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Sure. Here's my diet progression: Stage 1: Bariatric Full Liquid Diet (Weeks 1-2) #1 Sugar-Free Fluids This is the number one priority after surgery—drink a minimum of 64 ounces/day. Examples: Water, herbal tea (no caffeine), Crystal Light, PowerAde Zero, etc. Liquids should be non-carbonated, non-caffeinated, and under 15 calories/8 ounces #2 Protein Shakes Goal of 60g-80g protein/day. Mix with water or unsweetened nut milk. Stage 2: Soft Protein Foods (Weeks 3-4) #1 Sugar-Free Fluids Still the number one priority after surgery #2 Food 3 meals/day of soft protein foods (aim for 60g of protein as able—compensate with protein shakes if unable to hit 60g through food). There is no set portion size—you must listen to your body. Examples of soft foods: eggs, whole beans, canned meat, shaved/thinly sliced deli meats, fish, tofu, Greek yogurt, cheese, refried beans, etc. #3 Protein Shakes You may need to drink 1 protein shake/day to meet the 60g of protein if you can't meet this goal from foods. Stage 3: Bariatric Regular Foods (Week 5+) #1 Sugar-Free Fluids Still the number one priority after surgery #2 Food 3 meals/day focusing on protein. Small bites and stop at the first indication of fullness. There is no set portion size. Try new foods one at a time and in small amounts. Focus on solid protein for best portion and hunger control. Put fork down and pause between bites.

U look so happy, refreshed, and beautiful. I am truly happy for you. My highest weight was 360. Right now I am 338 and I feel miserable. And just like you said I am only existing and not living life. I can not wait to start living life because at the weight I am right now it doesn't seem possible. Thank u for being an inspiration. I can not wait to get this bariatric program rolling so that I can get my surgery.

I experienced a lot of pain doing the leg press surprisingly enough (Didn't realize I use my abs for that too)! When I asked the surgeon, he said he had sewn my port into the abdominal muscles and the pulling is what would cause me the pain. Others here say their surgeon didn't sew down their port (?) but I would definitely say all the sit ups could be aggravating it. One idea would be to lay off those for a week for two and see if you still have pain running and on the eliptical. If so, I may be tempted to call my Bariatric Center and see what they have to say...

Not sure about the mercury aspects. I should look into this. Same with cholesterol from eggs and such. Keep in mind that once you have your sleeve you're not really eating high volumes of protein.....just high percentage of your intake is protein. In other words.......consider a normal meal from your former life. Imagine it. Think about what the plate looked like when it was loaded down at your normal meals. Got an image in mind ? Good. Now, remove the side items from the plate. Zero in on the entree. Got it? Good. Now zero in on that Entrees and then shrink it down to 1/4 cup in size.....or 1/2 cup or whatever size meal your phase has you eating at meals. Now....you'll see that you may actually be eating LESS protein than you were before....and none of the other stuff. No side dishes....no salads.....no Desserts. You'll only have room for some of the protein rich entree. With this in mind, you can still cook the same meals for your family....but you select from just part of it for your own needs. Supplement the gaps with bariatric Multivitamins, Calcium, Iron and B-12. Stay hydrated. Get lean. It's simple......as long as you let it be simple. Stay away from foods that don't fit your new goals.....and even their substitutes. Stick with the basics and work through the various phases.

Not sure about the mercury aspects. I should look into this. Same with cholesterol from eggs and such. Keep in mind that once you have your sleeve you're not really eating high volumes of protein.....just high percentage of your intake is protein. In other words.......consider a normal meal from your former life. Imagine it. Think about what the plate looked like when it was loaded down at your normal meals. Got an image in mind ? Good. Now, remove the side items from the plate. Zero in on the entree. Got it? Good. Now zero in on that entrees and then shrink it down to 1/4 cup in size.....or 1/2 cup or whatever size meal your phase has you eating at meals. Now....you'll see that you may actually be eating LESS protein than you were before....and none of the other stuff. No side dishes....no salads.....no desserts. You'll only have room for some of the protein rich entree. With this in mind, you can still cook the same meals for your family....but you select from just part of it for your own needs. Supplement the gaps with bariatric multivitamins, calcium, Iron and B-12. Stay hydrated. Get lean. It's simple......as long as you let it be simple. Stay away from foods that don't fit your new goals.....and even their substitutes. Stick with the basics and work through the various phases. Very good points. You illistrated that beautifully.I have only been eating a 3 to 4 oz portion of meat and a green veggie (usually broccoli, green Beans or brussel sprouts) on the side for 4 months now and I am a month away from having my surgery so it shouldn't be too much of ashock to my system. Thanks Dub for all the encouragement!

I'm thinking I'll call the after hours general nurse line today and depending what they say I'll call the bariatric nurse for my surgeon on Monday morning and get advice. Sent from my Pixel 3 using BariatricPal mobile app

Hi! In the beginning of my journey I got in touch with INSURE nutrition to see if I qualified for no cost protein shakes, scar cream and vitamins. They did all the leg work and I ended up receiving all of that ( 5 cartons with 18 in each. Premier protein) for about a year. It then stopped and I was bummed. Because we all know how expensive it can get. Well, they contacted me 2 weeks ago. They check with former customers ins. plans to see if they re-qualify. I did! It is so worth the time spent going back and forth with them. I received the shakes, bariatric vitamins and a new folic acid supplement.

If metabolic syndrome is the cause of your weight gain, a diet that is low to moderate in calories coupled with an exercise plan may not be enough to lose the weight. And if you continue to eat the wrong foods, exercise and diet may not help at all. In the late 1970s the government mandated we get the fat out of our food. The food industry responded by putting in more sugar. And that, we see by historical data, correlates to the time when America’s obesity epidemic began. Read my article, “Cause and Cure of Obesity in America.” In the New York Times best seller Fat Chance: Beating the Odds against Sugar, Processed Food, Obesity and Disease, author Dr. Robert H. Lustig, a renown expert on obesity, points out that “a calorie is not a calorie.” Not all calories are equal. Whether the calorie comes from fructose, glucose, protein or fat is important to its metabolic effect and how much fat that calorie accounts for. Fructose and glucose — just two of the many names that sugar goes by — and even protein are said to be the culprits behind insulin resistance and metabolic syndrome. Insulin resistance and metabolic syndrome are two primary causes of obesity in both adults and children. If you are struggling with the problem of an overgrown waistline, aka “belly fat,” this may be an indicator of these health conditions. Read my article, “Belly Fat is a Danger for All People.” If metabolic syndrome is the cause of your weight gain, a diet that is low to moderate in calories coupled with an exercise plan may not be enough to lose the weight. And if you continue to eat the wrong foods, exercise and diet may not help at all. What are the Wrong Foods? Sugar goes by a variety of names, about 52 in all, including glucose, maltose, sucrose, and fructose. The result has been an altering of our biochemistry that has driven our eating out of control, according to Dr. Lustig. Dr. Lustig further states that so-called healthy sugars such as agave, coconut and palm sugars are all “crap.” Checkout this HealthCentral sugar infographic named Sugar is to Blame: http://www.healthcentral.com/obesity/c/380545/179644/sugar-blame-infographic/ Dr. Andrew Weil, a well-known guru for holistic health and integrative medicine, agrees on this point. Dr. Weil warns that sugar is toxic, and coupled with modern industrial food, has disastrous effects on the hormones that control hunger, satiety, and weight. Both Dr. Lustig and Dr. Ron Rosedale, author of The Rosedale Diet, advise that branch chain amino acids (BCAAs) and protein contribute to insulin resistance and obesity. I’ve been eating a high-protein diet and taking BCAAs because I thought I was doing my body good. Whey protein, which I and the majority of bariatric patients have been conditioned to consume, is one of the worst foods for releasing insulin in the body according to Dr. Andreas Eenfeldt, a Swedish medical doctor and specialist in family medicine. Dr. Eenfeldt, commonly known on the web as the “Diet Doctor,” interviews Dr. Lustig on the "Causes of Obesity" in the video below (or watch it on ). The Bottom Line If you think metabolic syndrome may be the cause of your weight gain, then eating a traditional “healthy diet” combined with exercise may result in failure to lose weight. Talk to your nutritionist. Further, you may wish to explore three diets for metabolic syndrome from Cleveland Clinic, Dr. Robert H. Lustig, and Dr. Andrew Weil in my article, “Metabolic Syndrome and Weight Loss.” Living larger than ever, My Bariatric Life

My pamphlet instructions from my bariatric surgeon said not to get pregnant for a year! Oh dear lord, I can't imagine getting pregnant at 49. I am already a grandmother to a almost 7 year old, LOLOLOLOL. You want my old opinion sweety- enjoy your new life being banded first, enjoy your new marriage, enjoy eachother 'first' ... take it from someone who got pregnant as a 'teenager' and missed out!!!

