Spartan

Everything you have described would suggest a Slip....those are some of the classic signs. An erosion would not be out of the question either, but it is VERY important to have it checked out. Regardless of what it MIGHT be, NONE of what you are describing could be considered normal. I would insist that your Doctor check it out, in person. DO insist on an Xray. S.

Ziggledog; What you are experiencing is pretty normal. Especially when you consider that there is not much "normal" about ANYONE'S Lap band experience. Everyone has a different band experience. You are only two months out, and you don't have much Fluid in your Band yet. You have a ways to go before you should expect to see much in the way of progress. Some would say that you are also still in the Healing part of your experience, not even 60 days out. In the few days post-surgery, the restriction you were feeling was most likely a result of swelling, and had little to do with the fluid contained in the Band, if there was any inserted at surgery. So, you are really doing just fine. You just need to give it time. You will no doubt have some additional fills before you begin seeing the band work as you had hoped. I would suggest that even though you CAN eat more than you know you should...don't. You need to begin eating as though you had the restriction you want. This will make it much easier for the time that you DO have the proper restriction. Again, be aware that this is a VERY individual process. Just because someone else was able to achieve a specific weight loss in a certain period of time does NOT mean that this is what YOU should accomplish. There are people who go for many months with little or no weight loss until they are able to hit what is known as the "sweet spot", and then the weight loss begins. Just hang in there, you will do just fine. S.

I, for one, am really angry that you were not given any instructions on these issues. Having the band can be hard enough without having any idea of what to do post-surgery. Doctors who do not provide their patients with instructions should NOT be practicing. You would be doing the LB Community a service by naming your Doctor. While it is true that the opinions of Doctors vary significantly on the issue of post-op behavior, you will find even MORE disagreement among people here on this forum, and elsewhere. Look at the handful of responses on this thread alone, on the issue of drinking before/during/after meals. Several different opinions. I think you would be very well served to find a local support group in your area that is sponsored by a Bariatric Surgeon. MOST Bariatric facilities have post-surgery support groups, and you might be able to join in even though you did not have surgery at that facility. You could also obtain a copy of that facility's post op instructions, and apply them to your situation. If you are able to, you might also consider seeing another Bariatric Doctor. In my opinion, EVERY bariatric surgery should include (as part of the package) a comprehensive post-surgery support system, including follow-ups, support groups, detailed instructions, etc. Bariatric Surgery is not like having your Appendix removed, where you have the surgery, and you are done with it. It is actually just the beginning of a long and sometimes difficult process, with many hurdles and potential setbacks. You NEED the support, and you NEED advice from professionals who are experienced in getting good results from the Lap Band. To all potential Lap Band patients, I would strongly suggest that before you engage a Lap Band surgeon, you really need to check out the quality of the post-care and support that you will receive. Talk to other Patients, find out their experiences, ask about the support they received. A fancy “Seminar” (sales presentation) does NOT always tell you what the aftermath of the Surgery will be like. You need to do some research before you commit. To the OP: DO find a local support group, and another Doctor, if you can. While the online info is good (sometimes), the conflicting information can have you going in a dozen different directions. S.

I do not know Dr. Liu, however a very well-placed associate of mine has suggested, professionally, that his (Dr. Liu's) Lap Band placements are not among the best. He has repaired a number of Dr Liu's "jobs". Again...I have no connection to, and have never met Dr. Liu, but I am providing this information merely for the consideration of potential patients. S.

Pretty much any time, I would think. I think it will be great for you to get, along with your new, slim body, some wonderful prematurely aged Skin and wrinkles, along with a nice dose of Skin Cancer. Isn't life wonderful, where we get to make all of these really lousy decisions for ourselves? S.

Good! That is what we like to hear. There will always be those dark days, those times when you feel like you cannot go on. But they always pass....you must have had them before, and things have always improved, right? You really HAVE done very, very well, and you should be proud of yourself and your accomplishment. But, if those doubts surface again....just look at your screen name, and you will find the inspiration to continue. "Mom2girls"....our kids are the BEST reason for doing this. You need to be strong and healthy for THEM,...and for yourself. Keep it up, Mom...you're almost there...:thumbup: S.

Lynn; I cannot speak to the particulars of the AU system, but if the question is whether or not you SHOULD have coverage in the event that something goes wrong, well, I think you should. Slippage and erosion are becoming more common, and they can be expensive to have treated. $105 a month is a lot for the extended coverage, true. I hope that there is provision for something like this in Public component of your Health Care System. S.

