fabfatgrl

You'll go into the fluoro room and they'll have you lie down on a table. Then... the funky thing... the table moves It can bring you to a standing position. Usually, they put the needle in... and then take you for a ride.... :star: Most docs will offer you the option of being numbed, but to be honest for me, it was just an additional shot. Much easier and less painful to have one quick poke. So.. they're going to move you to an almost standing position... and then usually, if you have Fluid in your Band, they remove it to check the amount... and then re-insert it... adding a bit. They'll give you a sip or two of barium so they can watch how it flows through your band... and adjust the amount of saline or contrast solution depending on that. When you're done, most will also ask you to drink some Water just to be sure. Then the needle comes out, small band-aid goes on... and you're on your way. Totally easy. Pretty much painless.

You need to try and get something in sooner. I know I was usually very very tight in the morning, but I could get in a warm drink... and that would help loosen things up. I never was a fan of most Protein powders, but for some reason, I liked the sugar-free Carnation Instant Breakfast... so I would do that with hot skim milk. Made a good breakfast.. and then maybe around 10:30 or so, I'd have a bit of cottage cheese and fruit. Sometimes the problem is that you're not eating enough... sometimes the problem is you're eating too much. Both can stall weight loss. As for exercise, talk with your cardiologist. I spent two weeks at the Pritikin Center back in 1990 or so with a bunch of cardiac patients. Many of them had recently had heart attacks... or were scheduled for surgery due to blockages. They all were able to exercise aerobically, usually on the treadmill. They were monitored, though throughout the workout. Your cardiologist may be able to refer you to a local hospital that has a cardiac rehabilitation/exercise program where you can exercise. Also, exercise will help your bad back... strengthening your abs will help as well as making sure that your hamstrings (back of thighs) are flexible enough. You may enjoy doing a gentle yoga routine... I believe Gaiam/Living Arts makes a Yoga for a Bad Back DVD/VHS. Totally designed for beginners... may help. Try Gaiam.com - Products and Ideas for Healthy, Green Living

Don't worry... as you get closer to capacity sometimes only 0.1 ccs can make all of the difference. It becomes all about fine tuning... very very tiny fills and unfills to find the perfect spot.

