Sara Kelly Keenan LC

Thank you Erika and Tanay. I'm going to digest what you've both said and I'll get back to you with more questions. Thank you for your openness in sharing your stories with me. Fondly, Sara

Hi B and R's Mommy and anyone else who's done or doing the band revision to sleeve in Tijuana......how much does this cost in Tijuana? Has anyone done a price comparison of the costs that the various doctors in Tijuana are currently charging? B and R's Mommy. Wht is Dr. Rodriguez' charge for that? How many days in a TJ hospital? Anyone else who can help with pricing and their doc's levels of experience would be great. I'm trying to not reinvent the wheel and hoping one or two or three of you have already invented this wheel? I think my insurance here will pay for the band to come out. I want to then wait about six months for my stomach and esophagus to rest and heal as much as they will and work on my own behavioral patterns of self-sabotage. Then in 6 months, and only if I'm emotionally ready and practiced at self-discoplina and following the rules I will go to TJ and pay cash for the Sleeve. Please share pricing. Thank you, Sara Thank you, Sara

To Everyone with Tijuana Sleeve doc knowledge........ Thank you Lissa and Sleeve Guru. From hearing people share their surgical sleeve experiences in the Tijuana area, who would you say are the 2 or 3 sleeve surgeons many different people have gone to for surgery and were happy with the experience AND the price? My band doc, Dr. Ariel Ortiz charges $10k for the sleeve surgery and some surgeons I don't know price it for under $5000. Who are the currently "hot" sleeve surgeons offering good service for a good price?

Hi Lissa, What is sliming and what are sliders. There's a band term called "PBing--Productive Burping"---which means puking the contents of an entire meal when to much food is eaten and as you say it is "more like my stomach ejected it's contents."

What is the sensation with the sleeve? Is there the sensation of physical hunger? With the band if you take one bite too many it results in puking everything. And you can only know in hind-site which bite was one bite too many. With the sleeve what sensation occurs and tells you it's time to stop eating?

I'm sorry I don't know Jerusalum Hospital's location. But there is a tourist zone with shops for pottery and you can ask the staff at the hospital if it is within walking distance. But if not, taxis are cheap. Get someone at the hospital to tell you what to say to a cab driver to get to the tourist zone with all the cute shops (which is about 1o minutes walk straight southwest from the boarder crossing. Then when you are ready to leave the shopping "Gringo Zone" just ask another cabbie to take you to Jerusalem Hospital and make sure you give him the address with the cross street because there's a hundred tiny hospitals all over TJ and you want to make sure the cabbie takes you to the right one. Have fun!!

Hi Patrick, Thanks for your thoughts. That's funny because I've felt like I haven't had physical hunger since 2003. I get tired, which is the symptom that reminds me to fuel the body. For me, the band did remove the sensation of physical hunger. Prior to banding I felt that the moment I woke up in the morning I had to do battle with an inner demon, demanding that I go to the kitchen and eat huge volumes of food the moment my eyes opened!!! I always lost to the demon. The only question was "how long would it be before I found myself in the kitchen eating huge amounts of food? 9am? 9:30am, 10am, certainly never beyond 10:30 or 11am. Couldn't happen. By then the demon had won and I would spend the rest of the day binging and loathing and fantasizing that tomorrow would be the day I would beat the demon. Patrick, the demon was gone on August 15th, 2003, when I was banded. Even with no Fluid in my band whatever restriction is there is enough so that I don't wake up craving huge piles of food before I'm even out of bed. My husband jut walked into the room and said, "Do you wanna do anything for lunch?" I thought a moment, felt no hunger desire and said, "Nah!" And that's what I say every day. I don't feel hunger ad I couldn't care less when or where my next meal is. But don't get between me and my 3:00 mocha, usually my third mocha of the day........which takes us back to those damn liquid calories that pass through bands and sleeves and bypasses with complete freedom. No matter which WLS we chose there's no escaping personal responsibility for every caloric solid or liquid we allow to slide dow our throats.

I've been walking across the TJ boarder for 9 years and walking the 10 minutes to my band-doc's office and I always feel safe. You'll probably walk passed a Costco, a Home Depot, a bunch of fast food places and supermarkets. My point is that you are walking in an area that looks a bit diry and rough by U.S. standards but look around and you see a huge population of middle-class mexicans doing their shopping, taking the kids for a happy meal and going about their lives.....in a more run-down, but I believe, essentially safe place. Good Luck!

I've been on many cruises to Mexico. Up until 3-4 years ago a driver's license was all you needed to cross the boarder and get back. A few years ago, in the name of "Homeland Security" the laws were changed in both countries and passports are required!! If you walk across or drive across the Boarder (as I've done for 9 years visiting my band-doc 10 minutes walking-distance into Mexico from the TJ boarder crossing) you will be screwed when you try to return via the same boarder crossing. They will not make you stay in Mexico forever but you will be detained and investigated for hours. Don't do it!!