My Dear, don't even THINK about giving up this close to your goal. You have done so incredibly well. The reality is that a lot of bandsters find those last handful of pounds can be very diffcult to shed, and you may need to make some adjustments in your eating, and perhaps in your band as well. Of course, I do not know anything about the particulars of your situation, but I have observed that Many people who have the Lap Band placed will continue eating pretty much the same things they did pre-band....only less of it. This creates a problem when you get down to the last 20 or 30 percent of your weight loss goal. You will find that the QUALITY of what you are eating becomes much more important at this stage. You should examine WHAT you are eating now, and make some changes in that area. I think you are very wise in seeing your Doctor. I am certain that you will find a reasonably simple solution to this. But DON'T give up on your goal! You've come this far....and you CAN meet or exceed your expectations! I'll be watching you......:thumbup: S.

That is Criminal. Absolutley Criminal. Do they put you up in a Spa in Beverly Hills for that? Jeez. You should consider yourself lucky to have been rejected by that Doctor. I would not have a Surgeon that focused on money perform my Surgery. You would be doing this community a service by naming this Doctor so that other will not waste their time. I can understand a small co-pay or service fee, but that amount is outrageous. S.

What you are describing is absolutely criminal, in my opinion. Some of these greedy, robber-baron doctors that charge an “administrative fee” or “program fee” should be taken out and shot. After torture. With regard to the Medications, you can, in fact, ask your Doctor for samples. However, I think in this case that you might not have any luck. This sounds like the kind of Doctor that will do anything to make a buck. As far as the Emend, its manufacturer, Merck, is pretty good about things like this, and they have a program in place to assist people on fixed incomes and disability, It is possible that you can obtain the medication at no charge from them. Here is the link to their program: http://www.emend.com/aprepitant/emend/consumer/assistance/apply_for_assistance.jsp It is generally for people who do not have insurance, but the do assist people who have insurance as well. Although you can receive an antiemetic via IV, if you are someone prone to nausea, you might want to have something on hand post-op in the event that you need it. Also, with regard to the Vitamins, some of the larger Vitamin manufacturers have similar programs in place as well. The bariatric vitamin companies are not particularly generous with their products, but I am familiar with a couple of cases where patients have been given supplies of Vitamins when they have demonstrated a need, and have limited resources. I am vehemently opposed to Doctors charging these outrageous extortion fees in ADDITION to what they get paid by the insurance companies. Personally, I would not trust a Doctor like this to perform my surgery. You would be doing the members of this community a service by naming this particular Doctor. Good luck in your process; I hope that the rest of it goes smoother! S.

