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All I can say is ... the haters can kiss my (thanks to my band) cute, small(er..) bee-hind!! I find that kind of thing so ridiculous. All of these kinds of surgery seem to work really well when done by good surgeons and on people who work the tool they are given. I don't view one as better than another -- I think it's really a matter of personal situation and preference. That said, I'm hearing good things about the sleeve from a few former bandsters who had to revise to the sleeve due to complications. But, otherwise, I don't know too much about it. The band worked very well for me -- I'll be 4 years out in October, and I've been at or under goal for more than 2 years. Best, Catherine

I'm 10 weeks out and seem to be doing really good with my hair. I did have the band for 6 years and had the revision to the sleeve so maybe that helps since it's not a total shock to my body. I took Biotin 500mcg before the surgery (1 month) and have continued that. I'm not big on protein shakes but try to get them in. Some regrets b.c I can't enjoy food the way I use too which is probably a good thing, and going out to dinner, yea forget that, it is so hard to eat or I can't eat it all. I know I am new and it will get easier to eat, but right now it is still hard to do. I wouldn't change it though. I use to be 300 the band took me to 185, I gained back some and ballooned to 235 b.c my band had to be un-filled and I'm not back on track at 196

Anyone out from the Feb 25th surgery? If so how are you feeling??? I had my revision on the 25th and dammit the pains

I started with a gastric sleeve surgery done in July 2019 weighing just shy of 350lbs. I had a lot of issues and tough recovery and it required a revision to a gastric bypass at the end of February 2020. I do not own a scale in my home as I would obsess over the number and with the whole Covid situation I was not going to in person dr appointments but today finally I was able to go and I weighed in at 187lbs!!!! That number seems crazy to me. I was over 200 at the age of 12 and I’m now 46. I want to laugh and cry at the same time. This last year was probably the hardest thing I’ve ever been through and I am not back to being 100% healthy yet but I am so excited to finally be under the 200lb mark.

Katy, I am sorry you still have some pain! My insurance was reluctant to pay because the original request to revise had made it sound like we needed to revise the pouch rather than te port. Once it was clarified ( through filing a grievence) they approved it. I had a talk with the surgeon before we went to the OR the next time and let him know that, whever he was planning to move it to... I did not want to be able to see or feel the port after this operation. He did a good job of making it happen. Afterward he said that what had happened was that 2 of the 4 stitched areas securing the port had broken free, so instead of laying flat, it was standing up... And in that position there was no way to fill it as the needle was entering parrallell to the port. My real concern now is that after being banded in May and not being ant to get it filled until November. I worry that I msy not be inthe right "mindset" to be successful. At first it's new, and you are sure you have found the thing that is really going to work for you. Then you get it done... And I lost 20 lb... But it was through dieting rather than the lap band doing much... Then that tapered off... And after a while it felt to me like the lap band was going to be one more failed diet attempt. Now that I have had my first fill i am trying to get back the optimism I had at the beginning... But there is still the self doubt that makes me afraid this too will not work. I am really hoping that I will see results that will give me some hope that this time things are going to be different.

Thank you I do still have some pain on my right side which my surgeon's PA said is where the largest incision is and where I had adhesions and scar tissue from my sleeve. She told me it would take longer to heal because they stitched it very tight to prevent abdominal hernias. It is mostly ok but I still get pain bending there so inflammation is possible. Menstrual cycle it's hard to say. I am 40 so could be in perimenopause but I have a Mirena IUD which mostly stops my periods. I drink mostly Gatorade zero, powerade zero and propel because that's what has tasted the best since revision and miralax mixes well. I do ok on hydration getting 40-50 oz a day. My gastroenterologist has me do two caps of miralax to prevent constipation and it is working. I do feel like #4 is what makes most sense. I think I dropped water weight rapidly due to the shock of surgery and bounced back up. As long as I don't keep gaining weight I'm fine here. My weight would fluctuate pre revision between 142-145.

