Jean McMillan

The version listed on Amazon is the 1st edition, which is out of print, so you'd have to buy it used. The version available from me is the updated 2nd edition.

After a lifetime of letting food run your life, forgetting to eat is strange, isn't it? All I can suggest is clock-watching. I am a cell-phone ignoramus but it's my understanding that most cell phones have an alarm or reminder feature. Probably some watches do, too.

I've used stool softeners from time to time, but they rarely work well by the time I'm truly constipated. They work better as preventive care. However, there was no way I could have successfully swallowed a stool softener pill when I was banded, so I would drink a cup of Lacie LeBeau Super Dieter's Tea (found in the supermarket tea/coffee section) as needed. It contains senna, which is a stimulant laxative so not to be used often, but it's more gentle than OTC's like Dulcolax.

I'm not sure the FDA has even withdrawn its approval of the 4 cc Lap-Band.

Bandwagon & Bandwagon Cookery are not sold in Canada, but can be shipped there. To order, click on the Bandwagon ads here on LBT (a big ad at the upper right hand corner of the page and 2 small ones at the bottom of the page), or go to: http://jean-onthebandwagon.blogspot.com and click on one of the purchase options (credit card or PayPal) on the left hand side of the page. If using PayPal, be sure to select the PayPal Canada option. I can autograph books ordered via PayPal (just specify a name in the space provided when placing the order). thanks for your interest! Jean

We're never quite sure if there's too much or too little of the "then some"....

Gosh, I could write a whole book of tips for band success. Oh, wait a minute! I did write a book about it! At this point in your WLS journey, i would suggest that you spend some time reading threads here on LBT so you can get an idea of what works and doesn't work for other bandsters, and ask questions as you go along.

Sounds like you've got your head on straight! One of the most successful bandsters I know took the exact same approach and vowed not to eat her trigger foods (including anything sugary) at all. She's 3 years post-op and maintaining a 130-lb weight loss. Another bandster who lost 120 lbs in the first 9 months after her band surgery says that her weight loss slowed and stopped the instant she let sugar back into her diet.

BOB, or band-over-bypass, is the placement of an adjustable gastric band over the pouch of a gastric bypass patient who has experienced disappointing weight loss or weight regain.

I know you mean well, but that's not useful advice. Frozen yogurt may be "skinny" compared to ice cream, but it's a slider food that provides a little nutrition and no satiety. Also, a big, big serving of anything is not appropriate for any WLS patient. Foods commonly found in a salad can be problematic for a bandster: raw veggies can be difficult to eat, and the fixings (like croutons, cheese, etc.) and salad dressing can cancel out any benefit derived from the veggies.

Thanks, Sandy. I can't imagine why a surgeon or insurance company would deny WLS to you because of fibroids in your uterus. I could be wrong, but it just doesn't seem possible that a gynecological problem (other than endometriosis) would have any bearing on a gastrointestinal procedure. Criteria for WLS is usually based on the patient's BMI and co-morbidities (obesity-related medical issues like hypertension, hypercholesterolemia, sleep apnea, diabetes, etc.). Criteria for insurance coverage depend on the individual policy. Oh, and a history of autoimmune disease is considered a contraindication for adjustable gastric band surgery.

Actually, surgeons in Mexico and Latin America have been doing band surgery a lot longer than surgeons in North America and I don't think it's fair to portray Mexican surgeons as snatching crumbs from the medical technology table. Current band design, development, and surgical techniques originated in Europe and Australia. The Realize band is a version of the Swedish band, with its origins in (of course) Sweden. The United States showed up late to the adjustable gastric band party. I'm proud to be an American, but American technology is not necessarily superior technology. From a business standpoint (since companies like Allergan and Ethicon Endo are in business to put money in the pockets of their shareholders), it doesn't make sense for band manufacturers to sell product in Mexico but withhold important product information from customers (surgeons/clinics) there. To do so would just about guarantee poor patient incomes, damage the reputation of the product, and kill the business potential of that market. Of course there's the whole issue of international dumping practices - the USA imposes high customs tariffs on cheap product from countries with a history of dumping product at below-market prices, but doesn't seem to have a problem doing that to other countries - but discussion of that would probably put everyone on LBT to sleep. (Next time you're suffering from insomnia, let me know.) No one asked, but I'll say nonetheless that I wouldn't choose to have any kind of surgery in a foreign country, based on my personal experience of being ill and needing medical attention while traveling overseas as well as a number of other challenges that anyone (American, Mexican, Australian, Lithuanian, whatever) faces when visiting a country whose native language is not their own native language. Plus then there's the challenge of finding a surgeon at home to do fills and aftercare. If we can say nothing else about MarketingDude, we can still say that he did a lot of research in the course of several years before choosing to go to Mexico for his band surgery.

