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NewSho

LAP-BAND Patients
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Everything posted by NewSho

  1. NewSho

    A new NSV for me!

    Woo Hoo! How exciting for you. I totally understand. I tried on clothes all day in stores I used to walk by and long to shop in. I'm so happy to see people's victories - Non Scale & Scale ones. Good for you :clap2: Happy Band Journeys To All...
  2. NewSho

    Secret Inspiration Clothes

    My entire current wardrobe is an inspirational wardrobe. Today I grabbed a few outfits from Bebe and Armani Exchange (yay) but although they fit, I'd look better if I got a fill and lost some weight. But the one item that I can fit (but need to look better in) is a teensy little Playboy outfit. It's still New With Tags and consists of a teeny rhinestone trimmed logo Tee with some super stretch low cut Playboy jeans. They are SO tiny - I had them forever until I could fit in them but even now - if I could lose some weight, they'd look so much better. See a similar pair of Playboy jeans here and a similar Playboy tee is here. Wish me luck!
  3. NewSho

    FDAs 3 yr study in lap band

    As I've posted before, I was in the original FDA LapBand study before approval. I also had my extensive 36-month-mark band testing included in the 3-year followup results published recently. I recommend extensive testing for all Bandsters at the 24-to-36 mark even if you are at goal (rare, but does happen) and even if you suspect no problems or issues with your band. Keep your tool maintained, folks! :paranoid No, the statistics are considered accurate. I am assuming your doctor did NOT participate in the original study, but I bet he wasn't questioning the statistical results - he was merely expressing that he is now seeing better results. That's very different. Those surgeons who did participate were given current and pending stats during and after the process. Your doctor may have been trying to communicate to you that the results have changed and improved at this stage and time - but I'm sure he wasn't questioning the accuracy of the study's original results. My original surgeon was definitely not a quack (nor have I heard any allegation that were quacks involved in the original study) and the processof getting involved was quite elaborate. In fact, he had been doing LapBanding abroad and his record was examined closely before he was allowed to participate in the FDA study here in the 'States. Which is true for all studies, I'm sure. The participants were also closely vetted to make sure they were clear on the requirements involved in the study. Naturally as with any group, there was some attrition or 'drop out' but I don't think the results reflect a lack of knowledge about the process - there wasn't any knowledge about banding in the USA in 2000 and 2001, and I was lucky to have had a surgeon who had done many outside of the USA. I've had 5 years of banding and am pretty well-versed in what it's like to be banded this long - so I'd think I'm more typical of the study participants. Makes sense but I think there are often other factors at work when there is not-so-stellar loss with the LapBand. And those aren't all related to being a good Band citizen, as I call it. I do think that 5-year RnY and other bypass surgeries' patients results are probably still going to be more successful than those of the original 5-yr LapBand results. But things are getting much better. Yes, there is definitely 'bounce back' weight involved with bypass/malabsorption types of surgeries, but their initial success in pounds and excess weight lost still tends to lean in their favour for overall 5-year results. We'll see. I say that because, to my knowledge (and my surgeon's) there aren't any official publicly-released 5-year USA studies published yet - they are still compiling the results from the 5-year participants here. If you know otherwise, please provide web links or references. I agree they are outdated, but it doesn't make the numbers inaccurate. Many of the doctors were those who had trained in Europe and Mexico and those were experienced Band surgeons. But there was very little success seen initially - just as we still see lower success rates with the LapBand even now, compared to other countries' results even after their early intial surgical periods of Banding. But as for this study, it reflected the success (of lack thereof) at that time. We all agree the Banding process has gotten more refined and hopefully we will see further long term success now. So let's not throw out the baby with the bath Water - for those of us with bands, it should be important to realize what might possibly lie ahead at the 5-year point. If I'm still banded and the FDA asks for longer term results from me and other patients, then I'm willing to be followed at the 7-and-10 year points if necessary. How else will any of us know how our devices might perform long term? I guess I do bristle a bit at the assumption that the FDA original patients were all gathering nationwide for late night shakes and ice cream parties to throw off the results. The results are, what they are. <!-- / message --> The early FDA patients (including myself) were subject to all sorts of very severe (and unsuccessful) protocol that in my opinion (and the opinions of many of the participating surgeons) made it exceedingly difficult to suceed at that time. Also there have been major changes in the actual technology and surgical protocol of the band. I still have the Old-School surgical placement of the band - but this placement has later been termined to be involved in more frequent occurences of slippage (and some surgeons think, possibly in erosion.) So I have to be vigilant in having my band checked regularly for any irregularities. I have already had a replacement to the newer, lower-profile port. Like many devices it is smaller and more efficient (we hope). Cars that were manufactored five years ago may have not had the technical expertise of cars manufactored now - there are lots of advances in technology, and LapBanding is no different. Be happy that you have better information and better technology at your disposals and hopefully you can be confident in your decisions to get banded. No I disagree about "ignoring" it. Every patient and surgeon should be aware that this is, to date, the only American series of results published from this device. And we live in a different culture and environment than our overseas counterparts who are banded. Rest assured this DOES affect the results for American band patients in my opinion. But there is a value in having those original unsuccessful results 'out there.' It provides a benchmark of what kind of results were done in the early pioneer days of US LapBanding. But don't be so hard on the original participants and original doctors: there are a lot more factors involved other than just some 'slow losers' skewering the results. Happy Band Journeys To All...
  4. NewSho

