Wendell Edwards

Typically, the lesser curve of the stomach, where the Lap-Band is placed, is extremely resistant to stretching out from the pressure of food. It is rather rare for a person's actual stomach to stretch out in that area. Unfortunately, the esophagus, located directly above the small stomach that is created by the Lap-Band, is NOT so resistant to stretching out. It can become stretched out like a balloon by "Stuffing the pouch", that is, continuing to eat after the small stomach is full. This is why learning to recognize our new "Full signal" is so important to a new Lap-Band patient. This is also why eating slowly, and measuring out small amounts of food is emphasized in the post-op diet plan. Continuing to eat large amounts of food puts one at risk for esophageal dilation. The normal course of action for a patient exibiting esophageal dilation is to completely unfill the band for a period of time. That time will vary from patient to patient, but typically is at least 4 weeks, up to a year, depending on how long the patient's esophagus take to shrink to normal size. Many doctors will recommend behavioral modification classes, or Band-Specific eating classes, to their patients during the time of unfill, to assist the patients in learning how to avoid repeated esophageal dilations. In cases of extreme esophageal dilation, or repeated dilations, the Lap-Band may be removed. The hidden risk in esophageal dilation is the rare instance of hemmorage of a blood vessel in the esophagus, due to the thinning out of the esophagus itself. Fortunately, this is VERY rare.

I recommend you contact your doctor and arrange a fluoroscopic exam to check for possible pouch or esophageal dilatation. Having a tight stoma with the presence of a pouch or esophageal dilatation could cause acid reflux while no apparent restriction is felt by the patient. Typically, the lesser curve of the stomach, where the Lap-Band is placed, is extremely resistant to stretching out from the pressure of food. It is rather rare for a person's actual stomach to stretch out in that area. Unfortunately, the esophagus, located directly above the small stomach that is created by the Lap-Band, is NOT so resistant to stretching out. It can become stretched out like a balloon by "Stuffing the pouch", that is, continuing to eat after the small stomach is full. This is why learning to recognize our new "Full signal" is so important to a new Lap-Band patient. This is also why eating slowly, and measuring out small amounts of food is emphasized in the post-op diet plan. Continuing to eat large amounts of food puts one at risk for esophageal dilation. The normal course of action for a patient exibiting esophageal dilation is to completely unfill the band for a period of time. That time will vary from patient to patient, but typically is at least 4 weeks, up to a year, depending on how long the patient's esophagus take to shrink to normal size. Many doctors will recommend behavioral modification classes, or Band-Specific eating classes, to their patients during the time of unfill, to assist the patients in learning how to avoid repeated esophageal dilations. In cases of extreme esophageal dilation, or repeated dilations, the Lap-Band may be removed. The hidden risk in esophageal dilation is the rare instance of hemmorage of a blood vessel in the esophagus, due to the thinning out of the esophagus itself. Fortunately, this is VERY rare.

Hi, Inamed/ALLERGAN told me on the telephone that the overwhelming majority of slips were caused by REPEATED, SEVERE vomiting. They said that the symptoms of a slip are either a sudden, UNEXPLAINABLE loss of restriction, or a sudden, UNEXPLAINABLE severe obstruction. Other causes of slips are a one-time only case of vomiting, or by the patient eating solid food too early in the healing time immediately after surgery. In rare instances, repeatedly over-stuffing the pouch can cause a slip.

Hi, I recommend water-loading before meals. Drink as much as you can about 15 minutes before eating, then sip some more until you absolutely cannot drink anything more.

Hi, this is just my opinion. I have talked about the women who choose to not tell their husbands with my wife, and this is what I told her: "I would divorce my wife if she had surgery without telling me" I believe that a solid relationship is based on a few fundamentals, specifically honesty and openness. If my relation doesn't have honesty and openness as fundamentals, I believe that relationship has already failed. But that's just me.

Different Doctors Disagree on NSAIDS. ALLERGAN warns against them, because they are a stomach irritant and may increase the chance of a band erosion. Some Doctors choose to prescribe them anyways, believing the chance or erosion is small, but the benefit of the NSAIDS is large. Some people take them with huge amounts of fluids, or milk or over-the-counter antacids to prevent irritation. Some doctors prescribe medications to buffer the stomach against the NSAIDS. When in doubt, talk to your doctor and pharmacist and explain your concerns.

