fabfatgrl

Your doctor should have some colleagues he can refer you to. Perhaps a letter from him saying that he is retiring, along with a copy of your surgical report, and any x-rays (including your barium swallow) might induce one of the other surgeons to take you on for less than their typical fees. As somebody who was banded in Mexico, I've gone through this a lot. Paying over $600 for my first fill (+airfare and rental care) to as little as a $15 co-pay. Usually, I end up with a $350 fill fee. I accept that as part of the cost of being banded. For a while, I was trying to go at it without getting refilled... and you know what??? I was back in that same old trap of my pre-banding days... buying diet books, magazines with diet articles, watching infomercials like crazy.... forgetting that I had the tool to make my weight loss work, I just needed to invest some money in it. I had probably about 6 fills my first year of being banded (can't tell you for sure as everything was stored in my diary-x journal (site went down)).... and then about 2 more the second year of surgery. My last fill was "the one"... the perfect fill where I kept losing effortlessly. I was then unfilled for two pregnancies. Now, I'm back paying for fills again. It feels good to be on track again, even if it's a bit expensive. (I'm a SAHM now, before I was working!)

For me, it's exercise that has always worked. Usually, I pop in my Leslie Sansone 4 mile Walk tape and get going. If I do that every morning (at least 4x/week)... that usually solves the problem. Netflix has a surprising assortment of workout DVDs... so if you have Netflix, it's a great way to check some out. Also, Collage Video has video preview clips on their site.... and great reviews. www.collagevideo.com Another option is to figure out what you'd pay for a fill (for me, it's usually about $300 -$350) and invest that money in some personal training sessions at a gym (if you belong)... or a gym membership. Also, look at what you're eating... write it down... just so you can see if you're maybe eating too much of some foods, too little of others. Also see when you're eating... how many meals... etc. I always did the best with 6 mini-meals vs. 3 big (well Bandster big) ones.

I lost 95 lbs in about 18 months before becoming pregnant. This time, I plan to make it well past 100

Suzanne: Glad you're fill went so well! I think we're all sort of shocked at how easy it is (usually) and painless. My first fill, way back in 2001 (9-11 actually!), the radiologist first numbed me with lidocaine... then did the fill. The lidocaine shot was more painful than the fills I've had since with no numbing! Most times, I don't even feel them going in. Sunta: Usually being too tight comes in later fills, not the first. Most docs are very cautious when they start out your fills... and I doubt you'll have any problems. Every fill I've ever had has included the "drink test"... where they give you some Water post-fill to make sure you can get it down. If you're fill is done under fluoroscopy, they'll also watch you drink barium (just a few sips... consistency of a smoothie, sort of).... both to adjust the fill as well as to make sure you can still get stuff down.

Thanks everybody!! I'll check Dory out. I just had a fill yesterday with a guy in Jacksonville Beach, FL. He was sooo conservative that he'd only put 1.3 ccs in my Band. Needless to say, I have no restriction whatsoever. He said he'd consider adding more in two weeks. -Sigh- I'll be back in NYC in two weeks. Guess I wasted my $350 here!

Fluoro usually gives you the best fill... but some people are so in tune with their own band, that they can tell by how the barium (or water) feels going down when the sweet spot is. As it's your first fill, who knows if you'll know this?? I guess that's why you were posting about them wanting to go slow?? (Different post.) If you're not going to use fluoro, then yeah... you may have to go slower. If the doc is experienced, you should be O.K. But I'd try and arrange a fluoro at least once per year to check on things. Honestly, I'm surprised they're willing to fill you without fluoro if they didn't do your surgery... especially as its your first fill. Typically, they want to check and make sure you healed O.K... the band didn't reposition, etc.

Hi: Let me know how you make out with fill docs... as I was banded by Rumbaut and live in the NYC area. 15 pounds post-surgery with no fill is totally awesome! YOu did not have an RNY or DS... you had a Band. You will not lose as fast as people who had their intestines bypassed. YOu need to educate others on this if they expect you to. If you lose 1-2 lbs/week, you'll be doing great. If you are too aggressive with your fills (and have a doc that supports that), you could run into trouble. Reflux is not what you want. Pouch dialation is not want you want. Slow, steady weight loss is the goal. Everybody is different. Every band is at a slightly different location... so the amount of saline/contrast necessary to provide restriction is slightly different. My first fill was 1.5 ccs. I then went back for another fill like 6-8 wks later. As your fill is done under fluoroscopy, the number really doesn't matter. It will be at the rate the barium goes down. (Hint: drink a lot of Water post-fill as barium can cause constipation.) The typical range is 1-2 ccs. You may want to ask what the window is that you can come back in for an adjustment (either removing or adding) and still be covered. Some docs give you a week, others 30 days, some no grace period at all. Also see if anybody will quote you a price for unlimited fills for a year. Slower is better. You'd be surprised at the difference .1 ccs can make when you're either not tight or too tight! Good luck Karla

