Spartan

If you do a search on this forum using Cedars, you will find several people who have had some unpleasant experiences there. I think at least one of them had a VERY bad experience with Dr. Khalili, who, as mentioned by Socalchic, is now head of the Cedars Bariatric program. With regard to Dr. Carson Liu, I am acquainted with a Bariatric Surgeon in the Southern California area who is regarded as an expert in the repair of BAD Lap band installations (and he is the Chief of Bariatric Surgery for a Major national HMO), and he specifically mentioned Dr. Liu in one of our conversations. He said that he could recognize Dr. Liu’s “work” when a patient came to him with problems, and apparently there have been a number of problems in his Lap Band installations. I do not know this from first hand experience, only what I have been told by a very reliable source. I would proceed with caution.

Lisa; Thank you for the Update....I am delighted to hear that you worked it out with your Doctor. I sensed that it was something that could be resolved with a bit of conversation. I have to give you a LOT of credit for approaching your Doctor about this, for several reasons. First, it is always a good idea, if possible, to stay with the Doctor that put the Lap Band in you. He KNOWS how he "installed" it, and if he is good, he keeps track of how his patients are doing....it is best to try and maintain that relationship. Of course, it requires doing a lot of homework before you choose your Surgeon (if you do it correctly), and if you do your due diligence, then you will have selected a Surgeon that you will WANT to have a long-term relationship with. Second, it takes a fair amount of gumption for some people to talk to their Doctor about the things that you have. People tend to be kind of "afraid" of their Doctors. When I was a little kid, I had a Pediatrician that our family had seen for a long time. A very nice guy, I recall, but he used a bit of profanity (a very tiny bit, by today's standards). This bothered my Mother, so one day before I went in for a follow-up, she told me that she wanted me to say this to My Doctor: "Dr., My mother likes you very much, but she wishes you would watch your language a bit". She COULDN'T say that herself, so she had a 10-year old kid say it! And this is the way many people are with their doctors....they are afraid of them. They shouldn't be, though. It can be intimidating to talk to a Doctor, especially when you are going to be critical of something they have said or done. But, YOU did the RIGHT thing, and you have my utmost respect. You are taking care of your best interests, and that is to be admired. As far as the smoking thing…..I understand your frustration about that. We do want our doctors to trust us. BUT….the fact remains that people DO lie to their Doctors. Patient Compliance is one of the biggest issues Doctors have. And because people tend to be a little afraid of their Doctors, they will sometimes lie when they have not followed instructions. So, many Doctors are inclined to be suspicious when their patients tell them that they ARE in compliance, when there is some evidence to suggest that they might not be, as in the case of the odor of smoke. But, he was wrong, and all it took was a quick conversation to clear that up. I was pretty appalled at the almost universal suggestion by people in this thread that you should dump your doctor. I was also pretty disgusted by some of the names people were calling your Doctor when it was pretty clear to me that you, in fact, did have a good surgeon who was probably having a bad day. One of the traits of a successful WLS patient, I think, is introspection. The capability and desire to be able to honestly ask oneself “am I doing EVERYTHING I can do to make this Band work?” And I think you exhibited that capability in the way you dealt with your Surgeon in this situation. You tried to figure out what might have been going on with him, and decided to confront him on it, and the result is that you now have a BETTER relationship with a good surgeon. You didn’t just get pissed off and dump him like most people here suggested you do. Internet forums like this one can really be a double-edged sword. You can find some good advice and support, but you can also find a lot of Boneheads who give you BAD advice and dump a lot of misinformation on you. You are clearly smart enough to be able to separate the good advice from the bad, and I think that will help you make good decisions, and make your band experience a good and successful one. I think you might become your Surgeon’s example of a lap Band that IS successful!

there really is no "the pain", because it varies so widely from patient to patient. Some will have more than others, many will have none at all. It is diffcult to quantify, because people experience pain in so many different ways and levels. But having said that, I think you will find that MOST people who have the Lap band say that they experienced little or no pain.....and was not even enough to mention. As surgeries go, it is one of the more painless operations.

No, not "normal"..... You need to stay in touch with your Dr on this.....don't let them brush you off.....infected ports can be very, very bad..... S.

