MikeBceo

I believe they are referring to Obesity Help

Add me to the list of those who have problems with scrambled eggs. I had received 2 fills in a 14ml AP-L band - the first fill was 3.5 and the second added another 1 ml taking me up to 4.5ml. I had no restriction and could eat any quantity of food. I struggled to lose weight and plateaued for a month. At my third fill, the surgeon added 2 ml more, bringing the total up to 6.5 ml. I had gotten into a habit of eating scrambled eggs every morning - my surgeon advised limiting carbs and ensuring I had Protein at every meal. The first bite of a scrambled egg I had the day after the fill got stuck. I slimed for about an hour until I violently vomitted. I had trouble eating the rest of the day. I'm now discovering what I can and cannot eat at this new restriction level. I don't think I'm quite at my sweet spot yet, but I'm pretty close. Others had commented that they feel most restrcited in the morning and the band loosens up throughout the day. This has been my experience as well. Anyone have any suggestions for a quick, simple, high protein Breakfast that will keep me satieted? Scrambled eggs used to do it for me, but they're on the "off limits" list right now. Protein shakes go down easy, but don't give me that "full" feeling. Thanks, Mike

Hi Debbie, You asked: I can't help with the first part of your question because I don't have a restriction yet. I was banded 4 weeks ago and have 2 more weeks before my first fill. Un-restricted, I can tell you that I can't feel the band at all. I don't even know it's there. Here is a picture of one At my informational seminar, the surgeon passed around a life-sized plastic model stomach with a band-in place. Along with this, he also passed around a real lap-band. I'm sure your surgeon would let you examine one. Good luck, Mike

In addition to the reasons already mentioned, gastric bypass is linked to Iron, Vitamin B12, folate, Calcium, and Vitamin D deficiency requiring patients to take vitamin supplements for life. With that being said, the overall effectiveness of gastric bypass is better than gastric banding. Gastric Bypass patients on average lose about 15% more of their excess body weight than gastric banding patients. From the Journal of American Medical Asssociation found here Bariatric Surgery: A Systematic Review and Meta-analysis The mean (95% confidence interval) percentage of excess weight loss was 61.2% (58.1%-64.4%) for all patients; 47.5% (40.7%-54.2%) for patients who underwent gastric banding; 61.6% (56.7%-66.5%), gastric bypass; 68.2% (61.5%-74.8%), gastroplasty; and 70.1% (66.3%-73.9%), biliopancreatic diversion or duodenal switch.

I like the EAS AdvantEdge Carb Control Ready-to-Drink (RTD). It has 17g of Protein, 4g of carb, 2g dietary Fiber (so a total net 2g of carbs), and 0g of added sugar. I like the chololate flavor, hate the vanilla, and haven't tried the strawberry. My surgeon wanted me on less than 1200 calories a day during the liquid phase, and still get in a minimum of 60g of protein. I'm able to do that because these EAS drinks only have 110 calories per serving. I drink 2-3 of these per day and usually mix them with some skim milk (and occassionally a teaspoon of Peanut Butter - for a Reese's-like treat!) A 4-pack costs $5 at my local Target and $7 at my local supermarket. I did try the GNC Pro Performance 100% Whey Protein - chocolate powder and have mixed it with both milk and Water with similar results. It was awful! I also tried the GNC Pro Performance 100% Whey Protein - Unflavored and mixed it with chicken broth. It's a great way to get your protein without additional carb calories. The Atkins Chocolate Delight shake has a little less protein (15g) and a few more calories (160) than the EAS, and tastes ok. I prefer the EAS over the Atkins. Obviously, we're all here to lose weight and keeping the calories down will help. Further, I've found the less carbs I consume, the less hungry I am. Also, I find that high protein items tend to keep me satisfied longer. I've been trying to keep the protein up and the carbs down. My surgeon recommended less than 1200 carlories a day and a minimum of 60g of protein, but didn't make any recommendation regarding fat or carb consumption. Also, I've read about some who blend in a packet or 2 of splenda (or other non-carlorie sweetener) into their shakes to make them tastier.