i think there's a long-term RNYer or DSer who has a business selling Protein powders... Vital Lady? perhaps is her name. Anyways, she has sample packages where you can try a whole bunch of different brands. www.vitalady.com

from what i've read, long-term w/ other surgeries you have a greater chance of nutritional issues... as well as more difficult reversals... so for that reason, the Band makes sense for those in their teens and twenties as they will most likely have to deal with the implications of their surgery for longer. even if the band is only good for you for the next 10 years, and instead of getting a new band you decide upon an RNY, DS, or whatever neat-o operation they come up with in 10 years (or perhaps a medication).... your stomach and intestines will still be intact. if you need to get your band out, it's relatively easy. if you need to have an rny or ds reversed, it's much more complicated. just think, if they come up with a new operation or even better, a med that works for mo, you have the band removed... and you're ready to go. if you have had an rny or ds and they come up with a new operation or a medication, you may not be elligible for the new operation (due to previous operations or your new anatomy)... or taking the new med may work but you'll still have to deal with the long-term nutritional issues of having had a bypass. as for the inamed statement, standard medical disclaimer (i worked for a medical device company.) just my two cents.

harleynana: i apologize. shouldn't have done that... it was wrong. should have waited to reply until this morning when i was more rested, less frazzled. that's cool that you can order it for only $35.00. if you do run into problems, let me know and i'll try and help. i don't remember there being anything really complicated about setting it up, etc. but i haven't had to do anything to it since i first set it up. i think you just pushed and held the main button for a few seconds.. but it's been a few months, so i don't really remember.

OK, not sure if you know this (or would guess), but even with my Band completely unfilled, I can still PB. Chunks of meat or eating a sandwich too fast are usually what cause it... and for some reason, airline food. (Go figure.) Anyway, as I'm preparing to be refilled (I hope soon!), I've been working with this little device called a powerseed to help me slow down, chew more.... and basically get back into a Bandster mindset. It really works! Even without a fill, if I'm honest, I find myself stoping sooner... definitely eating slower... and just being more tuned into myself and my hunger. (It's a small little device that beeps/flashes a light every few minutes.) So, I thought I'd recommend it to anybody who has PBing issues. Back when I was filled, I probably PBed at least once a week... I'm sure this would have helped.

HarleyNana... I'll try and read your post in a positive way... but please, no advice on my bite size. I've been unfilled for three years... and was just letting people know that with no fill, one can still PB. (After three years of no fill, it's very easy to completely forget about the Band!) It's rare... has happened maybe 4 or 5 times in the past three years... but I thought some may be interested to no this as I feel zero restriction every other day. I wasn't looking for "how not to PB" advice, bite size info, etc. As somebody who has had a Band for 5 years, researched the Band for two years prior to getting one, and chose to leave the country to get a non-FDA approved medical device inserted in my body... I'm pretty well informed on those matters. Yeah, $50 is expensive. Not sure what luck you'll have on eBay, as the company has a liberal return policy. I first read about them in Self a few months ago. You could buy a kitchen timer that counts up/down and just monitor it yourself... every few minutes... whatever... but for me, this is a lot easier (and less obtrusive.)

I could never stomach any of them. I usually used Milk chocolate Carnation INstant Breakfast... made with warm milk (as I was always so tight in the morning.) I typically made it with one packet and 2 cups of milk... so: 2 cups of milk = 16 grams of Protein Carnation Instant Breakfast = 5 g. Total=21 g Honestly, I never had an issue with getting my protein in as one of my favorite Snacks was cottage cheese and fruit... or those Breakstone Cottage Cheese/Fruit Jam thingies.

Assalamu Alaikum: Feeling the way you do is perfectly normal!! Insha'Allah, you'll be able to get your surgery soon. I'd definitely go with the guy whose done 90 bands vs. 3 Be sure to talk with your surgeons about fills/adjustments... when you'll come back for the first one... are they covered (at least for the first year) in the price you pay for surgery, etc. Ramadan can be really interesting with a band. I was always super tight in the morning, so I was lucky if I could get in a liter of Water and maybe some hot chocolate (made with milk) for sujud. Then for iftar... you have to just plan on a sloooow progressive dinner. Start with Soup... maybe milk. NOt sure if you'll be able to tolerate dates or not. For me, chunks of meat (the dish of fattah is popular among my community) did not work at all. Peace.

