keithf

What's grand is the fact that my belt and waistband aren't digging into my overhang nearly as much as they used to. I can wear shirts untucked without having to peel the the pants (quite painfully) from my waste when sitting at my desk. That alone is worth the surgery.

Still on my 2-month pre-op diet.. Lost about 25# so far, and another month to go. The pants gave me the compliment. They were new about the time I started. They fell off of me, fully buttoned/zipped this weekend. It amused.

I saw a special about a month ago, hosted by Alan Alda, covering new WLS techniques. One under research was a pacemaker for hunger. Basically, it manages to turn hunger on and off according to a schedule. It doesn't do anything for gorgers, but does help for grazers, as I recall.

Not scientific.. I just watch Alton Brown, and he's full of good tricks. For the record, steak's not my weak point. Mashed potatoes and creamed corn are. (disclaimer, I *did* get my BS in physics & astronomy, but I don't get my income from either)

I was considering strategies for steak, if I encountered problems chewing it enough. Steaks are usually cut such that the fibers run up/down, so that you cut in between them. But if you were to shave the other direction, through the fibers, it might make it easier to chew it sufficiently to pass. For this reason, too, I've been considering investing in a deli slicer.

I'm surprised you can do the croissant. Most folks I've seen aren't able to do breads. Or are you doing a lettuce wrap? We calculated this weekend that the pre-op diet alone as saved us about $600 in our food budget this past month, between not eating at the company cafeteria and other places. I expect that figure to improve substantially once I shift from about 1700 cal/day to < 700 (I'll guess it'll shift by another $300). The extra money will probably go toward a new grill. Our last one turned into a forge one evening. The temperature gauge was maxed out, so we know it reached at least 700F by the time we noticed it.

I was surprised, myself. And while they're not an every-night sort of thing, they're surprisingly affordable for once a year or two for (I'd say) a majority of people. I think that's the idea.. As for psychological boost, the pre-op diet has been a good chance to prove (again) that yes, I can lose weight as a remarkable pace (down about 25 pounds or so the past month, and another month to go). Just having less matter in my tract as a result, has made me feel less.. bloated. It's easier to tie my shoes, certainly. Borrow a cattle prod when pass by the Angus? It'd be infinitely better than vomitting.

My surgery's scheduled for 30 June. Like you, the band is the only surgery covered by my insurance that I'm comfortable with, so I certainly hope they like what they see when they start poking around. One thing they advise against is grazing .. eating many *small* things that don't fill you up makes it easy to bypass the restriction of the band, especially since you're supposed to be spending time in between meals drinking Water. My surgeon will want me to have 3, maybe 4 filling meals. I also spent a year debating whether to get WLS, because of how it may impact some pleasure eating: we have a very fine restaurant nearby we go to for our anniversary (VERY fine: they grow their own herbs, possess one of the finest wine cellars in the country, the former cook won the James Beard award, current used to cook for the White House, etc), and there's always the trips to Vegas we spend watching shows and sampling good restaurants rather than gambling. But I realized that the places I like can (1) adjust recipes, (2) adjust portions if needed, (3) box the rest.

I know my surgeon discourages fruit juices on the basis of caloric density. I can deal with that, though. As much as I'm an OJ hound, what I actually jones for is citric acid: I can be just as happy letting Vitamin C tablets dissolve (on) my tongue. I used to pop them like candy when I was a kid. Actually, I think I thought of them *as* candy. I figure if I *do* end up having problems with grape skins, I'll remove the skins and have the grape flesh. I could care less about asparagus, and cauliflower's a known-tasty substitute for potatoes for me. Part of my thinking on this is inspired by the horseradish crust I currently enjoy at Outback. I can see a variety of such garnishes, and it gives my partner fodder for cooking ideas. I imagine part of it's mechanical, and the other part is chemical (does it change the situation, eg by irritating the stomach lining?), and like allergies that's going to differ for everyone in non-deterministic ways. Like me and caffinated coffee -- my mother described the effect as labor pains, and I'll not question her judgement in that.

