Jean McMillan

I was just thinking that myself...

I know exactly how hard it is to stick with any kind of diet, and especially a liquid one. Been there, done that, and didn't even get a tee-shirt. But what I did get was far better than a tee-shirt. I got better health and a size 8 body. I think it's important to remember that the purpose of pre- and post-op diets is not to inflict torture on the patient, but to prevent complications and ensure good outcomes. And those diets are temporary. Following a restricted diet for 14 or 30 days seems like a small price to pay for band success. When I was banded, I had eaten whatever I wanted every day for something like 20,000 days. Compared to that, 14 or 30 days is a drop in the bucket. We can speculate all day long about why different surgeons require different diets and why some require none at all, but at the end of the day, we are still patients without the training and expertise of our surgeons - the doctors we trust enough to hire them to perform bariatric surgery on us. So it behooves all of us to do our utmost to comply with their protocols and instructions. Are we going to trip and stumble while doing that? Of course. I make mistakes every day of my life, but after each mistake, I learn from the mistake, pull myself together and go on. I wrote an article about cheating on your post-op diet, and most of the points in the article apply to the pre-op diet as well. Here's a link to the article: http://www.lapbandta...the-post-op-r78 Also, I wrote an article on how to survive your liquid diet (pre- and post-op). Here's a link to that one: http://www.lapbandta...liquid-diet-r69 And finally, here's an article about the value of patient compliance with their doctors' protocols and instructions: http://www.lapbandta...g-deal-abo-r112 Jean

No, I didn't. Cheating on diets is one of the things that made me so obese, I needed WLS. Also, my surgeon told me that if he didn't like the looks of my liver once he got his trocars into me, he would bail out of my surgery altogether. That scared the be-jeezus out of me.

A few weeks ago at JCP I watched a mom pushing a stroller. Seated in the stroller was a toddler who was busily doing something with a techno-thingie (ipod?). A TODDLER!

I'm sorry, Chuck. I keep forgetting that a lot of people don't like poetry quite as much as I do.

Do you have a different kind of e-reader? Or are you interested in the print version?

Fe fi fo fum, I smell the blood of an Englishman. No, wait a minute. That doesn't rhyme. I'll try again. Fe fi fo fum, I smell the blood of a cinnamon roll. Or something that rhymes with roll.

My pre-op diet was 1200 calories a day of real food. It had to be non-processed, low sodium, low fat. I think the same diet was required of all patients regardless of their size or their surgery type. 450 calories does seem awfully low, especially for 2 weeks. If you're diabetic, low intake like that can cause ketoacidosis, and that would be a medical emergency. I guess if you start feeling ill (faint, dizzy, fatigued, etc.) you could call your surgeon's office and ask for guidance.

To others participating in this discussion: I could be wrong (I know, I know, it's hard to imagine Jean ever being wrong), but I think Chez was responding to the title of this thread. "I don't belong here" does invite argument along the lines of "then why are you posting here?" However, I did read every line of what puppyphat said, and it was clear to me that she was offering encouragement. To puppyphat: I don't agree with your statement that "the sleeve is not that bad" because my sleeve revision hasn't been good so far, but I'm glad it's worked out well for you, and know that you're welcome to post anywhere on LBT at any time, since as far as I know, having the band is not a prerequisite for LBT membership.

I have the same problem at work, where I usually get only one 15-minute break per shift. Although I firmly believe that we should eat solid food, when at work I usually eat soft stuff or a liquid like soup or protein shake. That way I get some nutrition without causing an eating problem that can make my day even worse.

I could write a book about how to succeed with the band, including what and how to eat. As a matter of fact, I DID write a book about that, and I'd be happy to tell you more about it, but right now I want to say that there is no single way to succeed at weight loss with the band. No single food plan, no single exercise plan...because we're all unique individuals who have to figure out what works best for each of us...and that may change as we advance towards our weight goal. If you're a post-op and your surgeon or dietitian didn't give you a food/snack plan to follow, ask for it. If you're a pre-op wondering what a bandster eats, you'll find the answers extremely varied. One of the ways you can get ideas of what other people are eating each day is to post a daily "What are you eating today?" thread. If you had done that today, my answer would have been as follows: B: Protein latte S: egg beaters scrambled with chopped scallion, sugar snap peas, and cheese S: cinnamon-oat Breakfast cookie L: eggplant & tomato salad w/ Havarti cheese S: popcorn S: raw sugar snap peas D: sesame-orange shrimp, braised cabbage S: to be determined I should add that I have to eat 8+ times a day in order to manage some unwanted consequences of my 2012 revision from the band to the sleeve. It may look like I eat an awful lot, but each meal or snack is very, very small - maybe 3-4 bites each. Jean