Didn't have to do a liquid diet (or any diet) before my surgery, but I did do medifast at one time. it was nasty... i couldn't stay on it... and expensive, as well. As for Vitamins, when filled, I did two Flintstones with Iron and Viactiv for calcium. Remember that you can't always safely cut up meds... especially time-released ones. Talk to a pharmacist before doing so. I did have a pill get stuck once... some gigantic horse-pill antibiotic. Was horrible. Horrible. Ended up going back to the pharmacist and they exchanged my Rx for me (called my Dr first). BCP is a good size-gauge... but for me, I had no problem with normal sized pills... so aspirin size. Actually, i had a Rx for pills that size post-op for pain from Rumbaut... and they went down fine. So, I used that as my gauge.

It has two modes... one with flashing light only (it's very small... I doubt anybody dining with you would notice)... and one with beep/light. When I'm alone, I usually go for beep & light, light only when with others. It doesn't annoy me at all. My biggest problem is consciously ignoring it... days/meals when I really don't want to eat slowly, or stop when full. It's a me thing, not a powerseed thing. i don't use it every meal, although i did at one time. Now i tend to use it maybe a few times per week... or when I know i'm in a sort-of binge mode, I'll pull it out. I think if I ever get my new fill, I'll use it for at least a few months for every meal so i can get back into bandster mode... and also when dining out. It's such a pain to run to the bathroom for a pb... or be sitting there, waiting to pb... trying to get things unstuck... drinking Water....whatever.

I think for most people, the first fill does not stick for very long. I even remember being told that i would probably need another fill 4-8 weeks after the first fill. Not sure why, but it's normal.

Y'know what?? If I could have done that... stuck to any diet for any period of time... then I wouldn't have needed it in the first time. Reality for me was the Lap Band was the first time I ever lost weight of any significance (more than 10 lbs.) and ever maintained it. In 20 yrs or so of dieting. I had done personal trainers, diet meals delivered to my home, nutritionists, residential programs (spas and pritikin), psychiatrists, OA, WW, Diet Center, Jenny Craig, diet pills (I remember ordering them from the back of a mag when I was like 11 and they were not supposed to be used unless you were 12 or 13 or over), etc. I think the weirdest thing with the Band was being full after eating a Lean Cuisine... or an appetizer... or whatever. I had never really experienced what being full felt like. It was so strange. I think the problem is that still a majority of people do not see obesity as a disease, but they see it as a choice. If you really really wanted to, you could be thin. Yet it is a disease... and the research is proving that it's quite a more complicated disease than previously thought. You wouldn't say something like that to a diabetic (Gee... don't you think you could just avoid carbs and sugars the rest of your life instead of needing insulin???) so why is it acceptable to say that to an obese person. Surgery is the only treatment that has proven effective long-term. The only one. It's not a perfect treatment, but it's all we have. Hopefully, one day there will be other solutions.

Here's one from Germany, looking at 10 yrs of results. ** No intraoperative or postoperative death occurred in the first 30 postoperative days. ** [Long-term results after gastric banding] [Article in German] Stroh C, Hohmann U, Schramm H, Manger T. Departement fur Allgemein- und Viszeralchirurgie, SRH Wald-Klinikum Gera gGmbH, Akademisches Lehrkrankenhaus der Friedrich-Schiller-Universitat Jena. Christine.Stroh@wkg.srh.de BACKGROUND: Adjustable gastric banding is a popular bariatric operation in Europe. The rate of long-term complications like pouch dilatation, slippage and band migration and the long-term effect of weight loss are reported in meta-analysis and few studies for a period of more than five years. We report on experiences after gastric banding. METHODS: Over a period of 10 years 168 patients with morbid obesity were treated with gastric banding. Preoperative data, postoperative weight loss and long-term complications were prospectively obtained and retrospectively analyzed. RESULTS: Mean age of the patients was 41.7 years with a mean preoperative BMI of 49.6 kg/m2. No intraoperative or postoperative death occurred in the first 30 postoperative days. Intraoperative conversion rate was 7.1 %. 79.8 % of the patients (n = 134) were available for follow up (mean follow-up time 66.7 months). Long-term complications occurred in 22.5 % of the patients. 30 complications (17.8 %) were related to the band and 8 (4.7 %) to the access-port or to the tube. Mean excess weight loss was 39.6, 47.3, 44.2, 43.4 and 32 % after 1, 2, 4, 5 and 8 years. CONCLUSIONS: Laparoscopic gastric banding can achieve an effective weight loss. However band-related and functional complications will influence the late outcome. Pathways to choose the best surgical method for the individual patient are necessary to reduce failures after gastric banding. PMID: 16220436 [PubMed - indexed for MEDLINE]

