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I don't understand what you mean by there not being any sharp objects to nick one's intestine while doing lap band surgery?!? How do you think the surgery is done? Incisions are made, that requires scalpels or electrocautery. The instruments that enter your abdominal cavity during the laprascopic portion grab, staple and cut the tissue at the same time. They make cuts to remove tissue around the stomach so they can place the band around the stomach. There are lots of opportunities to nick one's intestines during this surgery. It's easy to judge someone else's work as incompetent but you need to understand that this is a risk anytime you have surgery!!! A lot of people seem to see this as "noninvasive" surgery, but there is no such thing. It's surgery, someone is going to cut you, and there is a risk that they will cut something they didn't mean to cut. Any surgeon can do that, no matter how good they are. You might want to first, find out if the other surgeon will accept you as a patient, because a lot of surgeons won't take other surgeons' patients, and second, meet with them and see if you like & trust them aside from this surgical complication. Then make a decision. Odds are, like most surgeons, this one won't accept you as a patient anyway because he didn't do your surgery, so the whole question might be moot. Or you can keep looking for the surgeon who has never made a mistake. Good luck with that.

Well, I have never been able to lose 1-2lbs/week before my band. I don't know why but I was never able to lose weight more than 1/2 lb per week, and I stopped trying to figure out why. Even since I was banded, I only was able to lose 2 lb/week in the first couple months, and now I've averaged out to just over 1 lb/week. But that's okay, because the actual weight loss wasn't the main reason I got banded--the number one reason was preventing the regain. I was so disheartened by years of dieting and regaining the weight, and when I learned that only 5% of people who lose weight through diet and exercise alone are able to keep the weight off for 5 years, I just decided to stop torturing myself. Right now, I would say ABSOLUTELY, I would do it again in a heartbeat. But if I were to have a slip or another late complication, and somehow end up losing my band, I might change my mind. Who knows? At this point, though, I can't imagine life without it. When I eat Breakfast and stay satisfied with 1/2 cup of food for hours, and remember how much I used to eat for breakfast, I just am so thankful for my band! If I had to have a different surgery, I'm not sure what I would do. Even the sleeve is more radical than I am comfortable with. I'm just so thankful this option was available because it seems perfect for me and my lifestyle. Good luck to you!

Hmm. I'm not a surgeon, but I am a health care professional. I've never heard of a miscalculation like that before, but that doesn't mean it's a matter of incompetence. People are anatomically different and there really is no way of truly knowing what you will find until you open someone up, even with all the imaging available in the world. I'm not saying that this is or is not a matter of incompetence, but I do know that sometimes surgeons get "surprises" like that even if they go by the anatomical landmarks that they are trained to use. As for suing...I don't think you have grounds to sue, just from the brief overview you gave, and it doesn't sound like that's what you want anyway. She did the appropriate thing in stopping, closing, and assessing the possible damage, and then having you closely monitored afterward. There are risks to having surgery, and this is an included risk, I'm afraid. She CERTAINLY should have come to see you as soon as she could to talk to you honestly about what happened and apologize. There is a lot that can be said about the appropriate use of litigation in US healthcare. You said it best yourself: the surgeon is human, and we accept a certain risk when we sign on to have surgery. But she definitely should have spoken to you directly about what happened, been honest, and apologized to you. That is the professional way to handle it. Unfortunately, a lot of surgeons were trained (especially years ago) never to apologize because then they are "admitting" fault and asking people to sue them. They have it in their heads that it's too risky to apologize, but for most patients that's what they actually want, not really to sue but to hear from the doc that they made a mistake. Despite all of that, I think it's totally normal that you would be hesitant to have surgery with this doctor again. If you are really uncomfortable about it, I would trust your gut and find a new doctor. I think if the doctor didn't take the time to explain what happened and how something like that can happen, apologize for the pain and inconvenience and extra risk and cost to you, and make you comfortable with her doing surgery on you again, I would find someone else. You will have to live with this decision for the rest of your life, and you need to be comfortable with it. Thank goodness that it was caught before something worse happened, and it sounds like you are recovering well. I don't think you have to be "fat forever". You've just had an unpleasant reminder that this is all major surgery and it carries real risks, however low they might be. Best of luck to you, and hopefully it will all work out for you soon!