"Should I tell my family and friends?" It's up to you. In an ideal world, everyone would love you and support your decision to have life-saving surgery. But this is the REAL WORLD, where some people just can't keep themselves from making nasty, hurtful, ignorant and insensitive comments to people. If you don't want those comments, or are not strong enough to NOT CARE what other people think, DON'T TELL THEM! ONE MORE THING..... Of COURSE I took THE EASY WAY OUT.... because only an IDIOT would take THE HARD WAY OUT!!! (Remember that for whenever some idiot says you took the easy way out!)

I have two suggestions for you: 1. Get some better tasting Protein Shakes. I recommend MATRIX 5.0 (In 4 flavors) and ELITE chocolate mint, both available on the internet, and BODY FORTRESS in chocolate or vanilla, available from your nearest WAL*MART. 2. Stay off the scale if it causes you anxiety. Matter of fact, I believe that anyone under 6 months from the date of their operations should only weight in at their doctor's office during their regular appointments. Scale obsession is extremely counterproductive during the time period when people really need to focus on modifying their lifestyle and eating behaviors. Focusing on the behavior modification, rather than a number on a scale will produce life-long changes.

My Dr. Said 6 weeks before water immersion in order to allow the incisions to fully heal.

It's unusual to find a Lap-Band patient who has not experienced the fears and anxiety that you are going through. Nerves are NORMAL in a person who is facing major surgery. Take comfort in the percentages. Lap-Band surgery is by far the safest bariatric surgery available, which is why I chose to have a Lap-Band.

It is critical that you follow the post-op diet. Most doctors prescribe a post-op diet of weeks of clear fluids, followed by weeks of full fluids followed by weeks of mushy food. My doctor said 2 weeks clear Fluid, 2 weeks full fluids and 2 weeks of mushy food. The time following the operation is for your stomach to heal. The Lap-Band needs to form a groove on your stomach. That groove makes the Lap-Band resistant to slipping. Eating food during the post-op period before you are supposed to be eating food could cause the Lap-Band to slip, or increase the risk of a future slippage. Food causes the stomach muscle to "Work" to digest the food. The "Work" could cause the band to not seat properly on the stomach. Weight loss is NOT to be expected during the recovery time after the operation. If you lose weight, wonderful, but don't expect it. The time between the operation and getting an EFFECTIVE fill that causes restriction is called "Bandster Hell" for a good reason. Without an EFFECTIVE fill, our hunger is just as strong, but the band does not work to help us. Getting an EFFECTIVE fill sometimes takes multiple fills, it is not unusual for it to take 3-5 or even MORE fills to obtain restriction. Because the band has to seat into the groove to hold its position, and every time the band is filled the fill adds extra pressure on the band, most doctors choose to let time pass between fills. Most doctors will not fill a band before 4 weeks after the operation, 6 weeks is common and 8-12 weeks of healing time is not unheard of.

:clap2:Good, pictures really help a lot.

My advice is to take a set of BEFORE pictures. Most people who are morbidly obese do not like having their picture taken. They avoid the camera because the photographs don't lie. That fact can be put to good use before and during your weight loss. Simply put, the best way to document weight loss is not a scale graph of pounds lost, or a size chart of inches lost. The best way to document weight loss is to take photographs before and during the process. I advise people setting out on this journey to take three initial pictures. The recommendations that I give are these: 1. Take three views, front, side and back (That means you need a automatic timer camera or a friend to help you) 2. Take the pictures in the same place every time. A doorway is a great choice, because it helps put a known quantity into the picture. Other good places are in front of a fireplace or another known point of reference. 3. Take the pictures while wearing form-fitting clothes. A swimsuit is IDEAL. 4. Take the pictures with the same camera, and make sure you are standing the same distance from the camera every time. That's why a doorway helps. You can line yourself up in the doorway and use a measuring tape to find the distance to the camera. 5. Take that same set of pictures every month. Front, back and side views. Wear the same clothes and make sure the distance to the camera is the same. 6. Have the "Before" pictures printed out, and tape them to your refrigerator. 7. Have the latest set of pictures printed out, and tape those next to the "Before" pictures. In doing this, you mind has irrefutable PROOF that what you are doing IS WORKING. People frequently do NOT "See" their weight loss, and they become frustrated, perhaps by a scale weight that is not moving, even though their body size is reducing at an amazing rate. This is a great way to "See" your weight loss. The best way to document weight loss is to take photographs before and during the process.