5 yrs out and not dead yet. I think that if you're going to die, you're most likely to die during the operation... and even then, the chances are quite low. But still, that's why the docs do all of the pre-op tests, etc. The longest Bandsters in the US tend to be those who participated in the FDA trials... so 5-7 years out. You'll find older Bandsters in New Zealand, Australia, and Europe. Might want to try Bandsters and Smart Bandsters on Yahoo Groups. Here's a recently published study on 3 yr results from one US study. The mean BMI of 50 is relatively high for a Band (in my experience)... but maybe things have changed: Three-year follow-up weight loss results for patients undergoing laparoscopic adjustable gastric banding at a major university medical center: does the weight loss persist? Sarker S, Myers J, Serot J, Shayani V. Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA. BACKGROUND: Very few large United States series with long-term data after laparoscopic adjustable gastric banding (LAGB) have been published. Here, we present results of 409 consecutive LAGBs performed at a major United States medical center. METHODS: Charts were retrospectively reviewed for perioperative morbidity, mortality, and repeat operations. Weight loss data were collected during band adjustments. RESULTS: Mean age of patients was 42 years. Mean preoperative weight and body mass index (BMI) were 142.4 kg and 50.6 kg/m2, respectively. There was 1 fatal myocardial infarction and 4 nonfatal pulmonary emboli. There were 50 (12%) repeat operations resulting in 16 (4%) bands being removed. Mean excess weight loss was 23.7%, 44.3%, 48.0%, and 53.3% with <1 year, 1 to 2 years, 2 to 3 years, and >3 years of follow-up, respectively. CONCLUSIONS: Three-year follow-up data demonstrated continued weight loss in patients after LAGB. The relative safety and continued adjustability of LAGB make it an appealing option for long-term weight loss. PMID: 16490549 [PubMed - in process] To put the weight loss into perspective. I'll use myself. Starting weight 297. Ideal weight.. 150 (or so). Excess Weight: 147 lbs. So 1st year weight loss: -34.89 1st to 2nd year weight loss: -65.12 (lost another 30 lbs.) 2nd to 3rd year weight loss: -70.56 (lost another 5 lbs.) 3 rd year: -78.31 (lost another 8 lbs.) So from 297 to 218 in 3 years... losing roughly 1/2 excess weight.

Yes, I've thought of it. Especially when my weight loss was slow... or when I wasn't losing as much as I thought I should post-pregnancy. But, usually once I asked myself if i was actually using my tool... and realized I needed a new fill... then i knew that until i truly used the band it wasn't time to consider different surgeries. Going into this surgery, I accepted that I may need a different surgery later on. That the Band might not work for me (due to my dietary habits).... that there could be complications. But now that I'm a Mom, it would be much more difficult to go in for more surgery as I would worry about my kids. With my Band, I was single and unmarried... so other than my cat, no other dependents. In my questioning phases, I've emailed Dr. Gagnier(?) in NYC who has written about doing a DS with a Band... so I've explored that arena. I've spoken to Dr. Rutledge about a Band to MGB conversion. I think i would probably choose one of those surgeries and not an RNY if I ever needed Bariatric surgery again. (Leaning towards the MGB based on his long-term results and lesser complication rates... but who knows what (if anything) I'd chose if faced with that decision.) I don't think I'd do the endoscopic stomach stapling just because of the long-term results of the VGB and stomach stapling from past years. Didn't seem to work long-term for most. Having said all that, the Band was the right decision for me at the time. I would not go back and change that at all. All WLS can have complications/issues... but the beauty of the Band is that if it fails you, it can be easily removed (relatively easily) and you're left with your stomach and intestines intact. With other surgeries, that is not the case. Revisions from RNYs and DSs are very complicated surgeries with much higher complication rates. I"m happy with my Band... and my weight loss. Peace.