The Band is not the right surgery for everyone.. nor is the RNY, MGB, DS, or VSG. Sometimes, it's the right surgery for right now... but you may end up with a different surgery later on. The same goes for the other surgeries. Reality is, this is a Lap Band board. Most of the people coming here are happy Lap-BAnders... or people looking into the Lap-BAnd. Makes sense. Places like OH tend to segregate people by surgery as well. Most of the people coming here have only recently been Banded and are still in their honeymoon phase (occurs with all surgeries... usually the first year to two years.) They want positive, happy support. They don't want to hear that the Band may not work long term or that complications may occur... or that even if they follow "the rules", they still may only lose 50-60% of their excess weight. (That's a tough one for many people to accept... that they won't get to "goal"... that they may be just average.) BUT, for most people, losing 50% of your excess weight and keeping it off is a pretty gigantic success. It doesn't happen with normal diets at all that have a 95-99% failure rate... with MO folks being much closer to the 99%. Posting about complications or a not perfect Band experience can get people flamed. It happens here and it happens on other WLS boards. It's normal, in a way, as a defense mechanism. Just as thin people think that if only MO people would try harder... exercise a bit more "willpower"... exercise a bit more... they too could be thin. Thin people don't understand (and don't really want to hear) that Leptin and Ghrelin operate differently in MO folks. They don't want to hear that there has never been one scientific study showing that eating less and exercising more (or any of the behavioral changes) made a lasting weight loss effect for any obese individual. Success in the obesity field is when a drug lets somebody lose 10% of their bodyweight. Well, when you're MO, 10% doesn't mean squat. (For more on this, I highly recommend reading "Rethinking Thin.") As for PBing and sliming, most people I know who are Banded do PB. Some do not. I know one person who never needed a fill in her Band to lose weight. But they are exceptions. Having said that, it becomes normal. You get used to looking for the restroom... carrying baggies in your purse, etc. You learn which foods are safe to usually eat out, and which are not. Perhaps the newer Bands reduce the incidence of PBing... I have no idea. But, there's a reason that most Bandsters know exactly what a PB is. Just as most RNYers are familiar with dumping. If you're looking into WLS, and are leaning towards the Lap-Band, then you know what?? You will discount the bad stories and focus on the good. That's normal. Same thing happens when a WLS patient dies in surgery... we all look for why that couldn't be us... his BMI was higher than mine... he had diabetes... whatever. BUT, reality is that it could have been any one of us. All surgery has risks... even Lap-Band surgery. It's a very low risk... but the risk still is there and somebody loses the statistical odds on occasion. From what I've learned over the years, there is a sort of continuum... with effort necessary by the patient relating to risk and weight loss. So... Lap-Band in general requires more effort by the patient, but has less risk for complications and death... but usually less weight loss than the others. RNY/MGB do a bit more of the work, you lose a bit more, but the risk is a bit more. DS makes it a lot easier, but there is more risk...and you have to be more vigilant with supplements. VSG seems to look good short term, in that it does a lot, risk is low, weight loss comparable to RNY, etc... but there isn't a lot of long-term data out there. Thing is, for most surgeries (not sure if it applies to the DS), all this goes away 2-3 years post-op. Then all of the surgeries require effort. Then behavior really does matter... food choices... exercise. All of these are tools. I would also say that people change over time. Lap-Band was perfect for me six years ago. Fit in with the risk I was willing to take, amount I could afford to pay (self-pay), and future plans (hoping to one day get married and have a baby.) Today, I'm in a different place. I'm glad that it is so easy to remove my Lap-Band and choose a different surgery should I want to. Not all revisions are that easy. So for those of you who say, "I could never have my stomach cut... or my intestines rearranged... I would just say, "never say never."" :star:

Hi Bonnie: I was Banded in Mexico, and there was a doctor north of Atlanta, named Dr. Ponce, who was always willing to see Mexican patients. I'm sure there are a lot more these days, as that was 2001 back when the Band was first approved. I don't think where you were Banded should be an issue in terms of removal. It doesn't even seem to be an issue for fills much these days (at least in my experience.) Most surgeons just want your op report (if available), and any recent fluoroscopies, etc. You can always go to Allergan's doc locator for a list near you. I think if you explain that your surgeon *died*, they might be more willing to take you. Good luck

So, I'm getting ready to hopefully welcome my third little Band baby into the world over the next few weeks. As far as the Band and being pregnant, I'm glad I had this surgery over a different one, as it was much more comforting to be totally unfilled and not worry about nutritional issues relating to the Band and my children. Now I need to figure out what to do post-baby. Ever since my first pregnancy, whenever I've tried to refill, I've had major PBing issues. Usually I can only handle it for a few weeks or a month, and then I have to have the fill removed. Everything is normal under fluoroscopy, BTW... and the fill amounts are very small. I've tried, unfilled, and tried again probably 5 times since then. Because of this, I'm thinking of revising to a VSG. (I figure maintaining a 95 pound loss through two pregnancies means that I can handle a restrictive-only op.) BUT, my husband (who is a physician) wants me to try once more with the Band... as he doesn't want me to risk any further surgery. I'm willing to try again... but am wondering if there is anybody else who has gone through this? Is it just psychological (difficulty dealing with restriction) or are there other issues involved? If you're somebody who has gone back to being filled after a long absence, what issues did you face (if any)?