I, too, had several gallbladder attacks and after the third painful one over the course of a year, I finally relented and scheduled a cholecystectomy. Prior to the surgery, I noticed tan/beige colored oily stools (sorry if TMI). I contacted my surgeon who had me come right in. He indicated that was a symptom of pancreatitis. After a 9-day hospital stay with acute pancreatitis, it finally resolved and I was able to have my gallblader removed. After the surgery, I was still experiencing pain in my right side and it radiated to my back as well. I talked to the surgeon and he said that some patients experience "ghost" pain for up to a year after surgery that could be caused by nerve endings that were damaged during surgery. Luckily, for me, he was right and the pain went away. Related to the surgery, I've heard that some experience back pain that could also be caused by a partially blocked bile duct. Other non-gallbladder related causes should be ruled out as well. Good luck.

A picture is worth a thousand words - you can see the port in her left hand and the band is in the right. Note also that with the new AP band, there are also 2 ports. The standard port and a new low profile port. Many surgeons use the low profile port now unless the patient has a high BMI and the surgeon feels that they may have problems finding the port. I don't know if the port is directly under the incision ??? I'm still a little tender around my port incision to attempt to feel around for it. I'm assuming it is underneath. The port is sutured directly to your muscle. HTH

The Vertical Sleeve Gastrectomy, sometimes referred to as a gastric sleeve, is an operation where 60-85% of the stomach is removed. The remaining stomach is shaped like a long cylinder ( or sleeve). It has an advantage over gastric bypass insofar as malabsorption is not an issue. Its effectiveness is purely by restriction - the stomach is smaller, hence, the patient feel fuller faster. Further, the stomach produces hormones which stimulate hunger and cravings, and by removing a large portion of the stomach, the hormones are released in much smaller quantities. The VSG is very similar to what is generically referred to as "stomach stapling", but it has a few advantages. Mainly, stomach stapling that was performed 20 years ago generally didn't remove the stomach, but just stapled it down the middle, effectively reducing its size. Often, short term results are extremely good, however, long term success isn't. Therefore, this procedure is usually the first in a two-stage strategy for long term weight loss. For those who may be too large for other procedures because their BMI is too high (e.g. > 50 ), a surgeon might suggest a gastric sleeve as the first phase in a weight-reduction strategy and, after the patients BMI comes down, a second operation (band, bypass, switch, etc.) can be performed. Regards

Hi Fenton, Yep - same band! The thing that attracted me to adjustable banding over the other methods (gastric bypass, duodenal switch, vertical sleeve gastrectomy, etc.) is that it is: less invasive, reversible, lower overall complication rate, and adjustable. It was the adjustability feature that really got me. I'm somewhat glad I had insurance issues - my initial consult was January 2007, however, my surgery wasn't until March 2008 (due to delays because of insurance approval). During that time, the AP-L band was introduced - it is the largest band and also the most adjustable. It can hold up to 14cc of Fluid. The other bands all have really good proven track records, but I'm pretty psyched that I have the APL. The downside to the AP-L is that clinical studies show that patients who have the AP-L lose less than those with the VG, or the AP-S. The current thinking is that doctors aren't filling them enough, hence, patients aren't getting enough restriction. The average fill for a 10cc band (both VG and AP-S) is about 6 cc. The average fill for a 14cc band (the AP-L) is also 6 cc. As the doctors get more experience with the AP-L, they'll probably fill it more than the other bands. This isn't a race, and I'm prepared to work with the doctor to find my sweet spot. I am preparing myself that it may take several visits and several months before I get there. Regards,

