CoffeeGrinDR

Dang, what is your Iron level?? Ask for a full blood workup!

I'm a little bit late to this party but I can relate, so I will chime in. Relationships are complex, our feelings about ourselves are complex, open lines of communication and support should not be complex. I went through something interesting this past year with a breakup where I began to not trust my partner because while she was obviously attracted to me, when she got mad at me she made some comments that made it clear she was being judgmental about my weight. Some people can let that stuff go. I know me, I can't. It's all I thought about since she made those comments and I found it increasingly difficult to want to spend time with her or be intimate with her (even though she is a stone-cold fox). Long story short, we broke up (after a few years together) and I'm still working through my feelings about self worth. Weight and attachment are my achilles heel(s) in life. I often correlate the two whether they deserve to be or not. I had the band out when I was with her and the only thing she thought of the band was that it was "barbaric"...she also felt that any other WLS was a terrible idea. So I didn't entertain it. I got caught up in the cycle of living my life for someone else's approval. The breakup hurt immensely and kicked my confidence to the curb but in retrospect I realize I needed out. The comments about control are right, but my bigger worries would be about the communication and trust. Whatever decision you make do it for you and let it be one that brings joy into your world. Life is too short otherwise. Congrats on making choices to be healthier for you and your family. Having a partner you deserve (and holding healthy boundaries) is also self-care. These are the lessons I'm reminding myself of everyday. Lots of love and support.

You are rocking it! Thanks for sharing and inspiring us!

Steamy, it did. Psycho-social research tends to be much more difficult to draw clear correlations from due to the sensitive nature of things. What I found were some interesting (and at times confounding) outcomes. I'm happy to do another summary. Basically, overall quality of life for WLS patients goes WAY up but there DOES tend to be higher instances of depression amongst WLS patients than the control population... Here's where this gets "noisy" in statistical terms...we know that the reasons for our obesity/problems with weight are attributable to a confluence of factors, and none of them will be exactly the same for two people. The advice from what I've seen in the medical journals mirrors that of what many wise vets here say: the work is not just about the body, but the mind, and the heart. I often think there needs to be a lot more done in terms of social and mental (and perhaps spiritual if that's your cuppa) support for healing than anyone in Western/modern medicine would ever want to admit. Some psychologists are finally wading into this difficult area. I read a book by Sara Stein, MD, that discusses her own personal struggle with weight (as a psychologist) and it is reassuring. That book is called "Obese From The Heart" and it is helpful but it is a beginning to a much LONGER conversation. There are a few other books out there -- workbooks on emotional eating, self-soothing without food - but I haven't gotten into them yet. I believe in books that help you see into yourself but for some reason these sorts of works don't tend to resonate strongly with me (and yet I KNOW I am an emotional eater). My plan is to see my therapist weekly and journal my experience and keep talking to you all. The one structured thing I plan to do is to document how I am feeling - how i would have responded before - and what my NEW response is. Classic cognitive behavioural therapy work...make the implicit habits explicit until you change them I guess. I'll be back with a psych-lit summary later.

No probs, Arts. Research is kind of my thing, citations are just habit.

If you want to make it happen keep fighting for another opinion until someone agrees. Medicine is much more of an art than a science than anyone cares to admit. Get your labs done and ask for a truly informed explanation as to why before you give up. No matter what, my thoughts and prayers are with you.

You haven't read these studies. I'm not sure you understand how to interpret results of intervention and outcomes. Quite simply: given regression to the mean, overwhelmingly the majority of folks who are banded are not successful. The only thing I'm stipulating is that the goal of the band is to be a tool in a patient reaching weight loss goals. It is not assisting more than 20% or so of people in doing that. If you read any of these studies you'll see that for many (40-50% average) have to have the band removed due to complications. It's pretty remarkable you all would attack someone on these boards who is struggling. Good health and good luck to everyone. God knows we all need positive support in our lives. And I mean EVERYONE. Good tidings.

The study is complete, did you read either of these studies? You are talking about sampling bias not completion. I'm glad it worked for you - but people should have full information before committing themselves to something. The study you cite states that 1:20 had to have the band removed. They didn't include these people in their statistics...that is what we call sampling bias. According to the original report only 22% people (714/3227) succeeded long-term (success being 50% of EWL). DeMaria, E. J., Sugerman, H. J., Meador, J. G., Doty, J. M., Kellum, J. M., Wolfe, L., ... & Turner, M. A. (2001). High failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Annals of surgery, 233(6), 809. V Giusti MD, P. D. (2006). A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates.Obesity surgery, 16(7), 829-835. Goitein, D., Feigin, A., Segal-Lieberman, G., Goitein, O., Papa, M. Z., & Zippel, D. (2011). Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surgical endoscopy, 25(8), 2626-2630.

Not your fault. A recent study suggests that the band isn't terribly effective (fails 44% of the time). Hang in there! Here's the link and citation if you are interested: http://www.soard.org/article/S1550-7289(13)00392-4/abstract Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.

Ok. Science has confirmed it: we didn't fail, the band fails. Check it out y'all: KEY FINDING: LAP-BAND FAILS 44% OF THE TIME. This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate. Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases. KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING. As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB. Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.

No worries, AuriP, I'm glad you raised the topic. It nudged me to do some reading which I was planning on doing anyway. My annoyance is with her, not you. Keep on keepin' on!