I have to give Abracadabra a LOT of credit. Until today, I have only seen two people on this forum who ever really understood the bypass, and I’m one of them! Abracadabra seems to “get” it. I always appreciate posts by people who are happy with what they have decided, but do not feel the need to bash other procedures. The RNY is a very viable procedure that has been successfully performed for over 50 years. If the patient is compliant, and the surgeon is competent, the outcome can be quite easily predicted….much more so than the band, in fact. I’m going paste a post I made here a few months ago that sums up my feelings on the Bypass, and answers most of the usual incorrect information posted by people who really do not understand the procedure: Here it is: The Band vs Bypass debate rears it’s ugly (and misunderstood) head once again. Loads of baloney from all sides. So, here are a few comments on things that have been said on this thread. And, if someone suggests that I have a Bypass Bias of some sort…that would be incorrect. Both Surgeries are quite viable, but they are meant for different classes of people. People just love to “defend” their own surgery, which is detrimental to other people who are still trying to make the decision as to what is right for them. “The Lap-band®® is less invasive than gastric bypass surgery.” This quote is right out of a LAP-BAND® brochure. This seems to be one of a couple of phrases that are continually regurgitated whenever the subject of Band vs. Bypass comes up. The Procedure is DIFFERENT. But this whole concept of “invasion” is pretty absurd. It is NO different than many other surgeries and procedures that are performed to correct a deficiency or malfunction in some area. We have appendixes removed, gall Bladders removed, Heart bypass surgeries, and on and on and on….we have TONS of plastic surgeries. I find it amusing that so many of the people who chose LAP-BAND® over Bypass because it’s “less invasive” are planning to have tummy tucks, facelifts….whole big pieces of skin (an organ) removed. Plastic surgery probably carries as much if not MORE risk than a GB. Not to mention all of the piercings and tattoos we have and don’t even think twice about. But a gastric Bypass? An effective surgery that has been successfully performed for nearly half a century and has benefitted hundreds of thousands of patients? Hell no! it’s too…”invasive”….funny stuff. “Gastric bypass is physically altering your stomach forever.” The old “irreversible” argument…..wrong again. It is, in fact, reversible. It is not something that is done very often, because it does not NEED to be performed very often. The vast majority of Gastric Bypass patients have their surgery, lose the weight they need, and continue on to live happy, productive, and HEALTHY lives. You hear of some adverse outcomes, but in virtually EVERY case, the problems occur as a result of patient non-compliance or Surgeon inexperience or incompetence. But the notion that the bypass is irreversible is NOT true. Doctors do not “advertise” the fact that it is reversible, because they do not want patients to consider it to be a temporary procedure. But it can be reversed. It’s not all that easy, but it is performed quite regularly on those who need it….which is not a lot of people. “Gastric bypass surgery does cause you to lose more rapidly, increasing the chance of hanging loose skin... yeah I'd love to have all my weight melt off in a few months, but the idea of looking like the saggy-baggy elephant afterwards... not so appealing.” Again…not the case in most circumstances. In many instances it depends on how much weight you have to lose. If you have 150 pounds to lose, you are going to have saggy skin regardless of what procedure you have. And, even THAT is dependant upon some very individual circumstances, such are your age, skin elasticity, etc. Also….if this element is of great concern, you do not HAVE to lose weight quickly post-bypass. You do have a LOT control over your weight loss. “You CAN eat sugar with gastric bypass, I work with 2 people that have had it done in the past 6 months.” This is one area where you are partially correct. I have watched this argument come and go for years on this (and other) forums. The facts are that a percentage of GB patients do experience a reaction to certain types of high-fat and sugary foods. It is what is called the “dumping syndrome”. As is the case with virtually all WLS procedures, there are no solid stats, but experienced surgeons will tell you that Dumping occurs in roughly 15 to 30 percent of GB patients. If they consume enough concentrated sugar (and in some cases that would be an astronomical amount), ALL GB patients will experience it because of the inherent mechanism by which the GB functions. And, the severity of the Dumping varies dramatically. For some patients, it is a mildly uncomfortable sensation. For others, it is more severe. MOST people who experience dumping are grateful for it. “Even for those that get dumping syndrome, though, it goes away within two years. So, eventually, all sugar addicts have to deal w/moderating sugar (without the help of dumping).” Not necessarily. For SOME patients, it diminishes somewhat over time, but in virtually ALL cases where dumping was present to begin with, it does continue, but, again, it CAN diminish somewhat. “Bypass is a great surgery for some people. But it causes significant lifelong malabsorption of nutrients--which is something we are thankfully spared.” Some nutrients are not absorbed properly post bypass. That IS one of the mechanisms of the procedure. But…..much of the BAD stuff is not absorbed as well. That is why it works. The solution to this problem is quite simple: Take your Vitamins. Period. If you take your supplements, there will almost NEVER be nutritional deficiencies. And please note: You need to take Supplements post-LAP-BAND® as well. The NEED to take Supplements post Band Surgery is not quite as critical as it Post GB, but you still need to. For most GB Patients, the Supplements are a non-issue. They take them and they are just fine. No Problem. Again: Patient Compliance is key. A few Vitamins a day is a small price to pay for the benefits offered by a GB. “And once the initial honeymoon period, the rate of weight loss success generally equalizes with ours---at a far greater lifestyle and health cost, IMO.” Wrong again. The LAP-BAND® faction of the WLS industry loves to toss this one out with great regularity, but as presented here, it is quite incorrect. Of