The FIRST person you need to ask is your Surgeon. Do what HE/SHE tells you. This subject comes up a lot lately, and everyone seems to have an opinion. People mostly think it's fine. I do NOT think it is a good idea for several reasons. MOST Doctors/surgeon will say it is not a good idea. It is NOT moving you any closer to your goal. People often do not stop at one drink, especially in groups. You do run the risk, as mentioned previously, of getting the "drunk hungries" as someone put it. This is a very real problem, and you run the risk of doing some damage to your band if you eat too much of the wrong stuff in an inebriated state. And in your case in particular, you are only 3 weeks out, and I would say that it is not a good idea to cross that line so soon. I have no problem with drinking, but when you are such a short distance into the process, I believe very strongly that you should abstain, at least while you are in the initial stages of getting used to life with the band. But...the Bottom line is: Do what your Surgeon tells you to do.

Lisa, I think you have very positive and reasonable outlook on all of this. And, the bottom line is that YOU are the ONLY one that needs to be satisified with the rate of loss. You do not need to satisy your Doctor.....only yourself, and it seems that you are doing that. As far as "averages" and rate of loss and all of that, you see a lot of different statistics and percentages tossed around about what is "normal" or "expected". But the real truth is that there are NO large-scale studies that have been performed from which to draw any meaningful statistics on ANY of the Weight Loss procedures. People (including some Doctors) love to regurgitate stats that they have read somewhere on the internet or in some brochure, but the reality is that they do not exist. Some states compile limited stats, some medical trade organizations gather some data, but the fact remains that most of the numbers we hear are simply guestimates used to support someone's idea that one procedure is better than another. Several people on this thread have tossed out the same old numbers that they got from another web site, who got it from another web site, and so on. My point is that results from ALL of the Surgeries vary wildy, and depend on SO many things, such as surgeon experience, post-surgical patient compliance, the TYPE of Lap Band that was used, whether it was filled at placement, etc, etc. And the absolute bottom line is what YOU as the patient are going to do to create your own success. And it sounds to me like you want to MAKE your success happen, and that is 90% of the battle. I am not sure you should give up on your surgeon yet. Perhaps a talk with him, or his office staff might make a difference in how he deals with you. I think, based upon everything you have said here, that you are going to be a resounding success in this. Most people do not put as much thought into their entire Lap Band experience as you have put into this single interaction, and I think that this indicates that you will end up EXACTLY where YOU want to be! Keep us posted!

Tanita. Hands down, probably the best scale around, and I have had them all. They make a wide range of scales, but I really like their quality and ease of use..

That is one of the most ignorant statements I have ever seen on any WLS Board. ALL of the various weight loss surgeries require work and effort. They are ALL difficult, in different ways.