I had my Banding done by Dr. Fernando Miranda at Twelve Oaks Hospital in Houston. I chose this doc and this hospital because they are both certified by Bariatric Centers of Excellence. Dr. Miranda is awesome. He told me ahead of time that he takes his time during surgery (mine was over an hour) and has a liberal fill philosophy. I did have to do a 10 day liquid pre-op diet to shrink liver, on which I easily lost mucho pounds. The only thing I did not like about Dr. Miranda's procedure is that immediately after surgery, they woke me up and wheeled me to an xray room where I had to swallow barium and then stand in front of the xray machine... with no meds. I was beggin for meds, but they told me that I needed to be awake enough to stand. So much pain, almost unbearable. I had to do TWO barrium swallos and TWO xrays before they gave me a shot of morphine and took me to recovery. For this reason, I cannot reccomend this surgeon. But maybe if you talk to him about this (I didn't know this would happen) you can work something out so that it is done a different way. No one else I have seen on this board had to do such a test immediately after surgery without any meds. As for Twelve Oaks Hospital. In no way can I reccomend it. They messed up on everything from pre-op to discharge. When I was there for pre-op testing, I had to wait for HOURS because they had no orders from my doctor, who was not in his office that day. Then, I overheard a nurse telling the addmissions people that for Bariatric patients, there are standing orders, so no individual orders necessary. I was furious! Getting all the testing done was a huge hassle- no one was ready for me in any department. The nurses during my overmnight stay for surgery were great. But when it came to discharge, I had to wait HOURS because they misunderstood the orders. This hospital is a dump. The rooms are dumpy, even the OR was dumpy. Again, just to clarify, the only problem I had with Miranda was the barium swallow. He is an excellent doctor and such a great bedside manor! This guy needs to get to a real hospital though! There are so many nice hospitals in Houston, I cannot understand why he goes for Twevle Oaks. Please PM me if you need more information about anything I have written here.