    What do you call yours?

    Mine is the "Silicone Freeloader" - as I sometimes fear it is NOT doing its part to carry the weight, so to speak. :party:
  5. NewSho

    Metabolic Test

    COOL. So if you're OK with sharing - what did yours say? Was your Target Calorie Range, for example, LESS or MORE than you thought you should be having? There is really a lot of science to the process of weight loss, so any extra information would be helpful, I guess. Happy Band Journeys To All ...
  6. Thanks, Hon. As you know, I'm NOT at all happy to be at this size. I'll never be a size 4 or whatever - but really need to wear just somewhat smaller sizes to achieve Weight Loss Surgery success in my mind. One good thing: I've stopped obsessing pound-by-pound about just my weight also and my former surgeon forebade me to have a scale so I haven't gotten one yet, although I will eventually. So I concentrate more of BMI, which is a reflection of my general range. But no matter what, a "30" BMI is still considered obese. That sucks! So I'm not nearly at a good body fat percentage yet. I only have real muscle tone in my lower legs - which predictably were one of the only parts of me that didn't totally just get huge during my battle with obesity. And my thighs are just hilariously fluffy - but no matter what, I've said no Thigh Lift. They are just too severe and the scars are too long. What exercise and Lipo won't do for my thighs, I'll just have to live with - but I know I have excess body fat in my thighs, butt, and hips that is always going to push my "body fat percentage" needle way over into the red. I am aware of that. But with some actual restriction and good fill level - I'll work on getting the weight down to a manageable amount, and then I'll work more on toning up. I haven't given up the fight. Happy Band Journeys To All ...
  7. Great to see your success in the past year! Wow, It's amazing how quickly kids grow. They're growing while Mom is shrinking. :confused: Happy Band Journeys To All...
  8. NewSho

    Phat Girls My Review for the ladies!

    Well, I was totally against seeing this film - it just obviously didn't seem like a movie I'd enjoy. I don't watch any of the TV shows Mo'Nique has been on, and I am not a fan of slapstick comedy, which is what I thought this was. I saw it with a friend and I absolutely thought it was delightful. It was a cute, sweet, funny little film. It's definitely low budget but I thought it was well made, and far better than I could have ever believed. EVERY plus sized woman should see this film at least twice, maybe - and every SKINNY woman should be forced to watch it at least once. It's not exactly a heavy historical drama, but it's a fun afternoon matinee to see with girl pals. Enjoy! Happy Band Journeys To All...
  9. NewSho

    Are you aiming for a bikini bod?