Overweightmom, I'm losing at about the same rate that you are. I constantly feel like it's "too slow", especially when I read about other people's seemingly "better" success. But it adds up, bit by bit, and our weight loss is "average". Every time I'm feeling discouraged about losing so slowly, I'll see my doc and she thinks I'm doing great...so I try not to worry. We all lose at different rates. I've always lost weight very slowly, before the band and now. I might be able to go faster if I cut my calories more--I average about 1200/day. I do exercise, cardio 5 days a week, and weights every other day. But I just don't really want to cut my calories that much, so I settle for the slow, but still mostly average, weight loss, and try not to compare myself to others. My restriction isn't as tight as many people's, and perhaps I can eat more than I should, but I try not to exceed the recommendations, whether I "can" or not. And I've never lost 50 lbs in less than a year, much less with as little suffering as I've had with the band. So I consider it all a success, and do my best. Hang in there, you're doing great.

SueSue, First off, you aren't a failure. You've lost half your desired weight in a pretty short amount of time, despite being on insulin and having fluctuating glucose levels. As others have said, getting your glucose under control is your first priority. Does your doctor that manages your diabetes have a diabetes educator that you can work with? A lot of docs have or can refer you to a nurse or other professional who does diabetes education as their job. Diabetes is complex and can be very hard to understand and get control of, as you know. It sounds like you could benefit from a lot more education. You are almost to a BMI under 30 as it is, which will make you no longer "obese" by BMI standards. It may be harder for you as you get closer to goal, but it will be much harder if you don't have control of your fluctuating blood sugars. As far as feeling like we might fail...I think everyone who has bariatric surgery is afraid that it won't work. After all, if anything else had worked before, we wouldn't be having surgery. There's no use in getting down about how hard it is to lose weight. We just have to take our challenges and learn from them, and do the best we can. One thing that will probably help you is if you look at your successes and give yourself credit for them. That can help you stay motivated to continue working at it. Good luck.

At the time I was a trauma ICU RN. I took 2 weeks off and had an additional week of light duty work. If I didn't have to lift so much for my job, I would have been back to work a couple of days after surgery. I felt great for the most part. But the 25 lb weight lifting restriction meant I couldn't do my job, so I had a longer recovery time.

What do you love about your band surgeon and their practice? I had surgery at Oregon Weight Loss Surgery in Portland, OR. My original surgeon was Dr. Hong, but now I follow up with Dr Emma Patterson. All the providers at OWLS are responsive and receptive. They answer any and all questions and are very personable. Their practice is very busy, they do about half bands and half RNY, and they do some other bariatric procedures that their patients request (DS, etc). They did not have any bias toward one procedure or another when I was having my initial consult; they felt either one would work for me and simply explained the differences. What do you hate? Nothing really, but the surgeon who actually did my surgery moved back to Canada about a month after my surgery and didn't mention it to me when I saw him. It was a sudden, unplanned thing (family circumstances) but I was a little dismayed that I wouldn't be seeing my surgeon anymore and that he didn't tell me when I saw him for the last time. Fortunately the practice has 2 other surgeons and a PA that I could see for followup, and they are all very competent and helpful. What do we do well? In my experience, pretty much everything. All the providers I worked with genuinely cared about their patients and their health. They are very respectful and compassionate. They are all highly competent and I felt very confident in the level of care I received. The surgeons in the practice I went to always have surgical fellows working with them, and the fellows always ask permission before doing anything (like performing a fill). Some patients don't like seeing surgeons "in training" but I've always worked in teaching hospitals (their practice isn't in a teaching hospital per se) and I understand that providers need to train with actual patients. The surgeons seem to do a good job in choosing surgical fellows who have similar values towards patient care. What could we do better? This is an ongoing issue with all band surgeons, but you could help us when we have to move away from your practice. I understand all the reasons why band surgeons are reluctant to take patients they didn't do surgery on (liability, the cost of aftercare, etc), but the reality is that a lot of us have to move away for various reasons, making followup with our original surgeon difficult to impossible. The fact that band patients need a lot of followup and aftercare, for a long time after surgery, makes this complicated. Dr Patterson happened to know a surgeon near the city I just moved to and was able to refer me, but if she hadn't he wouldn't have accepted me as a patient, because he didn't do my surgery. (And because he didn't do my surgery, he requires a fill under fluoro the first time...no matter that my port is extremely easy to find...for a cost of $600 more than a blind fill. Only for patients he didn't operate on.) I'm in a graduate program in a city 6 hours away from my surgeon's office, and I simply can't get there in the middle of the week when they see patients; besides, I need someone local in case there is a band emergency. If surgeons could understand this and help us out a little more, realizing that this is a common problem with band patients, it would help a lot. What more could we do to help you succeed? Not much more, I think. My surgeons did their jobs, and it's up to me to do my part. Once the band is placed, assuming that the surgery is performed as expected, the rest of the work is mine, provided that I go to my appointments and get appropriate fills when needed. The band doesn't do it all and neither can my surgeon--and for most of us, the band does require a lot of work. But they didn't really tell me this. I think for a lot of patients it would help to hear from the surgeon that most of the work is up to the patient. Also it would help to explain how many patients don't have any restriction right after surgery and that it might take a few months before they have any and weight loss really starts in earnest. No one told me that part. How could we improve your customer experience with our practices? Choose office staff carefully. They are your first liason with your patient and make your first impression for you. A lot of patient dissatisfaction with their doctors actually starts with the office staff. If they are not courteous and respectful of your patients, that makes a huge difference for you and for your patients. Obese people are especially sensitive to perceived slights and have often been disrespected in public due to their weight, plus the insurance approval process can be very stressful, so it's important to have staff who are compassionate and respectful. Dr. Patterson's office staff are pretty good for the most part, but I have heard a lot of sad stories about office staff from a lot of patients elsewhere. Thanks for all the insightful contributions you make to this board, Dr Watkins, and for taking time to ask and listen to actual patient feedback. Your patients are lucky to have a surgeon who cares so much about their experience and success.