I wanted to join the conversation and share my story with anyone banded that's wondering "can I get mine out and be okay?" There isn't enough out there in terms of stories of people who've done it and done it successfully - and we need a better, more public conversation about this. Tonight, in the wee hours of my bed as I type this, I am 14 hours post op. I had my band removed today (well, yesterday), on Saturday June 25, 2016 somewhere between 11am and noon EST. I was banded for nearly thirteen years, since December 22, 2003. Imagine, I went into the OR to get my band having just turned 25 a few months earlier. Today I had it removed, at 37 and a couple months away from turning 38. I have had the lap band for more than ONE THIRD OF MY ENTIRE LIFE. Today is truly a new chapter for me. I sit here without my band, post-op, feeling many complex feelings but with ultimately a layer of hope and relief and some joy on top. Through it all, I feel gratitude. The uncertainty and worry and anger that I also feel will dissipate. I want my story to be out there. I wrote practically a novel this evening- not originally intended for this website, but for me, to help myself clarify my journey and feelings. I am considering if I will edit it and submit it anywhere for publication or just on a blog, somewhere that maybe if even a couple other people stumble upon it, who are banded and wondering if they can/should have their band out, it will help. Or if someone who has had their band out, can relate to it, then that too would make it all worth it. This is a VERY long essay. Like, probably a solid 20 minute read. It is the first time in 13 years I have ever really put pen to paper on my story or attempted to articulate it aloud. I understand if you scroll down and go "Lord! I am not reading all that!" But, if you have the 15-20 minutes (depending on how fast you read!) and feel this may be helpful, my story is here to share with you and hopefully provide some measure of inspiration, comfort, perspective. I wish all of you, in various stages of your journey, the very best. Whether you are considering a lap band or other weight loss surgery, currently have the band, are thinking about having it removed or already have done so - my best wishes for whatever your future has in store for you. Sitting here tonight, freshly de-banded, I cannot tell you enough how long I have waited for this, and yet, until for how recently I worried and was uncertain if I would ever see this day. It has finally arrived. This is my story of the 13 years that lead to this very evening: -PG, Brooklyn, NY, June 26, 2016 --------------------------------------------------------------------------------------------------------------------------------------------------------- When I was young(er) In the summer of 2003, I was 24 going on 25. A trim kid but chubby teen, I had climbed up above 200 lbs in high school (though wasn't fat, just "thick") and then in college really put the pounds on. Instead of the Freshman 30, I did the Freshman 50. I followed that up with the sophomore 20, the junior 20 and the senior 20. I took a year off between graduating high school and starting university, and I took five years to graduate once I started, so by the time I graduated college in May 2002, I was tipping the scales at close to 300 lbs. By then, I was 6'2 (I topped out at 6'3 when I was about 24) and so while I looked heavy like a linebacker, I could lie to myself and others about how truly big I'd gotten. But inside I was miserable. Nobody wanted to date to me, I didn't find myself attractive, I felt huge, I smoked, so between that and my weight, I was not in great shape. I wasn't one of those "housebound" obese people at 80-90 lbs overweight and certainly my youth, some good genes and a fairly active disposition helped. But ultimately I was deeply discontent and unhappy. My overeating was turning to a binge eating disorder. In college, I developed some hair raising eating habits. It started with stuffing myself in the all you can eat residence hall dorms. I would eat an enormous fast food based lunch on campus most days and found myself going with friends to Chinese buffets and American home cooking style buffets and while my other friends had a plate of food, I squeezed out two packed plates and maybe on a special day a third. After play rehearsal and social plans with friends I would stop at 2-3 fast food drive thru's on my way home and have a "feast" for dinner of 2 to 2.5 meals. Hmm, how about a few tacos from Taco Bell, ooh, but I also need some Chili from this pace, or some wings or maybe a bacon cheese burger to go with those tacos and let's get some fries and a frosty while at it. I told myself it was because I needed "options" and "variety." Because I "loved food." I did want options and variety and I do love food. But I also was compulsively overeating and nurturing my very broken spirit with food. I hung out at a dear friend's house who lived at home with her salt of the earth family that had tons of food packed in the cupboards and home cooked leftovers. I can remember eating plate after plate of their food and to this day it's a wonder they never told me to get lost and never come back for literally eating them out of house and home. I was binging and while I sort of knew that I was, like many others with eating disorders, I got really good at lying to myself. I rationalized it any which way I could: I'm stressed, I am sad, I am gay and boys don't like me. Or I am still growing (yes, I sure was). And besides: I didn't binge every day. I learned to reserve the big binges, the ones that made me sick to my stomach, for a couple times a week and justified the rest of my unhealthy eating by telling myself that it was okay since I rarely ate Breakfast and most days had "smaller" dinners and lunches - meaning, one large meal at a time instead of two. The beginning of the 13 year saga After I graduated college, I moved to NYC to pursue graduate school. In the fall of 2002 I arrived nearly obese, lonely and, coupled with the stress of starting life in a new huge city on my own and adapting to the demands of a rigorous graduate program, I coped by eating even more than in college while trying to find workouts to do and researching different popular diets but regularly starting or staying on them. Talk about cognitive dissonance. I told myself "if I were just thin, I would have a boyfriend, be so happy and successful." The more I thought that (which turned out by the way NOT to be true), the more I found myself ordering $20 Chinese, Indian, Thai, diner, Mexican, BBQ style delivery dinners. I ate all the time between the fall of 2002 and fall of 2003 in NYC. I made briskets, pastas, even my salads were ridiculous, loaded with cheeses, meats, croutons, and large amounts of full fat salad dressings. I hit my diner across the street late night and had chicken fingers, club sandwiches, fries, milkshakes. NY pizza was a regular treat. And of course I went in on Cookies, cakes, ice cream, you name it, on the regular. No control. By the time summer of 2003 rolled around I was 24 and had gained over 50 lbs in my first year in NYC. I was hanging out right around 355 and at 6'3, that put me at between 130-150 lbs overweight. I could no longer pretend I was just "heavy" or "thick." I was now obese and very large. Working out became less viable, my stomach was stretched, I was constantly physically and emotionally hungry. And then that summer I learned about the lap band. I had tried everything else, most diets whether sound or scams, didn't last for more than a few weeks before I gained back the 15 I'd lose + an additional 10 for good measure. The band seemed different. I read as much as I could online and began researching. I knew quickly it was right for me. In the fall of 2003, I went to a weekday evening seminar given by Dr. Christine Ren who ran the Bariatric Weight Loss Program at NYU Medical Center. It was filled with other large people like myself and we all seemed to share one thing in common - we were at our wits end and most of us were ready. I began the process. I filled out paperwork, I met with Dr. Ren's team of specialists, and I eventually qualified. I found out that my health insurance would not cover the procedure (this was 2003 after all, long before most insurance companies had their act together and saw it as a preemptive measure) and so the only way to have the several thousand dollar procedure would be to pay out of pocket. I had a trust fund set up, not a huge one - I'm not from that kind of money - but a modest one left by my grandparents. I think they imagined it would be used to start a life with a spouse, buy a house, maybe help with future post graduate education costs. But it was enough that I could pay for the band and have a fair amount left over and so I decided to go for it. I started attending support groups, and as my day of banding surgery drew closer, 12/22/03, I grew excited, nervous, but excited for the "new me." I was TERRIFIED at the prospect of general anesthesia and being put to sleep - not sure why - I'd never had surgery before other than my wisdom teeth. But I decided it was worth it. I did the pre-op diet and liquid fasts exactly as I was supposed to. I dropped 8 pounds before and the day before I weighed myself at home naked and I was something like 345. But on the scale the next morning at the hospital (still in my clothes), I tapped out at 349. Guess I was wearing a heavy sweater and jeans. That was what my documented day of surgery weight came in at. I rounded it up a pound to 350 ever since. I mean, heck, that was the basic reality. Joining the band The surgery was terrifying. I had to sign a release that basically said if I had any complications, including death, I would not hold the hospital liable. I was amped up and worried that I would go into cardiac arrest on the table. Can you imagine? At 25, and in otherwise perfect health, I was having such thoughts. And yet, I knew this is what I needed to do. It was the only tool or pathway that seemed at all possible to help me achieve my true inner trim self. And so I did it. I climbed up on that table and felt like I was having a panic attack and had my first surgery / anesthesia experience (of many to come). It was rough. When I came to, I was very out of it and in pain in the recovery room. I can't remember if I was held overnight. It's been many years and I have had so many other hospital stays since, it all blends together. When I did get home, I followed the post-op diet near perfectly. Clear liquids for a few days. Thicker liquids for the second part of the first week or so. Then soft foods like mashed potatoes, purees, soft boiled eggs, etc. The weight began to slip off like warm butter. When I moved into regular foods, and began the getting my band tightened phase, now into early 2004, I noticed at first blush how sensitive my lap band was, or should I say, how sensitive my body was to it. The smallest tightening and food would get stuck so easily, I would vomit at nothing. It was rough. And still - it was a novelty then which made it do-able. Plus, the weight was literally pouring off without much effort. I mean, the effort of being careful with what and how and when I ate and drank. But without having to worry about being starving - and knowing that if I overate, I would throw up and be miserable. So it sort of took care of itself. Over the next 15 months, I lost over 140 pounds. I hit 208 lbs. in March of 2005 and I was slender. Not just thinner. I was legitimately a tall, slender man. Clothes shopping became a dream come true, catching my reflection in a plate glass window sideways became a joy for the first time and wearing my shirts tucked in with belts - what a dream. But with the joy, relief and new happy discoveries, came other obstacles unforeseen. More surgeries and a little reality ahead One of these obstacles unforeseen was the large amounts of sagging skin on my stomach and even what were formerly (the ever dreaded) male breasts. By November 2004, it was clear how much skin remained and that quickly became my new preoccupation - getting rid of it. I was referred to a reputable plastic surgeon on Long Island who had done numerous tummy tucks and gynecomastia procedures on men who'd lost substantial weight. The surgery was to include both the tummy tuck procedure and gynecomastia at the same time, on March 17, 2005. I was 26 years old and I was thrilled - thought I was going to now finally at last, after just a little over a year ago obese, and now slender, going to have the body I had dreamed of. I was scared though, even more so than with the band surgery, because while the band placement took about an hour under anesthesia, this was going to take SIX to SEVEN hours under anesthesia. And - guess what? It wasn't covered by insurance - no surprise there - but I had to have it. So I ponied up that fee, several several thousand dollars - out of my trust. It didn't matter. This was my life, my body, my self-esteem. I had "worked hard" and "deserved it." And so when the day arrived, I climbed on yet another operating table, counted backwards and went under the knife. Oh my God. There aren't words to describe how much I was not prepared physically or emotionally for that type of operation. This was an operation. Not a "surgery" or a "procedure." A full scale operation. When I woke, if you want to call it "waking," my initial jumbled, drugged thoughts were that something had gone terribly wrong and that I was dying in the recovery room. Shouts of nurses telling me "Breathe, take a DEEP breath! C'mon!" along with a myriad of other calling my name over and over again, trying to get me to stay awake. I felt like I couldn't breathe, couldn't open my eyes, couldn't think properly - it felt like I'd been literally hit by a semi truck and was fighting to live. Guess what? I wasn't fighting for my life - this was normal. I was just in a lot of pain and under the effects of a TON of anesthesia and drugs. Recovery took weeks of wearing bandages and compression suits. Dealing with pains and drains. Meds. And constant check ups. About 6 weeks after, I had all the gauze, bandages and compression suit off, I stepped on the scale and weighed myself: 199.2 pounds. A buck ninety nine and 6'3. I was 26 years old and thin. Literally thin. Gaunt. Friends commented: "Yo, buddy, you look great, but maybe that's enough. Eat a sandwich, okay?" (Which of course, with how tight my band was in those days, was not a possibility, bread in fact, was something I stopped eating altogether and still to this day, though I have resumed eating it on occasion, really don't mess so much with). My friends were right. I look at pictures of myself then and I was thin, but indeed gaunt. The loose skin being removed caused me to lose an additional 6-8 pounds and I'd dropped a couple more yet still from how tight my band was at that time. For a few weeks, I hung out under and at around 200 lbs. I was so sick. I thought "I like the way that SOUNDS. I think I want to get down to 195, to have a BUFFER, to make sure I stay UNDER 200." For what? Because it was an abstract number that appealed to me? Another consequence unintended by the band - my perceptions of reality versus the reality of health or reality of other people's perspectives came into clash. They don't talk to you about this in lap band training. Not really. They might throw around a few catch phrases, but that work is up to you. And rightfully so. It wasn't easy though. And to this day, while "better," I still have to challenge my perceptions - frequently. Within weeks, I had climbed up to 205 and hung out there for a while. Eventually: 209. 