I have a little different take on this than most people here. What has been described here covers number of issues, and you really cannot dismiss it by saying the surgeon is simply a jerk. I’m not going to try and explain away what he said and did, because I was not there. But the situation does raise a few interesting issues. First, I have to commend the Original poster on a couple of points. Congrats on the 50-pound loss. Regardless of HOW you did it, it’s a terrific achievement, and you should be thrilled about it. Also, I do see that you are trying to make sense of your experience with your Doctor. You are trying to figure out if you are doing everything you need to be doing, which is an awesome attitude. It’s pretty clear that this Surgeon does not possess a particularly good bedside demeanor. Or, as you suggested, he might have been having a bad day. It’s hard to tell…..we who are reading your comments were not there, so it’s hard to get a real solid sense of everything that is going on. It’s clear, though, that you are not happy about what happened. But to characterize this Surgeon as a “Douchebag”, “Asshole”, “dick”, etc,, as some people here have done is really out of line. He might not have had a good disposition during that particular appointment, but that does NOT mean he is a bad surgeon. There were, in fact, several things that made me think he is quite good at what he does. MANY Surgeons won’t even see you on a one-year check-up. They will leave that to the Nurse Practitioner or office staff…they just ask you a few questions, weigh you, and send you on your way. This surgeon also gave you an Upper GI….many would not, unless you were having some significant problems. But he did, AND he showed you the results. Many would not do that, they would simply tell you what the results were. This surgeon obviously cares about the results his patients have. He may have a problem expressing it in a manner that is acceptable to you, but it does seem to be important to him. You can say that it’s a matter of pride or his “personal stats”, but whatever the reason, he DOES keep track of how his patients do, and seems to take an interest in their success or failure. Some Doctors do NOT. As far as this discussion of him trying to “sell” you on a bypass……well….It might be entirely possible that the bypass is what you SHOULD have had, and that is why he said that to you. I do not think that it is appropriate at THIS point in time for him to be suggesting you SHOULD have had a bypass……It think it would be more constructive for him to help you work with what you DO have at this point….the Lap band. But the plain and simple fact is that the Bypass might have been a better option for you, as it is for MANY people, according to your surgeon. The various forms of Weight Loss Surgery are meant for different people, and I am saying this here only because of some of the comments made by people who clearly do not “get” this concept. He clearly feels this way. The other reason I mention the Bypass issue here is that if it IS true that the Bypass would have been the preferred surgery for you, then you need to realize that you might have to work a bit harder to lose the additional weight with the Lap Band. The Lap band utilizes restriction as the mechanism for Weight Loss, and the Bypass uses malabsorbtion to facilitate the weight loss, with some restriction as well..….two totally different approaches. This is important to understand because for someone who really needs Malasorbtion to lose weight (as your surgeon has suggested you do), then it’s going to be harder doing it with restriction alone. It CAN be done….it’s just more difficult, and will take some additional time and effort. You indicated that you exercise a lot. If you do indeed walk 2 miles a day, and do the other exercises you mentioned on a very regular basis, and are making good food choices, it COULD be argued that you should have lost a bit more weight than you have, IF you were a good Lap Band candidate. But the reality is that it is hard to say. People lose weight at widely varying rates, with or without Weight Loss Surgery. As far as your second question, is the band being replaced by the Bypass….well, no, not really. But the Lap band is NOT the “darling” of the Bariatric industry the way it was a couple of years ago. Incidence of erosion, slippage, and other types of complications and “malfunctions” have been increasing, mainly because the population of Band patients has been getting larger and there are more long-term patients that are having their band removed due to these complications. There is a growing consensus that the Lap Band will ultimately be considered more as a 3 to 5 year temporary solution, rather than a long-term/lifetime solution. Insurance companies are beginning to see this as well. The declination rate for Lap band requests is increasing because the Lap band, while successful in many instances, is not in many cases as well. So, what’s the take-away from all of this for the OP? Well, contrary to some of the opinions expressed in this thread, I’m not all that sure you have a bad Doctor.(and this is coming from someone who has enormous contempt for the medical establishment as a whole) He might not be as supportive as you would like, and he might have made some observations that were not all that appropriate, but he has also done some things that would suggest that he does care about how his patients turn out. I will tell you that I have been through numerous surgeries and procedures over the last decade, and I have had enormous damage done to me by surgeons who did not know quite what they were doing. So, I have come to value Competence FAR more than Congeniality. I’m not saying that bedside manner is not important for some people, but for me it is a non-issue. I am a very firm believer in doing EXACTLY what your surgeon tells you to do, for a variety of reasons. However, there are instances where your surgeon does not TELL you anything. When this happens, you have to be a little more proactive. You need to demand some answers from your Surgeon on exactly what you SHOULD be doing, or you need to venture elsewhere to get the information that you need to be successful. One of the secrets to a successful Bariatric surgery experience is to find the right surgeon, one that has deep experience in the surgery you are going to have, one that has a deep background in Nutrition (and many of the newer breed of Bariatric surgeons do have that expertise), and one who has a staff that will provide a high level of support and information for you post-surgery. You might be able to get that from your present surgeon if you ask/demand it, but if you don’t, do NOT be afraid to go elsewhere. If this is what you decide to do, take your time, and find someone who is everything you want and need. Having said all that, you’ve done great so far….keep it up, and I wish you success in whatever you end up deciding to do.

hair Loss does happen to some people....but....if you take Vitamin supplements, AND take a Protein supplement (like a shake) regularly, you can probably avoid that. As far as the "no beef" rule, I have heard of some Doctors doing that. Talk to him/her about it, if it concerns you. It is entirely possible that your Surgeon has initiated this rule for a very good reason, based upon his experience. If he insists on it, then STICK to it. GOOD Surgeons make rules for their patients based upon their experience and outcomes. If you have chosen a good surgeon, and have confidence in him, then it is always best to follow their directions.

Be aware that the article noted above was published nearly three years ago, and there parts of it that are presently inaccurate. The sleeve is a very viable alternative to the Lap Band, and is being covered by more and more insurance plans all the time. One very important component of the Sleeve procedure is the fact that in the portion of the stomach that is removed there is a gland called the "Fundus", which secretes a hormone called Ghrelin. This Hormone is also sometimes called the "Hunger Hormone" because of the role it plays creating the sensation of hunger. When the sleeve procedure is performed, the Fundus is removed. As a result, hunger is dramatically reduced. Some people consider this to be a major benefit of the sleeve. Other people are not thrilled with this aspect. It is very individual. The biggest down side of the Sleeve is the fact that it is the MOST permanent of ALL the procedures. There is no going back if there problems.... Having said that, I will tell you that it is a very good solution to the problem of obesity. Many people have had very good results with the Sleeve. The Lap Band has it's share of problems, and you need to be aware of that as well. Slippage is always a possibility, and erosion is a big problem as well. The incidence of complications with the Band has been rising steadily, and there are Doctors who say that the band is best as a short-to-medium term solution. And, there Doctors who say that the Lap is a bad solution and will eventually be removed from the market, in it's present form. ALL of the various surgeries have their good and bad elements, but the important thing is that you choose the one that is right for YOU. The surgeries are not as interchangeable as some might have you believe. Different weight issues and eating disorders require different surgeries to be successful. In your case, I would consider seeking a second opinion, if you are confused about the options. Doctors recommend different procedures for different reasons, and it's not always because it's the best option for the patient. I usually suggest that people talk to at LEAST three different doctors before deciding on a procedure. Best of luck in whatever course you choose!