This is great. Making new workout playlists is one of my favorite things to do, and I'm going to have a lot of fun going through this thread and finding new tunes!! Since I am procrastinating on the studying I am supposed to be doing right now...(ahem)...here's my most recent playlist: Break it Off--Rihanna Jenny from the block, Get Right--JLo Suck my Kiss--Red Hot Chili Peppers Don't You Worry 'Bout a Thing--John Legend (Stevie Wonder's original is great but I like this better to work out) This Is How a Heart Breaks--Rob Thomas I Wish, Higher Ground--Stevie Wonder Pump It--Black Eyed Peas Control Myself--LL Cool J with JLo Switch--Will Smith (great!) Get on the Boat--Prince Blue Monday--Orgy (New Order works too) Bye, Bye Baby, Hung Up--Madonna The Benefit--Alana Davis Last Night, Juicebox--The Strokes Don't Go--Yaz shake That Sh-t--Shawnna feat. Ludacris My Adidas, Run's House--Run DMC Glow, Maneater, Promiscuous--Nelly Furtado Hindi Sad Diamonds--Nicole Kidman (Moulin Rouge sndtrk) Lose Control, Pump it Up--Missy Elliott Take Me OUt--Franz Ferdinand Ain't No Other Man--Christina Aguilera Black Tambourine, Girl--Beck Root Down, Intergallactic, Ch-Check it Out--Beastie Boys Little Bird--Annie Lennox Move On Up--Curtis Mayfield God is a DJ--Pink What You Waiting For--Gwen Stefani Motorcrash--Sugarcubes Jump Around--House of Pain Send Your Love--Sting Come Out and Play--The Offspring When 3 is 2--Hammerbox Freak on a Leash--Korn Gone Daddy Gone--Gnarls Barkley Mama's Always On Stage--Arrested Development Lady Marmalade--Moulin Rouge sndtrk I'm Diggin' You (Like an Old Soul Record), If That's Your Boyfriend (He Wasn't Last Night)--Me'Shell Ndege Ocello Canned Heat--Jamiroquai Go--Pearl Jam My usual music tastes are pretty varied, usually veering more towards folk-like singer-songwriter types (Ani Difranco, Brandi Carlisle, Aimee Mann, Bruce Springsteen, to name a few) but when I am working out, I listen to a lot of hip hop and R&B, lots of old school stuff. Ok, back to work. Thanks for the diversion!

Your question is great!! If anything, I think most of them would be happy to help you develop a strength training program BEFORE you lose 50 lbs, to prevent losing your lean muscle mass while you are losing weight. It's easier to keep it up than to lose it and have to regain the muscle, which is what I'm trying to do now. I totally know where you are coming from, though...it's hard not to be intimidated by someone who makes a living being fit and teaching fitness. But everyone has to start somewhere, right? Otherwise no one would need a trainer!

Interesting thoughts. I guess the main reason for the two different sizes would be the INITIAL size difference of the bands, then. When it's initially placed, the size difference matters, but once fills start they can ultimately become equally small in diameter...although it could take longer with a larger band if your fill provider is very cautious with small fills. That makes sense. Thanks for the clarification! We learn something every day. Thanks for the other nice comments!