course, as I have stated before, there are NO solid, quantifiable research statistics on this, but most experienced, long-term Bariatric Surgeons (and not the batch of surgical clowns that have jumped on board the LAP-BAND® Gravy Train in the last few years) will tell you that the vast majority (around 85-90% by some estimations) of GB patients take the weight off, and KEEP it off, given some minor, normal weight fluctuation as age increases and time passes. “From what I've observed, dumping makes stuck look like a walk in the park.” Most GB patients would disagree with that, particularly those who have experienced both. Dumping is usually a mild to medium discomfort, and NOT the gut-blasting makes-you-wanna-shove-your-fist-down-your-throat-and-rip-out-your-esophagus experience that characterizes the LAP-BAND® “stuck” experience. SOME Dumping episodes can be difficult, but to suggest that Dumping “makes stuck look like a walk in the park” is ludicrous, at best. “Don't bypass folk get food stuck from time to time? My PCP had bypass and we were talking about getting food stuck. He spoke of some incidents he'd had with chicken.” CocoaBean, that is partly correct. What a lot of people are unaware of about the GB is that restriction is ALSO a component of this procedure. Malabsorption is the primary and fundamental mechanism that makes the GB work, but on very, very rare occasions, you can get “stuck”. MOST commonly, this occurs in the presence of a “stricture”, where the channel leading into the stoma is not wide enough, and eating without chewing properly can lead to a LAP-BAND®-like “stuck” feeling. It does not happen very often, and the stricture can be very easily corrected. However….many patients do not WANT it to be corrected….it provides another level of “forced compliance”, kind of along the lines of the LAP-BAND®. It does not happen often, but it is one of the things that CAN occur….but again, it is quite easily corrected, in a few minutes, actually. And yes, Chicken…..evil stuff…. J. Also the nature of the “sticking” is different. With the LAP-BAND®, almost anything can get stuck, it seems. And things get stuck on one day and not another. With the Bypass, the experience is very consistent, in the rare event that it does happen. And it is ALWAYS because you haven’t chewed properly or it is something you just should not have eaten. “I registered to the site just so I could post on this thread. I just wanted to point out that my best friend had a gastric bypass 6 years ago. One of the first things she ate post-op was a slurpee. (full of sugar) To this day, she has no issues eating sugar or candy. She only got dumping at the VERY beginning. Also, she is always getting food "stuck" and trying to either get it to come back up or go down. One of the very reasons I am not a big proponent of gastric bypass is having watched her and others who have gone through one. She doesn't eat right, and im worried for her in the long term as far as nutrients and vitamins are concerned. She lost a lot of weight, yes, and she's very happy and consideres it the best decision she's ever made. Im happy for her, but I just wanted to point out that she can eat sugar and gets things stuck.................. “ With all due respect, you have a very Stupid friend. Ultimately, it is likely that her Bypass will fail. PATIENT COMPLIANCE is KEY, with the band AND the Bypass….and the Sleeve, DS, FP, and all the other more obscure procedures. And from day one, she broke the rules. But guess what: The band wouldn’t work for her either. She would have the SAME problems, and would not have lost any weight, because of the ease with which one can eat “around” the band. For some people, NO Surgery will work long-term. Your friend needs the kind of help that no surgery offers. This whole debate over which procedure is better is pretty useless. The simple fact is that one of the procedures is better for someone than another. They are different procedures that work in different ways. One is Malabsorptive in nature, with some restriction; the other is almost entirely restriction. They are meant for DIFFERENT people with DIFFERENT eating and/or metabolic disorders. There is a certain segment of the obese population for which either one WOULD work reasonably well….But….ONE of them would be better. It is not a matter of simply picking the one that appeals to you….at least not if you want REAL success. It takes an experienced and skilled bariatric specialist to be able to help you sort out which one would be the most successful for you. There are a number of things that make the GB a preferable surgery for many people. It’s been around a LONG time, nearly 50 years. The procedure has been refined over and over. The advent of Laparoscopic technology in the last decade has made the procedure incredibly safe. As one very experienced Bariatric Surgeon said: “If the Patient is reasonably compliant, then we can predict pretty much exactly what is going to happen…the surgery is that reliable”. Finally, to the Original poster I would have this to say. It is difficult to know from what you have said if the Bypass would have been a better procedure for you. A “sweet tooth” is not always a specific indicator of the need for a GB, but it is a “clue”. I think that at this point in time, it would be wise for you to work with what you HAVE, rather than spend any time thinking about what you “should” have done. “Buyers remorse” is very, very common among WLS patients in the first couple of months post-op. Regardless of the surgery, most Patients will end up saying to themselves “what have I done to my body?” at some point. But, that will pass. It almost always does. Many people have a rocky start with the LAP-BAND®. One person on this board, Erin18, I believe, had a LOT of problems at the beginning. She was quite the topic of conversation here last year because she was posting every day, if not several times a day, complaining about the difficulty she was having. But, she has gone on to lose quite a bit weight. She is one example of people who had a lot of problems initially but went on to some success. If you do not find success with the LAP-BAND®, there are the other options. But you absolutely have to give the LAP-BAND® every chance to work. It sometimes takes a LONG time to find that “zone” where it starts working. Some people never do, but you have to give it your best shot before you start thinking about alternative procedures. It IS “doable”. It just takes time, effort, commitment….and COMPLIANCE. S.