Hey Crystal, I'm in your exact same boat, but I've gone through the revision from band to sleeve. Here's my deal: I have Aetna insurance, and I have the exact same wording in my policy that you posted above. However (I'm not sure if you have this or not), I have a $10,000 lifetime bariatric max. As such, if my surgeon was willing to, I wanted to do it all in one surgery. The hospital portion (vs the surgeon's fee) is the much more expensive side of the equation when it comes to surgery (at least for me), so going through two surgeries with a $10K max was sort of financially impossible for me. So anyway, my surgeon was willing to do the revision in one surgery. She put together a pretty good argument for me, and we submitted for approval. Aetna approved me in less than a week. They approved a lapband explant and a vertical sleeve, so exactly what I needed. I'm not sure which bullet point they approved me under, but frankly, I don't really care...I just needed a pre-approval. I did my revision 9 days ago.

Thanks all! Kimmr--I looked at my specific company policy and my bariatric max is unlimited, so no issues with that. GivingItMyAll--I think I qualify under 2nd bullet also... Wheetsin--I got the impression that the insurance companies only considers it a revision if it's done in one surgery (because I'm having to do the 3 month program again before the sleeve is submitted for approval). I'm worried that my band will be removed and I won't qualify for the sleeve because of my BMI and no comorbidities... I'm going to see if the insurance person will just submit both right now without waiting for the 90 days...I'll copy this portion of my policy and email her. Just got a call to schedule my removal...more news soon as I hear something!

A revision doesn't have anything to do with the length/lack of time between procedures. I was 6 months apart and am still a revision. You're just having a former surgery 'revised' to something else. Best of luck.

I'm having a revision too bypass 11/14/16. Good luck to you on yours !

I can’t decide which revision is best? Any opinions would be appreciated!!

When I started this process, I weighed 235. I set a goal of 150 for myself. When I was in college, I took a full load of classes, worked full-time and worked out 2-3 hours EVERY DAY at the gym. With that schedule, I weighed 150 and was a size 10. I thought that if I got THERE, then I would be at my 'best.' Well, I got to 150 and knew I wasn't done. So, I revised my goal to 143, because that put me at a healthy BMI. 143 came and I have still been losing, and I knew I'd eventually get to the 100 pounds lost mark. I MADE IT!!!! WOO HOO!!!

Bypass... I’ve seen too many revisions with the sleeve.

I hope I am only in this infamous stall phase too...... I am 4 weeks out today.from band to bypass revision.... and have lost a total of 1stone 5 1/2 pounds... but of that only 1 pound this week and 1 pound last week... I have a shake for breakfast.... a small low cal high protein lunch and dinner... around 60___80 protein... not quite making my fluid target... but very disappointed the last two weeks..... recovery wise I feel fine...

I had lapband in 2008 was 305 went down to 170 in 9 months. Kept it off for 6 years then my band eroded in oct of 2013. I was revised to bypass in May 2014 but had to gain weight to meet the criteria to have the bypass. Day of surgery I was 245 on May 21, 2014. I am at 189 now still have 19 left to get back to my optimal weight but it's coming off ????

When I decided on the sleeve vs rny I think the difference was like 13 lbs I think sleeve people average loose 60% and bypass people usually lose about 70%. Depending how I am feeling in a few months I will probably talk to my doctor about switching to a bypass, but for me its because of reflux. I had pretty severe reflux before, but I let the doctor talk me into a sleeve, and now it is the same or worse than before so I might be one of the revision people too. I'm down almost 40lbs but my weightloss has slowed this week. I think that people who have the bypass lose faster, but from what the doc told me by 2 years everyone is about the same.

@CammyC: I had my revision 26th February and I am convinced I am eating way more calories than you. I still don't feel that good, walks and grocery shopping are exhausting and I'm honestly not really expecting being able to jump around. We all should keep in mind that we had abdominal surgery and general anesthesia. It takes time, at least for most people. Tbh, I can't relate at all to the patients talking about "brimming with energy" shortly after surgery.