AFAIK, there are only 2 band manufacturers approved for use in the United States - bands by Allergan (formerly Inamed), which holds the "Lap-Band" trademark and bands by Ethicon Endo-Surgery, Inc. (an operating company of Johnson & Johnson) called Realize bands. Allergan Band Realize Band The Realize band was just approved for use in the US in the fall of 2007. In June of 2007, Allergan's next generation band was approved for use. The band is called the "Advanced Platform" or AP for short. It comes in 2 sizes - the large (holding 14 cc) or the small (holding 10cc). They are sometimes generically referred to as AP-S and AP-L. Prior to the AP bands, starting January 2004, Allergan sold a band called the Vanguard band (referred to generically as the VG Band - and sometimes (unfortunately VGB). This presented some confusion as there is a bariatric surgery procedure called Vertical Banded Gastroplasty which is sometimes called VGB - hence, the confusion. Vertical Banded Gastroplasty is sometimes called Stomach Stapling. Other than being prescribed for morbid obesity, the similarities with laparoscopic adjustable banding techniques ends there. Prior to January 2004 and the VG bands, there were 3 bands available in the US distributed by Inamed and they were distinguished by length - the 9.75cm, 10cm band, and 11 cm band. Each of these bands held 4 cc. There are a lot of references describing the differences between the bands. My surgeon started using the AP band in late 2007 and uses Allergan bands exclusively. I was fitted with an AP-large. HTH,

The band I have is the AP-Large band from Allergan. Their instructions state: The initial postoperative adjustment should occur at six weeks or more, and usually 3 - 4 cc of normal saline would be added. http://www.allergan.com/assets/pdf/lapband_dfu.pdf Your doctor is probably just following manufacturer's directions. I'm just a little ahead of you. I had my surgery on March 13th, so I'm 10 days post-op now. The first few days after surgery were pretty easy - I wasn't hungry and the Protein shakes kept me satisfied. After the 3rd or 4th day, my hunger started returning, although I'm sticking to the doctor's orders and only consuming liquids (both clear and full). I've read too many horror stories about band slippage because of patients eating solid foods too early. The reason for the liquid diet is to let your stomach heal with the band in place. The band is held in place by just sutures now, but as your body heals, scar tissue will help hold the band in place. If you eat solid foods too early, your stomach will churn to digest the food, hindering the formation of the scar tissue. Even worse than this is if you vomit - the violent action of the stomach may cause the band to slip. If you think slippage is a rare event, it isn't. In Allergan's clinical studies, 11% of all patient had band slippage. It was the most prevalent serious adverse event (versus erosion, dilation, etc.). Good luck,

Hi Jenna I was banded on the 13th as well. My surgery was at 9am, done in a little over an hour (including a hernia repair), however, I spent about 5 hours in post-op suffering ill effects from the anaesthesia. The surgeon told me about 75% of the moring surgeries were discharged same day, but because of my nauseasness, they kept me overnight. I came home on Friday, March 14th. I have been feeling pretty good - my lap incisions are healing nicely, I'm essentially off of pain medication, and my appetite has returned. My doctor has me on a liquid diet, including full liquids for 2 weeks. I've been pretty strict, but don't know how long my "willpower" will last. I generally consume 2 Protein drinks a day and spike them with a tablespoon of Peanut Butter and 4-6 ounces of skim milk. I mix them all in a blender for a nice protein smoothie. I'll occasionally throw in half a banana. I'll have 2-3 Dannon Lite-n-Fit yogurts per day and 2 cans of Cream of Anything soup (chicken, mushroom, herbs, etc.). I may have 1-2 SF Jello snack packs as well. I'm about 900-1200 calories a day on the liquids. My doc says I can start mushies on Thursday. Just today, I started to get a little tightness (or mild pain) in my sternum area. I took some pain medication today for the first time in several days. Even though the surgery was 10 days ago, I still can't sleep on my left side (where the port is). It is still kind of tender. I really didn't experience much pain overall, other than the occasional left-shoulder pain. I would get pain in my left shoulder if I drank anything too fast. From what I understand, the left shoulder pain could be caused by the gas they inflate you with to do the surgery or is also common in patients who have a hiatal hernia repaired. Apparently, the pressure on the diaphram (from too much drinking) stimulates the vagus nerge and is felt in the left shoulder. A good burp or two usually resolved the pain. Good luck,

Hi Shortgal, I, too, was denied for not having proof of morbid obesity for 5 years. Aetna recently changed their guidelines and reduced the 5-year requirement to 2 years. I initially met with the surgeon in early 2007 and now that it's 2008, I have a weight history for 2 years. I got approved last week and my surgery is March 13th. If you don't have Aetna as your insurance carrier, you may wish to consider changing when your employer offers open-enrollment. Good luck, Mike