    I saw this thread title and I thought - Hmmmm, definitely a PreOp poster. Not just this thread, but the rather-naive posted response on the other "what size do you want to be" page that you quote in your own thread. And I was right. I don't mean that in a harsh way, but this is one of the things that absolutely consumed me before I had surgery, and now it doesn't really vex quite as much. I'd love to do it, but I have more bottom-line concerns now - like getting to the right fill level, not PB'ing, making good food choices - the basics of being Banded that we all deal with daily. Just an observation. Once you get "into the thick of it" after surgery, you sometimes find yourself concentrating more on the day-to-day process of losing weight and sometimes focusing a bit less on what the ultimate "fairytale ending" goal will be. Great - Count me in. Make me a Size 8. (Not after being sick, or just temporarily, but for the next say, 10 years of my adult life.) What do you want? Money? OK, sure, I'll get it somehow. Just tell me where to mail it. I don't know what I'd have to do to get it, but if you could guarantee me I'd be a size 8 - I promise you I would get it to you someway, somewhere, some how. Trust me! I'm willing to work, willing to work hard, willing to pay - and it hasn't happened yet. I am so willing, that I'd have a revision to a bypass tomorrow if I thought it'd get me there. Of course the insurance company won't pay (a BMI of 30 is acceptable to them, those dirty pennypinchers) as they don't think I'm obese enough, and my own original LapBand surgeon has resigned himself that I'll never get any thinner. Pfffft, I don't lack motivation but as someone who's been banded 5 years, trust me when I say not every single person will come out of this process in "bikini condition" no matter how hard they work, or how dedicated they are. It's a fact. After a lifetime of obesity if there is a Size 8 inside me, she is WELCOME to emancipate herself and take center stage. She has my permission, I promise. I care. I don't want to be chubby, a little bit chubby, and certainly not fat anymore. I don't know what normal standards are, and I reject normalcy as a desirable option. I would love to be at any weight/size that would allow me to wear upscale fashion brands, overpriced designer jeans and of course, adorable little swimsuits. Me too. But 1 and a half LapBand surgeries, and an Abdominoplasty later, I don't see me getting into anyone's bikini in public, unless there is some sort of cool prize being offered in return for sure public humiliation. No but seriously, no one wants to see me in a bikini - I'm just not there yet. At this weight, I could wear a one-piece swimsuit without the authorities being called or without raising eyebrows. But nobody wants to see a size 14/16 shoehorn into a bikini. Now, Check me out later on - after I get some real band restriction and some weight loss, a Boob Lift and some Lipo later - and we'll see. But right now, it ain't gonna happen. Do you guys ever go back and forth on this too? I'm never back and forth. I seriously want to be a Junior Size 9/10 or a Misses Size 8 or 10. If you know another way to go about it other than diet, exercise, surgery, prayer, and more - let me know. I was hoping I wouldn't have to trade my mortal soul for a single digit size but after some dark days I've had after surgery, even that thought hasn't been such an appalling thought. :eek: But take it from a post op Bandster: Don't think people who aim for larger goal sizes aren't lacking in dedication or hard work. And they aren't necessarily selling themselves short - some of us just don't know how to do it, and have begun to think it might not be possible. Thanks and Happy Band Journeys To All ...
  10. NewSho

    Had My Endoscopy Today

    Congrats, HagerTeresa: I know you are so relieved. Good for you! :clap2: Model Bandster, there is such a thing? QUICK! Get this strange and rare animal right in this chat room immediately. It's like a unicorn - if they exist, where are they? :eek: I've been banded for what seems like forever, have met a zillion other Bandsters and have never seen a model Bandster, in captivity or in the wild. Believe me, there might not be such a thing - so no beating yourself up. If occasional chocolate and the odd latte meant Band failure then no one would be posting the incredible success stories that we do see daily, with the band. And luckily, smoking is one vice I don't have (I'm more of a wine and cheese girl :nervous ), but when I go out to nightclubs with my Banded pals I'm continually amazed and how many of them light up regularly. (Three of my most successful banded patients - who have lost 380# between the three of them - now work for Band surgeons and they smoke. They are in brochures, at seminars, and in all the ads. And then they sheepishly light in up public and are embarrassed when people remember them from the seminars or the newspaper ads.Oy, vey! ) So if you quit for your own health, hooray, but so far it hasn't stopped my friends from losing 100# or more pounds with their band. In fact, I have two other banded pals who quit without any significant weight gain - and the band probably stopped them from the weight gain that a lot of patients fear when they are contemplating giving up smoking. So that's just something for you to think about. One thing at a time, eh? Absolutely, I agree 100%. I've honestly seen most band issues rear their heads around the 2-to-3 year mark, and nothing beats a good offense like a good defense. So a peremptory check to make sure everything is where is should be, is a great idea coming close to the 2-year Band anniversary. I highly recommend it to all Bandsters. Happy Band Journeys To All...
  11. NewSho