Whoa, sister, you've lost 38 lbs in 2 months! That's way above average. Plateaus are a normal part of weight loss as your body adjusts to the weight loss. They WILL happen as you continue to lose weight. Don't lose heart. Just make sure you are following the band rules for eating, tweak your calories a bit if it seems like you are eating too much or too little, and like the others said you'll see a difference in inches before pounds. But don't lose sight of the fact that you have done great so far, and you WILL start losing again. Plateaus totally suck, I am with you there. It always feels like it lasts so much longer than when I actually look back after the plateau is over. That's why I weigh frequently (I know, a lot of people don't but I do) and record it online, so I can look back at trends. A lot of times I will think my plateau has gone on for longer than it really did. But just know it's a normal part of weight loss and sooner or later it will pass. Also, you didn't mention what you are eating, how often, whether you have any restriction...entering your foods in an online food journal like fitday.com or sparkpeople.com for a few days can help you see if you are getting more than you thought you were, or if you can tweak some choices to improve your calories. Hope some of this helps! Good luck.

Yay Jen! You've already lost almost 8kg--that's terrific! At almost a year out, I do have visible scars, but they aren't bad at all, and they are definitely better to look at than my fat belly was! :frown: Glad to hear you are doing so well. Keep up the great work. Gwen

There is an incidence of memory and cognitive problems among people who have bariatric surgery, related to thiamine deficiency. It's called Wernicke's Encephalopathy, it's not common but more common among people who have had WLS than the rest of the population. Alcoholics are the main group that gets it. There are other problems that can happen because of various Vitamin deficiencies as well. It's less likely for us than for RNY people, for example, or DS or the other surgeries that cause malabsorption, because we absorb all the nutrients from our food, but it does happen, which is why we need to take Vitamins. For us it's an "insurance policy" in case we aren't getting what we need from our diets. I don't mean to scare you! Just a little information. These kinds of complications are totally preventable, especially for band patients, so I'd get a workup of your nutrition status and restart your vitamins and whatever form of Iron you need.

Hmm, they sure LOOK like different sizes in person. They passed both bands around the class when I was at my pre op class. The 4cc looked quite smaller (diameter wise) than the 10cc in person. And I thought the differences in diameters (deflated) were 10cm vs 14cm??? Or something like that. My surgeon told me that was why they have the different sizes, to accomodate different sizes in people's stomachs. I didn't see AP bands as it had not been released yet when I had my surgery (I think it was released April 07), so I can't really speak about that one. I guess that doesn't really make sense to me. The bands don't have to be dramatically different sizes to be significant in how they restrict, but since my band had to be almost completely filled to provide restriction, it wouldn't make sense that a band with a larger diameter would be able to provide me with restriction. The photos above don't have a reference in them (like a ruler or a dime) to show their size relative to one another. They are obviously different sizes in person. Am I looking at this incorrectly?

It's always been slow for me, but not slower than average. Some people lose more quickly than others. I've always been a slow loser, but I am more concerned with keeping the weight off for good than how quickly I lose the weight. I am expecting my last 27 lbs (or more if I decide to lose more) to take another year (since I just started grad school). I have lost more consistently since I started strength training; I've been exercising 5 days/week the whole time, but only recently started strength training. That has made the biggest difference.

NP, glad to help. BTW, way to go on your weight loss! That's awesome--only a month post op! You are doing great.

The size of band is chosen by the surgeon at the time of the surgery. All sizes can provide good restriction if they are placed on the correctly sized patient. Some people have more stomach tissue and fat around their stomachs than others, that is why they make the different sizes. I have the 4cc band and my surgeon told me it was kinda loose on me when he placed it, so I had to have a lot of saline in it before I experienced restriction. If they had put the 10cc band on me, I never would have had restriction--my stomach just happens to be smaller in that area than some people. Which doesn't mean I was any less fat than any other patient--that's just the difference of anatomy between different patients. It is certainly possible to have a band that is too big, but honestly I haven't heard of that happening to anyone. I have heard of people whose bands were too SMALL and had to have it replaced before they ever left the hospital, because they were over-restricted immediately post op. As for the amount of saline, there's no use comparing amounts, because everyone's fill level is totally dependent on their individual anatomy. I've heard it said that there are only 3 levels of fill in a lap band: too little, too much, and just right. 10cc might not be enough for one person, and might be way too much for the next person. Also, just so you know, the amount of saline that each band can hold is a suggestion by the manufacturer. They all can actually hold more than the advertised amount and surgeons will fill a 10cc band to 11 or 12cc if that's what the patient needs. Don't worry, you'll get restriction! But it might not be on your first or 2nd fill. I didn't have really good restriction until my 3rd fill. Hope this helps!