LOL!! Yeah, TJ, i'm kinda thinking the same thing......

Poodles, I am in complete agreement with you. There are other surgeries than the Lap Band that are FAR more suited to certain individuals. The Lap band is being thrust down people's throats (pun intended) through TV Ads, billboards, bus stop signs, and while it does work miracles for many people, it is NOT the best choice for some. People need to look at the options, because there ARE options.

Britt; It really depends on which one is right for you. They are two TOTALLY different surgeries, and while they both work, ONE of them will work MUCH better for you. It's not a matter of which one you PREFER....it's which one will be the RIGHT one for your particular weight and eating difficulty. Has the surgeon given you his/her recommendation? If he is a good, experienced Surgeon, then he will have an opinion.....

You know, if it was merely ONE Doctor that was suggesting that you have a Gastric Bypass, then I would say that it was because that was the surgery that they were most familiar with, and that was what they were trying to sell you. However, you indicated that you had received the same advice from several Surgeons. Therefore, there must be a good reason for it, and you would be very wise in at least considering it. You asked “Why do they keep saying it won’t work?”……I’m thinking maybe you should ASK them….? There are a number of very specific reasons why they might be suggesting a gastric bypass in YOUR particular case. The Lap band does not work for everyone. For many people, a Gastric Bypass IS a much better choice. There are a number of Weight Loss Surgeries available today in addition to the Lap band. The Sleeve, the DS, the Bypass, and a few more obscure procedures.. All of them work, to a CERTAIN degree. But, for most people, they are not all that interchangeable. They are meant for different people, with different weight and eating issues. Many people (including even some in the bariatric industry) don’t get this. I see people all the time that have had a Lap Band, and they may lose some weight, but not nearly all that they need to. What they should have had was a Bypass, plain and simple. The Lap Band is being sold these days as a one-size-fits-all solution to the problem of Obesity, but it’s not that simple. The Band works miracles for SOME people…but not for everyone. People say a lot of bad things about the Gastric Bypass….most of it is quite untrue. I have observed of lot misinformation about the procedure being discussed on this forum. But the fact is that it is still considered to be the “gold standard” of Weight Loss Surgery. It has been performed for over 50 years, and if the patient sticks to the rules, then they will lose the weight, and will maintain the weight loss….plain and simple. The problems that a very, very small percentage of people have as result of GB are almost always due to surgical incompetence or misbehavior on the part of the patient. The people who do regain their weight after Bypass are people who will also find a way to “eat around” the band, which is very easy to do. So, regardless of the procedure, much of the responsibility for the success or failure of the surgery lies with the behavior of the patient. So, do not dismiss the option of a Gastric Bypass, as it might be the procedure that is suited for you. I do think that you need to ask some questions of the people that are giving you this advice, so that you will know exactly why this procedure is being recommended. However, because you have heard the same thing from several surgeons it could very likely be that a Gastric Bypass is what you really need.

Mary, I do think that is a wise choice. I would also suggest that you see a nutritionist that has a background in working with Bariatric Surgery patients. They can help you with the portion issue, and give you other advice. It's not always a matter of stopping when you feel full....sometimes you have to wait a little after you eat, and then you will feel full. The lap band does not always keep you from being hungry. That is one of the myths about it. It happens in some people, but not all. It does sound like you have not received very good aftercare or nutritional counseling from your orginal surgeon. It would really be in your best interests to seek out some additional resources, such as a Nutritionist and perhaps a Pyschotherapist that has a background in dealing with weight issues. There are many pieces to this weight loss surgery "puzzle" and SO often many of these pieces are neglected either by the Doctor or the patient. Sometimes you have to be a little more proactive to be able to get the most out of your Lap Band experience. Keep us posted on your progess.