Ok, I know this needs to go into the research/science area and I'll cross post it, but just to follow up with some...you know...data...here is a summation: KEY FINDING: LAP-BAND FAILS 44% OF THE TIME. This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate. Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases. KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING. As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB. Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029. KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term). Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option. Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326. KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity. Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD. Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France) KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years. At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively. Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540. KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA) Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138. Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475. Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565. Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570. Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

I'm all for counter-points and information but she is very slanted in her commentary. She also never follows up with any factual information. Based on your questions and my own curiosity, I plan on examining the medical literature for long-term gastric sleeve/gastrectomy outcomes. I'll let you all know what I find. (disclaimer: I'm not an M.D. just a Ph.D.)

Hi! It's interesting how much variation there is in the pre-op diet. I went through a number of abdominal surgeries in the past few years (not all bariatric-related) but the rationale for the liquid diet, as explained to me, is to shrink the liver and make the area easier to work in for the surgeon. Particularly as many of us have "fatty" livers, apparently the healthier liver also does better through the recovery process. It's not just about numbers for outcomes but viability. At least that's the prevailing philosophy (for now) amongst surgeons I have seen. Interesting to hear a myriad of experiences! Personally, it makes me less nervous so thank you for sharing!

WOW! Way to LIVE!!! Inspiring Congrats!

I'm not telling anyone but you all out there (who get it), my god, and the angels that get me through each day. Everyone else and their opinions can suck it. I'm tired of living my life for other people.

Anybody else planning on using an abdominal binder? Thoughts??

DUDE, you are hilarious. I watched your vid on the interwebz. "They said don't go chasing waterfalls...and well...I did." Hilarious.

I'm not sure there is really any recourse in the US healthcare system unless you happen to be particularly well-off. Given the rate of comorbidities most of us have, it's not as though the army of lawyers any US hospital has is going to make an easy case for any US lawsuit. Also, a business model has little to do with the reputation of a surgeon's track record. The deposit makes sense. It's an elective surgery, I imagine without some aspect of financial good-faith people would be scheduling and backing out all the time (I've already shifted my date once and they were great about it). I don't think it's fair to cast a US/Mexico dichotomy (I've lived in three different countries and been through all kinds of medical systems -- here and abroad). Indeed, the first and most prominent university in North America was in Mexico before the US even existed. Due diligence is important no matter what your latitude or longitude. When you incorporate "elective" surgery and the market factors in play here it's important, just as anything else in life, to be informed. I find that people are best able to think clearly when they aren't panicked, afraid, or rushing. I like to think this board is a safe place for people to come and ask questions. Personally, I spent last night reading the complications board (just as one source of data) and found that overwhelmingly the surgeons were insurance-backed US-based doctors. Sometimes nuance matters. And also: trust yourself and your body, you know what's best for you! Always advocate on your own behalf in ANY medical setting...I think we all know what fat prejudice in healthcare feels like!

For some reason (maybe it's my background in international relations) but I find it strikingly funny/ironic that the remains of my stomach will be a permanent resident of the sovereign nation of Mexico. I know Medical Tourism isn't new and I'm sure I could battle the red-tape here in Estados Unidos to try and help with my first-world obesity (thanks, Nixon for all the corn syrup!) but I am not a patient patient. I've lived in the US, UK, and Australia, and I can't wait to experience the Mexico healthcare system. Somehow I feel badly about our immigration policy given that I'll be leaving behind 75% of my stomach to return to my capitalistic lifestyle back north of the border. There's something really strange to me that there is such scarcity of good, real food. I just moved back to the US from a year in Oz and while I was a bit aghast at some of the culinary offerings down under I am struck by the pervasiveness of processed, synthetic, chemical, and genetically-modified foodstuffs that have invaded our food system. Why aren't we angrier about these issues? If competition is supposed to force the optimal outcome why do we have substandard food as the norm in the United States? I'm grateful I've kept my portion sizes to AUS standards and I'm grateful I have the opportunity to make a huge change in my life including elective surgery and an amazing health club for continued life improvement. I actually took a job in Colorado to ensure that I was in a healthy environment and had access to organic foods. I rented an apartment right near a great health club and I have a job that allows me time to get surgery and time to go work out. I am lucky, I am fortunate, and it's time I take advantage of it all. At the end of the day I'm left thinking: this all shouldn't be so complicated. No one knows how to eat properly because we've been fed misinformation all our lives. Time to get simple I s'pose.

I suppose since you're in Oz you'll actually be a day ahead of us over here! No worries, we can be overseas sleeve buddies. I just moved back to the States from Oz. Good luck!

I'm also scheduled for January 16th!

THAT IS AWESOME! CONGRATS!

Oh my gosh. We might need to start a comic strip. Your stomach can be called "Stars" and mine will be called "Stripes" and we'll write all about their adventures across Mexico after we leave! HILARIOUS! (Can you tell it's almost 3am??)

Hey chica! Well...this has crossed my mind so I'll chime in publicly. Sometimes I feel like I've already eaten a lifetime's worth of carbs and sugar and I'm looking forward to not wasting so much time and energy on craving things. I've been also wondering, though, what a good mourning process is. A grieving process and an adjustment for how to cope now that the carb "release" is taken away. Will exercise be my replacement crutch? I FREAKING LOVE pizza. I know I'm not going to be able to slam in half a pizza in about 10 minutes like I can now. THANK GOD. Nothing really tastes as good as I think it will taste. I need to start daydreaming about what I will be able to do not what I plan on eating. This is a toughy. I'd be glad to see what some of the successful sleeve vets on here have to say about their transition away from carbs was like. Thanks for your honesty, NoLa! *hugs*