210. And then a period of time where my body seemed to settle between 212 and 215. Which in retrospect was a healthy, nice weight for that time of my life. The novelty of the band, however, began to taper in the coming months and years. I turned 27, looked "good." 28, 29 brought more of the "I look good and I like what the band had done/does for me, but I'm also starting to hate the band and the lack of normalcy I realize I may never fully have" feelings. During these years, the picture I had for myself of myself at that self, often didn't match up with the earlier discussed little issue of reality. I shopped for clothes that were too tight, even though I was now "lean," they were still too small. I tried buying Medium tank tops that didn't fit me. I rationalized that a "large" was too big even though - it wasn't. My view was distorted. Men didn't start tripping over themselves to date me. I thought that would be "solved" and that being thin would get me a boyfriend. But it didn't. Nothing changed and I developed a deep hurt, a deep anger, and an even deep lack of confidence than before. At least when I was fat I had an excuse. It's not me - it's the weight! But trim, why couldn't I get men interested? Was there something fundamentally ugly about me that I was missing? Was this a curse? Why the continued lack of attention, the continued rejection? Oh once in a while I would get a guy interested and we'd date for a while, but it didn't seem to work and I secretly wondered if he was put off by my surgery scars and/or was it something else? Were my facial features not attractive? My hair cut/color? Or maybe, I started to believe that because I didn't have a six pack that was the problem. Even though I was slender, I started to realize that I was actually "skinny fat." No definition, no muscles. Just slender in clothes, lean appearing, but jiggly out of them. My stomach looked good - that came out really nice from the tummy tuck. But the gynecomastia not as much. There were these "divots" or small craters on both sides of my chest, that looked like some flesh had been scraped out with a grapefruit spoon, where the smooth contour of my breast area dipped down below the nipple into a small nook. I didn't realize it but the subcutaneous tissues had collapsed from scar tissue or bad healing or who knows what - I will never know the reason why. I've tried to get my surgeon to explain it to me, to fix it for me, but to this day it's still a mystery and yet one more thing I have come to hate about my body. The irony of finally being slim after so many years of struggle and theoretically ready to be shirtless at the beach but now not ready to be shirtless because of this random issue - of chest "divots." What? How does one even manage or fix that? The only attention that seemed possible to get from men was sexual. You know, a guy online or a guy at a favorite gay bar with friends, noticing me from a few feet away. I was never that promiscuous - and without making this story all about that - let's just say - I became more promiscuous. I wanted love, but was willing to replace love with whatever physical affection opportunities, even if temporary, presented themselves and met with some minimum standard. It's not easy at 29, to realize that being thin was not solving or satisfying all that I thought it would, when it came to attraction and love. I'd had a few boyfriends here and there in life but nothing super long-term or successful in the long run. I believed that the issue must be with my chest and began an arduous process at 27 of under going revision after revision. My plastic surgeon did the same speech and dance each time the revision didn't work as he had predicted it would: subcutaneous tissue this, skin healing that, fat alignment this, don't worry we'll make you happy no matter how long it takes that. I, young, insecure and desperate to achieve what I thought I was owed, lined up willing to under go any hurdle. Even involving anesthesia, a fear so big that I probably qualify for a diagnosis or phobia if there is such a thing. Funny that I stupidly shelled out the "cost" for these revisions, which was a few thousand a pop to factor in a reduced fee for him, surgical costs, anesthesiologist costs, etc. It's now been 11+ years since that original plastic surgery - and I'm still not happy with my chest. After my 6th revision in 10 years, completed last July 2015, one side - the left side - is finally finished to my satisfaction. I was never looking for perfection - just a normal, flat, non-divot appearance. The left part of my chest has finally achieved that. The right side still has some remnant of that divot. The surgeon, who has long ago stopped being sweet and full of promises with me, has now reluctantly agreed to give the right side alone one more go on July 21. This time to my sheer relief, no anesthesia, other than local, will be involved. He thinks it will take 40 minutes and I can be completely awake, with no sensation from the lidocaine and along with a cocktail of Versed to keep me relaxed, it should be a very simple procedure. To the plastic surgeon's credit, the right side, while still after 6 revisions is not fully there, is closer than it has been. The surgeon thinks this will be the last and final time and that it will match the left side after it's done. I know myself that it will be the last and final time because regardless, I'm done after this. I've given it my best try. From here on out, the quality of my chest appearance will have to be derived from as far as his gynecomastia + the revisions has taken it + my future weight lifting and healthier lifestyle can make it. The rest will be what I can do to accept myself and feel sexy and confident with my chest as is. It's not hideous. Some people say it looks good. The trick for me is as I get older, letting go of unrealistic dreams of lovely pecs that may never be. And that is okay. It's becoming more and more okay. ​The in-between years: Slips and sticks Years with the band passed. In 2008, a couple months shy of my 30th birthday, I was now learning to "eat around the band." I had learned some good habits with the band and made some good self discoveries about myself and how and why I ate, triggers, and in general, had begun trying to find healthier ways of eating. But the binging never completely stopped and the emotional urges to eat, triggers, all of that, while maybe slightly diminished, never disappeared. In June 2008, I noticed that I was having tremendous pain in my band and that nothing was staying down, not even Water. It was dire. At some level I knew that this was more than being too tight. In the NYU Medical Center ER, on a Sunday evening, they were initially not sure what the problem was. They admitted me overnight and the next morning I was given an esophgram - which brought about the dreaded results: slipped band AND a hiatal hernia. I was devastated and scared when they said that they were immediately prepping an OR for me and that I would be rushed into emergency surgery. Part of me had had it. I thought "I've lost the weight. I could survive without this band now." But when the bariatric surgeon on call came to speak with me, he said in no uncertain terms when I asked about taking it out and leaving it out: "Foolish. I can take the band out and not fix it, and not re-band you, but you will absolutely gain all the weight you lost back. The results are conclusive. You wouldn't have a chance to keep it off." And I believed him. And who knows, while part of me is angry for not getting another opinion or standing up to him or saying "well, screw that, tell me how I CAN fight this and live without such misery," part of me feels like "okay, maybe I was not ready then. Maybe I still did need the band." I was prepped for surgery, rushed in, quietly crying, convinced I was going to die, my usual surgery/anesthesia phobia in high gear. Final preparation happened as I was brought up on the OR table, IV inserted, versed, anesthesia, darkness, begin. I came to and was told it was all fixed and that I was successfully re-banded. I cracked jokes and way too looped up on pain meds, I told the surgical resident when he came to check on me in the recovery room after, that I loved him. He shook my hand, high tailed it out of there, and it wasn't until later that I felt more than sheepish and cursed this cycle of never ending surgeries, all from a self inflected weight gain from years earlier - that I did. I had caused. I did this to myself. Let's be honest. That is perhaps what hurt most of all. Until 25, I never knew the inside of an OR. After, I knew it frequently and had come to quake in its presence. Life continued as a lap bad patient. Time rolled forward. I tried getting filled a couple more times as my weight in 2008 started to creep up, out of the 210's and into the 220's and 230's. But I couldn't tolerate the tightness. My body was so sensitive and the pain and inability tolerate it grew with each passing month. Any restriction seemed to irritate my pouch and stoma and life became an embarrassing array of me rushing to the mens room at restaurants with friends to go throw up some stuck food, me avoiding certain foods like asparagus or meat that seemed too tough to avoid such embarrassment, me trying to eat healthy but then giving up and eating junk food that I knew would just go down easier. It became an array of pain when something I ate got stuck and it became a constant fear that I would end up having my band slip again. And yet I hung in for the long haul. By 2009, I had had most of my Fluid taken out of the band - all but maybe 0.2 cc's or some symbolic amount like that. And I stopped going into my surgeon's practice. I went on with my life with a nearly deflated band. I went up and down in my weight. By now, my daily eating ritual had devolved to eating what I wanted and especially when I was not trying, I used water or soda or other cold beverages with each meal to push food through my stoma into my pouch until I felt the "ploomp" feeling of the food passing through. That feeling became pure joy. I learned how to manipulate the band and eat around it. I no longer ever ate without pushing food through with liquid. Of course that came to backfire every once in a blue and got me hopelessly stuck. But I would sit out of the game for 12 hour or so and then be back in with full force. The band was not doing so much to stop weight gain anymore. I let it become a useless instrument. In August 2012, at 33 going on 34 and just under 9 years with the band, I was at my heaviest weight since getting it put in. 265. I wanted to be 215. That means I had re-gained about 50 of my original 140 weight loss. To me it seemed like a nightmare, but in retrospect, it was pretty amazing that I had kept the vast majority of my weight loss off for so many years and even at my heaviest, I had only regained about 35-40% of my weight loss. I immediately took action and got on Weight Watchers. I had heard so many good things about it. And now I decided to see, with a deflated band and while still not too big, if I could stop the bleeding without depending on a silicone donut to do it for me. And guess what? Pounds started melting away again but because of ME. I did the work. I started grocery shopping every weekend at Whole Foods or Trader Joe's and menu planning. I cooked healthy meals and weighed and measured my food. I educated myself on eating more whole foods and less processed foods. I still had triggers and mild binges on occasion but now when I did, I COUNTED them and owned up to them and tried to understand at least what was causing them. If I decided to say "the heck with it, I'm getting 3 glazed Krispy Kremes," then I asked myself "what's really going on here and why?" I made myself at least know why I was doing it and even if I still went through with it after- which I often did - I tried to be at least conscious about it. That was something that counted - and tangibly helped me grow further than I had up until this point previously. The very beginning of the end of the band Weight Watchers lasted for about 10 months and saw me lose a total of the 39 of the 50 pounds I had regained. I came within 11 pounds of being back at my goal of 215. Without the band. And then it all went downhill. In 2013, my dog, my beloved best friend, was diagnosed with Cushings disease and if you know what that is and what it means for a pet - the amount of work, the amount of witnessing them suffer, the amount of money spent trying everything - then you know what a toll it takes on you and your pet. Factor in that I was not the happiest in my career and in my life - and I found myself falling off the wagon of Weight Watchers for a couple weeks - which turned into a couple months which turned into I was no longer on Weight Watchers and eating whatever I wanted. Between June 2013 and early 2015, so a solid year and a half, I went down the darkest eating hill I have gone down since having the band. I caved. I ate everything and too much of it and my band didn't stop me. Other than every few weeks stuff getting stuck, causing me to be sidelined from eating for 12 hours, I was able to eat with almost the same gusto as I was before the band. Oh how the mind tricks you on weight gain. Sure, I knew I was putting weight on. But I'd say "hmm, well, it's been 6 months since I've been off WW, and while I feel a little thicker, I am guessing I have probably gained maybe 2-3 pounds a months and have put on somewhere between 15 and 25 pounds. So maybe I'm like between 230 and 240." Then: "hmm, well, it's been a year since I've went off Weight Watchers and I got very involved in the gym and working out with a trainer recently, so I think even though my eating and stress has been a nightmare, I think I've mitigated some of the damage. I am probably at like 250. After all, most of my clothes still 'fit.'" Finally, after two years of fighting to get my dog stabilized and healthy, his health took a huge nose dive in late January 2015 and over the next two weeks a hell on Earth began trying to literally save him. I lost that battle on February 15, 2015 and at a few months shy of his 9th birthday, way too young, my beloved hound mix passed away in my arms on the way to the ER vet. (His third time going there in less