I loved my band. With its help, I had great success losing 100% of my excess weight (90 lbs) in one year, and in maintaining my weight loss for almost 4 more years. Vertical sleeve gastrectomy is quite new as a stand-alone procedure, and is currently the darling of the bariatric surgery community. It is not without risks. Just the other day I posted about my experience at some length (brevity not being one of my strengths), so I suggest that you click on the link below and read through the comments on that thread, including mine. http://www.lapbandtalk.com/topic/163124-help-guys-band-or-sleeve-im-scheduled-for-band-feb1/ If after reading that thread, you still have questions, let me know. If I can't answer them for you, I can probably send you in the right direction. And by the way...congratulations on starting your WLS journey. I hope you're as successful as your husband has been with his gastric bypass. Jean

See, the idea of the band allowing us to eat whatever is a tricky one in my mind. Eating whatever doesn't serve any of my long term health goals, quite aside from my weight. I saw a nearly miraculous improvement in my cholesterol, triglycerides, fasting blood sugar, A1C and blood pressure at only 3 months post-op, and my blood tests looked fantastic until I was around 17 months post-op, at which point they went bad again - not to my pre-op levels, but no good, either. The ony thing that had changed in that time was that I had discovered I could eat whatever (in small amounts, but indiscriminately) and not gain weight.

It did for me. I also had a 4 cc band. One of the most important things for me has been emphasizing solid food. Even so-called healthy soft foods (like yogurt, cottage cheese, tofu, some fish, Beans, etc) get a low scale on the satiety scale.

Rather than repeat it all here, I'll direct you to another thread on which I gave a lengthy account of my experience with the band and the sleeve. Just click on this link: http://www.lapbandtalk.com/topic/163124-help-guys-band-or-sleeve-im-scheduled-for-band-feb1/ If you have more questions, after reading that thread, let me know. If I don't know the answer, I can probably point you in the right direction. And congrats on starting your WLS journey! Jean

I was banded for almost 5 years and have been sleeved for 5 months. I have posted several times recently about my experience, so you might want to check out these threads on the band vs sleeve debate. http://www.lapbandtalk.com/topic/163124-help-guys-band-or-sleeve-im-scheduled-for-band-feb1/ http://www.lapbandtalk.com/topic/162501-conveting-from-band-to-sleeve-has-anyone-at-or-near-goal-weight-done-this/

I'm not sure that any obese person needs a full-sized stomach, but I would also be concerned about someone so young having the sleeve. For one thing, 75-80% of her stomach would be lost forever. If she one day decided she'd chosen the wrong surgery, she won't ever get that chunk of stomach back. It'll be gone forever, and she'll have to make the best of what she's got. That's a bitter pill for me to swallow at age 59; I can't imagine how that would feel to some 40 years younger. My other concern is that 19 is very young to be making a decision like this. I can understand that you don't want your daughter to grow up obese, with all the social and medical problems that can involve, but if I'd been able to have WLS at that age, I don't think I would've been mature enough to handle it. To succeed longterm, she's going to have to make a lot of behavioral and lifestyle changes at a time when she's still growing and maturing. Also, in his book about the gastric sleeve, Dr. Guillermo Alvarez writes candidly about some teenaged patients of his who were sleeved. Some have done well (so far) but some of them have made a mess of their lives because they just could not wrap their minds around so many changes in their bodies so fast. Social and sexual relationships are a big problem for those kids. My suggestion is that you and your daughter go to see your surgeon together and talk about the options. Then I would leave the room and let her talk to the doctor by herself, and after that (if she gives you permission) you could talk about it with the doctor while she waits for you in the waiting room. At age 19, legally able to vote and serve in the military, your daughter is in some respects an adult in charge of her own body, but you will always be her mother, and if I were you, I'd want to hang onto her a little bit tighter as she goes through this life-changing process.

That is just not true. There is no such thing as an easy, foolproof, risk-free, one-size-fits-all WLS procedure. The dietitian who reviewed Bandwagon and wrote a foreword for Bandwagon Cookery once said at a WLS support group meeting that bandsters have to make lifestyle changes immediately in order to succeed, but that eventually, every WLS patient must make those same changes in order to lose weight and keep the weight off for the rest of their life. It's a pay me now or pay me later thing. Every WLS patient must fight the eating demons that live in our heads. WLS happens in the abdomen, not the brain.

The exact opposite has been true for me. When I was banded, I managed my type 2 diabetes with very little effort and no medication. Since being sleeved, my blood sugar has gone crazy, causing miserable side effects and goodness only knows what damage to my body, and I now have to take metformin and eat 8+ times/day to keep my blood sugar steadier. But aside from that...weight loss alone will improve type 2 diabetes, and gastric bypass surgery is the only surgery that the medical establishment recognizes as an effective treatment for diabetes.