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I sometimes wonder why some people even BOTHER to get a Lap Band or any other kind of WLS. I also sometimes think that the Lap Band constricts the flow of blood to the brain in some people. I am quite amazed at the number of people here that advocate doing it their “own” way, and ignoring the instructions that were given to them by the Surgeon, and their team. And the only thing worse than not following the specified protocols is BRAGGING about the fact that you haven’t. By doing so, you are encouraging others to follow in your not-so-smart footsteps. So…. when you get a prescription from a Doctor, do you ignore the instructions and just dump the whole bottle down your pie-hole…because that’s what you WANT to do? I’m thinking you probably don’t. So, why would you ignore the instructions given after a very expensive and potentially life-changing surgery? The rules are important, and it doesn’t make any difference whether you or anyone else thinks they are or aren’t. The only one whose opinion matters is the person who PUT YOUR LAP BAND IN. Period. And if you choose to ignore the instructions, then you deserve what you get. And most often, what you “get” is problems with your band and less-than-hoped for weight loss. So what if the instructions vary between Surgeons. Their installation techniques vary as well. Some place it a little higher, others a little lower. They suture it in differently. They angle it differently. They have their OWN METHODOLOGIES for performing the surgery. And, if they are good at what they do, they have their own, specific post-op protocols that have been developed to ensure YOUR SUCCESS. AND THEIRS. Good surgeons have a vested interest in you being successful at this. They want you to succeed, if only for the reason that it makes them look good, and will potentially bring them more business. IF you have selected a GOOD Surgeon who has a proven track record of success with Lap Band patients, there is no reason NOT to follow his/her direction. One REAL problem in the weight loss surgery industry is that there are a lot of clowns who have jumped on board the WLS gravy train to take advantage of all of the insurance money that is being thrown this way. They are not experienced, they don’t have a track record, they don’t keep good records, they don’t follow up, etc. And this is just one more reason that you need to put some serious effort into finding the right Surgeon to place YOUR lap band. There are doctors that give lousy instructions. There are Doctors that give NO instruction at all. But….there are plenty of very good Doctors out there, and if you take the time to look for them, you WILL find them. And it will be in your best interests to FOLLOW THEIR INSTRUCTIONS. I have long been an advocate of following the Surgeon’s instructions to the LETTER. And it’s funny to see some of the people who have disagreed with me on this issue are NOW recommending that you DO follow the instructions. Funny stuff…talk about sheep….. So…you think you know better than your surgeon? Well, think about this: You became FAT by following your OWN rules. It’s time to sit down, shut up, and follow the rules of a Medical Professional who has experience in helping people with this problem. Your way DIDN’T WORK. And chances are that your fellow lapbander who thinks that Spaghetti-o’s, Frappucinos, and berry Parfaits are “good ideas” is not going to be of much use to you, either. People can blather on all they want about this being “Their Journey” and how They “know their own body”, and all sorts of garbage like that, but the simple fact is your “journey” thus far has been a failure, with regard to weight loss. Your “journey” has brought you to the point where you need a silicone noose wrapped around your stomach to keep you from shoveling down so much food. The decisions you have made regarding your consumption of food thus far have been, at best, faulty. It’s time for someone ELSE to begin making those decisions for you, and if you don’t “get” that, you will very likely have a long, ugly “journey” ahead of you. As human beings, we are imperfect by nature. We make mistakes. We make bad choices. And one of the most valuable lessons we can learn is when to step outside of ourselves, and let someone else HELP US MAKE GOOD CHOICES. Another part of this that isn’t discussed much: There are a number of people on this board who are self-pay. They can do what they want with their money, I don’t really care. BUT…if you are someone whose insurance is paying for your surgery, and you choose to disobey the rules laid out by your surgeon, well,….I have a big problem with you, and potential Lap Band patients should as well. Insurance companies are tightening up with their money for Bariatric surgeries. They do not approve the procedures as readily as they did a year or two ago, and a part of the reason is the increasing incidence of failures: Increasing Erosion, Slippage, and the inability of the band to effect the desired weight loss in many people is causing the insurance industry to re-think the way it allocates funds for these surgeries. And part of this reevaluation is because of the nitwits that decide that they know better than their Doctor how to behave post-surgery. They eat what they want, when they want, and how they want, and then whine about how they’ve only lost a third of the weight they need to lose, or their band slips. YOUR failure has the potential to impact the chances of other people to have their band paid for by insurance. So, if you are not going to play by the rules laid out by your surgeon, you need to stand aside, and let someone who WILL cooperate get their band, and be successful with it. Every Lap band success means that there is a better chance that insurance will continue to pay for this procedure. Every failure diminishes that chance. Here’s the bottom line, as I see it: Follow your Surgeon’s instruction TO THE LETTER. If you do not see significant results in six months to a year, then consider making some changes. BUT….Consult your surgeon first. If you don’t feel like you are getting the answers you need (and that means NEED, not WANT), then consult another doctor. You are not married to your Surgeon. If you feel you have made a mistake in who you chose to perform your surgery, then look elsewhere. Get professional advice. SOME people have been able to be successful with the Lap band by doing it their OWN way. But they are the exception, rather than the rule. You need to do it your Surgeon's way first, and if you are not successful, THEN try something different. You’ve been doing this on your own for your entire life, and the result has been that you are fat and unhealthy. You need to put someone else in the driver’s seat, and for the first year or so, that person needs to be your Surgeon, or someone qualified on his/her team. And just because someone else on this forum has been successful THUS FAR by creating their own rules does NOT mean YOU will be. It only means that they have been lucky. Period. The Cat ain’t so savvy, sorry to say….. S. "Human beings, who are almost unique in having the ability to learn from the experience of others, are also remarkable for their apparent disinclination to do so." - Douglas Adams