I haven't seen any BOBsters here on LBT. I do know a few who've had mixed results. At either extreme are a woman who has done fabulously well with the BOB and another who lost no weight at all, mostly because of poor food choices and overeating due to some sad and complex emotional problems. One thing for sure: the band isn't a magic solution (any more than any other WLS procedure). Since you already have malabsorption, you may find that weight loss with the band requires more work and maintenance that it did with your bypass. Why doesn't your surgeon do a fill for 4 months post-op? Fills are what make the band work!

Oh, one more thing. About the rumor of tissue death resulting from any kind of plication - I have never found any studies or clinical evidence of that. I'm sure it's possible, but I suspect that it's rare. One thing to keep in mind is that gastric plication as a WLS procedure is relatively new. The first patient I personally know of to have it is a Canadian woman, about 2 years ago. With such a new procedure, there just isn't enough evidence of anything (negative or positive) for us to be able to confidently state a list of risks and complications (other than those related to laparascopic surgery in general).

The band always was done with plication? I've never heard that. I was banded in 2007, did not have plication at that time, so that's news to me. The only published research studies I can find on early uses of the band with plication are related to adjustable gastric band placement in a juxtapyloric position as part of biliopancreatic diversion surgery (one of the most "drastic" bariatric surgery procedures). Juxtapyloric means placement of the band at the base of the stomach near the pyloric valve. That's not the same kind of plication that's now done as a stand-alone WLS procedure or in combination with band placement. There is also a procedure called Nissan fundiplication, a treatment for reflux. I don't know if can be done in conjunction with band placement. It involves folding the upper part of the stomach up over the lower esophagus and stitching it in place. Plication just means folding in and suturing of tucks, so I suppose it could be another way of describing the way bariatric surgeons pull a fold of tissue over the band and suture it in place to prevent band slippage, a technique has been refined over time.

They did plication on you without telling you or your insurance company? That's kind of scary to me...Not the plication part, the part about not telling you...Just sayin'!

Based on my experience with the band and the sleeve, the function of the band w/ plication is not equivalent to the function of the sleeve. Off the top of my head, some differences are: SLEEVE: 1) has a hormonal feature: removal of about 75% of the stomach supposedly (not for me, yet) drastically reduces production of the hunger hormone, grehlin, so the patient is rarely hungry 2) it's permanent 3) it's not adjustable 3) rapid gastric emptying can cause dumping syndrome 4) has a little-discussed malabsorption effect: removal of about 75% of the stomach reduces the production of hydrochloric acid (needed for absorption of micronutrients) and may cause Iron and other deficiences/excesses with various medical problems (such as anemia) as the result 5) may have neuronal effects (I can't find the source for that data at the moment, but I didn't make it up) BAND W/ PLICATION 1. has no known direct effect on grehlin production 2. Is reversible 3. it's adjustable (band fills/unfills) 4. no dumping 5. no malabsorption 6. presence of the band against the stomach has a neuronal effect (activates the vagus nerve) that results in hunger and appetite suppression 7. reduced size of the stomach below the band decreases the patient's food capacity 8. the plication can delay the need for band fills

I'm pretty sure plication can be reversed. None of the stomach is removed.

The 5 day pouch test is supposed to "shrink" your upper stomach pouch but I don't believe it does. I think what it does is break the cycle of carb addiction by forcing you to eat nothing but protein for 5 days. I know that seeing your surgeon is difficult and expensive, but to me it would be worth the time and $$ to go see him and find out what he thinks you should do: remove your band, replace it with a different model/size band, revise to a different procedure, or whatever approach will give you the best outcome in his expert opinion. Good luck!

IMO, it's too soon for a fill. You're doing fine and while your stomach is healing from the sutures and your band is settling in against your stomach, you do not need more irritation from a fill.

The old 4 cc band (like the one I had removed) is still used in Mexico and probably will go on being used there because Allergan sells it at a discount there, thereby increasing the profit made by bariatric clinics there. My current surgeon says that the 4 cc band tends to be too tight even without fill in it, but some people feel it's "better" than larger bands because the smaller fill range makes it possible to achieve restriction faster. I think that's only the case when a surgeon doles out tiny fills to patients with the larger bands. And at any rate, Dr. Kuri is the best person to tell you why he used the 4 cc band for you.

Even if you just try one new food or new recipe a week, you'll be improving your nutrition as well as your cooking skills.

Your worry about band slippage from eating the pizza was appropriate. One of the common causes of band slippage is failure to follow the post-op diet progression. But since that pizza incident is in the past, the best thing you can do is to acknowledge the lesson learned and move on. So it's time to stop beating yourself up over it.

Depending on how badly clogged you are, you might want to wait for 24 hours before calling the clinic for an unfill. During that 24 hours, don't try to eat solid food and get in as much liquid as you can. That should let everything calm down a bit. But if you're so clogged up that you can't drink Clear Liquids, do call the clinic.

I guess I missed the part about allergies and mucus plugs in your original post. I have seasonal allergies and they often did a number on my restriction. My surgeon said (not in these exact words)that the sticky mucus drains into the esophagus and gunks everything up. For me, taking allergy meds was crucial.