Jackie: The DS stands for the Duodenal Switch. Basically, two things happen, one you're given a sleeve gastrectomy... meaning 60-80% of your stomach is removed... which is good in that, they remove the portion that produces a lot of the ghrelin (hunger hormone.) (Note: now they do only the VSG part alone.) The second part is the duodenal switch where they bypass the intestines. The good part about the DS is that they have the highest level of weight loss, most cures with regard to diabetes, etc. The negative is that it is the most prone to nutritional complications... severe anemia, osteoporosis, etc. You can find out more on duodenalswitch.com or by googling it. Karla

Well, the average weight loss for the Band is only in the 50-65% excess weight... so you may be completely normal. There are no guarantees of 100% or even 80% weight loss with the Band or any other WLS. If you've been able to maintain a 60 pound weight loss for two years, that is a major success even if you never lose another pound. The average person cannot do that without surgery. So... perhaps you need to rethink what success is. For me, after about 6 months, unless I was exercising, I wouldn't lose weight... regardless of my calories or the type of food I was eating. Another thing to try.

Can you drink Water? Do you ever PB on water or other liquids?? That can be a sign that you're too tight. As for PBing on solids, it may depend on what you're eating. Not everything works with the Band for all people. Personally, I could never do steak or big hunks of meat, bread, rice, Pasta, or salad. Foods that rarely caused a PB for me were tuna and ww crackers, bean/lentil Soup, scrambled eggs (although some people can't handle them), cottage cheese. Are you drinking with your meals?? That might cause a PB. Are you chewing until liquid/mush? 4 ccs seems a lot to me for a first fill (but hey, my Band doesn't even hold that much! )... so I would talk to some other Bandsters who have your same Band size and see what their first fill amount was. (Although everybody is different.) Good luck

Honey: You're not to blame in any way. You really should pick up the book "Rethinking Thin" that talks about all of the obesity research, genetics, etc. After losing a lot of weight, your body acts like it is in starvation mode... the urge to eat (and the biochemical signals your body is sending) are extremely powerful. Same like the signals telling you to drink Water. It's not about willpower or control. The reason 95-99% of people regain weight after a diet has nothing to do with willpower... the odds are even worse if you've been MO. Surgery is the only thing that has shown to be effective. Period. Don't beat yourself up about this. Look into rebanding, if that interests you, or into a VSG, RNY, or DS. Peace.

People get the Band removed usually for slippage or errosion. Some get it removed because they can't deal with the lifestyle changes (eating) or because they decide to revise to a different operation.

I'm sorry you're having so much trouble. I've been Banded for 6 years now (wow!)... but unfilled for a lot of them due to pregnancies. I agree that the Band can sometimes seem like forced Bulimia...LOL My life unfilled is pretty normal, though... unlike yours. I can eat almost anything... and rarely PB (although it still happens... but maybe 3-4 x/yr vs every day/week.) I've been looking at the Sleeve Gastrectomy for two years now, and am really impressed with it... especially the testimony of former Bandsters who have gone ahead with it. I know Dr. Pleatman has a great self-pay package for the VSG... it's like $12,000 or so. He has a good reputation among the VSGers as well. You may want to explore it further either on obesity help's VSG forum or through the Sleeve Gastrectomy Yahoo group or vsgfaq.com website. Regardless, if you're still PBing with no fill, then yes... I'd get a removal. I can't imagine living like that for the rest of my life.

Good luck Alexandra.

Thanks for sharing your story. I know that when I got pregnant with my first Lap-Band baby, I was probably deficient in a lot of nutrients. I was so restricted.. and was happy that I was losing so well... that I kind of ignored it. BUT, deep down I knew... so the second I found out I was preggers, I got unfilled. The good thing is that during pregnancy, your body puts the baby first... but I have no doubt that if I had kept a fill, I could have faced nutritional issues myself.

The radiologist can watch the barium go down your esophagus and into your pouch... and then see how slowly it empties out. Let's them see exactly what the fill is like. I don't believe they can see the Water on x-ray. They'll often have you drink water after, just to make sure you can get it down... but it's not used for calibrating the fill under fluoro. It is used if you get a fill without fluoro, though.