This isn't about making baby food. Most people are content to order their filets mignon medium-well and gorge on sugar-coated fat. This is about taking an interest in food, to replace the interest in eating. The OP likes veggies. Some veggies are difficult in their typical form. There are only three responses to this (or any other) problem: - ignore the problem, stop complaining (stupid) - keep complaining, but do nothing about it (annoying) - find different ways to prepare them (creative, interesting) So maybe solid asparagus, etc don't work. Fine: change its form as use it as an ingredient in something else. You'd get the flavor (sans the texture), and you're better off than you were before. My apologies, and please don't think it's directed at you -- I have been finding myself with an incredible lack of patience for negative attitudes. After all, I've an empire to run. :wink2:

Had you been using it the whole time, or only at the very end?

Disclaimer: I'm still a month from surgery. This is all based on reading what others have noted for themselves. food tolerance is different from patient-to-patient. Some foods are in general more difficult to make tolerable to most people (for example, things that are hard to chew well enough to pass through the stoma -- grape skins are often noted, as are woody plants such as asparagus). That may lead you to exclude some items, or discover different ways to prep them. I'd consider, for example, the possibilities of using a bit of pureed asparagus as a garnish for meat. Or perhaps take the puree and dehydrate it into thin, crispy wafers.

There are a few endocrinological diseases that cause, among other things, weight gain. They screen for these so that they can determine if there's an underlying condition that must be treated first. Another way of performing this screening is a 24-hour urinalysis. I also agree with her suggestion not to watch TV so late, for the same reason.

And don't get me wrong -- I certainly don't recommend hauling out medical journals and giving the child an impromptu symposium. I've a degree in physics and symposia drive me batty. I'd much rather watch Cosmos, Nova, or some other not-tedious but not-dumbed-down synopsis. You have to gauge what the child has interest and therefore attention span for, naturally. Just don't underestimate either. Getting them involved, I'll assert, is more likely to help than annoy. At least, before puberty. :scared2:

The OP said 10 and 12.

I felt that way for a while. Eventually, after a series of positive responses from friends and family, the shame I was feeling dissapated. We pretty much all demonstrate we *can* lose weight as a condition of surgery, but what we need help with often enough is to not gorge when presented with (like most Americans) an over-abundance of food. Over the past 30 years I've grown accustomed to eating too much, and so I have not developed any talent for knowing when I've had enough. So I need medical assistance. As for your children.. I don't have any, though I'm the eldest by 8 and 14 years (I hate cloth diapers with a passion few can comprehend!). I know when I was that age that I, personally, was perfectly able to carry on an intelligent conversation about anatomy. In fact, I dare say I found the subject fascinating. Now my father wasn't the sort to try to shock, but he did me the service of not under-estimating either my intelligence or my ability to integrate new information. Whether it was kidney stones or wondering whether I'd object to a younger brother, he was up-front with me, and I think my response to that approach helped put him at ease with treating me as an apprentice he could train rather than some boy in a bubble. In some ways, I think I was a little too easy on him, but said younger brother's made up for it and then some. If you were my father, you would probably sit me down and explain the mechanics of the surgery and why you've chosen it: -- many obese people *have* tried diet and exercise.. many times; if it worked so well, why are more of us (especially children) gaining weight? -- we often don't receive, or recognize, or we just outright ignore the signal to stop eating. We're often conditioned in that response, and the environment our society has created is happy to feed that conditioning (as it were) with eating contests, the glorification of excessive weight (it's one thing to not abuse the obese, it's another to encourage that shape), candy in schools, high-fat/high-fructose/high-carb as a *staple*, we can continue on. WLS in general helps with that by making the signals come sooner and more .. dramatically. This helps us focus our efforts toward healthier food, both kind and quantity. -- they can help you. Teach them how to help you measure food, or what Vitamins you need. Tell them why you need them. (I've put my *other* brother on vitamins, and he feels the benefit already, and he's not even in need of more than a good pair of walking shoes.) Let them learn from your new example and hopefully avoid your old one. Take advantage of any latent Electra complex. :tt1: -- and how many years does your current BMI deprive you of? Okay, maybe not the way to phrase it to the 10 year old, but I estimate my surgery will give me a dozen years more to spend with my sweetie.

From over my shoulder: "I can't believe he actually had a shirt that said that. That would mean someone actually *made* a shirt that said that."

If there's a nerve ending and a way to reach it, someone somewhere will enjoy having it stimulated. Whether it's the touch they like, or the feeling of (no longer?) being in control, doesn't make any difference. That's what makes sex so much fun.