Uh....being that HE is the Doctor....I'm thinking that...um.....HE might have the resources to find out that information? If he doesn't, I'm not sure i would want him sticking a needle in me..... just sayin'...... S.

Sue; Have you considered a sleeve? Because you have had one slip, the odds are pretty good that you will have another one...depending upon a number variables, of course, but it might happen again. If you have to put out that much money, well...I would consider a more permanent (and in some people's opinions, better) option. S.

It's the Ice Cream that draws us, and the Fish pic that keeps us here. :confused: Seriously, Chief....that is a MONSTER trout. We don't get those beasts here in Southern California. I go up to Lake Tahoe every year for some R&R and fishing, and on occasion something like that (but not NEARLY as big) will land on my hook....I fish regularly here in SoCal, and Mammoth lakes, and I've been fishing all over the world....looks like NT has to be a stop for me at some point....!!! S.

It's not "better". It is better for SOME People. It is DIFFERENT than the sleeve. But NO Weight Loss Surgery is "better" than any other for everyone. S.

I think the better question here would be: WHY are you eating chicken McNuggets??? I don't think that there is a Surgeon/Doctor/Nutritionist on the planet that would sat that is a GOOD choice....ice tea or not. S.

An interesting variety of responses. And the answer actually covers a wide variety of issues. I do, of course, have an opinion. Anyway you look at it, it was a bad choice. Those of you who say that this is a “healing period” may be correct….But, it is NOT a “bad choice” period. Eating this kind of stuff should have ended during the pre-op diet. I am a believer in the concept that the little choices that we make on a daily or even hourly basis can have a profound impact on the long-term efficacy of ANY Weight Loss Surgery. It may be true that the OP lives in an area that has a limited selection food-wise, but if there is a McDonalds, then there MUST be a 7-Eleven or supermarket or someplace where you could have picked up a little container of Apple Sauce or pre-made protein shake or something like that. I know that old habits die hard; for most obese people, a normal response would be exactly would the OP did….pull into a fast-food joint and grab whatever I could. But life is different now. You have to-retrain yourself, get rid of the old responses, and create a new, healthier mindset. Now, this issue of whether people are being “supportive” or not is a little confusing. Some of the people here seem to think that “supportive” means saying “forget about it, it’s fine”. I think being supportive means acknowledging that a mistake WAS made, and encouraging the OP to avoid doing it again. The OP asked if it was a “big no-no”….and yes, it IS a big no-no. It is a reality that should be acknowledged. Anything else is enabling negative behavior. I also have to take issue with those who say that it is ok to “have a treat” every once in a while. That MAY work for some people. But a significant percentage of the obese population has an addiction to various types of foods, and they need to avoid those kinds of food at ALL costs. Otherwise, you just perpetuate the addiction. I am quite certain that if you had a friend who was an alcoholic, you wouldn’t offer them a Martini as a “treat” because they had been sober for a few months. It’s the same thing. As obese people, we do not have the “luxury” of abstaining from our addictive substance. We have to continue eating to live. BUT….we DO have power over WHAT we eat. The Lap Band helps us with how much of it we consume; But not WHAT we consume. That is entirely OUR choice. As far as “feeling guilty”…..well….you ARE guilty of making a bad choice. So why not FEEL that, move on, and avoid doing the same thing in the future. There is NOTHING wrong with feeling guilty about something if you are, indeed, GUILTY. It’s not a crime you have committed; it’s merely a lapse in judgment. Feeling guilty about something we do is one of the mechanisms available to us to help keep us from doing the same thing again. If you DIDN’T feel guilty about it, I would suggest that perhaps you had a bigger problem. But you do, and that is a good thing. So, embrace the guilt, and move on. If you do live in an area where the food choices are limited, then you would be well served by stocking up on foods that you can take with you and use as needed, such as ready-made shakes, protein bars, etc, so that you will never be at the mercy of McDonalds again. Or Wendy’s. Or Jack in the Box. Recognizing when you have done something counterproductive and resolving to avoid that kind of behavior in the future is NEVER a bad thing, and feeling a little guilty about it is really a good thing, and will help you stick to the program. By the way: Nice fish, man. What is it, how much did it weigh? You live in a nice place. S.

