Ilene62

I got an e-mail from Bariatric Pal about a June 14th meeting in NYC, Third Avenue. I was interested in going. I tried sending an inquiry at the e-mail address in Lisa Caron's post (nyc.li.3s.bariatricpalgroup@gmail.com) and my inquiry was returned by my system administrator as undeliverable because the address didn't exist. Okay. So how do I find out about the meeting? Do I have to register for it, rsvp, or just show up?

I've been taking MSM regularly for years for joint stiffness. I have osteoarthritis and it seems to help a little for that. It's good for many things that involve connective tissue, like skin. If you're young enough, exercise will help tighten the skin. However, my skin has been sagging more and more as I age and at some point nothing short of surgery helps, especially if there's been a lot of weight loss. I'm currently saving for bracheoplasty, which I think is the least expensive procedure. The band has been great and I'll never regret doing it, but I haven't worn short sleeves or a bathing suit in years. When the excess skin situation gets severe, I don't think that MSN is going to make much difference.

This is a major on-going problem. I've been reading posts about it for years. I was banded in NY, but my doctor was not part of a group and he relocated shortly after my surgery, leaving me without follow-up care. It took me years to find a practice that would do adjustments and follow up care. I was banded five years ago and I thought I did thorough research beforehand, but no one, NO ONE, discussed the problem of getting fills and follow-up care. It's a well-kept secret. Surgeons like mine who were not part of a center of excellence, or surgeons in Mexico don't want their patients to know that this is a problem. They just want to do the surgery and get paid. Do not have the surgery done until you have lined up follow up care. It's primarily important for fills, but it's also important to have a doctor following you in case there's a complication or emergency. I would recommend that you contact bariatric centers of excellence in your area to see if they offer care if the surgery is done elsewhere. That's how I finally found a place for adjustmensts and care. Good luck!

It's a big problem (no pun intended), especially for older bandsters. Skin naturally loses elacticity through aging, and a history of repeated weight loss and regain only makes it worse. Unfortunately, it's very difficult to get insurance to pay for tummy tucks and other procedures. I'm grappling with that problem now. Trying to figure out how to fund some surgery. Lose skin around upper arms, thighs and butt (oh, that butt!) makes for ill-fitting clothing and too much cover up in the summer. I'd like to hear from older bandsters who had this problem: How old is too old to have plastic surgery for these problems. Can anyone recommend a plastic surgeon in the NYC area?

First, never use the word failure. it's too negative. We all do the best we can. Just the decision to be banded is a positive sign. Second, I'm curious to know what kind of band you have. I was banded in 2007. I've lost about 60 pounds, which is considered a moderate success. It's okay, but not nearly as good as I had hoped. Like you, I found it difficult to do. My doctor moved away not long after my surgery and when I finally (don't ask) found a center in NYC that does fills (NYU, by the way), I was told that the band I had--the VG band--was not successful and is no longer used. The original bands developed in Europe were successful in re weight loss, but caused a lot of throwing up and other problems. The VG band was designed to be more flexible and have a wider opening. This reduced the vomiting, hernias, etc., but people were not as successful with weight loss. A newer, smaller band is now used. My fill doctor said that he has replaced a lot of the VG bands with newer ones for people who have had difficulty losing weight with the VG. Of course, none of this was known in 2007 and I had no reason to question the kind of band my surgeon used. So, first of all, do you have a VG band? This may be part of your problem. Also, with all of the forums and comments at this site, I've never seen one discussing the VG band and its problems. Some of the long-term bandsters would have the VG. Is anyone out there familiar with the VG problems? Has anyone had the VG replaced with a newer band? P.S.: For bandsters looking for fills in NYC, NYU is a center of excellence for bariatric procedures and they will see patients for fills and follow-up who did not have the surgery there. You'll need your operative report and an esophogram. It's a very busy practice, so bring somethng to read in the waiting room. Everyone I've seen at the practice has been very nice. They take most insurance plans, including Medicare.

I'm a vegetarian, although I, too, have some dairy. I do fine with 'eating plants,' as a friend of mine says. Actually, I think a vegetarian diet is better with the band because meat is difficult to chew into mush and some bandsters have problems eating meat. And meat is calorie dense. Lentils are a great substitute for meat. They're high in protein, fiber and vitamins. You can make a lental loaf instead of a meat loaf. I make a lentil and quinoia stew with lots of veggies, chopped tomatoe and spices. Delicious and very filling. A lot goes a long way. Whiz up a protein shake with fresh fruit. Strawberries and/or banana is great. Beans are an excellent source of protein. Beans and rice (preferably brown rice) combined forms a protein. Get a good vegetarian cookbook and experiment. There's lots you can eat without meat.

Wendell: Over the years you've been a great source of knowledge and information (many thanks). Perhaps you (or someone else) can answer a burning question: Why is it so hard to find a fill doctor? Like many banders, my doctor moved away. Over and over, we see desperate messages looking for fill doctors in a geographic area. I've heard two theories on why it's so difficut to find a fill doctor: 1) The surgeon doesn't like to treat patients that did not have him or her do the surgery, or 2) that there is increased liability to the surgeon (hence higher med mal insurance costs) to surgeons who treat people other then their original patients. Any truth to this? Personally, I think there's a gold mine out there. People like me would pay a lot to be able to get a fill once in a while. Help! What's causing this problem?

I have never been given a consistent reason for the 30 minutes fluid rule. I have been told everything from "it washes the food through the band and you're hungry too soon," to "it could cause you to aspirate if there's too much food in the pouch." I asked my primary care MD and he had no idea why we're told this (and he's a well-informed guy). Wendell, you're the resident site expert on how the band works. Do you know the reason for this rule?

I've heard good and bad things about having the surgery in Mexico. But one problem is the lack of aftercare. The process doesn't end with the surgery. You will need follow up care and adjustments to the band. Also, as you lose weight, you may need additional adjustments (fills). It is very difficult to find medical providers who will treat someone who had their surgery done by someone else. (I think there are malpractice issues, among other things.) This has become a major problem for lap people. My doctor moved away and it has taken me a year to find a surgery group that would agree to give me an adjustment, and I have to provide medical records and a recent barium swallow test before they'll set up an appointment. When you decide where you'll have the surgery, make sure that there's aftercare available where you live. There's a company called Fill Centers USA (or something like that). I don't know how good they are, but they are constantly announcing that they're opening up at new locations. You might want to see if there's one in your area.

Betty Joe: Do it! I got banded at 62. I've never regretted it. My friend just had it done at 64. If it wasn't a good choice for older people, Medicare wouldn't be paying for it.

Dear Teee: I'm responding to your post of 4/10/08. It was awhile ago, but I came across it when I was surfing the site. Were you ever able to find a fill doctor in Manhattan? If so, could you let me know who? I need a Manhattan fill doctor also. Thanks. ilene62