You've lost 23 pounds or so in 2-3 months?? That's great. In general, most Bandsters lose no more than 1-2 pounds/week. Some weeks more, some weeks none. 8-10 pounds/month is great. Try not to compare yourself with others, although it's hard. Everybody loses differently and at a different rate. As for your doctor, it's actually good to have a doctor that goes slower rather than one who is more aggressive. It's annoying, but it's better in the long run as you'll have less of a risk of slippage, and can make the most of each fill. Are you exercising as well?? I know for me, exercise seemed to make all the difference in terms of weight loss. Weeks that I exercised I lost weight... weeks when I didn't, I may or may not lose weight. I really like Leslie Sansone's Walk Away the Pounds Express when I was first starting out. Easy choreography and fun.

Usually they can put another Band on for slippage. Erosion can be a different story... sometimes they need to let the stomach heal... other times, they don't recommend rebanding. With nearly all weight loss surgery, they don't recommend you get pregnant until at least 12-18 months after surgery. The good thing with the Lap-Band is that should you get pregnant before then, you can have your Band deflated. Future pregnancies was one of the major reasons I chose the Lap-Band. I'd choose the surgeon who had more experience...and who you were most comfortable with. They used to say that the learning curve was for the first 50 patients, but the more, the better. There is such a big difference between the two, that I'd almost always choose Dr. 900. Just check out his/her reviews on Obesity Help and see what other Lap-Banders have thought. S/He's not going to not let you stay in the hospital if you're having problems... don't worry. I definitely second the recommendation of getting a hotel/motel near by and staying for two days or so. When I went to Mexico, I stayed at a Hampton Inn which served all of Rumbaut's patients. One of the great recommendations I had was to request both a handicapped room as well as a room with a recliner.. as sleeping in the recliner was a lot more comfortable than a flat bed immediately after surgery.

You ask for erosion and slippage statistics. Favretti has been doing the Band almost longer than anybody... and he shows the following: * Erosion in 21 patients over 6 years of follow-up from 1893 patients total. Which translates into 1% He doesn't list any stats for slippage over 6 years... but does include gastric pouch dilation in 93 patients or 4.9% * There's a study from Switzerland that shows a gradually reduced slippage rate ranging from 3.8% to 0.9% over three years. They attribute this to the newer Band and pars flaccida technique. Weiner also shows a slippage rate of around 3-4% in his 8 year follow-up study. I know that from looking at the complications boards, one can assume that the rate of slippage or errosion is higher than it actually is. Why?? Well, most Bandsters stop hanging out on support boards after the first year or two. They've lost their weight, and they're out busy living life. The only reason they come back is to either give back/share their experience -or- because they are having issues. There have been more than 300,000 Lap-Bands placed worldwide... you're definitely not seeing the average patient if you look at the complication board. (This applies for any surgery, though.)

You also mention that you'll be paying cash for your procedure. Be sure to ask what follow-up is included... does your doctor cover fills for the first year, two? Or not at all? Is fluoro extra?? What about unfills?? Will they do them for free, for free within a certain time period after a fill, etc.?? All important things to know... especially as a self-pay. I've paid anywhere from a co-pay up to $650 for a fill... with the average being around $350. You need to budget for these especially during your first year. If your not losing weight, and you can't afford a fill, you will most likely become very frustrated. You can check/ask on the Fill boards specifically to see if there may be a doctor or fill-center that is closer to you that might work better for you.

No doubt he was trained by a Mexican surgeon.. as Dr. Rumbaut had done over 3000 Bands before your doctor ever did his first, and was hired by Inamed to teach the technique to the US docs. There are fabulous Mexican surgeons... better than any in the States... and there are those that are crap. Same goes for US surgeons. You cannot say that erosions or slips are only seen in Mexican surgeon's work.. nor can your surgeon. Just go the Complications board.

Congratulations :fish: :cool: You must be so happy. I'd ask to see whatever studies there are on the AP band before agreeing to it, though. Just be sure you're comfortable that this truly is a better Band.