Based upon the description you have given, no, there should NOT be any immediate Health concern in this situation. As far as what the problem might be, specifically, and what caused it, that is a little more difficult to ascertain. There are several things that could cause what you have described. Your surgeon will be able to tell very quickly what the problem is, and how it occurred. As far as the other issues, that brings you into the very murky world of insurance, and what they will or will not pay for. I do think that in this case, the insurance will not pay for a repair/replacement, because they did not pay for the original fitting. If it can be demonstrated that it is the fault of the device itself, then you MIGHT be able to recoup your expenses from the Manufacturer… I have seen that happen, but again, it is unlikely, considering that it has been 3 years. Because you were a self-pay, it is POSSIBLE that the surgeon might replace it, but that is dependant upon what was in your original surgical contract,…..MOST people do not read those, and they would be amazed to see how well the hospitals and surgeons have protected themselves in this regard. As far as seeing an Attorney, I would wait on that a bit, and see what your insurance company and your surgeon have to say about it. You might have several entities to deal with in this (Surgeon, insurance, Band Manufacturer, hospital) and one of them might offer you an acceptable solution outside of involving the courts. I am a very strong advocate of following your Surgeon’s pre and post-op protocol TO THE LETTER. And the situation that you are describing is one of the two primary reasons. In the event that you become involved in post-surgery litigation with ANY of the involved entities, you will need to demonstrate that you have followed the Surgeon’s instructions EXACTLY….otherwise, your case will likely be thrown out the door. If the Surgeon says in his/her instructions that you need to be consuming Mushies ONLY for two weeks post-op and you make a Domino’s Run after three days, the Defending entity can make an effective case that what you did undermined the integrity and functionality of the band mechanism, and that can damage your claim. So, patients need to do as their surgeon instructs. NOTE: I am not suggesting that this is the case in the situation we are discussing….I am using this only to emphasize the importance for ALL Lap Band recipients to follow their surgeons instruction to the LETTER. Please let us know what happened, when you find out. I will be very interested in knowing if you are able to get any of the involved parties to pay for whatever repair/replacement is required. S.

KarmaandKismet; You are very wise to consider this. Personally, I feel that counseling and ongoing therapy should be a REQUIREMENT for anyone who undergoes Weight Loss Surgery of any kind, and I am kind of surprised that insurance companies do not make this a KEY part of the process, other than the initial Psych consultation. I believe that it is a KEY component of success in this area. SO MUCH of the obesity enigma is that it is a “mind game”. The Lap Band and the other forms of WLS can very effectively deal with the Physical component of Obesity, BUT unless the “mind’ component is dealt with, a very large percentage of WLS patients will not be as successful as they would like to be. It is known that a certain percentage of Gastric Bypass patients will put the weight back on within a few years of losing it. This is not a result of any deficiency in the surgical mechanism, but it is a direct result of the “mind component” of weight loss not being addressed properly, or even addressed at ALL in so many cases. It is also known that in the case of the Lap Band, a large percentage of Patients never reach their intended goal, and, again, it is because (in many cases) the psychological and emotional issues that brought the patient to the point of needing surgery have never been addressed. So, yes…you ABSOLUTELY need to make Psychotherapy an integral part of your Weight Loss Surgery experience. In answer to your question about Therapists who specialize in Weight Issues, yes, there ARE those who maintain a Specialty Practice in that field. You need to hunt for them a bit, and I should warn you that MOST Psychotherapists will say that they deal with weight issues, but the fact is that most of them do not deal with it as a SPECIALTY. And, you really do want someone who is a specialist in this, someone who has been doing it for a number of years as a primary practice. Sometimes you will see them in the yellow pages, but as is most often the case, the BEST practitioners do NOT have to advertise. It is very possible that you can get a referral from your Surgeon’s office; they very often have good links to Professionals in this field. Also, if you contact your local chapter of Overeaters Anonymous, they often can refer you to Professionals as well. Again, I have to emphasize the importance of finding someone who is very well experienced and trained in Bariatric Psychology as a SPECIALTY, and not merely an incidental part of their practice. I think if you ask most Psychotherapists if they treat people with Obesity issues, they will all say yes. But, the vast majority of them will only have a couple of patients for whom it is a defining issue, and their experience in treating this problem is not very deep. So, take the time to find someone who really IS an expert in this….you will be well-served by having this kind of professional on your Team. Good Luck with your Surgery, and please keep everyone posted on how you are progressing! S.