That varies from patient to patient and surgeon to surgeon. *My* process took a couple weeks to reach the initial disapproval (they lacked some records of my sleep apnea tests which were performed years earlier in a different state). Once I got around to getting copies sent to them (a delay on my part of about 4 months), I was instantly approved to enter the program in late March. The program involved a large amount of tests -- fluoroscope to check for upper GI problems, various blood tests, a urinalysis (to check for endocrinological problems that could be an underlying cause of weight problems), etc. The longest thing for me to go through was the psych exam. 10 minutes of me filling out a questionnaire, about 3 weeks of waiting for the social worker's schedule to clear up, and a 20 minute phone call to make sure I was realistic, had external support from family/friends, etc. My surgeon requires a 10 week pre-op phase of dieting and nutritional counselling, which I just completed 2 weeks of (there are 10 months post-op as well). My surgery date (30 June) was established at the start of that phase. The psych interview I mentioned was completed Friday, just after my orientation class. (The bariatric program I'm involved with is very hands-on. My surgeon founded the program 15 years ago on the condition that this approach be taken.) Overall, for *me*, the minimum amount of time that could happen would be about 2.5-3 months, and that would be if all the stars aligned. In reality, because of the missing documentation and my dalliance, it's actually been going on since October. Pre-op, I will be expected to lose between 5-10% of my excess weight, eating at least 1200 cal/day plus exercise. I've lost about 15 pounds in the past two weeks and had a minor plateau that lasted about 3 days. I'm switching to checking weight every few days to a week now that the pattern's establishing itself. Post-op, I will be eating less than 600-700 for as long as possible (I'm expecting about 300), with increased exercise. I'm actually having a hard time getting over 1200, and I'm not feeling hungry. Actually, it's dinner time and I've only had about 300 calories so far, and I'm noticing a little bit of ready-to-eat going on. I'll be having a dinner salad. Of the people who make use of this forum, and follow their surgeon's rules, most seem to be losing 1-2 pounds per week. I've seen a small handful lose much much more (order of 1 pound per day), and some lose much less. IMHO, as long as you're consistently losing, you're doing it right. As a result of losing this weight (about 120-150# from my peak of 350#), I expect to have a fair amount of loose skin. I'll be saving up to have work done to remove it. It would be nice to look like Craig Ramsay when I'm done (ModelMayhem.com - Craig C Ramsay - Model - West Hollywood, US), but that's not gonna happen. Instead, I know what parts of me looked like in college, and it'll be nice to see them again. I'll work on muscle god status seperately. If you do not follow the rules you may not lose weight, you may experience discomfort or embarassment, and you stand an increased risk of complications. Follow the rules.

Hear hear. My surgeon was quite clear on a lot of things, as was the nurse, and our guest speaker. I really liked his attitude -- it wasn't a sales pitch. I'm about to try to learn the joys of konjac-based noodles. Right. But the emergency isn't to eat *more* -- it's to be able to eat at all. If you're in a situation where you're unable to keep things down (perhaps you're enjoying the effects of demerol, as I understand from a friend's experience), the medical motivation is not about overeating. Of course, that doesn't necessarily reflect in the patient's attitude. Agreed. Unfortunately, I only have the two options if I get it through insurance. If I were to get a revision to an existing procedure it probably *would* be to a sleeve. I did see a special (hosted by Alan Alda) demonstrating a "pacemaker", but that was effective against grazing, not gorging. I actually don't know when the last burger I had was. I think it was a month ago. I can't actually remember what the mouth feel was like. Yup. Themla and Louise was supposed to be a movie, not a way of life. I used to go to interesting parties in San Francisco. Pretty much nothing shocks me these days.

