BetsyB

Wow! What a tremendous loss so far!

When your doctor said, "work on self-discipline," what do you think his motivation was? Some doctors really do have unrealistic expectations of what their patients can accomplish without restriction. Others --maybe yours--have different goals. For example, he might be encouraging you to work on behaviors that will make it easier (and safer) for you once you have more restriction: things like eating very slowly, chewing very carefully, and so on. In your shoes, I'd kind of want to know what was going on in your head. I mean, if he thinks just putting a band around your stomach is going to do the trick, chances are, he's wrong. (Sure, some people only need one fill--or even NO fill--but the vast majority of us, regardless of our determination and self-discipline, require more. And that IS, after all, why we got banded!) All that said, motivation and interest aren't required in order to make the band work for you. We do all kinds of self-care things independently of motivation. We don't wait for motivation to brush our teeth, or to exercise, or to do a million other things each day. Sometimes, making things non-negotiable can be really useful. My doctor's eating plan is kind of rigid. There's leeway for personal decisions, but by and large, it's pretty formulaic. By making it non-negotiable--something I will do no matter what I feel about it on a given day---I think I've not only done myself huge favors in terms of rate of loss, but also in terms of freedom. food has taken its proper place in my life as a result. When I didn't yet have good restriction, it was hard to follow sometimes. I was hungry. But by making it non-negotiable, and telling myself it didn't matter if I was motivated or interested, it really was lots easier.

In general, my doctor is not concerned with calories. He's more concerned with way of eating; his plan does come out, with the choices I make within its context, to be around 800 calories. It could come out higher, if I made different choices. I stick in this range because I identified (by journaling over a long time before surgery) that I need to be in this range--to lose and, when I am at "normal" weight (where I have been before), to maintain. It's the reason why I got banded in the first place!

My doctor does all fills under fluoro, but fluoro doesn't guide his placement of the needle in the port. So far, he's never needed more than one stick, but my port is nicely placed and easy to locate.

Does your doctor weigh you fully clothed, like my doctor does? Ordinarily, this spurs me to go for lightweight clothes---but if you have the option, wearing a pair of jeans adds a good pound or two. Shoes add another pound or two...you get the picture.

I'm six months postop, and have lost consistently and steadily on about 800 calories/day. Some bodies need more, other bodies need less. Mine is one that needs less--it always has, which is why I was banded in the first place.

Alcohol likely won't affect you differently postop, except inasmuch as you won't be eating as much with the alcohol--and food can delay absorption. I know my tolerance is nil--but that's because I very, very rarely drink at this point. That's not really band-related--it's just what happens when you do it less

It doesn't sound like an emergency to me---I'd give my regular doc a call or, since it's the weekend, head to urgent care if I felt I really needed it.

It's totally normal. Unless you're experiencing discomfort, I wouldn't worry. A mild stool softener can't hurt, but chances are things aren't moving because your intake has been far less than before (and your bowel was cleaned out pretty well preop).

oh, Gypsy, I'm so, so sorry for your loss. How devastating. I, too, have lost a sibling; the pain is crushing. If you ever need an ear or shoulder, I'm here to talk.

I was never told that. There was a minimum amount I had to lose in order for my doctor to approve me for surgery. My insurance used the weight from my first office visit to determine BMI--none of my later weights factored in to their decision at all.

I'd start by going to an approved surgeon's informational seminar. The surgeon will have, on staff, an insurance specialist who will be able to navigate ALL of the insurance requirements for you. My insurance required a letter--and the surgeon provided it, along with all the other necessary documents. If your insurance requires something from someone else, your surgeon's office will be able to acquire that, or give you instructions to do so. So, attend a seminar (or two, or three---see which surgeon you like the best). Then let them give you the guidance they specialize in offering. Good luck!

2.6 pounds/week is my average. But it frequently comes off in smaller or larger amounts---bodies are weird.

I do like that my doctor uses fluoroscopy for all fills; it enables him to check the position of the band each time. I am not sure that I achieved restriction any quicker than I would have without. While the doctor can see how tight I am immediately, I don't know that this information provides a faster result. The less-objective method of having a patient gauge restriction by swallowing liquid is probably as effective. It took me 5 fills before I hit what I think is my sweet spot. (Time will tell; too close to the fill to be sure it won't taper off...) I do think that fluoro let my doctor be a little more aggressive with early fills. But as I toe the line, he's using progressively smaller amounts, and I don't think the feedback from the images is as valuable as it was earlier in the game. I'll have to ask him next time I'm in!

What was the date of your surgery? January 12, 2010 How healthy did you/do you eat? very healthily--before, too much, but healthy; now, the right amount and healthy :sad: How much do you exercise? every.single.day, at LEAST once How much have you lost? just shy of 70 pounds Are you happy with your results? very!

I never felt discriminated against, but I do feel as though I became invisible.