    Slipped Band

    Moss - First of all - HUGS to you. This is a difficult thing to grapple with and I totally understand. First of all - do NOT blame yourself. I don't think carbonated beverages are a good match for any type of Weight Loss Surgery (bypass or banded types) due to the fact that our bodies now process carbonation a bit differently, but sodas alone did not undoubtedly cause your slippage. And if occasional overeating made bands slip - you'd be talking to an empty chat room - because as WLS patients we sometimes have our moments where we revert to our previous bad habits. For most of us, those habits led us to need/want WLS and believe me, those weaknesses don't just vanish into thin air when they stitch a silicone band on our tummies. So no more self-blame and doubt. You bought a tool and it's currently not working up to snuff, so you are taking the right steps to get back on track. And you're right at your Three Year Anniversary point, and believe me - many, many little band irregularities are discovered around the 2-to-3 year mark. It's like a car that's approaching the end of it's 36-month or 36,000 mile warranty, and although it's running fine, you might start hearing little noises here and there. :puke: No, there isn't always going to be a problem but it's a great idea to see what's going on down there in Band Land. Although my Band has not currently slipped (err...fingers crossed), I certainly have had major Band incidents over my last five years (five years and 2 weeks, actually, LOL ). So last year I had a repair in my tubing and also had a replacement from my old-school access port to a newer lower profile port. And those are just some of the highlights :rolleyes . Also, like Shauna, I too had adhesions that were found when they replaced my tube - yet no one bothered to tell me about them. I read about it a year later when I requested my surgical records (after my longtime first surgeon dismissed me as an 'active' patient, saying I'd lost all the weight I ever would lose with my band. Gee, thanks for the support, doc ). So I don't know how severe my surgical adhesions were, but somehow they were able to to repair/remove them and continue with the second surgery. My replacement/repair surgery took less than an hour with all that - and recovery wise, it was a breeze compared to the original banding. So I have high hopes that yours will proceed as smoothly, Moss, and you'll be back on track soon.:puke: So as you prepare for your upcoming surgery, I would ask your Dr O and/or Dr M one important question - since you were banded in 2003, I'd find out which technique they used to attach the band to the stomach. Specifically I'd find out whether they used the original Peri-gastric technique (which is what I have, unfortunately) or if they used the newer Pars Flaccida technique. My pals & peers who were banded in Mexico in '02 and '03 - usually had the older Peri-gastric technique. This technique was definitely used in the 2000-2001 surgeries(when I was originally banded) and that surgical placement has been associated with a higher rate of slippage (some have even thought it has some relationship to higher erosion rates, especially with some of the Mexican surgeons who utilised this approach longer. So I think it might be important to ask if that was utilised in your original surgery, as if it was, they will probably revise you to the newer Pars Flaccida placement. This will undoubtedly ensure greater long term success with your banding - and will hopefully reduce any chance of further slippage. You're not critically ill (been there), you're not sick with no idea what's happening to you or your band (been there) and you're not stuck in a hospital ICU unit with a bunch of doctors circuling around you hoping they get to see this band when they cut it out since it's so new that they've never seen one in person (been there too - and I don't recommend the T-shirt :eek: ). So things could be much, much worse. I'm not at all minimising your difficulties but thank goodness you know what's wrong, what's been causing your symptoms, and that your surgeons can fix your issue. I wish you all the luck in the world, and have high hopes for your continued journey. Please keep us posted on your progress. And Big Hugs again. Happy Band Journeys To All...
  12. NewSho

    What size do you want to be?