It is very, very individual, but many people will, in fact, feel very weak and fatigued in the beginning. Much of it has to do with how much you are used to consuming. If you drop down to 1000 calories overnight, you will very likely feel some significant fatigue, but I'll assume that you will be on a pre-op diet of some kind and will have adjusted to a lower intake by the time of surgery. As far as what the "Band Rules" are, they are pretty much whatever your Doctor says they are. There is a LOT of variation among Doctors when it comes to post-op instructions, and there is a LOT of information and advice out here on the 'net. BUT.....IF you have done your research and selected an experienced Bariatric Surgeon who has a good team with him/her, then you should probably follow their instructions TO THE LETTER, at least for the first few months. A GOOD Bariatric Team will keep track of their patients, and be aware of what works and what does NOT work. They will have hundreds, perhaps thousands of patients that have gone before you, and they will have a very well-defined and tested protocol in place for you to follow. You might need to make adjustments along the way, but you do need to follow the Surgeon's instructions quite closely for the first few months. S.

No, you should not tip them. The Patient Informational Management Professionals or "PIMP" make a nice, fat commssion from your money, and they don't need a nickel more from you. S.

Scott; What you are experiencing is not all that unusual. And if it is working, I wouldn’t spend too much time trying to analyze it. There are people who go through their entire Band experience without ever having a fill, and they are able to lose the weight they need to lose. Others seem to need fills quite continually, and even when the band has reached capacity, it doesn’t seem to be enough. Most peoples experience falls somewhere in the middle. One of the interesting parts of the Band experience is how totally individual it is. Everyone seems to have a unique experience in one way or another. Even though there are several different types and sizes of Bands, they are very close in specification. But the range of diversity in the human body is huge. Measurements vary dramatically between people, thus the performance of the Band is going to vary dramatically as well. And the way the Surgeon places it is going to have an impact, too. My point is that even though it might seem strange that you are doing well with no fills, the fact is that simply having the band in place might be all that you need. It DOES work this way for some people. The time might come when you DO, in fact, need a fill….but there is no need to have one if you don’t absolutely have to. And, thus far, it doesn’t sound like you do. So if you can get by with no fills, just enjoy it. No needles, no co-pays, no trips to your Doctor…..Enjoy it while you can! S.

Meandtheboys; I’m sorry you had to experience this so soon after getting your Band. However, you have a wonderful and positive attitude about it, and I’d like to share a few thoughts about your situation. The Lap Band has been sold/marketed as a long-term weight control device, but in the years since the FDA approval took place here in the states, many Surgeons and Bariatric Specialists have to come find that there is a significant and growing incidence of Slippage, Erosion, and other complications that contribute to the early removal of the band. This happens for a wide variety of reasons, some of which are not entirely understood by the Medical Community. And, the band does not work well for everyone; only a small percentage of people who have one ever entirely reach their stated weight loss goal, and incidence of the aforementioned complications have been rising steadily, as the numbers of band fittings have increased. This is not to say that the Band is not a good thing; it has worked miracles for many people, and has provided the little “something extra” that many people need to be able to lose the weight that they could not lose on an ordinary diet. However, in some parts of the Bariatric Community, the Lap Band is now being viewed a little differently than it was 2 or 3 years ago. At one time, it was the “darling” of the WLS industry, but that tide is turning a bit. Many Bariatric Surgeons are beginning to see the lap band as a temporary solution, to be placed for a period of 3-5 years, during which time the patient will be strongly encouraged to modify their eating habits and choices in food consumption, rather than a lifetime weight loss solution. A “re-training” period, if you will. So…my point is that you are NOT alone. This is happening more than most people are aware. I recently read some preliminary notes from a study that was done in Europe. It has not been published yet, and I don’t have all of the information regarding the number of subjects, etc, but what I read of it was very interesting. It seems that Lap Band surgery was performed on a certain number of patients, but out of those patients, a certain percentage were NOT given the entire Lap Band….only the PORT was placed to give the feeling that the entire surgery had been performed as planned. The idea was to test the “mind component” of weight loss. The result? The non-recipients who THOUGHT they had a band placed performed EVERY BIT AS WELL as those who DID, in fact, receive a full Lap Band. The point is, of course, that the MIND is a powerful component of the weight loss process. The “Placebo Effect” made it possible for these people to lose even when they did not have a Lap band installed….they only thought they had one. Remarkable. So, I do believe that you can continue forward with your weight loss without the Band. You need to take what you have learned during your time with the Lap band, and simply continue doing it. Because, when you get right down to it, it is YOU that is making the decisions…NOT the Lap band. The band can be very easily defeated. It is not difficult to “eat around” the Band. The power for it to promote weight loss really comes from YOU. I wish you the best of luck in this, and I think you have an excellent chance of succeeding. Please keep us all posted on your progress, as there are people on this forum now who may be in the same situation you are in at some point, and they will need advice and encouragement as well. S.