Kudos to this poster. This is a very well-written explanation And I was a Loan Officer. :mad:

He's normal. food in the digestive tract absorbs huge amounts of Water, and water weighs 8.33 pounds per gallon. When he goes back on solid food, he can expect a weight regain as his body absorbs water to keep the food in his digestive tract in a semi-solid state.

A very common thing among Lap-Band patients is a sense of anxiety over different issues. A common denominator of those issues is a sense of frustration due to a belief system in which the patient feels as if they are "Behind schedule". These feelings are self-generated, and usually come from a desire for things to happen "Right now". I know that it seemed like it took FOREVER to get my insurance approval, and I wanted it right now. Then it took forever to get my surgery scheduled, and again, I wanted it right now. Then the surgery came, and as I was waking up in the recovery room I was slightly disappointed that I was still fat, because I wanted the weight to be gone "Right now". As time passed without restriction, I wanted that... you know the rest... Then restriction lessened, and I wanted it back right now. And the weight kept slowly coming off... And somewhere along the line, I began to realize that weight loss with a Lap-Band is NOT a "Right now" type of thing. Lap-Band surgery and the weight loss following surgery requires PATIENCE, which I admittedly was in very short supply of when I started this journey. And it began to dawn on me that before Lap-Band, if I wanted something right now and didn't get it, I sometimes got food instead of what I wanted "Right now". I used the food to substitute for whatever it was that I wanted, but could not have just yet. Now I am a more patient person, because of my experience with Lap-Band. I understand that things in life worth having are going to take time. And being normal sized is going to take some time. It took me 38 years to get to my all-time high weight, so if it takes me a few years to get back to a normal weight, well, that's OK. I am just going to try to enjoy the ride.

Day one post-op was a haze of painkillers. Actually, it was that way for a while!

I have never heard of a person with such a low B.M.I. being banded, but you might want to ask your doctor who he/she had in mind to do your surgery.

In my opinion, anyone who does not modify their lifestyle, including types of food, volume of food, exercise, how they vent stress (If they were using food as a stress reliever) and a host of other areas is DOOMED TO FAIL WITH THE LAP-BAND OR ANY OTHER WEIGHT LOSS SURGERY! (But what do I know? I am just a guy trying every day to follow my own advice!)

The band re-trains the brain through negative re0inforcement. Once you learn how to eat in the way the band requires, having incidents like the ones described are blessedly rare.

This may help you in understanding the restrictive mechanism of a Lap-Band. The INAMED protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band. Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band. Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week. The normal cycle of fills, restriction and weight loss is as follows: 1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to two weeks. A “Delayed-Action” means that the fill may not become effective for up to two weeks after the fill. That is why the INAMED protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill. 2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band. 3. The patient loses weight because they cannot eat as much food. 4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient. 5. The reduction of the residual fat-pad causes the Lap-Band to become loose again. 6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food. 7. The patient receives another fill and the process starts all over again. Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

Hi Denise! Thank you for the compliment! Nice to see you also! :car:

Hi, Actually I have not. I am operating on very limited time now, as I am far more involved in other projects. I am adding another machine to my home gym today, and doing some other projects also, so I haven't had much time to look around. If it were not for me having to drink some Protein coffee, I wouldn't be online right now. And I am *NOT* a "Guru", neither do I wish to become one. I am just a guy who struggles every single day to take another step down the road to "Normal". :car:

:biggrin1: And good morning to you too!

I was never successful at keeping weight off when I dieted. I could lose tremendous amounts as long as my willpower held out, by inevitably hunger destroyed my willpower. In asddition, I don't believe I ever felt full before Lap-Band. What I THOUGHT was full was in fact PAIN from a horribly over-stuffed stomach. Now I feel full on small amounts of food, and my brain thinks everything is OK with that, so there is the difference to me.