than 2 days). There aren't words to describe the devastation. To this day, nearly a year and a half later, it's too much. After he died, for a week, I literally stopped eating. Listen, when I am upset - I eat. But this? This was beyond upset. If I wasn't eating, this was pure devastation. But, as the initial shell shock and utter grief moved into numbness and disassociation, the cravings returned with a vengeance. I am convinced that between late February 2015 and six weeks later, in early April 2015, I put on a good 15 pounds alone. In early April, most of my clothes now didn't fit and I had been telling myself for MONTHS, "you must get back on the horse. You will wind up gaining all your weight back. You cannot let this happen." My dog had died, I was sad, but there was no longer an excuse. And so I returned nervously but full of hope to Weight Watchers and re-joined on April 15, 2015. The weigh in was crushing: 289. Nearly two years of out of control eating and I had gained from my low of 226 on WW, approximately 63 pounds. That's approximately 31.5 pounds a year. That's 2.5 pounds a month. Guess what? I was right at six months. I probably only did weigh around 240 then. It's the fact that for the first time since 2003, I had let myself not get back on the horse and had just nearly given up. I had literally regained 60% of what I lost. I was determined to STOP it now, and I did. One small note to add: in August 2014, I ate something and became so stuck by the band, that I could not eat for 24 hours and the pain became unmanageable. I went to the ER in Methodist Hospital in Brooklyn where I now lived. At 35, going on 36, I was yet again facing another lap band slip and thought "if it is, it's coming out. I will manage. I cannot live like this." They hospitalized me to get fluids in me and examine me. They did an esophogram. It showed no slip but that the band was tight and my stoma and esophagus was very painfully inflamed. An on call bariatric surgeon was paged to meet with me. His message, naturally, was the same as the other on call surgeon back in 2008: "I'll take the band out for you if you want, but just understand you'll regain all the weight." I was livid. "No! I will not! I will not let myself!" He was insistent. "Yup, you will. Not only will you gain it all back, but you'll gain extra too - you'll be bigger than you ever were before and you'll do it very quickly." I argued that a year earlier I had made tremendous progress with Weight Watchers and that my band these days was useless, it was nearly empty. His response? "Doesn't matter, the band sits on your gut and presses on nerves that reduce hunger craving hormones. Once you get that band out, your appetite will be insatiable and all your old habits will come back." Do you know what he said next? "It's your destiny to be obese. You cannot be a healthy weight with out some form of weight loss surgery." I rolled over in my hospital bed and looked at the wall trying not to break down and cry. I felt trapped. He left the room and I never saw him again. The regular doctor withdrew the remaining 0.2 cc's left in my band from years earlier, and I was released the next day after I was able to swallow a cup of water and hold down some Jello. I left that hospital defeated and continued to gain weight. I now had a COMPLETELY empty band. Deflated. Nada. Nothing left but a loose silicone band. Which made my last several months of my eating frenzy even easier. When I finally re-joined Weight Watchers approximately eight months later, for my second time, my life yet again changed drastically. Now I was back on plan with a vengeance. I started where I left off. All the good habits and learning and planning and accountability. Now I did something new: before I used to do meetings but would only attend periodically and then it became online WW until I dropped out. I now attended a meeting every single week that I was in town. I shopped, I cooked, I planned, I allowed myself some flexibility and treats and I discovered that I could really eat a lot of delicious, satisfying foods and actually felt more nourished and satisfied eating this way than I did when I was out of control. I was able to eat out, drink beer, wine, cocktails, have a lot of what I wanted - and I was losing the weight fast. By February this year, about 10 months after I restarted, I had lost 62 lbs through diet and exercise. I weighed 227 and was 2 pounds from my new, more realistic goal of 225. (Which my doctor signed off on and approved since Weight Watchers says your goal weight for lifetime membership must match the approved charts - at 225, I am pretty slender - but according to the charts, for my height and age I am supposed to be between 185 and 195. Ha! My body would never get there and even if it did, I'd look like a famine victim). I got 2 pounds from goal and then I hit a NASTY plateau. I became defeated and started slipping on plan. I gained a few, lost a few, gained a few, maintained a lot of weeks that I worked my ass off and was so frustrated. To taste it - to be that close and just miss it. But something else started happening. I chilled out. I was hanging around my 230's at this time and other than getting off plan and eating whatever I wanted for a week or two, I noticed, I was getting BACK ON PLAN, faster and completely committed. I went to Ohio in late February to visit college friends - that was one time I got way off plan and then within a week, got right back on. In late March, I went with family to the DR to an all inclusive resort. The food was amazing - yes - I got off plan. Within a week after? I was back on plan. And in late April, I went to LA for a week for the Jewish holiday and to spend time with a friend for her 40th birthday. Yes. I got way off plan. And by May, two weeks later? I was back on. Here's what I have learned that I think is crucial for us compulsive overeaters, us emotional eaters, us up and down and life long weight strugglers: We will slip. We will be triggered. Lap band or no band. The key is to try to 1.) Be aware of when you are struggling, why you are struggling, what is causing the overeating, emotional eating, etc. 2.) Challenge that behavior / mitigate that behavior WHEN you can. I have started to do this with myself now and it's new for me - I can talk myself out of a bad eating moment and replace it with healthier behavior - not all the time, not even half the time - maybe 20% of the time. But that's a BIG improvement and important! 3.) This is the most important: if you find yourself slipping, as we all will, acknowledge it and SET A DATE for getting back on the horse. That date could be in one hour, one day or one week. Heck, it could even be a month if that's what it takes. But SET THAT INTENTION and STICK TO IT. Don't let it go 4 months or 9 months or 2 years like I did when I got close last time and it all fell apart. Be accountable and aware and willing to GET UP when you FALL DOWN. I think that right there is the key to winning this weight battle and to maintaining weight loss or taking off weight. Here's where I am grateful to my lap band: I could never have lost 140 pounds on my own. I have lost 62 pounds on WW and though I've been caught in a plateau for the last few months, I'm only ten pounds up from my lowest weight back in February. I have not thrown in the towel and I will not throw in the towel. I will soon engage another weight loss cycle and I will hit my goal of 225. I know I will. And then I will work hard to maintain that on lifetime maintenance with WW as best I can. There will be literal and figurative ups and downs. But none of this, where I am at today, would be possible had it not been for the band. I was not ready for Weight Watchers and that commitment back at 24 years of age. I would have liked to have been, but I wasn't. And even so - me losing 30, 40, 50, 60, even 70 pounds on Weight Watchers is one thing but losing 140, more than twice the amount I set out to lose this past time - is another story entirely. I know I could not have done it then - and I am not sure if I would be able to even do it now, with as far as I have come. Regardless, in 2003, the band was the only tool I could find at that time that allowed me to take that kind of large scale of weight off - and effectively keep it off for a long time after. Eventually, the tool became less effective and I clammed up in seeing it and figuring out what to do about it. But in the end? I am where I am today because of that lap band. Better or worse. And I personally think even though rocky and bumpy as it was, it's better. I am better for having had it as a part of my life. Scars and all. The actual end of the band A few months ago, I started noticing that I was getting tight in my band - that was empty. I started getting stuck on foods I should not have been getting stuck on. When I had my "stuck episodes" the episodes were BAD. Violent. Out of nowhere. Rendered me unable to function. Yes, I was used to the occasional getting stuck because of my complicit misuse of my band. But this was different. This was a new kind of stuck. In addition to a full time professional career, I also teach college as an adjunct professor a couple evenings a week. During one of these classes, in late January of this year, I took a sip of water while I was teaching. Something that had not passed through earlier and was mildly stuck - but not in such a way that it really bothered me - suddenly became VERY stuck, with 20 minutes left of my lecture to go. I should have been given a Tony Award for my acting performance. I think the color drained out of my face, but other than that I managed to be all smiles and on point but inside was DYING. Trying to hold it together. I ended class five minutes early and made a beeline for the bathroom. I threw up but it was not resolved. I could not eat for another 18 hours. Imagine my horror when, in my other class that I teach, a few weeks later in February, during a 5 minute break, I got stuck on trail mix. Badly. Trail mix?? That was usually a no problem food. Not this time. I ran to the bathroom for the remaining three minutes of the break and puked like my life depended on it. I knew I was in rough shape. The waves of pain radiated up my chest into my throat. I could tell that I was so inflamed and tight that I would not even be able to get one drop of water down. I had to return to that class and continue teaching in pure misery. I couldn't stand it. I am not sure how I got through it, but it was a new low point for me. A point of no return. I couldn't live like this. In my 13th year of the band, now at age 37 (imagine, I was 24 when I started this journey!), I was starting to have had enough. And not just thinking "maybe this is enough." The uncontrollable feelings became that it "was enough. Definitely enough. Too much." I started thinking constantly about getting it out. Every time I'd have a stuck episode, and they kept coming, and the pain increased, I fantasized about pulling the plug once and for all, and GETTING IT OUT. I was approximately 120 lbs less than when I was banded, nearly 13 years later, and yes, while I'd gone up and down a few times over 13 years, I had mostly kept the the bulk of the weight off and recently, I was learning to finally be more aware than ever before about my eating and to get back on the horse when I lost my way within a couple of weeks. To hell with what these few weight loss surgeons had said to me about "you will definitely regain all the weight and then some if you take the band out." What? No, I won't. I have learned how to stop myself now. Give me a little credit as a functioning human being - I think I've earned it. Look past your statistical research and numbers and look at the individual patient, doctor. Look at ME. I began to realize that this band has not kept the weight off all these years. It helped me LOSE all the weight and initially helped me maintain it, but it is ME who has done the work to keep it off and try and maintain the bulk of the loss and the band - ? No longer really helps. I am the one, I do the work. I don't need this misery. I had far more control than I had ever previously given myself credit for and dawn was starting to break on me realizing this powerful truth. The problem was my health insurance. I had done a cursory search and had found that in 2016, my union insurance did not cover weight loss surgeries - at all - period. So, not only was I shocked that they were such dinosaurs about it, but figured "well, there goes that, cause I don't have the $8,000 extra right now or whatever it would cost, to have this safely and properly taken out." March and April passed and the episodes continues. In the middle of this past May, just five weeks ago, I had such a bad episode I almost went back to the ER. I could not eat for 24 hours - not even sip water. I was in pain. It was misery. Desperate, I finally called my surgeon's office whom I had not called in YEARS. What was wrong with me that I suffered all this time alone and in silence? I had emotionally moved beyond my band and now even resented it. Is that why I didn't have the clarity to ask for help, instead of holding it in alone? Instead of making assumptions? Was it out of fear of my insurance saying "nope, band removal not covered, you're on your own." Would that anger me so that I feared hearing that and then REALLY feeling stuck (literally and figuratively)? Was I avoiding having one more surgeon tell me "fine, I will take it out but you will regain all the weight and fast." Or was it that deep down, I believed that I wasn't actually capable of keeping the weight off WITHOUT the band? Was that what was holding me back? I suspect there were tomes of all of these thoughts that held me in chains for months and even the last few years that I was ready to take this step. But by May, after that particularly harrowing episode, something instinctively, desperately said "enough. You cannot continue like this. Ask Dr. Ren for help." And so I did. I called up for an appointment and it's like, the easiest answer all along poured out of the skies and my life took a major turn that I am so grateful for. I had an esophogram done the morning of my appointment with Dr. Ren, June 1, 2016. After swallowing the barium, the results were sent to Dr. Ren's office and upstairs to her suite I went. After meeting with the nurse and going over the situation, Dr. Ren came and met me and invited me into her office. She was wonderful in 2003 and she's wonderful today. I really hadn't seen her other than in passing over the years and we sort of both had this moment in the hallway where we realized how long it had been. We joked about how much younger we both were then and marveled at how much life had changed and thriving her practice had become over the years. She sat me down in her office and asked me what was wrong. I told her. Everything that I have written above, in so many words. And what she said astounded me. It went something like this: "You have