WasaBubble Butt, you're a newly Banded person... 5 months, 6? Still on your Band honeymoon. I admire your love of the Band and total support for it. BUT, no surgery is right for everybody. Everybody is different. She's willing to consider a bypass, which is at least as invasive as a VSG... although in my mind, more, as not only is the stomach stapled, but the intestines are re-routed. Secondly, you need to get your facts right. It does not carry a "great deal more surgical risk." Is there more surgical risk? Yes, but the risk of death is only 0.25%. I believe the Lap-Band has a comparable risk. (And yes, I was around in the days when people thought nobody would die during Lap-Band surgery... yet I remember clearly when the council woman from Detroit did die.) Remember, the VSG was originally conceived as an initial procedure for super morbidly obese for whom regular WLS was too risky. With that slight increased risk, you have better weight loss... better hunger control (initially... due to the removal of the portion of the stomach that produces ghrelin)... as well as not having to worry about fills or finding your sweet spot, so to speak. For some those risks are worth it. The negative is that yes, once that portion of your stomach is removed--it is gone for good. But unlike with a RNY, you do not have a blind stomach to worry about. And BTW, yes, the Lap-Band is reversable through surgery... although many will tell you that removing all of the fill will achieve the same result. As somebody who has done that, I can tell you that although it seems like I am back to normal 90% of the time, I still deal with PBing and sliming on occasion. Even with no fill. Here is a good study on the VSG vs. Lap-Band. I'd also check out www.lapsf.com for more info. I'll add, as somebody who has been banded for over 6 years, I can tell you, that if it's not convenient for you to get fills, your Band will not work... your weight loss will not be optimal... and you will end up looking at revisions. Fills are everything for the Band. I was one of the first Bandsters in the States--banded a few days before it received FDA approval (but in Mexico). I've been around a long time. Trust me on this. Or just go to any of the revision boards and talk to the Lap-Banders there. If you can't easily do the follow-up, it will not work for you period. And BTW, fills can last for life (including the expense). There's been research published that shows that the Band membrane is semi-permeable... and loses a small amount of Fluid regardless. So even once you've lost everything, there's a good chance that you'll still be getting fills. The Band was the right operation for me back in 2001. I don't regret it at all. But I'm not going to recommend the Band for somebody who can't easily get fills. Every weight loss operation has an audience it will work best for. The Band is not for everybody.

Honestly, if you live that far from a doctor, I would really be concerned how realistic the Lap-Band is for you. 99% of people need fills for their Band to work... some as many as five or more during the first year. Can you see yourself driving back and forth that often?? If you're interested in a restrictive, non-malabsorptive operation, you might want to check out the Vertical Sleeve Gastrectomy. Check out vsgfaq.com or ObesityHelp's VSG board for more. Weight loss is comparable to the Duodenal Switch so far, but without the nutritional issues. And no fills needed. I guess for me there is such a difference between malabsorptive and restrictive-only operations... that I'm always surprised when a person is willing to consider either one. Usually people who want restrictive-only operations do not want to deal with the issues related to malabsorption. People who want malabsorptive operations usually hope that the malabsorption issues are managable and worth the potential additional weight loss.. .although, honestly I see tons of RNYers looking for revisions after 3-5 years. The only malabsorptive operations I don't see that with as much are Duodenal Switch people (who have to be much more vigilant with Vitamins and such) and MGBers.

See what things look like with your fill under fluoroscopy. I lost very slowly my first year... I think I lost 45 pounds total. But right after that, I finally hit my "sweet" spot and had doubled that weight loss by 18 months. You really can't rush fills or the process. As for RNY or VSG after Lap-Band, both are done quite frequently... but I would be cautious about doing any revision surgery (especially a more invasive one) until you give your current one time to work. There are a lot of Band to VSG people on the Sleeve Gastrectomy Yahoo! Group as well as Obesity Help. You can also find lots of Lap-Band-->DS and Lap-Band-->RNY folks.

evcase... please seek out a second opinion from a different surgeon. It sounds like you really aren't comfortable with this doctor and his approach to you. Follow your gut. You mentioned Miami in a previous post. If you're there, I've heard really good things about Dr. Rosenthal at the Cleveland Clinic in Miami. His insurance person, Anita, is also supposed to be amazing. It doesn't hurt to make a call and just see one more surgeon... and you may end up with somebody who you're a lot more comfortable with... and who can give you what you want/need.