Yes, port site pain is expected--it is the most nagging of the discomforts, IMO. It does get better--and it will change over time, too, as the position of your port changes. (It doesn't really move; the muscle it's attached to seems to move lower on the body as the weight filling out your abdomen is lost.) So, you might find, just as you think you've gotten over the hump and are used to this banding thing, that you have a resurgence of pain in the area of your port. But again, it settles down

In our bodies, the liver stores carbohydrate in the form of glycogen. We draw on it when our blood sugar is too low---so it's a great mechanism to maintain homeostasis. However, too much stored glycogen causes the liver to become engorged/enlarged. The purpose of the preop diet is to deplete the liver's glycogen stores. This shrinks the liver in size, and makes it easier and safer for the surgeon to manipulate tools during banding. Carbohydrate, including sugar, is limited during the preop diet to spur the liver to release its glycogen stores. (If you don't eat the carbs/sugar, then glycogen is released by the liver to keep your blood sugar steady.) If choosing between foods, I'd opt for Splenda over sugar during the preop diet; your doctor can give you more specific guidelines about how many grams of carb to which to limit yourself, if you need them. (Mine just spelled out exactly what I could eat: 2 Protein shakes/day--with <10 g carb each---4 ounces of lean protein and 1/2 cup nonstarchy veggies each day. Plus up to 2 servings each of broth, sugar-free popsicles, and sugar-free Jello. So maybe a total of 35-50 g carb, max.)

I use Bariatric Advantage Biotin, 5 mg (1667% of the USRDA--I hope the person who posted she's getting 5000 mg meant 5000 mcg!). I also take a zinc supplement, at my doctor's recommendation. And I get close to 100 g Protein most days---and use Nioxin. Most days, I think I'm just doing these things to make myself feel better; though I've been doing all since before surgery (except using Nioxin; I saved that until I was starting to see some loss), the loss has still occurred. I think it's just one of those things--the hair growth cycle is knocked out of whack by trauma.

It may or may not be too low in calories--we have no way to assess that; everyone's different. I've consistently eaten 800-ish calories/day, have lost almost 70 pounds, and have not yet had a lasting plateau. I have more than enough energy to exercise vigorously at least once, and most of the time twice, a day (which, in addition to my Protein intake, ensures that I am losing fat, not muscle.) My body requires that level of intake in order to lose; it's the reason I was banded. I am grateful my doctor was able to see this--it led me to the tool I needed! (There is little peer-reviewed research to back the popular "starvation mode" theory.) That said, if the nutritionist said "no carbs," I'd want a great deal more explanation from her. My doctor's regimen is low-carb & high protein. As I mentioned, it's in the 800 calorie range--though he doesn't emphasize calories. (It's just what it turns out to be when I eat that way.) I do eat carbs---from legumes, vegetables, and fruits. I will add whole grains back in when I reach 75% of excess weight lost. But most days, my net carbs are less than 50 grams--which is pretty darn low. It's been very liveable for me. Stomach space is at a premium once restriction is achieved, so making good choices in terms of food quality (lean Proteins, veggies, fruits, Beans, heart-healthy fats) is lots easier. Before restriction, it took a good deal more willpower (and hunger!)---but it was still liveable; the results made it worthwhile for me. Still, I'd want clarification from the nutritionist. Did she mean no refined carbs? That's not bad advice, most days (though there's always room, in any lifestyle, for treats and exceptions). If she meant no fruits, veggies, or legumes? That'd be a problem for me. Off on a tangent a bit, but it's important for you to remember that your body is different from every other body on this planet. Mine really responds well to low carbs--I feel better without the grains (but I've long suspected intolerances). Your body may be totally different. Most people don't find that the source of their calories (carb, fat, protein) makes a huge difference; if their calorie intake is in the right range, they lose no matter what. I can't; it's just the way it is. But once your band is doing its job (once you have restriction), I think you can feel pretty free to see what works for YOU. If you journal for a while, you'll begin to see patterns that are helpful for you. If you find that more carbs work for you, then add 'em in! If not, don't. My point is this: your doctor's/nutritionist's recommendations are made based on what they've observed to be useful for the majority of their patients. If you find it doesn't work for you, find a way to tweak them so that your needs are met. If your doctor's nutritionist is rigid and can't help you do that, there are others who can. Just make sure you meet your body's basic nutrient needs---that's what is most important. Well, that was rambly and incoherent! (Did I mention my doctor also vetoes caffeine LOL?! Clearly, I need it this morning.)

It's weird. The band was exactly the tool I needed to put food in its proper perspective in my life. People say, "It's surgery on your stomach, not your head," but it was as if I got a brain transplant at the same time. I enjoy food still--but it simply is not the centerpiece of my life. Something was switched off when I was in that operating room. Maybe I wasn't as disordered as I'd been told--maybe I really was just HUNGRY, like I thought! (I have a ridiculously slow metabolism and need to eat very few calories; being satisfied doing so is MIRACULOUS to me.) Everyone is different--I'm glad you found what clicked for you. It's always wonderful when we find our ways to success :thumbup:

Your insurance policy is what you need to focus on. If you don't meet their requirements, then ...you don't meet their requirements. A doctor's office can only do so much, in terms of "creating" comorbidity. Joint pain and psychological effects of obesity are not among those covered by my insurance. The place to focus your attention is your HR department. They have the ability to request changes in the policies they offer employees. You may have to wait until they are next negotiating contracts to get approved--but between now and then, you can make a lot of noise so that they DO make this request. Fact is, with a BMI of 47, comorbidity will ultimately cost your employer health dollars. You can make a strong argument for them to change their requirements. (It's their decision; they chose the coverage based on $$--they thought it would be cheaper to restrict bariatric surgery; you need to convince them that in the long run, it's not.) Failing that, is there another health plan they offer? We have the choice of a handful---and have a window, each year, during which we can switch. If so, read ALL the policies to find which is most favorable to you, in terms of approval for the surgery you want.