Challenge Starting weight: 200.4 Current weight lost: 0 Losing or maintaining weight: LOSING Fitness/exercise goal: NOT RELEASED YET JUST JOINING. REVISION RNY 10/25/18 Revision 10/25/18 Kattrax421B.Com Don't meddle in the affairs of dragons, for you are crunchy, and taste good with catchup!

Hi Nicki, I'm having revision from lapband to bypass and I can tell you, I wish I would have just gone with the bypass to begin with. For me, the gas pains from having the lapband was terrible and I'm not looking forward to that again and the lapband didn't work at all for me. I do have a sweet tooth so I'm keeping my fingers crossed that I dump to keep me away from those foods, not that I'm even thinking of having those things anytime soon after my surgery. Ultimately the choice is yours and you have to do what makes you feel comfortable. Good luck in your journey!!! Heather Sent from my iPhone using the BariatricPal App

Dr Snow & Dr Van Wagner no longer share a practice as of Feb 1st. I will call Dr Van Wagner's office though and see if their nutritionist takes outside patients. Thanks so much!!! Hello! I am new here and am seeing Dr. Snow, also (though I live in the Festus area). Have my 5th out of 6 dietitian appointments on monday before I can be officially approved for the sleeve. I have been seeing the dietitian in Dr. Wagner's office and before the first of the year, visits were free. After the split, I pay $20 copay, but can still see her. Oh that's fantastic! I did email her earlier today to see if she's accepting new clients since I didn't see her before my revision. Thanks again for sharing Best of luck at your last appointment & on your weight loss journey!

