Akbar

Ahh, yes, that initial feeling of restriction was a revelation to me too. The physiology of appetite is much more complicated than the vagus nerve. Control of body mass, energy expenditure, appetite, are regulated by redundant systems at several levels. It is likely that you will adapt over time (years) to the new signals from your effectively smaller stomach and will not have such a dramatic satiety... but you won't return to your preoperative state. The downside, as you may soon learn, is that if you get too much dense food in your pouch too quickly your stomach will let you know that you have an outlet obstruction - with a feeling of distension, hiccups, increased salivation, maybe even tearing eyes or running nose, and "PB". (If you keep in mind your new small stomach and go slow, though, this is far less likely to happen).

I was banded Jan 2006 by Rumbaut & his team in Monterrey. It was a very good experience, and about half of what the local bariatric surgeon charges. The local group is not eager to take on aftercare for patients they did not operate on, but Rumbaut had a couple of other resources within an hour or two drive. If you are self-pay, or live in an area where lap-band costs are high, I would consider Rumbaut at the top of the list.

Slow and steady loss is probably much healthier, anyway - you're still well on your way. Dr. Fox mentioned at my first fill (and I had already found this out) ".. as far as alcohol, you ALWAYS have an empty stomach now". His nutritionist also mentioned that I would now be cheap date. How true.

To be absorbed, B12 has to not only be in your diet (not a problem for most of us), but then has to bind to "intrinsic factor" in the stomach, then this complex is taken up by specialized intestinal cells at the end of the small bowel. It is stored in the liver for long periods of time. B12 deficiency can have very serious and not always reversible neurologic consequences, as well as the more common and reversible anemia. The traditional treatment, because of this, is an intramuscular injection of B12. Every month. Forever. It turns out that many people can absorb adequate amounts of B12 either by taking very large amounts (1,000 mcg) orally daily, or by using sublingual tablets - the idea is that some of the B12 passes through the thin skin on the bottom of the tongue into the bloodstream. Take the B12! If you are using oral replacement, it might be a good idea to recheck the levels at some point.

These medications come in both immediate release and sustained-release forms. It should be possible to simply crush the medicine if it is immediate release (usually 2x/day dosing). Sustained release might be a problem

I was just banded (same group as XAnn) by RR's group. I was acquainted with him from high school days - and based on those hazy recollections, I expected him to be very good. He has probably as much or more experience with this procedure as anyone else in the western hemisphere; he is, and has been for years, active in training other surgeons in the procedure. I had a great experience, and think he did a good job, although, well, I was anesthetized, so I couldn't watch. He has a good team in place, and even has e-mail follow-up nutritional advice. Finally, he's a straightforward, approachable sort, with a very appealing bedside manner. Although the hospital he uses is very modern and nice, Monterrey is still in Mexico - while it is in part a wealthy city, there is tremendous disparity, with many poor as well (just not in the part of the city we were in). I would advise going to Mexico with an open mind - not everything is done in quite the same way, and a little effort on the visitor's part goes a long way. Also, the museum is closed on mondays, and you probably won't feel like walking around too much the first day or two post-op.

I was just banded (1/31/06) by Rumbaut in Mexico. I'm 44, and have struggled mightily to shed the excess weight, with only modest results. I have a considerable family history of obesity, but no significant medical consequences yet. Even without any fill, it seems to reduce the quantity of food I eat before feeling full, so I have high hopes that this will tip the scales, so to speak. It is both expensive and extreme, but it also seems to work, without any of the disadvantages of drug therapies. So far, it HAS been difficult, or at least tedious, to explain or justify to others - I think I may have to stay in the closet for most people.