There's an article on MSNBC.com that deals with the same study. It was done in Australia and compared type II diabetics, some who had lap band surgery and the others who had conventional (diet & medication) therapy. It showed 13% remission of diabetes in the conventionally treated patients versus 79% remission in the lap band patients. That's HUGE. There are lots of interesting things about this study, but hopefully it will help make it a little easier to get this treatment in the US and elsewhere for diabetics. Here's the link: Obesity surgery may cure diabetes - Diabetes - MSNBC.com

Another thing that can be helpful is if your surgeon has a nutritionist. Ours was really good about suggesting things that fit my diet restrictions and were band friendly.

LOL, Juli... I know what you mean about buffets! We went to them all the time when I was a kid, so as an adult I've really hated them anyway, but especially as a bandster, it's so pointless! Today I just didn't feel like going to my gym, which is a bit of a drive and it's all snowy here in Spokane, so I decided to go for a run, as much as I could, and walk between. In the snow. What was I thinking? LOL. Actually it wasn't that bad, I only ran where the sidewalks were pretty much shoveled, to reduce the likelihood of landing on my ar$e, and I'd guess I ran about 12 min out of the 30 I was out there, walked briskly the rest of the time. My HR was still pretty high by the time I got back, so I must have done some good. It's freakin cold out there, though! I know you guys in the Northeast might think I'm a weenie, but that's cause I am...I'm from western Washington, where dropping below freezing is a state emergency, and our daytime temps in Spokane have been in the low 20s, at night around 12. That's too cold for this gal. I'd never last a winter in Alaska or Wisconsin or Michigan! This morning my landlord almost burned the house down trying to thaw my pipes to the kitchen...smoke was billowing into my kitchen from the basement, sure enough the heater he was using caught the wall on fire! :yikes:He put it out and it's all better now, but that is just another reason not to live where it gets this cold. Ah well...my weight is holding steady, despite TOM on its way this week, AND eating out all weekend in Portland (ahhh, sushi!) so I'm feeling pretty good about that. Next goal...50 lbs down..that's around the corner!

That's awesome! Almost at goal in 8 months...congrats!! I think it will take me another year to get there, just because I just started anesthesia school. I'm not in a hurry. I feel so much better now, I can take my time with the last bit. anyway...congrats, and welcome!

How are you feeling, greeneyez? It's been almost a week...doing okay with liquids? Things should be looking up about now, less pain, less soreness...although the post op diet is no walk in the park. Hope you and all others who just had surgery are doing well!

I know what you mean, Texgirly...my hubby and I are both on marriage #2. We have agreed that our firsts were our "practice marriages". We know ourselves so much better now than in our twenties, and have more to offer one another as partners. I think it's WONDERFUL when people do find someone so young and have a long and happy marriage together. I just don't think it ever could have been me. I'm just such a different person than I was even 10 years ago, much less when I was in high school. Good luck on getting your approval for surgery!

I've been able to eat meatless protein (meat substitutes) and tofu without problems. If you eat dairy and eggs it will be pretty easy to get enough protein, otherwise you will just have to get creative with tofu, legumes, and the like. Eggs are great protein so if you eat those you will be fine. I happen to eat fish now too, so I don't really worry about it, but for years I didn't (17 years actually) and I still got plenty of protein. You might have trouble with some of the Morningstar Farms products getting stuck (not just that brand but others, Boca etc), but I haven't. Just depends on how tight & how picky your band is. You'll be fine, just be careful about where you get your protein from.

I don't think it's helpful to think of the post op diet as a "joke". Surgeons disagree on how long it should last and how quickly it should progress, but the research on slips shows that any diet that prevents the stomach from doing the kind of maneuvers that it does when it is "grinding" real food for about 4 weeks helps to allow the stomach to heal adequately. The band is seated into a groove by then, the sutures heal completely, and then the stomach is ready to do some actual work of grinding with decreased risk of slips later. Most slips seem to happen more than a year out of surgery, not soon post op. So you can't really tell early on if your post op diet is helping or not. Yes, there is a lot of difference among the surgeons. Some surgeons don't believe the research about diet being related to slips, hence their willingness to progress to real food quickly post op, but most seem to and do some variation of this diet to optimize the stomach's healing. That is my understanding of the rationale behind the post op diet that we all refer to as "bandster hell". It's not hell, but it is hard to stick to. You will do your body the best service by sticking to it and giving yourself the best chance at healing.