    What a cool thread idea. Heck, I don't know what my 'goal' size is anymore. I was so fat for so long that anything without a "2" in front seemed like a gift to me, LOL. I'm a Shopper - and I absolutely love clothes. So my initial goal was to get into any normal store (not designer, just 'normal' store) and be able to fit into something off the rack... I got to that point. And now I can pretty much wear any 12-14 top and 14-16 bottoms depending on the store. (I have to wear Tall or Long in pants sizes, so I'll never be exactly "off the rack" but now I can generally buy clothes in most places.) Cool. ( CONFESSION: But normal store clothes is not what I desire. Nope! Not even close. I want to be able to wiggle into Designer Sportswear brands. In little "Junior sizes." I mean, brands like Bebe (I could usually wear the tops but can only just get into the more casual, sporty Bebe Sport clothes now *after* losing weight, sigh) are what I crave and I am nowhere near their jeans sizes yet. Ultimately I desperately, desperately, desperately want to be able to fit into a pair of true designer jeans (like Citizens for Humanity - or as I call them "Skinny Citizens for Humanity" jeans, Joes Jeans, Seven for All Mankind (which I have also nicknamed "Size Sevens for All Mankind" because anyone bigger than Size Seven might have trouble wiggling into them :mad: ), Chip and Pepper, True Religion, Rock and Republic ) and etc... Most of those jeans retail in the $175 to $300 range and none of them fit me. Isn't that crazy? What makes us humans want things so badly, just because we can't have them?:Banane04: So if I have any hope of ever squeezing into any of these brands - I'd have to get down to a Junior size 9 - and I wasn't even that small during the (beloved) Phen Fen years. ) If I aimed to be what I call Unrealistically Fashionable or even Fashionably Unrealistic :mad: - I'd go for a junior size 9. I'm tall and could pull it off - I think I'd honestly look like a video girl, seriously. But More realistically, it'd be a miracle if the Band helps me get down to a Misses 10 or 12. That's my story! HAPPY BAND JOURNEYS TO ALL....
  13. Bless your heart. ((( HUGS )))) You'll get through this, I promise. These band journeys are all different, and your journey is very different so far. Sorry it's been so rocky. Keep us posted.
  14. Well, quite honestly, Bandsters who lose 2-3 lbs per week (which would be an average of 100-150# a year) are quite unusual, and would generally have a significantly higher starting weight and BMI. The band is a great tool but it isn't magical and stats like 2-3 lbs a week aren't really ever the norm for most folks. Although literature touts that 1-2 pounds per week is what is quoted most often - even this is quite out-of-the-ordinary for most Bandsters. I am ALWAYS happy to see & congratulate Bandsters who have lost up to 100# in a year :clap2: - but this just isn't usually the case. One surgeon who posts here (Dr Pleatman) says he dreams about having his banded patients lose 1-2 lbs a week. Realistically I know a lot of other Banded folk and most haven't been able to achieve or sustain 50 to 100 lbs a year in weight loss, even with fills, exercise and being a good banded citizen. But hey, we take the loss that we achieve and we run with it. It's not a race for speed, but for better health and lifestyle - and the band does help most to work towards that. It is important, however, to be honest about its' capabilities. Happy Band Journeys to all...
  15. For those Houston-area LapBand patients who might not have heard (on the phone or on other online forums), local LapBand (and bariatric) surgeon Dr Hadar Spivak is no longer accepting United Health Care (or UHC) insurance - effective immediately. This is a big revelation, as UHC is known as being one of the most LapBand-friendly insurance companies (for those members whose employers did not specifically choose to exclude bariatric surgery coverage). It is also an insurance company that this surgeon, and many others, often encourage their patients to switch to - so they can increase their chances of insurance approval. He will apparently now be "Out of Network" only to patients, because (his office has said) that they can no longer accept the smaller payments that UHC is offering to their in-network bariatric surgeons now. This means that Dr Spivak's UHC patients may be asked to defray the difference in costs between what surgery/treatment/fills/visits would cost at In-Network rates (which is usually covered at rates of 80% to 85%, and sometimes to the rare but wonderful 100% coverage) for UHC patients to now an Out of Network rate of 55% - 65% to patients. For example, one UHC patient has said if they continued to plan to have surgery with Dr Spivak, now that Dr Spivak is Out of Network, the patient is responsible for paying a $5800 difference. (That is the difference from covering 55% of LapBand costs versus the 85% coverage they would have had when Spivak was in network.) This is notable as Dr Spivak was one of the first LapBand surgeons in Texas, and usually leads other local surgeons in how Lap Banding issues are handled surgically and otherwise. In other words, if other local surgeons eventually follow his lead (it has happened before) then patients will have some significantly higher costs in store. (Dr Spivak and Dr Spiegel's Surgery Center is already Out of Network with United Health Care but those costs have always been detailed and explained up front.) I realize this seems complex, but the bottom line is that the costs for patients with UHC may well be increased, effective immediately. I am double-checking with some contacts I have from UHC (on the corporate end) to verify that the financial concerns for patients are correct. Just an FYI. (I will cross-post this on the insurance board, just to make sure everyone gets a chance to see this if they haven't already.) Good Luck and Happy Band Journeys to all, New Sho
  16. Oh, Shanna. I am so, so, so sorry. ((( HUGS ))) are inadequate, but it is all I can offer. You'll be able to handle it eventually, but I understand how painful this is for you now. Just take it day by day....
  17. NewSho