I can understand what a surprise it was to hear that your surgeon no longer does band surgery. I wouldn't just swallow his explanation (too many complications) for that, though. I'm not saying he was lying, but that there may be more to his decision than meets the eye. As a surgeon, he may have become fascinated with the sleeve procedure, and almost certainly can charge more for it. Also, poor patient outcomes can't all be blamed on the band itself, because other surgeons do nothing but band surgery and have plenty of happy, successful patients. The factors affecting good versus poor outcomes include the surgeon's technical skill, fill philosphy (aggressive vs. conservative), a strong patient education (before and after surgery), and a complete support and aftercare program (including dietitian consults, nutrition classes, support groups, psych services). Your surgeon contradicted himself when in one visit he blamed the band for patient complications and revisions yet also told you not to worry because your band looks good. That alone would make me want to ask him for a lengthier explanation. For example, in the year 2012, what percent of his practice was band surgery, what percent of his band patients experienced complications, and what percent of those patients opted for revision surgery? I sure wouldn't have my band removed just because your surgeon bad-mouthed the band. I might consider finding myself a new surgeon who can get behind the band and offer his/her patients the care and support they need. I know it's hard to contradict an authority figure like a doctor, teacher, boss, etc., but as adults we need to be proactive about our healthcare and not swallow everything doctors tell us without even cursory inspection of it. Here's a non-medical explanation of the authority figure fallacy. My ex-husband was considered slow in grade school and had to do 3rd grade twice. Finally someone thought to test his sight, found that he was extremely myopic and also color blind. His new eyeglasses improved his grades, but in high school his guidance counselor strongly advised Joe to go to trade school to become a mechanic (or the like). But since Joe's "smarter" older brother was in college, Joe wanted to attend college too, and guess what? He did very well, graduated in 4 years with a B.S. in geology, got a high-paying job at Texaco, later got a M.S. in environmental engineering and even better job at a power plant, and advanced quickly to one of the top positions in the power company's entire region, despite having been "slow" in school and (as it turned out) legally blind. Meanwhile, his "smarter" older brother flunked out of school and went to work as...wait for it...a mechanic. OK, Miss Jean's Story Hour is over now. You may all resume whatever you were doing before I jumped in. Edited to Add: I forgot to mention that I had to revise from the band to the sleeve last year. I loved my band and I do NOT love my sleeve. There is no such thing as a perfect, risk-free, one-size-fits-all WLS procedure. The sleeve is the flavor of the day. Wait another year and your surgeon may have become a brain surgeon. Or a mechanic.

I know from personal experience how hard it is to juggle jobs, family, food, exercise etc, but if you were able to do that before, you can do it again. I have to plan all my meals in advance so that I'm rarely forced to make a poor food choice. It's not impossible to eat when you're on the run - it just requires you to plan ahead, keep a cooler in your car, keep healthy Snacks where you work. Don't keep trigger foods in your house, car, or workplace. Also, when was the last time you saw your surgeon or dietitian? I suggest that you make an appointment to see them, get a band refresher course and pep talk, and talk about whether you need a fill. It's their job to help you lose weight and keep it off. They're not going be surprised that you're struggling - they already know you have a problem with food. You might also want to consider asking them for a referral to a counselor who has experience with eating disorder and/or WLS patients. With a counselor, you'll have some "me time" with someone who can help you figure out why you're sabotaging yourself and how you can stop or at least minimize that behavior. If you can't afford counseling, consider going to 12-step meetings such as Overeaters Anonymous. And if you're not attending WLS support group meetings, start. Yes, all of that will require you to spend some time and/or money on your WLS journey, but surely that's a better investment than pizza and a box of donuts?

No issues directly with my band. I loved that little thing. About a year ago, I started having problems with esophageal motility (motility is the function that moves food through the esophagus into the stomach). My surgeon and gastro doc strongly recommended removing my band because it could be aggravating the problem. I had it removed in April 2012 and revised to the sleeve in August 2012. Last year I talked with my surgeon, local gastro doc, and a gastro doc that my surgeon insisted I consult. The consensus is that my esophagus was damaged from decades of "silent" reflux. In other words, I had reflux with symptoms that I didn't recognize as having a gastrointestinal source. I can remember going to an ear-nose-throat specialist in the mid 1980's because of a persistent cough. He told me it was probably from reflux, but I didn't believe him and didn't pursue any treatment for it (of course, back then, there weren't a lot of good treatment options). So the reflux had almost 30 years to make a mess of my esophagus.

A band slip doesn't automatically call for surgical treatment. As in the rest of American medicine (especially as dictated by insurance companies), the first approach is a conservative approach, and if that doesn't work, the treatment gets stepped up to the next level. So usually the first step in treating a band slip is an unfill. If that doesn't resolve the problem, the patient is re-evaluated and a more "drastic" treatment (like surgery) is identified and, if approved by insurance, performed. Although sometimes I get very impatient with that approach, I would very much prefer to have an unfill than to have to go back to the operating room!

According to my surgeon, when the patient is having symptoms like that, an unfill would be the treatment whether or not the band had slipped. So MKB's surgeon may have felt that exposing her to radiation when it wouldn't affect his treatment was not the best approach. If the unfill doesn't resolve the symptoms, the x-ray would be justified at that point. But I'm just guessing. I had big unfills a few times because of eating problems, and a complete unfill to treat a suspected band slip. In every case, the unfill fixed the problem. I didn't have an upper GI x-ray until after the unfill to treat the band slip. My appointment was in the late afternoon and I couldn't wait for the hospital radiology department to fit me in after all the scheduled and emergency patients. I have a 6 hour round trip to get there, so I had the upper GI study done locally, and by that time, my band, esophagus, and stomach were fine.