Hi Lissa, Thanks for writing. As you say, "they don't operate on our heads, just our stomachs." They are free to operate on my head too if they think that would work!! :-))

Dear Pokieism, You ask so many good questions that I'm going to cut and past your questions and then give you very honest answers so I can keep it all straight. Sara - there was a question I wonder if you would answer - were you taking only what you are supposed to of the Alli? I did take more than the recommended doses. I took the dose doctor's prescribe when writing an Orlistat prescription, which is more than the over the counter recommended maximum. Overdoing is a lifetime pattern for me. All things to excess, nothing in moderation. Have you developed any eating disorders? I am addicted to Frozen pineapple on a stick from Dryers. I credit it with the 30 pound weight loss during the last 2 years. I make my main meal of the day lunch and then replace dinner with Dryer's Pineapple Pops. I stopped keeping ice cream in the house 2 years ago and go through 9 boxes of Pineapple pops a week--that is addictive behavior because many times a day I'm grabbing a Pineapple Pop give give my mouth something to do when the people around me are eating meals or when I'm feeling weak and might eat something with fat calories if I didn't keep the pineapple around. Dorrie had a wonderful answer for you. I would say a concern for you from me is def the cheating - because that will set you up to fail. Another serious issue. Crossover replacements for your foodstyle...they are known as addictions. Alcohol, smoking, weed, cutting, and replacement "feeling" (I forget that one - help me out Dorryie!). Yes, in the first 5 years of my band I did develop addictive behavior with wine coolers. The band was tight, and I would skip solid food and drink wine coolers after dinner. I was never a drinker before I got banded and one night I was watching an Oprah after work enjoying my dinner ---a 6-pack of Green Apple Smirnoff's Vodka Coolers. The topic of the show was people who got WLS who developed alcohol, sex, or gambling addictions once food was cut off to them as their go-to addiction. That was probably 2005 and even though I was at my goal weight I knew that Oprah Show was talking about me. I cut myself off from those friendly little bottles cold turkey. Now I may have one or two bottles once a month but that is all. Going to a counselor is OK - but what then - do you actively work on what you have talked about? Do you read on your own? If you were not taking a diet aid, could you maintain your loss? If I was not taking the Alli I could maintain my weight. I credit the Alli (and walking) for the 30 lbs I've lost in the last 2 years. I did go to a counselor for several intense years and I thought our work together was completed. I am going back to her. My nature is mostly that of a loafer, a lazy person who does the minimum required to get by in the world and I make no apologies for it. I know who I am, I like living a lazy life and I don't have kids so I'm not failing a duty to children to teach them by example to work hard. I will always look for the easy way out. But when I want something I will work. When I lost weight I jogged 5 miles per day 3-4 days per week. When I wasn't jogging I was on bike rides with friends in which 200 miles cycled in a day was not uncommon. I loved it, but then had a nasty bike crash while in a pace-line and that wrecked my right knee and ended my cycling career. The esophogeal stretch may be a way to get some of it covered by insurance, even if they will not approve the sleeve. My insurance is happy to pay for the band's removal, but with my behavioral patterns and a BMI of 32 I no longer qualify for WLS as a covered medical procedure. Replace the mochas with a coffee, or warm up and froth a glass of hoodia soy milk in chocolate or a spash of coffee. I go to Peet's Coffee and they make a non-fat, sugar-free mocha that doesn't taste sugar-free. I get a small and that's 250 calories. That is something I enjoy and wil continue to gie myself several times per week. I don't like soy milk, or black coffee, or tea. I have tried and they are not for me. Popscicles are good (Dryer's Frozen Pineapple Chunks on a stick) , Jello too! If you cant get away from alcohol, make a jello shooters, freeze them, and blend them in a blender with some crystal light you have poured into ice cubes. I stopped alcohol in my life because I knew it was becoming a problem in 2004/2005. Get onto My Fit Pal, get to know the site well, it will help you alot. Never heard of it. I'll look into it. Thanks! If you find yourself off the band, still go to therapy, and prepare yourself to do this old-style until your esophagus and tummy can heal - get the original "eat this, not that" book, and feel free to stick around the forum. There is alot discussed here, not all VGS related, and you can build up a healthy bit of knowledge. Notice I did not say yay or nay about whether you should get the sleeve...I cant make that decision. Whatever you go, I hope you work through everything and are well. You misunderstood me. Sorry my words were unclear. I wasn't asking anyone to make the "sleeve after band with esophageal stretching" decision for me. I know that only I and a willing surgeon can do that. I offered my medical history and was asking if anyone in this forum ever got the sleeve after having a band removed due to esophageal stretching, and did it have the desired outcome. I talk like I am telling you what to do - it is just my nature, I only intend them as suggestions... If you don't believe you can find a way out you become the problem. If you believe you can find a way out you have solved the problem. I know that ultimately it is up to me to change my love-relationship with the things I put in my mouth and learn to eat for nutrition rather than comfort. I'm working with a dietician now to do that. But I also want to take advantage of the latest medical procedures to build upon my efforts. My knees are shot and my spine is shot in two places so I live in constant pain and on Oxycontin 24/7. I need to keep working at getting the weight off this body sooner rather than later and this time I'm committed to doing it right with my therapist, my dietician and my personal trainer. But I do also want to know if anyone has a medical history similar to my medical history with the band AND has benefited from an additional, newer procedure. Thanks for your ideas and concerns. I really do appreciate them because you help me develop my own thoughts to a point of greater clarity and you help me see where blind spots in my thinking might cloud my judgement. Sincerely, Sara

Thank you Dorrie. I have begun to do just that. The surgeon who will remove my band has required everything you mentioned and he has personally hooked me up with all these resources in my community and the large medical group he is part of. I would only pursue the sleeve after 6 months of eating healthily in reasonable quantities. Do you know if my stretched esophagus would make a sleeve revision not work for me or is it a potential tool for me in the future? Thank you, Sara

Switch!!! I've had the band since 2003. Lost all the weight and regained it, which seems to be a common tale. Now here I am researching VSG. Save your money and skip the band.