done such a good job with your band. Some lap bands last longer than others, but many don't last for life. 13 years is a GOOD run with a lap band. That's a long time. In looking at your esophogram results, it's no wonder you're having the problems you are. I see swelling and inflammation on your lower esophagus - and not from a recent episode from the other week. This is more long term inflammation caused by the pumping your esophagus is trying to do with an irritated stoma and possibly too tight of a band. Even though it's empty! It must be so painful. It's time for your band to come out." I felt like I'd won lotto. Like every cloud ever, not just the current clouds, but the past clouds, didn't just clear - but evaporated. I felt heard. I felt vindicated. I knew it. But what about regaining weight? We had a long talk about how she normally always feels in agreement with what the other surgeons had said - that the vast majority of people having their lap bands out regain the weight. Most of it or all of it. But - that a small group does not. Some people have managed to keep the weight off through that hard type of work I have been attempting to do - yes - without much help from the band. And my dogged and determined efforts showed that I was a possible candidate for keeping that weight off. She said that if I could commit to Weight Watchers and if I could stay on it, get to maintenance and get back on that horse quickly after I fall - she didn't see why I couldn't do it. We talked about the sleeve and other newer weight loss surgeries - but I just didn't have it in me and she UNDERSTOOD and RESPECTED it. I was thrilled. Dr. Ren also told me that there was now a non-surgical weight loss doctor in her practice that she recommended I see as well. I agreed to do so. And best of all? She said "of course your insurance will cover your band removal. Your esophagus has some damage - it is reversable but it needs to get out now and that's a medical necessity. She walked me over to her billing specialist who investigated it and she said "what is your insurance? Oh! We've had a few people who have had it out with your insurance. This should not be a problem when we submit it as a medical necessity" (which it was). She said she would presubmit the claim and we would schedule the date. It all happened so fast. Dr. Ren does 1 Saturday morning a month in the OR, the rest of her surgery days are something like Mon and Wed. Monday was not great as I didn't want to have to take a whole week off of work for this or you know, half the week. And Wed sounded good but she was booked through August on Wednesdays (and this was back on June 1). The billing specialist who does her surgery calendar too said "hmm, if you'd want to come in and do it on a Saturday morning, she has her one Saturday a month this month on June 25th. I have one spot left." I scooped it up right there and then. Details got planned. I would need pre-op blood work, an authorization from my doc, she would have to make sure the claim was approved by my surgery. I would need to take the Friday before off from work (for me for self care) and the Monday after off, which was no problem, I would need to pick up some supplies, prep emotionally, arrange a family member to be with me/pick me up day of surgery, and decide who I shared this info with. I scheduled an appointment for Dr. Lofton, the non surgical weight loss doc that Dr. Ren recommended. She was highly booked and hard to get me in. They put me on a cancellation list and on June 10 they called me and said "hey, we have a cancellation on June 13 first thing in the morning, can you be here?" YUP! I made it happen. Dr. Lofton and her PA were great. They looked at my history and ultimately she recommended a medication called Saxenda, formerly used as an insulin controlling daily injectable for diabetic patients, it became marketed in 2014 as a new weight loss medication that has shown to be quite successful in diminishing appetite and feelings of satiety by reducing a hormone in the gut that causes hunger - the same one all of these bariatric surgeons were referring to when telling me "even if your band was deflated, it's been reducing a hunger inducing hormone." Hey! How about that? So - the plan was I would pick up the Rx, if approved by my pesky insurance - and keep until after the band was removed. I would spend a few weeks seeing what it felt like to be "normal" again with no intervention, get familiar with my baseline hunger and if I noticed I was too hungry or eating too much, then I would give the Saxenda a try. I will have to inject myself once daily in my gut, leg or arm and it apparently does not hurt and is easy and no big deal. I am 100% willing to try it if I need it. And after an initial denial from my insurance company citing the need for prior authorization, Dr. Lofton's team was able to get said prior authorization and last week I picked it up and brought it home and have it ready. This month of June flew by. Before long it was the eve of my surgery and I was terrified. And excited. But more terrified. 4,569 Days (12 years, 6 Months, 3 Days) I have been terrified of surgery, since I mentioned before, in 2003 when I first had the band put in. It's something about the combination of worrying irrationally that I will go into cardiac arrest on the table and never awake again - combined with the idea of being cut open, combined with the idea of what it can feel like to wake up throwing up and out of it and having people yelling at you to take a deep breath while being wheeled naked in a gown down a bright hallway to recovery - that has rendered me a frozen five year old being asked to jump off a high dive. I knew I would be terrified but until last night, I didn't realize how much. I managed to get myself into the hospital on time. Upon arriving at 9:30am for my check in this morning, there were several fire trucks parked in front and in the main lobby, the fire alarm lights were flashing while firemen rushed around. They took out all elevators and I was told, "if you want to get to the fourth floor you'll have to wait and it could be a while or you'll have to take the stairs." It's a good thing I'm relatively lean and in shape. And that it was the 4th floor and not the 14th floor. But - I of course internalized this as a sign of "you are being warned, this is an emergency waiting to happen, you are going to crash and die during surgery." I won't belabor the rest of the details of my tremendous fear. During the check in and pre-op holding area where I changed into my gown and was counseled and examined by a lovely nurse - I was practically giving myself a heart attack. I go through this near every time I have surgery now. A lovely small moment that helped was that as I was lead to a curtained cubicle with a recliner chair where I was to change and be examined pre-op, I saw a young man laying the curtained stall across from me. He seemed maybe 17 years old. He was Latino, had braces and was scrubbed up and ready of this own surgery. His parents sat eagerly next to his bedside and held his hands. A Spanish translator was speaking gently in Spanish with them and he, the young man, seemed to not be paying attention too much. He followed me with his eyes as I was seated in my stall and watched me closely. When I finally made eye contact with him, he smiled sheepishly and waved timidly at me. As if to say "I'm scared, are you? We're both about to go through this together." This young man had to see someone much older than him, but perhaps younger than his parents and the closest person who could understand what he was about to go through. I recognized it in his eyes. We kept smiling at each other every so often over the next 30 minutes, while the nurse came in and took my temp and blood pressure, and explained the surgery to me, had me confirm my name and date of birth, while his surgeon, a middle aged white man came and spoke to him and his family and translator - during this whole that they prepped both of us, we searched for each other, 20 years apart in age, but somehow totally intertwined in what we both were preparing for. I tried to send him soothing, reassuring facial expressions. His youth and kindness and desire to have but a small connection in the wake of such a frightening, uncertain trial induced me to put aside my fear for a moment and care for him, instead of perseverate on my impending death. Soon, he was wheeled away by an orderly and his parents walked away, slowly, mother crying, I heard the nurse directing them to the waiting room and saying that he would be okay. As he was wheeled away, he gave me one last glance, as if searching for clarity in what would happen next. My nerves returned, but there was a deeper force in me now, one that was rooting me on and saying "if you just get through to the other side of this procedure, you will find a freedom for which you've searched for not just the last 13 years of this lap-band, but your whole life. For 37 years. It's not that I thought, like when I got the band in, that my life was going to become AMAZING. I was simultaneously having fears about regaining so much weight and knowing how much work was going to be required. But - a feeling that I could now feel healthier, take this step on my own, get the training wheels off after more than a dozen valiantly fought years, some improvements - not perfect - but some - and that gone were the days of getting stuck and maybe now I could eat kale and asparagus and a not worry about the ramifications. Now I could be intimate with a partner and now worry about them feeling my giant port and saying "um, what is that?" Now I could go out to dinner and eat unencumbered - not meaning pig out - but just not worry "ugh, what happens if I get stuck in front of these people who know not of my situation and have to run twice to the bathroom?" After so long, I was going to be at last free of this. One way or another. Soon they came for me and it was my turn. They wheeled me away out of the pre-op staging area and brought me to a patients only elevator. I watched countless doctors and nurses walk past me, register by the look in their eyes that I was on my way to the OR and you could see the curiosity: "hmm, he's young, wonder what he's having done." My surgery nurse met me at the point of no return, double doors where scrubbed up personnel only were permitted to pass. She spoke to me for a while, had me sign some papers again and then wheeled me inside those doors. She parked me outside the OR #4 for while she walked away to find someone. I looked inside the window on the door of the OR trying to see if I could figure out if it was going to be my OR. Inside was a plasma TV screen and on it I saw a long metal wand pointed at what looked like someone's intestines, smoke wisping out of the end of it as it cauterized and made a high pitched sound I could hear through the doors. "Bzzzz." I realized they were in middle of surgery on someone and wondered if it was my 17 year old friend. I thought of his frightened face and thought about how by now he was most certainly unconscious and under way, whichever of these many OR doors he was actually behind. Soon the surgery nurse returned and wheeled me down one more door, to OR #5. I considered whether or not I liked the sound of OR #5, there seemed to be best I could tell up to 12 OR's on this floor and I decided I liked the sound of #5 and its placement, as she parked my wheelchair and motioned that we had arrived. It took all I could get to muster up every last ounce of strength when my moment came, that I had dreaded for the last several days, of climbing up on that operating table this morning. At NYU, they wheel you to the door of your OR and then you get to walk your ass in and climb up on that table. It's so clinical and sterile. No windows, no music, no TV. Just like 6 random scrubbed up people prepping instruments, the plasma screen, your table, etc. They got me on the table, tears streamed down, they tried to soothe me and work quickly. To my nurse anesthetists credit, she got my IV in no longer than 6 or 7 minutes after I got on that table and within another 2 minutes, they'd delivered a strong dose of versed. I thought about my mom who had passed away years ago that I missed and asked her and God to be with me. I asked for forgiveness. I thought of my grandmother who I had loved in her life - and I thought of even my dog! His sweet face and constantly happy disposition. His wagging butt and smiley nature - it actually made me feel better! I thought "whatever happens, God, it's out of my control and in your hands. I am letting go and trusting. And if I make it through, which I am choosing to have faith that I will, the real test will continue after, as I move forward with eating healthy and staying trim WITHOUT these training wheels." Around that moment, I was very loopy and high on versed, sleepy but I remember the anesthesiologist had suddenly appeared and vaguely was aware of him saying it was time to deliver the anesthesia and commenting "ohhh, i think I feel it coming, it feels..." That was all I remember. Like every time before. And like each time before, I was immediately aware of beeping machines and voices and a woman's voice calling my name. No real sight at first, just a strong fatigue and desire to sleep mixed with a desire to be conscious and - the very happy and grateful feelings of "oh my God! Oh my God! I did it! I'm done! I'm on the other side!" Like finishing the dreaded mile I used to run in junior high. Dreading it all day, not because I hated running it but because I hated the feeling of trying to remain in the middle of the pack, the fear of falling behind and coming in last or second to last. Knowing that I had to blend in and fight to keep pace, fight to not be made fun of for failing. At the end of the mile, stepping over the final stride, came always an exuberant elation, not because I had set any records or felt proud of my run necessarily, but joyous that I was FINISHED, it was not me who now had to dread it, it was behind and I had survived and could go on with the next order of business that preferred fare more than that. So is waking up for surgery. I didn't love it. I hated it in fact. But I survived. I was on the other side. And though I was becoming aware of pain and fighting the super high effects of Fentanyl and Dilaudid (simultaneously wonderful and frightening), I felt a constant relief that no matter what I was here now. I slept and woke and in between blurted out crazy comments to my dedicated recovery room nurse about banana pudding, banana cream pie, about how I hoped she was not voting for Donald Trump (which I would never say to a nurse I didn't know under a non-drug induced state and to which she replied "what do you think of me? Of course I would never!" I am still feeling lucky that I wound up with either a polite nurse who lied for my sake or most likely being New York City, a sensible moderate or liberal). I was brought ice