    doc in MEXICO

    Quite honestly, I'm admittedly NOT a fan of the idea of going to Mexico for Lap Band surgery. However, having said that - Exactly. Most experience, best reputation, internationally respected, great facility, Banded himself, handsome and charming with great patient manner. It's no contest. He's the ONLY surgeon in Mexico that I would consider. It is absolutely not even close. If you're going to Mexico, go with Rumbaut. Period. Happy Band Journeys to all...
  18. NewSho

    Whats your sign?

    Well, I eat almost all my meals out - so that little "hiccup" (or worse, but rarely that little 'burp' sound :paranoid ) is a signal that means, "Check, Please!" That does it for me, most of the time. Happy Band Journeys to all...
  19. NewSho

    Good Thoughts Needed - PS Tomorrow

    Congratulations to you! :clap2: I had my TT 13-14 wks ago, and I hope to have my combo Boob Lift & Lipo later this year... You can honestly be assured that this will be the best thing you've done for yourself since the Band. Once you're home, read trashy tabloid magazines (mindless celebrity gossip and pics of aesthetically pleasing folks is strangely inspirational when you're recovering from plastic surgery) and don't worry if you sleep like you're hibernating at first. Indulge yourself and your body - and rest, rest, rest. Finally, no matter what you do- don't try to lift anything heavy including children, chubby pets or luggage. Take it easy! You'll do fine. Good luck & congrats Happy Band Journeys to all
  20. Tylenol kills even healthy adults by causing a type of liver poisoning. And my former nephrologist (liver doctor) who is British is still wondering about the link with Tylenol and LapBanding but he's convinced there is one. Especially since the UK has had banding so much longer, he thinks there will be some long term effects of Tylenol (or acetaminophen) use there before we even see it here. And of course, evidence suggests NSAIDs are detrimental to bands, too. So where does that leave us? If only we knew all the answers Happy Band Journeys to all...
  21. NewSho

    Pleatman's Conversion Surgery

    Yes, I don't even watch "Idol" (I know, I know and they actually let me keep my citizenship) and even I can see Randy is a lot smaller... Big difference between being in his 300's and the 200's. So I can't think of him as an RnY failure, sorry. Happy Band Journeys to all...
  22. NewSho

    Its Wonderful to be in Onederland

    Congrats and welcome to Wonderland. Oh that was a WONDERFUL feeling, indeed. Happy Band Journeys to all...
  23. NewSho

    Update...

    This is funny - whether I was fatter or flabbier - I never ever wore a girdle. I never even owned one. After my TT more than 13 weeks ago, now as I graduate from the surgical binder my plastic surgeon's office recommends panty girdles to keep the post-op swelling down. So when I'm out and about, I wear a control smoother (kind of panty girdle like) or body shaper. Now I wear my now-falling-apart (after so many washings) abdominal surgical binder in the evenings when I'm at home, or especially when I sleep. Happy Band Journeys to all...
  24. NewSho

    Alcohol after banding

    I posted on another thread about this... but I still have a glass of wine a once or twice a week, usually. I don't have many vices so a nice Chardonnay is a nice perk for me to have when I can. So I was so worried that if I had an RnY that I'd never be able to have a bit of wine now and again. (Of course later, I find out many of my friends with RnY bypasses can still drink, but being as a single who goes out, I was concerned.) I told my surgeon before I was banded and he thought it was fine. So I just try to compensate for the carbs elsewhere - Works for me! Happy Band Journeys to all...
  25. This is so true. I eat almost all my meals out - I'm single/no kids, travel a bunch so eating out is easiest for me. I just go with an appetizer (or half appetizer) or a kids' portion. I ate at home mostly only during the liquids phase and once I was on mushies - I hit the soup menus and went on my way. :hungry: The one thing I didn't want to give up: my glass of wine with dinner...Makes me feel civilized and I told my surgeon before LapBanding. His feeling is as long as I compensate for the carbs elsewhere, then a glass of wine isn't detrimental. Happy Band Journeys to All

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