Just wanted to add that my band was the standard Inamed band... the same band that was approved in the US a week after I was banded. My port was a sternal placement--which is easier to access, but more noticable once you lose a lot of weight. As for J&J Band vs. Inamed, remember that J&J bought ObTech...so they've basically revamped the old Swedish Band that was the first on the market. That band used to be filled using a different substance, but I'm not sure what the new J&J Band is using for fills. I'd go for the Inamed as it's been proven longer... and it will be easier to find a doc familiar with filling it. However, once the J&J Band is approved, I'm sure they'll use all of their Ethicon-Endo reps to push surgeons to change. AFter all, Ethicon-Endo makes a majority of the laproscopic equipment in use today... as well as Ethicon making all of the sutures, etc. If they're smart, surgical technique and follow-up should be similar to facilitate an easy learning-curve for the surgeons.

Hi Cheryl: I went to Rumbaut in Mexico as a self-pay and had a wonderful experience. His staff and the staff at the hospital were all wonderful. It was actually the best hospitalization experience I've ever had (been in the hospital two other times giving birth.) But, I've heard good things about both Kuri and Sanchez as well. I think Rumbaut is now the most experienced, but I'm not 100% sure. Rumbaut has great bedside manner.... visits you at your hotel... totally available to you. Also, he has a band...so understands the whole banding thing. If I were you, I'd check out flight prices to both TJ and Monterrey. Why?? Because if you're planning to return for fills, you're going to need to factor that into the equation. TJ was too far for me being an East Coaster, but getting to Monterrey is a pain as well. And usually runs around $600 for me. Dr. Rumbaut does not charge for fills except for $100 if you need fluoro. Still, the cost (and time factor) of getting to MOnterrey has meant that I've had to try out numerous US docs for fills. Some charging me nothing more than my co-pay, others charging close to $650. I'll also say that even though every one of my fill docs used fluoroscopy--not every one of the fills stuck. Technique does matter. From what I remember, the radiologist needs to push down a bit on the needle before removing... but i'm not 100% sure of the technique. Given that, you may want to consider a US doc who includes fills in his price and perhaps has a discount for self-pays. (And is easily accessible to you.) Peace, Karla

Banded in Mexico in June 2001 Dr. Rumbaut No Erosion.

I think it's important to define success. I know that some posters are happy at a BMI of 30 and others are upset about having a BMI of 30. For me, coming from a BMI of 46, maintaining a BMI of 30 would be a success. I would have significantly reduced my health risks from obesity; I'd be at a more normal size; etc. I think part of this may result from whether or not you were thin most of your life... and then got fat... or were chubby/fat all of your life. As somebody in the latter category, MO since I was 21, being "just" obese is nice. LOL And a BMI of 30 is just one point from 29... which is overweight, not obese. I agree with Favretti and others that the Band, for many, should be a first step. Why go for more complex and invasive procedures if one doesn't need to? I was considered a very slow loser... losing 50 pounds in my first year. I had numerous fills, but very few stuck. To be honest, I ate too fast, so I PBed a lot. In my second year, I finally went back to my original surgeon (Rumbaut) for a fill. It was the magic touch. The perfect fill. I dropped another 45 pounds in 6 months and then became pregnant. Did my diet change?? No, not really. Did my exercise change?? No, not a lot...although I was a bit more regular with it. For me, the key was the right fill... which came after 7 or 8 fills. With my love of ice cream and sweets, yeah, maybe the DS or RNY was a better choice for me... but I don't regret the band at all. I was young when banded, and still wanted to have kids. I was able to unfill my band completely and have two healthy, normal pregnancies. That is priceless to me. (Yes, I know many RNY people have healthy pregnancies too... I just didn't want the risk.) Some tools/tips which may help less sucessful bandsters?? 1) Try the powerseed. www.powerseed.com It's a device designed to help you eat more slowly. Basically, it beeps or flashes a light every few minutes to tell you to take a bite. After so many minutes, it flashes a different signal to ask you to evaluate fullness. It's fab. I use it even though I'm unfilled and will continue to use it after being refilled. 2) Pedometer. Get honest with yourself about how active/unactive you are. 3) The 1/2 plate fruit/veggies rule. When eating easily band friendly food, like ice cream. I always made sure to add a lot of fruit, such as berries or bananas... at least half the dish. The fruit would fill me up (wheras the ice cream passed right through), so I wouldn't eat as much. 4) Weight Watchers. Join and see just how many points you're eating. Be honest with yourself. Personally, with my band was the only time I could actually do weight watchers and stick to it. It helped me through a period in my first year when the fills weren't holding very well and I was losing slowly. Peace, Karla