I am right at two weeks post op, and during the liquids phase my paperwork says nothing about calorie goals. My goals are 60 - 90 grams of protein and 64 ounces of liquids. Liquids for me is three, long weeks. Pureed and soft diet stages I have a calorie goal of 650 - 800 calories. Protein and liquid goals are the same as the liquid phase. Full bariatric diet has a calorie goal of 1000 calories for the first six months and 1200 calories from six months onward. Protein and liquid goals are the same as the liquid phase still. Hope this helps.

BTW I forgot to say this about my taste. Sometimes it has a horrible bitter taste and sometimes tastes like metal. I was told by a fellow Bariatric person that I should have my vitamins or reg medicatons checked out. But I have had this bitter and tin taste before my RNY. I do think it has got worse too. Not fun sometimes this is why I chew gum all the time. LOL Another story there!!

What you are experiencing isn't right, but you do have some choices. Have you had any tests to see why you are having these problems? If not, and your surgeon isn't willing to look into it, then you'll need to look elsewhere. Your regular family doc can refer you to a gastroenterologist. The GI doc can order tests. There is also the possibility of switching bariatric doctors. There is a program in Annapolis that you could check out. (I don't know anything about it.. just that it is there). If things become an emergency, like you can't drink, then you can go to the emergency room at Hopkins. Always choose an ER of a hospital that has bariatric surgeons so you have the chance of seeing one of them. Not saying you will.. but at least the possibility exists. Physical therapy is nice, but if you can't keep down food, that is your problem, and exercise won't fix it. Please be proactive getting some help. Don't wait so long that it becomes a life-or-death situation.