I've seen at least one recent post here where someone was PO'd because he was going to have to, you know, change eating habits. That was one person, who managed to find this place. Undoubtedly there are more, finding surgeons who aren't engaged beyond collecting a few bucks. Absolutely. Absolutely. And yet it's seen as a feature. The ability to do an emergency unfill because of some illness that changes priorities (getting fluids and nutrition is always more important than weight loss) is an option I want to have. In the event I wake up and Tina Turner's saying she don't need a hero, I'm definitely unfilling (finding a doc under those conditions.. that's a different question /g/). The problems with slippage are mechanical, and I'm not convinced they are inherent in the band itself, but rather in the ability to anchor it. They've taken to using part of the stomach to do so, but I wonder what else they could use. Nothing they do, of course, will be 100% effective, if for no other reason than stitches need to be able to give before the tissue they're stitching does. .. leaks in staples. These happen. My doc's had two bypass cases where leaks happenned far out from "the day after". One was about 2 weeks after, the other was almost 2 years. Overall, as I mentioned, he sees roughly equal re-operation rates. My point, too. Oh, you have no idea what I tend to drink. I have a $200 bottle of Tokaji that I intend to nip at every year or so. I couldn't get my birth year, so I got the year of my conception (yeah, that's it). I'm the sort to nurse a drink all night. Except when I actually *do* want to get drunk. Which is maybe once or twice a year. But I am aware I'll be doing it on a mostly empty stomach. However, I won't be fast-tracking it directly to my intestines for mass absorption.

You must always be cognizant of the population over which statistics were gathered. One counter-example does not invalidate statistics. Nor even a forum full of examples. From what I can tell, many people go into WLS with expectations that it's magic, and that they can go willy-nilly at the Krispy Kreme and have perfect figures every time. Many of those same people don't have any sort of support or accountability structure. The folks here do. We know we have to change, and that it really isn't some magic wand, and I haven't even had my surgery yet. There's a strong selection bias if you try to poll any focussed group: people here are more concerned with being knowledgable about the procedure and how to succeed with it. Are more apt to confess their weight loss sins, and are more apt to repent and get back together. Those that fall off the wagon tend to fall off the forums. I finally had my orientation class yesterday (required by my bariatric program, as is the year-long nutritional counselling). We had a former bariatric patient as guest speaker, who declared that she didn't go to support group meetings anymore. Reason: sheer frustration at the number of people gloating that they ate an entire cheeseburger, and the equally large number of people whining that they had an adverse reacting attempting to do so. She, on the other hand, was eating healthily, and had lost 160#. She had the same good attitude you can associate with other successful patients here and elsewhere. With the dramatic increase in surgeries, how many patients getting the procedure are *not* following the rules? That's where the statistics are getting pulled toward. But back to the OP's question: Based on my surgeon's experience, lap band produces the least complications in the short term, but about the same rate of re-operations as bypass. It produces somewhat less weight loss, and is somewhat easier to cheat although, as he points out, the bypass can also be cheated (insert anecdote about the bypass patient feeling so proud she had worked up piece-by-piece to an entire chocolate bar). If you get the bypass, you will probably become a cheap drunk -- the alcohol goes right to the intestine, since the pylorus is no longer in the way. For this reason, if you have any alcohol issues, you *MUST* have a long, meaningful conversation with your surgeon. I would probably opt for the band in that case. Dumping, as described by the guest speaker, nurse, and surgeon, is different for everybody -- sometimes they vomit, sometimes they get diahrrea, sometimes they just have to lie down and be miserable for half an hour. The guest speaker cannot have milk for this reason. Banding has similar vomit-producing issues, but for different reasons. If you were diabetic, my surgeon would recommend a bypass. Of that I'm certain: the statistics he's gathered show a dramatically higher incidence of remission from diabetes than with the band. Still less than duodenal switch, but he doesn't perform those. (Nor will he convert a band surgery from laporascopic to open -- he doesn't feel comfortable compounding the risk of band infection with the risk of an open procedure. He will simply back out in that case unless instructions to convert to a bypass were filed.) Overall, my surgeon, is more *comfortable* with the bypass, but he's also performed about 10x as many bypasses as bands over the past 15 years. However, he doesn't exhibit any strong, long-term preference between the two for the non-diabetic case.

My impression from the bariatric program I'm enrolled in is that I'll be doing 300-700 cal/day during weight loss. As the surgeon put it, I won't be starving -- I have plenty of reserves.

In my case, my PCP had submitted everything he had -- what was missing was my fault. While he had anecdotal evidence of my apnea, he didn't have record of the actual study that had been performed years ago and in a different state. Some delayed response on my part in getting him copies of the records, he was able to amend the file. Would it be something like that?

That's unfortunate. The bariatric program I'm working through requires a self-pay enrollment into both pre-op and post-op support before they'll even schedule for surgery, and your performance (including attendence) is reported to the surgeon before he'll give the final confirmation.