SouthTX LapBand

Something which your doctor can't always be counted on to explain in detail ---- expect to have to cut pieces of meat not much larger than your little fingernail. If you can manage that well, then you can try a bit larger.... But if you take too large a mouthful of something with muscle Fiber, no matter how moist and tender, those long fibers will GET'CHA!!! :faint: It is often suggested that you invest in a cocktail fork for eating and leave the regular flatware to your wife. Some people buy baby spoons, or a toddler spoon and fork set. Some people even use chopsticks. And creating a habit of putting DOWN your fork/spoon between bites and just "be" for a minute. You should expect it to take you 15 minutes or so to finish a bandster sized meal. We are so used to a lifetime of shoveling food in, eating TINY is difficult. For me, it also bothered me to not be able to finish a meal while it was still real warm, but now I've gotten used to cold food and I don't mind anymore. :hungry: Theresa

The role of dehydration in restriction Recently, MoonShadowRN has posted that when you are dehydrated, you are much tighter. When you are drinking lots of liquids, you loosen up. This finally helped me make sense of why I could have gotten SO loose, needing another fill - then suddenly tightened up as tight as I was a few days after my first fill. I have never been a heavy drinker -- tho when carbonated soft drinks are onhand, that can change. Since my banding, I have tried tea, Crystal Lite, plain bottled Water, even tap water, but it has been hard to keep up the volume -- but I drank anyway and needed another fill - badly. Now I am tight again, and I find I can control the degree of tightness. But you can't get SO dehydrated that you can no longer drink. I think the woman who started this thread needs to be hooked up to an IV (or an NG tube) and very well hydrated til she can drink easily again. It is highly improbable that a few weeks of banding can cause scarring and restriction.... and I say that the banding surgeon needs to see a fluroscopy (not xrays) of the barium going down to know what is happening. I advise a hydration ASAP -- several pints, til urine is pale straw colored -- and then a trip to the surgeon for diagnosis and treatment. Theresa

I think so much of this in the evening is head hunger --- we are often relaxing with the TV and used to having a little snack during the evening... Or spouse and/or children are home and there are issues to deal with and, as food addicts, we respond to the stress by reverting to our drug of choice to soothe the anxiety, ease the pain, dim the thoughts. On "Starting Over" recently, one of the house mates has been going to a unique addiction recovery program called Passages and I am finding it helpful in dealing with my head hunger. Check out the schedule in your area at http://www.StartingOverTV.com I am also using a free online self-help cognitive reconditioning program called "Inner Peace" -- helping ease my triggers and build my esteem. I strongly recommend it. Stopping Your Monkey Thoughts is especially effective. http://innerpeace.org/newusers.shtml Theresa

You are GORGEOUS and I can't believe how little excess skin you have -- I am sure it is a combination of great genes and your youth. I am purely amazed at your weight loss journey. Yes, you COULD be featured on some show on TV and get that surgery paid for you. You are an incredible inspiration. Theresa

The book mentioned is The 3-Hour Diet: How Low-Carb Diets Make You Fat and Timing Makes You Thin - by Jorge Cruise, weight loss & fitness guru. Here is the 5-page transcript of a Web-MD interview from this past May. http://www.webmd.com/content/chat_transcripts/1/108026.htm He is against low-carb diets, focusing on being in "ketosis", a metabolic state when your body is burning fat. No "bandster for life" diet is zero carbs -- everyone is eating vegetables, fruit, milk or milk products. The only time a bandster would encounter this state of ketosis is when you have a surgeon who orders you to stay on purely No-Calorie liquids the last week or two BEFORE surgery or the first week or two AFTER surgery. This will obviously lead to some rapid weight loss -- but also muscle lost. I have heard of people complaining of the horrible bad breath and smelly urine. It is a state that is unhealthy, to be breaking down muscle to survive -- it is a state of starvation. This is why bandsters are counseled to maintain 60-80 grams of Protein a day. When you are taking in that much protein, there is no net protein loss. Actually, ANY kind of dieting where you are losing weight will cause you to lose protein UNLESS you are getting in enough protein. Lettuce and celery stick diets are NOT healthy. But all that said, this is a very interesting interview - and his views tie so directly into banded life where BROWSING (nibbling all day) IS NOT ALLOWED. He is quite knowledgeable about metabolism, and I encouage you to check out his interview. For those of you who are AOL members, turn up your speakers and check him out -- for he is one of AOL lifestyle coaches! Theresa

OH YES!!! I KNOW what you're talking about!! But I got LactAid type tablets to chew (or you can throw them in the blender with it).... but STILL had "that sort of problem" :phanvan turns out, I'm very sensitive to Nutrasweet :tired Theresa

SOME doctors order it for the weeks or month before surgery. I used it post-operatively during the first two weeks of liquids ... It is good for the first few days after a tight fill. HOWEVER, I use ONLY Slim-Fast Optima -- It is more expensive, has Nutrasweet and more Protein. Stays with you longer. No liquid calories are the RULE for banded life. It's definitely not something to live on. But it's not unhealthy for you. More nutritious than Crystal Lite ... and not as much salt as broth and most Soups. Theresa

Your statement was unclear, to say the least... And I will say this - NONE of us knows WHERE we will be living in 5 years. The band is a life-time appliance and you HAVE to consider the long term consequences of appliance brand. If you have surgery with an un-approved band, even should you eventually get insurance to cover fills, it will not cover fills in un-approved devices. And IF J&J eventually get a band approved in the States, it is quite likely to not be the same model -- just don't chance it. Theresa

Yes, you need some more taken out.

Eloquent enough!! Inamed added it as a CYA (cover your ass) legal defense against silocone law suits. Theresa

Hi, Libby --- so nice to hear about your experience with Dr. Sanchez. I have been referring patients to him and he is doing my aftercare. Theresa

My Mexican doctor gives every patient the actual box that your appliance came in (with the documentation and Inamed booklets, and the expiration date is right there. He packs the box with your operative report, your prescriptions and your medications, as well as the signed Inamed wallet card for child-menu and senior-menu prices. I think all US docs would be doing their patients a service to do the same for them. It's hard to keep track of things on your trip home, so having everything in a box is nice. Theresa

A port that gets infected after the first few months, especially after one year, is more likely to be an early sign of Erosion, with the bacteria traveling up the tubing from the break in digestive tract integrity. There is one very popular Mexican surgeon who has a HORRENDOUS early port infection rate, which obviously indicates a SERIOUS surgical suite problem that he refuses to address and deal with. BUT, in my limited experience, this one case is an anomoly. I was sent home on a course of oral antibiotics and only experienced the amount of redness, swelling and tenderness that is NORMAL since the port is stitched into place and, as a foreign object, will have some scar tissue development as the body deals with it. If you wish to know more, I would suggest you go to PubMed.com and do some searches and read the abstracts for findings about post-operative infections. Theresa

I just finished this rant on another thread, so will repost it here with one added paragraph. Once a surgeon has placed a few hundred bands, he is as good as he is going to get - tho good doctors keep going to training sessions and learning new techniques and modifications to keep their slippage rate down. Once a doctor has been banding for at least 3 years, he will have encountered his share of problems with fills, slips, and erosions, and will hopefully have gained skill in handling them. What is MORE IMPORTANT after those early years is the QUALITY of CARE when dealing with complications -AND- how easy it will be to get back to see him. I agree that there are many EXCELLENT surgeons in Mexico, but when it comes to planning your aftercare, you MUST figure in how much income you have that can go towards getting your fills and fluoros, and having ready access to a lap band surgeon after banding. You should ALWAYS locate a State-Side doctor before you are banded who will agree to help with your after care --- and ask about charges. An initial office visit, fill and fluor can range from $150 to over $500, so go over ALL possible charges. But back to selecting your Mexican physician. If you have slippage or erosion, these are both things that must be taken care of PRONTO -- and both may involve repeated surgeries, to remove and then replace the band. You need to be able to get a QUICK flight, good connections, and a SHORT DRIVE to the Monterrey or Tijuana doctors. Tijuana is MUCH cheaper for people to get to from just about anywhere in the US. And when you can't keep anything down or have bloody vomit, you won't be able to get those "early purchase" specials but will be paying top dollar for the flight (but will be saving BIG TIME on the procedures, hospitalization and aftercare). These are ALL things that you MUST consider. What I most dislike about SOME patient coordinators and SOME doctors is how they pressure you to make a quick decision and schedule surgery as soon as possible ----- you must NEVER EVER let the idea of a "quick decision special rate" or some such promotion guide your decision. Believe me, if you want a special deal, contacting the DOCTOR personally first and bypassing the website companies is the best way to negotiate a price.... and they ALL want your business and will "extend" that special for you. PLEASE PLEASE PLEASE. I think I am going to create a website telling people what can happen, about the patient coordinator horror stories out there, and how "charming bed side manner" is a WORTHLESS indicator of surgical skill or morals or integrity or follow-up or employee oversight. On a rant based on MY OWN experiences. My doctor is from Mexico, but not Kuri & not Rumbaut --- and he does not practice in either Tijuana or Monterrey. Theresa

I find myself SO very very puzzled about why your doctor operates on this "take all the fill out" stuff --- why not just back off a bit?? Sometimes it can be just one or two tenths of an inch between good restriction and overfill. I think this round robin of jumping from nothing to full, nothing to full, nothing to full, is nonsense. You should be very very slowly increased past 2.5 ccs UNTIL the right spot is found --- and this time do NOT go home so soon -- get the fill as early in the day as possible and hang around and have a meal of Soup before you head off home. And I agree with the doctor -- your pain sounds EXACTLY like diaphraghmatic pain.

I agree that Rumbaut is an EXCELLENT surgeon (he is banded himself and is looking fine), but when it comes to planning your aftercare, you MUST figure in how much income you have that can go towards getting your fills and fluoros, and having ready access to a lap band surgeon after banding. You should ALWAYS locate a State-Side doctor before you are banded who will agree to help with your after care --- and ask about charges. An initial office visit, fill and fluor can range from $150 to over $500, so go over ALL possible charges. But back to selecting your Mexican physician. If you have slippage or erosion, these are both things that must be taken care of PRONTO -- and both may involve repeated surgeries, to remove and then replace the band. You need to be able to get a QUICK flight, good connections, and a SHORT DRIVE to the Monterrey or Tijuana doctors. Tijuana is MUCH cheaper for people to get to from just about anywhere in the US. And when you can't keep anything down or have bloody vomit, you won't be able to get those "early purchase" specials but will be paying top dollar for the flight (but will be saving BIG TIME on the procedures, hospitalization and aftercare). These are ALL things that you MUST consider. What I most dislike about SOME patient coordinators and SOME doctors is how they pressure you to make a quick decision and schedule surgery as soon as possible ----- you must NEVER EVER let the idea of a "quick decision special rate" or some such promotion guide your decision. Believe me, if you want a special deal, contacting the DOCTOR personally first and bypassing the website companies is the best way to negotiate a price.... and they ALL want your business and will "extend" that special for you. PLEASE PLEASE PLEASE. I think I am going to create a website telling people what can happen, about the patient coordinator horror stories out there, and how "charming bed side manner" is a WORTHLESS indicator of surgical skill or morals or integrity or follow-up or employee oversight. On a rant based on MY OWN experiences. My doctor is from Mexico, but not Kuri & not Rumbaut --- and he does not practice in either Tijuana or Monterrey. Theresa

regarding http://www.PubMed.com PubMed is completely free for a wide-ranging variety if information. The only thing you have to pay for is to retrieve the entire published article. However, the Abstract is free. Go to (and bookmark) this page - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed Enter the words gastric bypass and click on the GO button On the next screen, click on the "down arrow" button on the right hand side of the first "window" labeled Display and select "Abstract" You will then receive 2,178 articles, 20 articles to a page, 109 pages -- from Romania, Italy, Spain, Brazil, Austria, Greece, France, The Netherlands, Chile --- and a few from the USA. And that's just on the first page. Lots of good reading.

Visiting Greensboro, NC - Any fill docs? I am visiting my daughter and wonder if there are any Greensboro docs who could give me a fill? Since I may soon be moving up here for good, it's definitely time for me to look for continuing band care. Thanks, Theresa

I am visiting my daughter and wonder if there are any Greensboro docs who could give me a fill? Since I may soon be moving up here for good, it's definitely time for me to look for continuing band care. Theresa

Found this on ObesityHelp and thought I would share.. How to Tell When You Are Perfectly Adjusted - You are losing 1-2 pounds per week without struggling with hunger. If you are not losing 1-2 pounds per week, then: A. You may need an eating adjustment 1. Are you eating 60 grams of Protein a day 2. Are you eating 25 grams of Fiber 3. Are you avoiding all liquid calories _a. Soup can be sign of “soft calorie syndrome” _b. Alcohol contains a lot of calories – 7 calories per gram ...(1) It’s also a stomach irritant ...(2) It relaxes the stoma, allowing food to go thru easily _c. fruit juice is just sugar Water 4. Are you making healthy food choices from a wide variety of foods? _a. Are you avoiding soft foods _b. You can’t just eat what’s easy _c. cheese is glorified fat 5. Are you drinking 6-8 glasses of water a day between meals 6. Are you eating too much junk? _a. chips, chocolate, nuts, ice cream, Cookies and other highly processed junk foods are too calorically dense to be regular parts of a healthy diet. But don’t avoid them completely to the point where you feel deprived. _b. Stay out of fast food places 7. Are you getting in two servings of Calcium daily? 8. Do you always eat the protein first? 9. Then the vegetables or fruits _a. Five servings a day _b. Potatoes are NOT a vegetable 10. Is your portion size appropriate? _a. meat or fish ...(1) 3 ounces – the size of a deck of cards _b. Vegetables ...(1) ½ cup – the size of your fist _c. Starch ...(1) If you eat the protein and the vegetables first you don’t need much ...(2) Avoid: rice, potatoes, Pasta 11. You might try avoiding artificial sweeteners _a. Some people think that artificial sweeteners stimulate the appetite _b. They are HUNDREDS of times sweeter than sugar _c. They teach you to like things too sweet _d. There is no evidence that people who use them are any thinner than people who don’t 12. Avoid most diet foods _a. Real food usually tastes better _b. Real food is more satisfying than low calorie substitutes _c. When you are only eating a tiny bit the caloric savings is not that great ...(1) Use a teaspoon of real butter instead of a tablespoon of diet margarine ...(2) The body has no way to break down artificial fats ~~~(a) They may go into permanent storage ~~~(:bananajump: Some people think liposuction is the only way to remove hydrolyzed fats from the body B. You may need a behavior adjustment 1. Are you eating only when you are hungry? If you’re not sure drink 8 ounces of water and wait. 2. Are you eating three meals a day? With maybe 1 or 2 small Snacks 3. Are you sitting down to eat? 4. Are you eating consciously? No distractions, turn off the TV, put the book or newspaper away, pay attention to your food and your companions 5. Are you eating slowly? _a. Put the fork down between bites _b. Take 20 to 30 minutes to finish a meal _c. Taking longer might cause the pouch to begin emptying 6. Are you taking small bites? Use a Tiny spoon, chopsticks, cocktail fork 7. Are you chewing well? 8. Are you drinking with your meals or too soon after your meals? _a. Practice water loading between meals _b. You won’t be thirsty if you are well hydrated before the meal 9. Are you stopping at the first sign of fullness? _a. Sometimes it’s a whisper: not hungry, had enough _b. Hard stop versus soft stop 10. Do not eat between meals. Stop grazing. 11. Do not eat when you are not hungry C. You may need an activity adjustment 1. Are you getting in 30 minutes of physical activity at least 3 times a week? _a. Over and above what you would do in the usual course of your day _b. Could you make it 4 or 5 times a week? _c. Could you make it 45 or 60 minutes? 2. Are you taking advantage of opportunities to increase your physical activity? Easy Ideas - a. Taking the stairs instead of the elevators or escalators b. Walking on the escalators instead of riding c. Parking your car further away from the entrance d. Getting out of the car instead of using the drive through e. Getting off the bus one stop before your destination f. Washing you car by hand instead of the car wash g. Playing with your kids D. You may need an attitude adjustment 1. Are you committed to your weight loss journey? 2. Are you totally honest with yourself about how much you are eating and exercising? _a. Log your food and activity on Fluid added to your band 1. You feel like you are making healthy food choices in appropriate portion sizes, but getting hungry between meals? 2. You can still eat white bread, fibrous vegetables and large portions. 3. You are having to struggle to lose 4. You are gaining weight in spite of eating right, exercising and having a good mind set. F. Signs You may need your band loosened 1. There are times when you can’t get fluids down 2. You are vomiting (PB'ing) too much _a. How much is too much? 3. Do you have frequent reflux or heartburn at night? Ideas for controlling indigestion a. Do not lie flat or bend over soon after eating b. Do not eat late at night or just before bedtime c. Rinse your pouch with a glass or water an hour before bedtime d. Certain foods or drinks are more likely to cause reflux: ..(1) Rich, spicy, fatty and fried foods ..(2) Chocolate ..(3) Caffeine ..(4) Alcohol ..(5) Some fruits and vegetables such as Oranges, lemons, tomatoes, peppers ..(6) Peppermint ..(7) Carbonated drinks e. Eat slowly and do not eat big meals f. If you smoke, quit smoking g. Reduce stress h. Exercise promotes digestion i. Raise the head of your bed j. Wear loose fitting clothing around your waist k. Stress increases reflux l. Take estrogen containing medications in the morning m. Avoid aspirin, Aleve and ibuprofen at bedtime (Tylenol is OK) n. Take an antacid (Pepcid complete) before retiring o. Try other over-the-counter heartburn medications p. See your health care provider G. See your health care provider immediately (or call 911) if 1. You have a squeezing, tightness or heaviness in your chest, especially if the discomfort spreads to your shoulder, arm or jaw or is accompanied by shortness of breath, sweating, irregular or fast heartbeat or nausea. These could be symptoms of a heart attack. 2. If your symptoms are triggered by exercise. 3. If your pain localizes to your right side, especially if you also have nausea or fever 4. If you throw up vomit that looks like black sand or coffee grounds. Or if your stool is black, deep red or looks like it has tar in it. These are symptoms of bleeding and need immediate attention. (Note: Pepto-Bismol or other medications with bismuth will turn your stool black. Iron supplements can also make the stool tarry.) 5. If your pain is severe This was written by Jessie H. Ahroni, Ph.D., A.R.N.P., C.D.E., B.C.-A.D.M.

Hi, Anthony .... You had never mentioned (in any thread I read) how much you initially weighed or how much weight loss you had had since you were banded in 2003. But this info really intrigued me, given your problems with back pain and inability to deal with gas. I know you had said your gas problems were related to ingested air and being unable to belch ... but maybe???? At 200 gram of whey protein, you were consuming at LEAST 9 or 10 cups of at LEAST 80 calories JUST for the Protein powder -- unless you used the more frequently found flavoured blends which have up to 30 calories more per prepared beveragle. And then their is the milk or juice you may have been mixing it with. So you were DRINKING at LEAST EIGHTY OUNCES at at LEAST 800 liquid calories (and that only if you were using you were mixing unflavoured unjury with a zero-calorie liquid. Non-Fat milk has 90 calories a cup. And I have repeatedly heard that 60-80 grams of protein a day is the maximum needed for most of us. 4 servings a day of protein. And you were eating 400 grams a day. Not only was most of that unneeded calories, but if I had that much intestinal gas being produced every day, I'd be having severe back pains, too. And how much in zero-calorie liquids were you drinking a day? Did you have lots of problems with poor or no weight loss? You've certainly got me wondering what doctor or nutritionist told you that hunger is related to how many calories a day you are consuming. For people with metatbolic syndrome, extra calories just provoke extra hunger. Hunger is ONLY dealt with by fooling that upper bit of stomach into thinking your entire stomach is stuffed to the top. What surgeon did your banding? What nutritionist supervised your diet? Are you lactose intolerant?? I would advise you to get some further advice before you have a conversion operation. I'd hate for you to continue to find WLS to be a losing proposition for you. Theresa

Dear Mark .... I apologize, but indeed I did not mean to suggest that you are a poor surgeon in the sense of not proficient, talented or skilled. That's not what I meant at all. And I think I pushed my two major points to the max. The two points were 1 - the necessity for ONGOING GOOD EDUCATION & SUPPORT on how to become a successful Bandster 2 - the fact that some patients are headstrong and want to determine their own course, ending up in their ... a) failing to take advantage of educational and support opportunities, not getting fills or staying too tightly filled, or c) resistance to the need to change eating habits. You say you provide unlimited free fill opportunities and that is terrific. And you say you provide continuing contact with a nutritionist. I'm not saying it is true of your practice or nutritionist, but again and again I have heard reported how a patient discovers that they are being taught bypass rules and guidelines. And how sometimes staff and nutritionists subtly or overtly communicate to the bandster patients that they "are not okay". Sometimes this results in a patient failing to follow-up. Doctor-sponsored support groups often meet at the same time and location --- ending up with a mixed room of bypass and banded patients. This is a terribly demoralizing, confusing and invalidating experience. Again, I am not saying this is true of your practice... but it is important for you to give your patients ample opportunity for double-blind feedback opportunities. What comes to mind is a self-addressed envelope or post card (perhaps various ones at different visits) where patients fill in dots to indicate how well they feel their needs are being met. Yes, it is true that not all patients are good candidates for banding. And it is also true that for some of us (like me) metabolic syndrome (sky-high insulin resistance) and negative garbage that I will need a lot of head work to overcome, together make it certain that I will not be a storybook loss story without a GREAT deal of support ---- but all the available support in the world will not help me a twit if I do not ASK for what I need. So I acknowledge this is all a very muddied picture ---- but I also think that self-defeating scenarios can set a lot of patients up to fail. The relative dangers of long-term life after the two kinds of surgery make it imperative that the surgeon follow the dictim of "First, do no harm." It is the responsibility of doctors to check into those bariatric practices with particularly good long-term outcomes and discover how their practices differ from theirs. When I see so many bypass patients 2 and more years out who are regaining weight steadily and resorting to banding to control their appetite, then I recognize that there is NO MAGIC SURGERY. And to tell a patient that there is... is beyond the pale.

My LORD, woman. You've lost FIFTY-SEVEN POUNDS in little over 5 months. That is an average of 10.5 pounds a month. Considering that the lapband is only capable of helping us lose 1-2 pounds a week, you have shown a REMARKABLE weight loss. And you only have 25 pounds to go to goal!!!!! Then, for the rest of your banded life, you will NEVER again gain weight like you did in the past. For the rest of your life, you will never have to struggle. So let's deal with what is causing your hunger. It is the very top part of our stomachs that is "wired" to sense fullness. But for some reason, you aren't getting that any more. This tells me something has changed about how and/or what you are eating. Soft calories pour right thru you, so you can't achieve a Full Feeling. The only way to combat that is to eat SOLID Protein - 3 or more ounces. And then dark green vegetables -- not cooked to mush, but something you have to CHEW. At least 1/2 cup or more. THEN, if there is room, a TINY dab of something else solid. Another thing that can cause a raging hunger is anything more than a MINIMAL amount of carbohydrates. If you work hard to eliminate ALL carbs from your diet except for the minimal amounts in cheese and vegetables (NO WHITE RICE, NO WHITE POTATO, NO Pasta, NO GRAINS BUT LONG-COOKING OATS & SUCH, NO FLOUR PRODUCTS), then your raging hunger should drop to zero, as long as you are also consuming solid calories. Monitor your blood sugar levels carefully to make sure your insulin levels don't get too high. You may have to increase how often you check during the day. Work closely with your doctor's office. Again, I want to reinforce to you that you have done FANTASTICALLY for a diabetic patient. Diabetics and those with pre-diabetic metabolic syndrome have the DEVIL OF A TIME losing weight. You are a SUCCESS STORY. Don't feel discouraged. Look at your weight loss and be proud of yourself. It doesn't get better than what you have done for yourself. It took you more than 5.5 months to gain that 26 kilos (57 pounds). The lap band is not magic. It is not designed to bypass our intestines so we CANNOT absorb the calories we eat. It takes time. 2 pounds a week like you have managed is purely magnificiently rapid progress.

Has no one ever suggested you take "Colace" - a stool softener? I took a couple the night before surgey and never had the typical post-surgery problems. Things went well til suddenly, a few months out, I found myself mysteriously constipated. It was DARK, too. Looked closely at the bottle of Centrum I had opened the day before, and it wasn't the Centrum Silver (which doesn't contain constipating iron). However, one or two Colace a day is keeping me fine.

Not to fear. Eventually Google's spiders again make their rounds of the web, and new versions of pages are cached, replacing the old. Won't linger for more than a month.