Are you willing to travel into KC? Ft. Leavenworth is really not that far at all when you come down K7. I'm in western Shawnee by K7 and Johnson Drive and go in to see Dr. Fearing at Malley Surgical in Mission. Shawnee Mission Med Center has the Bariatric Center (http://www.kcbariatric.com/compare.php), which is off 95th and K7.

I also think you can just order a normal meal, eat the 7 or 8 bites of bariatric friendly food (the meatballs on a plate of spaghetti) take the rest home and throw it out when you walk in the door.

Nonono... he does not work out of a clinic. Only a hospital. No clinic. ;o) His website is: Alberto Aceves, MD-FACS Certified Bariatric Surgeon

My company was bought and our insurance will change to Anthem Blue Cross in January. The plan is called Prudent Buyer. My new employer is California based however I live in Texas. We haven’t enrolled in our selected plans yet however my HR person gave me the EOC for this year explaining all the coverage and stated nothing will change. Bariatric is covered and the only stipulation is that it must be deemed medically necessary and performed at a BDCSC facility. There are absolutely no other requirements listed like wait times, nutrition visits, etc. Anyone else have experience with this plan?

I am unable to locate information about bariatric surgery and security clearances. I am interested in a career with the Department of State as a Foreign Service Officer. The position requires a worldwide medical clearance. Does anybody know if bariatric surgery would disqualify a candidate from receiving a worldwide medical clearance?

Oh, I do not have a cookbook lol. I just have favorite recipes. There is a Bariatric Cookbook that you may enjoy.

I find myself noticing others who might benefit from knowing more about bariatric surgery. I have kept my mouth shut thus far but it's getting harder when I see struggling,and our of breath young people. I want to tell them there is hope and answer, but in their place(where I was until I started my journey) would I have accepted a gentle suggestion? I have found 2 acqaintances who are post surgery but they didn't tell me of their plans. I'm afraid I asked one if she'd had cancer- well she was thinner and so was her hair- how was I gonna think? She is looking better now cause her is thickening back up, and most important she feels better about herself. Sent from my VS880PP using BariatricPal mobile app

When I google, the following turns up at a Medicare site: Certain bariatric surgery procedures for treatment of co-morbidities associated with morbid obesity are considered reasonable and necessary under the Social Security Act (Section1862(a)(1)(A)) if the following conditions are satisfied: 1. The Medicare beneficiary: Has a body-mass index (BMI) > 35, Has at least one co-morbidity related to obesity (such as diabetes or hypertension), and Has been previously unsuccessful with medical treatment for obesity. 2. The Procedure is performed in an approved facility listed at Bariatric Surgery on the CMS website.

Every Dr does something different, but I haven't heard of one that won't recommend RTD shakes. Did they give you a reason? I don't do powders at all and never do anything put the Premier brand of RTDs. IMO Bariatric Advantage isn't one of the better brands, so you might want to think about switching to nectar or really any other one. Go to GNC or Vitamin Shoppe and see if they have samples. You can also get unflavored Protein from unjury (Google it). Isopure comes in bottles and has flavors other than chocolate and vanilla and can be mixed with Powerade zero. In the mean time, when making your shake, put the powder in the cup, put about 1/4 the liquid in it and stir really hard to make a paste. Then add the rest of your liquid. You can also try adding some dry milk powder to it as well. What ever you do don't stop trying. /

Today I loved my shake!!!!!! I did the bariatric advantage chocolate plus skim milk and peanut butter blended into a paste then added ice and blended.... yummmy....... way better than the chalk I've been eating. ........ thanks everyone for the tips.... helps so much.... ♡♥♡

This is all my bariatric advantage shakes prior to surgery... I called my doctor and they didn't recommend I use pre made shakes... why is that????? So basically I can use powder milk ice water plus a fruit... I'm tryin to be very strict and not cheat but I feel like I'm drinking chalk... gotta find another way to like this.... 0_o