calories, etc...... I'm going to do this because as a "failed" band patient I know that I have to eat and drink responsibly and exercise to succeed with any procedure and I was lazy and expected the band to do all the work while I ingested irresponsibly. I'm trying to lay a solid foundation so I get it right this time. How about you? What's your status?

Wow! That is so exciting. What was it about the band that didn't work for you and why does Dr. Forgione think the sleeve will be better? The surgeon my insurance requires I go to doesn't believe the sleeve is a valid replacement for the band. "Failed at the band, you'e fail with the sleeve." That's what he says. I'm going to have to educate him about the sleeve. Thank you and I hope you feel good......

Hello New Friends, My name is Sara. I got the band in 2003 in Mexico and liked it too tight. I lived on liquids and tiny amounts of food, which caused sliming and puking every day for years. I lost 100 lbs in the first year and slowly regained it all with liquid calories. My band was so tight and I ate a quantity of food that caused esophegial stretching. So my lower esophogus has become a pouch that stores food until it makes its' way through the band. I have now had all fill removed and the gastro surgeon in my doc's medical group wants to remove the band but he says I would not succeed with a sleeve revision because the ways I cheated with the band (liquid calories) I can also cheat with the sleeve-- mochas, wine coolers, ice ream, etc. So he will not approve me for further surgery. Also, of that hundred pounds I've lost 70 lbs again, by using Alli daily for 3 years, so my BMI is too low for insurance to pay for WLS for me. Do you agree I am not a good candidate for the sleeve? I am having an upper endoscopy in a few weeks to see if there's any tumors or cancerous disease process in the esophagus. Then the surgeon wants to remove the band and thats it. No more surgeries for me, according to the surgeon. Do you agree? I'm thinking about going back down to Tijuana in 6 months, so my anatomy has time to rest after the band's removal. I'd like to give it another shot to do it right with the sleeve. Eat protien first, then veggies. No abusing liquid calories. I'm ready to try to obey all the sleeve rules for success if my stretched esopgegus can tolerate and not sabotage my new sleeve. What do you think? Please be frank. I need the truth, even if it's ging to sting when I hear it. Thanks, Sara

Barb, Nice to know his price has come down. When I checked 2 yrs ago it was 11k-sleeve w/revision......10k no revision. Dr. Ariel Ortiz did my band on 4/15/03. Is his charming mother still driving patients from test to test the day before surgery??

thanks, i didnt know there was one. i'll go hunting. im not good with computer searches. thanks

Wow! As a cash-pay I love Dr. Kelly's package price. Is that 5500 for a band revision to sleeve or just the sleeve? I think my insurance will pay for removal of my band because my esphagus is very, very stretched. I am leaning towards getting my band out "at home in the US", waiting 4-6 months for my esophasus to continue healing and then go to Tujuana and Dr. Kelly. I'm getting an upper GI and report in mid-july so I'll ask for a copy of the photos and report and then mail copies or email copies to Dr. Kelly via Omar. Thank you for sharing your info so freely with me! Sara

Thanks anyway. I don't have Kaiser.

Oh Alice, I', sorry you are having a rough time. What is so difficult about the sleeve that it needs all this figuring-out post-op by the doc? Any idea why you are having such a rough experience? Is it common? I don't understand what it making your sleeve so hard to make work right that your needing an upper GI in Tuscon. Will you have to go back to Aceves? What's going wrong and why do you think it's going wrong? If it's too depressing or sad to write about in depth and it would cause you emotional pain to answer my questions then please don't answer. It sounds like you are in enough emotional pain without having to type your troubles in detail to a newby and I don't want to add to your pain. I'm just trying to understand. I hope you feel much, much better very soon!! Sara

Thank you Alice. That does help! That's a lot more than I thought it would be for Mexico, but it sounds like his patients pay for "the best" and I keep hearing about leaks when the surgeon might not be the most experienced. I don't want leaks!! I will contact them after I read the website. Thank you for the link. I might not have been able to find it on my own....I am a computer-challenged 50something being left behind by technology with every day that passes. Thanks again, Alice! Sara

What is the cost with your doc for band revision to sleeve? I'd certainly like to pay more for a very experienced surgeon. Good luck and please let me know the costs! Thank you, Sara

Dear MamaM, I see your doc is in Fresno. What was the cost of your revision? I just assumed I had to go back to Tijuana to get a good price. I'd love to only have to drive from the Bay Area to Frenso! Thank you in advance for sharing your costs. Sara

DEAR THINMYMIND, What does Dr. Kelly charge for sleeve surgery and hospitalization, etc. Is it a "package" price? Thanks and GOOD LUCK!! SARA

DEAR LISA, I will be a self-pay to Tijuana as well. What doctor have you chosen? What other docs did you consider? What were your price-quotes and what is your final price? Is yours a band to sleeve revision or strictly a sleeve? My insurance will pay in the US for my band to be removed since my esophagus has stretched and formed a sort-of-a-pouch above the band. My BMI is 32 so I'll be a self-pay to Tijuana to get the sleeve. Thanks in advance for sharing your pricing info and GOD LUCK !!!! Sara

SORRY FOR THE CLUMSY CUT AND PASTE JOB ABOVE. I NEED TO FIGURE OUT HOW TO QUOTE AN EARLIER POST BETTER! SARA

DEAR THIN SOON, . I agree. Dr. Ponce has a name I've heard good things about since 2003, when I was banded. Do you have a band. Is your surgery just for the sleeve or are you getting a band revision to sleeve? What are his prices like? Can you pay with a visa card? Thanks in advance for the info and GOOD LUCK!! SARA

ALSO, DOES ANYONE KNOW IF SLEEVE SURGERY IS EFFECTIVE EVEN IF THE ESOPHAGUS IS PERMANENTLY STRETCHED INTO A POUCH ABOVE THE BAND?