Sometimes it is the very small changes that you make that can create the biggest differences. The wine might be "it", or at least part of it. There has been a lot of discussion on this board on the subject of alcohol and weight loss, and there are lots of opinions on both sides of the issue. MOST Doctors will tell you that it is beneficial to lay off the booze while you are losing weight. I would agree with that very strongly.....I have seen the elimination of alcohol make a huge difference in the rate that some people lose. Why did you have your port replaced?

If you are suggesting that because some Doctors provide different instructions than others, that the patient should eat whatever they feel like based upon chatter on an internet forum, then you are doing a serious disservice to the patient. The assumption here is that the patient has performed due diligence in their selection of a surgeon, and they have chosen one that is very experienced both in General Surgery, Bariatric Surgery, and specifically the Lap Band. If this is the case, then there is no reason NOT to follow their directions to the letter, and plenty of reasons for them TO follow the directions. There are generally accepted protocols and methodologies for installing, filling, and maintaining the Lap Band, but as more people have the Lap band, and more research is performed on the outcomes, these protocols change. Doctors will also change their own instruction to patients based upon their own observation on the outcomes of their surgeries. In other words, they KNOW what works for THEIR patients. And you should listen to them. If you do not TRUST your Surgeon enough to follow their instructions precisely, then you have very likely chosen the wrong surgeon. “The fact that there is a wide range in 'advice' regarding postop diets suggests that there is no real reason for one person being on solids in a week and another still on nothing but liquids a month later other than the personal preference of the doctor.” And just where do you THINK the Surgeon gets his or her “personal preference”? From their EXERIENCE in compiling the results of the surgeries. A competent surgeon performing surgeries of any kind will keep track of what works and what doesn’t, ESPECIALLY in situations like this, where the outcomes can be so variable. They have their preferences for a reason…..they have WORKED for that surgeon. There is one other reason to follow your doctor’s advice that people usually do not take into consideration. If for some reason things do not go well with your Lap Band, and if any of the numerous “bad things” that can happen do happen to you, and you end up having to sue your surgeon, one of the first things they will ask you is “did you follow your doctor’s instructions?”…..and you had better be able to say YES without hesitation. I am not going to get into a discussion here about lawsuits and the Lap Band and malpractice and all of that, but there have been situations where lawsuits were necessary, and to be on the winning end of the lawsuit you have to be able to say in all honesty you did indeed follow all of the instructions provided to you. IF you are continuing to have problems, not losing any weight, etc, then you need to seek out a 2nd opinion, from another Bariatric Doctor….one that you have researched THOROUGHLY. But until such time as you feel that way, you really NEED to follow your Surgeons’ instructions.

There are two things you need to begin doing right away. First, you need to begin eating as though you already have the Lap band. It's not easy, I know, but you need to start trying to live that way. People say that they are tired of dieting, but the reality is that the Lap band IS a diet....a diet with consequenses. If you eat too much or too fast, there will be some pain involved, to put it simplistically. The best thing you can do is to prepare your body for it NOW, before you have the band. The other thing you need to do is to begin regular therapy with a Psychotherapist who SPECIALIZES in the needs of bariatric patients.....not just any Therapist, but someone who has a demonstrated specialty in this field. SO much of weight loss is a "head game". And a therapist who knows what they are doing can help you get to the root of whatever eating disorder you might have. Many people who are "sold" on tha Lap Band go into it with the wrong idea. They think of it as some magic "switch" that is flipped, that will make the hunger go away, and the pounds will simply drop off. For MOST people, it does not work that way. It's not an easy road, and you will need all the help you can get. And dealing with the mental component of the weight-loss puzzle will be a huge benefit to you in this process.

Whatever it was that your Surgeon specified is what you should be eating, is what you SHOULD be eating. If you have any questions about what that might be, contact your Surgeons office. A lot of people don't understand how important it is to follow their Surgeons instructions to the LETTER....but it is vitally important, for a number of reasons. So, if he/she didn't spell it out for you, call their office.

Call your Doctor. If you are really THAT weak, where you cannot walk more than a few steps, you need to speak with your surgeon right away. Seriously. Call your Surgeon.

You really need to call your Surgeon about this right away. I mean, right now. You don't want to mess around with this.

Oh, now that's a GREAT way to pick a surgeon....by "winning" it.....lol. jeez...

I do believe that it is IMPERATIVE that you follow your surgeon's rules to the letter. If you have chosen a good surgeon that has plenty of experience, then they will know what works and was does not work for THEIR patients. Every doctor has different rules, but every Doctor has a different level of experience and probably performs the surgery just a little differently than other surgeons. If you have done your homework on your surgeon, then you should be able to TRUST him or her, and follow their instructions.

Trust me....it ALL gets better. More size, more stamina...everything is better. :smile2: