Randi

This past Wednesday, I finally returned to see my surgeon after a year. Most people will think the year I'm referring to is a year from the date I was initially banded. So, I need to clarify the "year" just a bit. I was banded on November 20, 2006. Yes, that's right, the week of Thanksgiving. It was total surprise to me too. From the time I made my first visit to the my Surgeon in October 2006 to the time I was notified of my surgery date was less than a month. The way my surgeon explained it to me is that since I was self-paying for the procedure, I could be moved ahead of the insured patients who had to wait on various approvals. Regadless of the reason, when the call came I was sitting at my desk with my mouth hanging open and my heart pounding in my chest. I thought I still had more time. I thought I would be able to have one last hurrah for over the holidays. I thought I had until at least January. I thought, I thought, I thought . . . But, ready or not on D-day, I was banded. By the time the middle of January rolled around, I was 20 pounds lighter. The reason is I was trying my best to stick to the guidelines my surgeon had given me and I was on an aggressive fill schedule. How agressive you might ask, take a look below: December 6, 2006/1.0cc December 13, 2006/0.6cc December 20, 2006/0.6cc December 27, 2006/0.6cc January 17, 2007/1.0cc January 25, 2007/0.6cc (unfill) That's right. After two weeks of recovery, I received a fill every week for four weeks, had another fill three weeks later. One week after the last fill, I returned to the surgeon's office to have some fluid removed from my band. For the record, I must say that last fill terrified me. I had done a lot of research on the band, surgeons, methods. I even watched a lap-band surgery being performed from start to finish online at the National Institute of Health website. I knew that every surgeon's aftercare requirement varied, even their fill schedules. My surgeon, however, stayed on the cutting edge of research and based on that infomation, he was filling patients sooner to alleviate hunger and faciliate weightloss. I was apprehensive. I had read no such information on such an agressive fill schedule. But I chose my surgeon because I trusted my him and I still do. So, I continued to return for fills as told until the fill on January 17th made me return a week later because I could barely swallow water. I knew something was wrong. As it turned out, I was overfilled. When some of the saline was removed, I was able to swallow again. I never returned to the surgeon's office after that. And, that's the "year" I needed to clarify. There are several reasons or rather excuses why I didn't return: A. The surgeon's Physician Assistant told me that I only need to return if I needed fills. I didn't think my surgeon would have totally agreed with that statement had he heard it being made, but it made a sort of half-way sense to me.[/b] B. I was self-pay and only had 90 days of services from my surgery date covered in my treatment plan by the surgery group. So, after the 90 days were up I was going to be the payee responsible for flouroscope fills and office visits including visits to the dietician. I didn't know how much that would cost, never tried to find out the final totals that would be charged for self-pay patients, and some part of me thought I couldn't afford it anyway. However, I was afforded the opportunity of four free visits to behavioral health within a year, which I never took advantage of because I had taken issue with a statement the counselor made and my pride wouldn't let me use the visits. C. I wasn't closely (or loosely for that matter) following the lapband guidelines. So, what sense did it make to return to the surgeon's office when I knew EXACTLY what I wasn't doing. D. We were selling and purchasing a home and I totally lost focus on me and was focusing on everthing and everyone but me. E. The contract I was on ended in September, which meant I no longer had a job. Who in their right mind pays for something they could only afford with a job after they lose their job? Not me. E. I was ashamed. I had paid all this money out-of-pocket and I still wasn't successful losing or keeping the weight off. I had regained it all. So, as 2008 reared it's ugly head. I was once again contemplating the same New Year's resolution about losing weight. I knew something had to change. I knew that "something" was me. On January 17th of the new year, I was given a ray of hope that I could now afford to go back to my surgeon's office and get back on track. My friend, Phia, sent me an email containing an article that my insurance carrier had officially announced that they were now covering lap-band. So, to me, it only made sense that they were now also covering fills and office visits. I called and made a follow-up appointment with my surgeon's office immediately.

I'm preband and considering becoming a possible self-pay patient with Dr. Spivak. I would like to know where Dr. Spivak placed your port, his rationale for port placement, and whether you have a low profile port. Also, if you have lost a substantial amount of weight, please tell me whether your port is visible based on the placement location.

Marieze, This is probably a rhetorical question, but have you ever eaten something like chips or sweets when you weren't hungry, or eaten until you were just stuffed? Well, that's what we referring to as head hunger and the band does not solve those mental urges. You'll have to develop strategies for dealing with issues such as boredom, holidays, general celebrations, mindless eating, etc. just like in WW. All the band does is restrict the amount you can eat in one sitting and helps keeps you from being "physically" hungry only IF you follow the band eating rules your doctor/surgeon prescribes -- usually eating Protein first, then vegetables, then fresh peeled fruit only after you've consumed your protein and vegetables and you're still hungry. Choose not to follow the rules consistently and the weight creeps right back on.

Was this your first fill? If not, are your fills done under fluoroscope? I've heard of people who get blind fills sometime having to have their port tubing replaced because it got punctured by the fill needle.

There's a website which lists suggestions for dealing with head hunger. Here are the links: Why am I hungry all the time? Coping with head hunger and overeating triggers http://www.amihungry.com/pdf/101_things_to_do_besides_eat.pdf

I vote for wait 'til she asks, then at that moment it will be your decision if and when you'll tell her. The reason I say "if or when" is because you may be in a group of people when the question is finally asked and the question may not be asked by your friend. I think it's possible that your friend was able to come up with 75 reasons not to have weight loss surgery because she, at some point, considered the surgery herself and used those very same reasons to talk herself out of it. So, she could have been just projecting her feelings about the surgery onto you. Also, there are still a lot of people who don't understand the fundamental differences between the gastric bypass or a similar procedure and the lapband. However and whenever you decide to address this issue to your friend you definitely know her better than any us ever could. If you're a very private person and you share this information with her, will she keep your confidence? Or, will she be angry that you didn't tell her and turn vindictive telling anyone and everyone who will listen?

It's a little past 4:00 a.m. my time. I couldn't sleep, so I decided to get up and take my official Wednesday weight, which was 234.4. I actually peeked at 233 this week, but I ruined getting solidly to that number or past that number by eating too many carbs. After I pigged out on all the carbs at the end of January, I had a party challenge on Saturday, February 2nd. We had some neighbors from the old neighborhood bring their family over for dinner. We decided to prepare fajitas for the main portion of the meal, but I also made snacks to tide us over for the meal and to ensure that there were leftovers for at least Sunday's dinner. I wasn't disgusted with myself after the party. I had a small meal of brisket and beans earlier in the day. So, that held me pretty well. At the party, I tasted all the snacks I made and after I fixed everyone a quesadilla who wanted one, I made myself a very small plate of fajitas and beans. If I had to admit to going overboard on anything, it was probably the corn chips with guacamole and one to many oatmeal cookies. Other than that I did fine. Although I didn't enjoy a six-pound loss like I did the first week, I kept up with my exercises and ate decently for the other days of the week and still had the projected two-pound loss. I must lose 10 more pounds before I will reach my first major goal of 224, which was the lowest weight I remember reaching before I regained it all. I think I will make some homemade chili. I ate chili from Red Robin the first week and did pretty well. So, with homemade chili, I'm hoping to do even better.

It's a little past 4:00 a.m. my time. I couldn't sleep, so I decided to get up and take my official Wednesday weight, which was 234.4. I actually peeked at 233 this week, but I ruined getting solidly to that number or past that number by eating too many carbs. After I pigged out on all the carbs at the end of January, I had a party challenge on Saturday, February 2nd. We had some neighbors from the old neighborhood bring their family over for dinner. We decided to prepare fajitas for the main portion of the meal, but I also made snacks to tide us over for the meal and to ensure that there were leftovers for at least Sunday's dinner. I wasn't disgusted with myself after the party. I had a small meal of brisket and beans earlier in the day. So, that held me pretty well. At the party, I tasted all the snacks I made and after I fixed everyone a quesadilla who wanted one, I made myself a very small plate of fajitas and beans. If I had to admit to going overboard on anything, it was probably the corn chips with guacamole and one to many oatmeal cookies. Other than that I did fine. Although I didn't enjoy a six-pound loss like I did the first week, I kept up with my exercises and ate decently for the other days of the week and still had the projected two-pound loss. I must lose 10 more pounds before I will reach my first major goal of 224, which was the lowest weight I remember reaching before I regained it all. I think I will make some homemade chili. I ate chili from Red Robin the first week and did pretty well. So, with homemade chili, I'm hoping to do even better.

I've also been looking at buying an elliptical, but I want one that lasts and that is close to gym quality because this old body can't take any more aches, pains or injuries. The specific model is Precor and it runs over $3,000 at the Hest store in Texas. Before you sell your treadmill, you may want to try out the elliptical for a while to make sure it doesn't irritate your joints in some way, especially since it doesn't sound like its gym quality.

I've heard of people sewing fish weights into their clothing.

Make it fun. Run this experiment every time. If water is brought to the table or you request it just to avoid the beverage hassle, immediately shake a lot of pepper into the glass and then add a pinch of salt in the middle. What happens? The pepper moves over to the sides of the glass. Now THAT'S entertainment!

I record my weight once a week on Wednesdays. Also, on days I go to the gym, I weigh in the a.m. so I know what weight to enter for my workout on the elliptical.

I completely crashed and burned yesterday. Since I restared my journey to health, I've been eating one or two meals per day. Yesterday, after I exercised and took a shower, I was hungry. So, I asked aloud, "What can I eat?" I settled on two strips of Turkey bacon and an omlette consisting of one whole egg and two egg whites, fresh tomatoes and red onions. I also added some fish sauce, garlic powder and onion powder to give it an oriental flavor. Until about 2:00 or so, I just kept drinking water and chewing sugarless gum, but I chewed almost a pack of gum. Since I was getting hungry again, I decided I would eat leftover turkey and pinto beans that I had purchased from Rudy's Barbecue the night before. After I ate that, I had this feeling like I needed something crunchy. So, I stepped into the pantry and that's when I completely lost control. Before I stopped myself, I had consumed an oatmeal pie, four granola bars, a handful of animal crackers, and three snack bags of chips in the form of Doritos and Cheetos. Although my crunch, as well as my sweet tooth, was satified, I was disgusted with myself for eating all that. I should have known it was a mistake to stay home all day, and I should have made an effort to get some of the errands on my list taken care of to get me out of the house. When I'm out and about, I'm just too busy to continually focus on food. Fortunately, that binge occurred early afternoon and I didn't eat anything for the remainder of the day, but that really isn't the point. Needless to say, after cosuming all the carbs, I fell asleep on the couch and woke up in a bad mood. Today, I'm trying to satisfy my crunch early with a Special K protein bar and two crisp slices of turkey bacon. I also plan on getting out the house and getting some of the errands done that would have kept me from binging yesterday. Hopefully, that one day of eating won't keep me from achieving the two-pound loss I've projected for next week. I'm also hoping to get at least two more exercise sessions in before the week ends to help combat yesterday.

I completely crashed and burned yesterday. Since I restared my journey to health, I've been eating one or two meals per day. Yesterday, after I exercised and took a shower, I was hungry. So, I asked aloud, "What can I eat?" I settled on two strips of Turkey bacon and an omlette consisting of one whole egg and two egg whites, fresh tomatoes and red onions. I also added some fish sauce, garlic powder and onion powder to give it an oriental flavor. Until about 2:00 or so, I just kept drinking water and chewing sugarless gum, but I chewed almost a pack of gum. Since I was getting hungry again, I decided I would eat leftover turkey and pinto beans that I had purchased from Rudy's Barbecue the night before. After I ate that, I had this feeling like I needed something crunchy. So, I stepped into the pantry and that's when I completely lost control. Before I stopped myself, I had consumed an oatmeal pie, four granola bars, a handful of animal crackers, and three snack bags of chips in the form of Doritos and Cheetos. Although my crunch, as well as my sweet tooth, was satified, I was disgusted with myself for eating all that. I should have known it was a mistake to stay home all day, and I should have made an effort to get some of the errands on my list taken care of to get me out of the house. When I'm out and about, I'm just too busy to continually focus on food. Fortunately, that binge occurred early afternoon and I didn't eat anything for the remainder of the day, but that really isn't the point. Needless to say, after cosuming all the carbs, I fell asleep on the couch and woke up in a bad mood. Today, I'm trying to satisfy my crunch early with a Special K protein bar and two crisp slices of turkey bacon. I also plan on getting out the house and getting some of the errands done that would have kept me from binging yesterday. Hopefully, that one day of eating won't keep me from achieving the two-pound loss I've projected for next week. I'm also hoping to get at least two more exercise sessions in before the week ends to help combat yesterday.

Today was my first official Wednesday home weigh-in since revisiting my surgeon's office. My weekly goal is to lose two pounds each week. I identified my starting weight as 242; this week, I'm down six pounds and the scale is rewarding me with a weight of 236.4. Ordinarily, I would be ecstatic about a six-pound loss. However, I plan on keeping my excitement in check until I'm at or below my last known weight in January 2007 (224lbs) before I started slowly putting the weight back on. The thing is, I've been in the game long enough to know that you always have to ask yourself, "Six pounds of what -- water, fat or muscle?" I can't answer that question, but I can I do my part to work with my band and not against my band. So, I ensured that I drank at least the recommended amount of water and switched to Propel when I got tired of water, exercised at the gym, which included using the elliptical for 45 minutes to 1 hour and performing my standard series of weight training exercises, stuck very closely to the prescribed eating order of protein, vegetables and fruit, skipped meals when I wasn't hungry and last, but not least -- journaled to ensure a written record of my journey.

Today was my first official Wednesday home weigh-in since revisiting my surgeon's office. My weekly goal is to lose two pounds each week. I identified my starting weight as 242; this week, I'm down six pounds and the scale is rewarding me with a weight of 236.4. Ordinarily, I would be ecstatic about a six-pound loss. However, I plan on keeping my excitement in check until I'm at or below my last known weight in January 2007 (224lbs) before I started slowly putting the weight back on. The thing is, I've been in the game long enough to know that you always have to ask yourself, "Six pounds of what -- water, fat or muscle?" I can't answer that question, but I can I do my part to work with my band and not against my band. So, I ensured that I drank at least the recommended amount of water and switched to Propel when I got tired of water, exercised at the gym, which included using the elliptical for 45 minutes to 1 hour and performing my standard series of weight training exercises, stuck very closely to the prescribed eating order of protein, vegetables and fruit, skipped meals when I wasn't hungry and last, but not least -- journaled to ensure a written record of my journey.

I love Woman's World magazine. The front page always has a diet showcased on the front cover and it contains health information, recipes, stories, and bytes of information that you may or may not need to know, but are interesting nonetheless. While I was doing some more journey preparation reading today, I came across a little tidbit of information that I had clipped from the Woman's World magazine. What made me clip the article in the first place was that it was a prayer created for an eDiets experiment where 2000 volunteer dieters said the prayer three times a day and lost an average of 4.5 pound in two weeks, some without even dieting. One dieter name Kim said, "When I finally started praying for help with my weight, it showed," Here's the prayer tip verbatim from the article: "Dear God, I surrender my body and my weight loss to your divine care and love. I ask that you remove all excess and unnecessary weight form my body. Return my body to its most helathy and balanced state. Give me eating habits that support my health and life energy. And, finally, teach me to love my body and to care for it from this day forth. Amen." I know I've said aloud and to myself a few times during my second career as a yo-yo dieter, "Lord, Help me lose this weight." However, my prayer has never been longer than a sentence for one of the biggest road blocks to my personal path of success. Maybe I'll add this prayer or create another as I develop and adopt strategies for my own weight loss success.

I love Woman's World magazine. The front page always has a diet showcased on the front cover and it contains health information, recipes, stories, and bytes of information that you may or may not need to know, but are interesting nonetheless. While I was doing some more journey preparation reading today, I came across a little tidbit of information that I had clipped from the Woman's World magazine. What made me clip the article in the first place was that it was a prayer created for an eDiets experiment where 2000 volunteer dieters said the prayer three times a day and lost an average of 4.5 pound in two weeks, some without even dieting. One dieter name Kim said, "When I finally started praying for help with my weight, it showed," Here's the prayer tip verbatim from the article: "Dear God, I surrender my body and my weight loss to your divine care and love. I ask that you remove all excess and unnecessary weight form my body. Return my body to its most helathy and balanced state. Give me eating habits that support my health and life energy. And, finally, teach me to love my body and to care for it from this day forth. Amen." I know I've said aloud and to myself a few times during my second career as a yo-yo dieter, "Lord, Help me lose this weight." However, my prayer has never been longer than a sentence for one of the biggest road blocks to my personal path of success. Maybe I'll add this prayer or create another as I develop and adopt strategies for my own weight loss success.

My surgeon requires two day of liquids after a band adjustment. So, I had some time to reflect and figure out how I was going to stay on track. I thought the best place to start would be by doing reading and further reflection. I decided to read a book I purchased somewhere around the time I was banded, but never took the time to read. The book title is Before and After: Eating and Living Well After Weight Loss Surgery by Susan Maria Leach. Some of the things I summarized from reading her book that have really hit home for me are: Even after all my research, I wasn't prepared for how day-to-day living would really be after weight loss surgery until I lived it. What I realize now that I didn't quite grasp before is that the band only keeps you from becoming ravenously hungry and restricts your intake -- that's ALL it does. The hardest part of being successful with WLS depended entirely on me and my choices. As I moved from liquids, to soft foods, to solids, my daily food challenges grew. At some point I let "life" overwhelm me and failed to develop personal strategies for dealing with my emotional issues or eating habits. I also expected my band to do more for me than I was doing for myself. Now I completely understand that if I want to be continually successful, I MUST: GET MY HEAD IN THE GAME. not drink and eat at the same time. eat like I had the gastric bypass focusing on getting in protein first, then veggies, then fruit in that EXACT order and control the portion sizes/ratio. AVOID high carbohydrate foods because they are the DEVIL reincarnate. Don't EVER act like I don't know what carbohydrates are and there's no label to read. If I do, the only one I'm fooling is me. My band, my body, and my scale have proven they will not be easily fooled forever. build up to EXERCISING at least 5 day per week to lose fat instead of muscle. Take dietary supplements morning, noon, and night. Hold myself accountable by tracking my weight weekly and my diet and exercise. KEEP MY HEAD IN THE GAME. First thing this moring, I created a weigh-in chart through the end of calendar year 2008. According to my estimates, if I average two pounds a week, I should be at or below goal (150) before the end of the year. Is this goal set on perfection? Nope, it's set on continually striving to reach my goal in small achievable increments. Is this goal attainable? Well, I really don't know yet. The lowest weight I can ever remember being is 156 and I was 19 years old at the time. So it will be interesting to see where my body lands on the weight scale with continously applied effort. For now, my sites are initially set on getting back to the January 24, 2007 weight of 224lbs, from there I'll be working on breaking the 200lb threshold, then my focus will turn to achieving a healthy BMI of 29, which will put me at exactly 190lbs. Hmmm, now that I'm thinking about it. I'm going to update my weigh-in chart to include BMI changes for extra incentive. Since my surgeon only sees follow-up patients on Wednesdays, I've decided that will be my weekly weigh-in day. So, I will take and record an official naked weight every Wednesday even if it's a day I'm scheduled to see the surgeon. I will also record the clothing weight on those Wednesdays as well. I still have to come up with a plan that addresses all my issues and not just identify what I've failed at doing in the past and a documented weekly weigh-in chart. I need a plan that helps ensure my success. That will definitley be a bit harder. So, I'm going to have to address one issue at a time as soon as possible. My next appointment with the surgeon on 13 February and I want to ensure that both our scales show my effort.

My surgeon requires two day of liquids after a band adjustment. So, I had some time to reflect and figure out how I was going to stay on track. I thought the best place to start would be by doing reading and further reflection. I decided to read a book I purchased somewhere around the time I was banded, but never took the time to read. The book title is Before and After: Eating and Living Well After Weight Loss Surgery by Susan Maria Leach. Some of the things I summarized from reading her book that have really hit home for me are: Even after all my research, I wasn't prepared for how day-to-day living would really be after weight loss surgery until I lived it. What I realize now that I didn't quite grasp before is that the band only keeps you from becoming ravenously hungry and restricts your intake -- that's ALL it does. The hardest part of being successful with WLS depended entirely on me and my choices. As I moved from liquids, to soft foods, to solids, my daily food challenges grew. At some point I let "life" overwhelm me and failed to develop personal strategies for dealing with my emotional issues or eating habits. I also expected my band to do more for me than I was doing for myself. Now I completely understand that if I want to be continually successful, I MUST: GET MY HEAD IN THE GAME. not drink and eat at the same time. eat like I had the gastric bypass focusing on getting in protein first, then veggies, then fruit in that EXACT order and control the portion sizes/ratio. AVOID high carbohydrate foods because they are the DEVIL reincarnate. Don't EVER act like I don't know what carbohydrates are and there's no label to read. If I do, the only one I'm fooling is me. My band, my body, and my scale have proven they will not be easily fooled forever. build up to EXERCISING at least 5 day per week to lose fat instead of muscle. Take dietary supplements morning, noon, and night. Hold myself accountable by tracking my weight weekly and my diet and exercise. KEEP MY HEAD IN THE GAME. First thing this moring, I created a weigh-in chart through the end of calendar year 2008. According to my estimates, if I average two pounds a week, I should be at or below goal (150) before the end of the year. Is this goal set on perfection? Nope, it's set on continually striving to reach my goal in small achievable increments. Is this goal attainable? Well, I really don't know yet. The lowest weight I can ever remember being is 156 and I was 19 years old at the time. So it will be interesting to see where my body lands on the weight scale with continously applied effort. For now, my sites are initially set on getting back to the January 24, 2007 weight of 224lbs, from there I'll be working on breaking the 200lb threshold, then my focus will turn to achieving a healthy BMI of 29, which will put me at exactly 190lbs. Hmmm, now that I'm thinking about it. I'm going to update my weigh-in chart to include BMI changes for extra incentive. Since my surgeon only sees follow-up patients on Wednesdays, I've decided that will be my weekly weigh-in day. So, I will take and record an official naked weight every Wednesday even if it's a day I'm scheduled to see the surgeon. I will also record the clothing weight on those Wednesdays as well. I still have to come up with a plan that addresses all my issues and not just identify what I've failed at doing in the past and a documented weekly weigh-in chart. I need a plan that helps ensure my success. That will definitley be a bit harder. So, I'm going to have to address one issue at a time as soon as possible. My next appointment with the surgeon on 13 February and I want to ensure that both our scales show my effort.

Blund, Mourning food (high carbohydrates - Desserts, sodas, chips, bread, rice, Pasta, etc.) is not unusual after weight loss surgery nor is having last suppers prior to. I think we can all admit to having a last supper just before embarking on yet another diet. Had I chosen Gastric Bypass (Roux-en-Y or RNY) as my weight loss surgery, my last supper would have consisted of solely a dessert table of all my favorites and that probably would have been my Breakfast, lunch and dinner for at least two days. Gastric Bypass patients have an even greater challenge nutritionally because their stomach is reduced to the size of a thumb and the intestine of the rewired stomach can't tolerate sugar -- if they're lucky. Foods high in carbohydrates cause them to become painfully and violently ill. So they have to really watch their carbs or pay the price. You've probably heard it called "dumping syndrome." A prior acquaintance of mine who opted for the gastric bypass, and was about eight months post-op, tried a sliver of my cake one day and had to go home for the rest of the day. I didn't know about the various surgeries being performed at the time, but I made a mental note that if I ever had WLS it wouldn't be THAT one. In fact, if I ever have to have the band removed, I would rather have the vertical gastrectomy over the gastric bypass.

Chica, Actually, you'll find not drinking while eating is just not that difficult. In fact, this is one bandster rule you can easily get into the habit of doing right now. Here's the strategy I adopted pre-band: 1) GET YOUR HEAD IN THE GAME. :cursing: Prepare yourself each and every time for what you have to do. 2) Do a "how thirsty am I check" before EVERY meal, then drink 'til you're satisfied. Be sure your "drink" is always a sugar-free, calorie-free, non-carbonated beverage (remember you're training to go live). 3) Once you begin your meal, don't take another sip. This could mean removing or having the beverage removed from your sight, pushing it to the other side of the table out of reach, or drinking it all before you start your meal. 4) After you finish your last tasty morsel, check and make a mental note of the time or write it down if you have to. 5) Wait the prescribed time. Note: My surgeon requires waiting one full hour before you take a drink to allow the nerves in the pouch to fully register fullness and to feel full longer before you wash the food through, but follow your surgeon's instructions. 6) Drink your favorite sugar-free, calorie-free, non-carbonated beverages to your heart's content . . . until the next meal.

Future Bandsters, Even after all your research, you won't be prepared for how life (day-to-day living) will really be after weight loss surgery until you live it. Hopefully by now, you realize the band is just a "tool," but don't mistakenly believe that if the band does its job of keeping you from being ravenously hungry and restricts your intake, the rest will be easy. It won't. As you move from liquids, to soft foods, to solids, your daily food challenges will grow. If you had emotional or other issues pre-band that contributed to your weight, you will have to develop personal strategies to counter them when making food choices. To be continually successful, you MUST: GET YOUR HEAD IN THE GAME. not drink and eat at the same time based on the timeframes given to you by your surgeon. Wash solids through the pouch too soon and your body will want another meal, which equals more calories. eat your food in the EXACT order and portion sizes/ratio specified by your surgeon. Usually Protein first, then veggies, then fruit. AVOID high carbohydrate foods as if they were the DEVIL reincarnate. Don't EVER act like you don't know what carbohydrates are and there's no label to read. If you do, the only one you're fooling is you. Your band, your body, and your scale will not be so easily fooled forever. build up to EXERCISING at least 3 to 5 day per week (preferably 5) or you won't be losing fat, you'll be losing muscle, which will make it even harder to keep the weight off after your initial losses. KEEP YOUR HEAD IN THE GAME. I highly recommend you read Before & After: Living and Eating Well After Weight-Loss Surgery by Susan Maria Leach. In fact, the bulleted list above are just some of the insights I've paraphrased from her book. If I had read this book before I was banded, I believe I would be much further along in my weight loss journey and could have avoided many pitfalls. Other areas of the book I'm finding useful are her journal entries, insight about relationships with food and people pre- and post-surgery, and recipes. The book is actually a very quick read because more than half the book is dedicated to recipes for weight loss surgery patients. Good luck and I hope this post was helpful.

I was self-pay. So, I did a lot of research before I put my money down. I actually went to five different seminars -- two with an Austin surgery group and three with a San Antonio surgery group -- to meet the different surgeons until I found one I was comfortable with. I chose Dr. Pilcher with New Dimensions (San Antonio Bariatric Surgery - New Dimensions Weight Loss Surgery - Home) because I felt we were a good patient/surgeon fit for the long-term, which was very important to me. Also, the New Dimensions group is designated as a "Center of Excellence" and does the lap-band, vertical gastrectomy, and the gastric bypass. They may do other procedures, but those are the ones I remember from the seminar. Something else I remember from the seminar is that in surgery you actually have two surgeons. I don't know if this is still the case, but it was when I was banded. Anyway, research everything. The surgery group, the surgeon, the cost of aftercare (especially if you're self-pay), and whether the group provides other services such as Dietician and Behavioral Health support. You definitely don't want to end up with a new surgery group that disappears on you, and then be left to find another surgeon to take you on as a patient -- I have seen posts where many won't, especially if you were banded in Mexico.

Prior to the making the appointment for the first return visit since I was unfilled, I rummaged through my post lap-band paperwork to call the surgeon's office to find out pricing information and to make an appointment. What I learned from that phone call is that the surgeon had "divorced" the old the bariatric program group and returned soley to private practice with his comrades. So, now the I was able to afford a visit to see my surgeon, the dietician, behavioral health and have a fill for $70. Because I was too embarrassed to see my surgeon after regaining all my weight, I decided to email him over the weekend at an address I came across on an old business card. He replied the same day and basically told me he was glad I had contacted him and to make an appointment to see him. He also told me that he felt his team could help me get back on track. So, I made an appointment first thing Monday morning for Wednesday afternoon of the same week to see my surgeon, the dietician and behavioral health. I knew I need a complete overhaul of mind, body and spirit. I had wasted enough time. After I checked in, my surgeon's physician assistant (PA) gathered all my history. I still felt uneasy about having regained all the weight, but I was there to come clean and restart my weight loss. So, I just gritted my teeth and beared all the questions and what appeared to be disapproving eyes. At one point in our discussion the question came up about why I had regained all my weight. I asked her honestly if she really wanted to hear all my excuses. She jokingly replied, "No," but I think we both knew nothing I said was going to change my current situation. Since my surgeon was already aware that I had regained the weight, I realized that everyone else was hearing it for the first time and didn't have time to adjust their reactions appropriately. The only reaction I cared about anyway was my surgeon's. He had had time to adjust. When my surgeon entered the room, I still felt uneasy. I didn't know what he would actually say to me knowing that I had not applied my best effort to lose as much weight as I could after banding, but he handled it well. He basically told me he was not going to beat me up because that wasn't his style. I told him, "I appreciate that." He told me that they were gonna check out my band to see if it was okay, and that he was going to run a series of bloodwork. I was then sent to the band adjustment room to check my band under flouroscope and to see how much saline was in my band. Fortunately, the band was still exactly where it should be and hadn't slipped, which was a relief. The PA was surprised that there was so much saline in my band. I mumbled something about my aggressive fill schedule, but I don't know whether she understood it or not, and I really didn't care. She also remarked on slowness of my esophageal function to the surgeon when I swallowed the barium, which my sugeon summised was due to swallowing pushing agains the pressure of the band. My surgeon took everything into considertation and decided to have the PA add .04cc to my band. So according to my calculations, I currently have a 3.6cc fill in my band, which breaks down like this: December 6, 2006/1.0cc December 13, 2006/0.6cc December 20, 2006/0.6cc December 27, 2006/0.6cc January 17, 2007/1.0cc January 25, 2007/0.6cc (unfill) January 23, 2008/0.4cc When I went to see Behavioral Health as part of my treatment plan, she told me stuff I already knew and wrote it down for me. I'm recording the list of things to do here for future reference. I also plan to enact some if not all of the suggestions. Here the list: Visual cues in refrigerator and pantry. Cordon off kitchen area. Do not go into the kitchen except to prepare meals and eat; have someone to do cleanup after meals Exercise five times per week; out of house preferably Plan menus for meals Journal The dietician visit surprised me because she was very obese. Mentally I questioned how she could advise me when it was so blatantly obvious that she was overweight. I flashed back to a time I considered becoming a dietician. However, I decided that if I couldn't keep my own weight in check, how was I going to help others. So, I braced myself to hear what she had to say and put my biases aside so I could better help me. As it turned out, she was simply the messenger. There to guide me based soley on published information provided by the surgeon and other sources. She directed me to pages within the guide she handed me so that I could see where I had gone wrong since my surgery. Guess what? I learned the only thing I was doing wrong was EATING! Imagine that. I had gotten so far away from the band rules that I was doing EVERYTHING in excess. I knew then that I was going to have to severly adjust my eating habits or as the saying goes, "If you always do, what you've always done, you'll always get what you've always got." What did I get? No surprise there -- I got FAT!