Hello... I thought I would post this must read article by the surgeon who invented the "Green Zone" and how the band should "ideally work".... http://bariatrictime...1/#comment-2133 Gastric Banding and the Fine Art of Eating BT Online Editor | September 22, 2011 by Paul O’Brien, MD Dr. O’Brien is from the Centre for Obesity Research and Education (CORE), Monash University, Melbourne, Australia. Bariatric Times. 2011;8(9):18–21 Funding: No funding was received for the preparation of this article. Financial Disclosure: Dr. Paul O’Brien is the Emeritus Director of the Centre for Obesity Research and Education (CORE) at Monash University, which receives a grant from Allergan for research support. The grant is not tied to any specified research projects and Allergan has no control of the protocol, analysis and reporting of any studies. CORE also receives a grant from Applied Medical toward educational programs. Dr. O’Brien has written a patient information book entitled The Lap-Band Solution: A Partnership for Weight Loss, which is given to patients without charge, but some are sold to surgeons and others for which he receives a royalty. Dr. O’Brien is employed as the National Medical Director for the American Institute of Gastric Banding, a multicenter facility, based in Dallas, Texas, that treats obesity predominantly by gastric banding. Abstract The author reviews the physiology of eating and what the adjustable gastric band does to the function of the distal esophagus and upper stomach of the patient. The author also provides the “Eight Golden Rules” on proper eating habits for patients of laparoscopic adjustable gastric banding, including what, when, and how they should eat, in order to achieve optimal weight loss results. Introduction Laparoscopic adjustable gastric banding (LAGB) has been shown to enable patients with obesity to achieve substantial, durable, and safe weight loss,[1,2] which can help reduce or resolve multiple diseases,[3] improve quality of life, and prolong survival in patients with obesity.[4] LAGB is a weight loss surgical procedure performed solely for the purpose of affecting a key physiological function in weight loss, appetite control. In 2005, we conducted a randomized, blinded, crossover trial that showed that the LAGB controls the appetite.[5] However, if the LAGB is not placed properly or if the patient does not eat properly, it will not perform at an optimal level. For example, if the band is placed too loosely, then it will not provide the proper level of reduced satiety and appetite, and likely will have little effect on the patient’s weight and health. If the band is placed too tightly or if patient eats too fast or takes large bites of food, slips and enlargements can occur, leading to reflux, heartburn, vomiting, and sometimes the need for revision. Optimally, the band should be adjusted so that it squeezes the stomach at just the right pressure. If the patient eats correctly and the band is placed correctly, the LAGB should adequately control the patient’s appetite, resulting in optimal weight loss. The Physiology of LAGB Dr. Paul Burton, a bariatric surgeon at the Centre for Obesity Research and Education, Melbourne Australia, has studied the physiology and the pathophysiology of the LAGB closely. He used high-resolution video manometry, isotope transit studies, endoscopy, and contrast imaging to understand what happens during eating in normal controls, eating in patients who are doing well after LAGB, and eating in patients who have symptoms of reflux, heartburn, and/or vomiting after LAGB.[7–15] In Burton’s series of articles, he concluded that in LAGB, it is not the band that fails, but rather the patients who receive the band and, more importantly, the doctors who care for them. Many years ago at the Centre for Obesity Research and Education (CORE), my colleagues and I developed the Green Zone chart, a conceptual way of identifying the optimal level of band restriction (Figure 1). When a patient is in the yellow zone, it is an indication that the band is too loose. When in the yellow zone, a patient may be eating too easily, feeling hungry, and not losing weight. When a patient is in the green zone, he or she does not feel hungry, is satisfied with small amounts of food, and is achieving weight loss or maintaining a satisfactory level of reduced weight. When a patient is in the the red zone, it is an indication that the band is too tight. The patient experiences reflux, heartburn, and vomiting. The range of food the patient in the red zone can eat after undergoing LAGB is limited and he or she may start to eat abnormally (so-called maladaptive eating), favoring softer, smoother foods like ice cream and chocolate. While in the red zone, patients will not lose weight as effectively and they may even gain weight. Burton measured the pressure within the upper stomach beneath the band in numerous patients when they were in the green zone. He found the optimal pressure was typically 25 to 30mmHg. The art of adjustment is to find the level of Fluid in the band that achieves that pressure range. That level of pressure generates a background sense of satiety that persists throughout the day. The patient, when correctly adjusted, normally will not feel hungry upon waking in the morning, and throughout the day should feel much less hungry than he or she did before band placement. In my experience, it is common for LAGB patients to have no feeling of hunger in the morning. Then, during the day, a modest level of hunger will develop, which a small meal should satisfy. One of the key lessons learned from Burton’s studies was that each bite of food should pass across the band completely before another bite is swallowed. There is no pouch or small stomach above the band and there should never be food sitting there waiting. The esophagus is a powerful muscular organ that typically generates pressures of 100 to 150mmHg, but it is capable of generating pressures above 200mmHg. Esophageal peristalsis squeezes the bite of food down toward the band and then progressively squeezes that bite across the band. Each bite must be squeezed across the band before the next bite starts to arrive. Figure 2 shows a bite in transit across the band. A single bite of food, chewed well until it is mush, will move down the esophagus by peristalsis. At the level of the band, the esophageal peristalsis will squeeze that bolus of food across the band. It takes multiple squeezes (usually 2–6 squeezes or peristaltic waves) to get that bite of food across in a patient with a well-adjusted band (Figure 2). Those squeezes generate a feeling of not being hungry and stimulate a message that passes to the hypothalamus to indicate that no more food is needed. If a single bite of food is able to generate between two and six waves of signal, a meal of 20 bites may generate 100 or more signals. This is enough to satisfy a person and is enough to signal him or her to stop eating. We recognize two terms for appetite control, satiety and satiation. Satiety refers to the background control of hunger that is present throughout the day regardless of eating. In the LAGB patient, satiety is generated by the band exerting a constant compression on the cardia. Satiation is the early control of hunger that comes with eating. In the LAGB patient, satiation is generated by the squeezing of the bolus of food across the band during a meal. Each squeeze adds to the satiation signal. There are sensors in the cardia of the stomach that detect this squeezing. The exact nature of these sensors is still to be confirmed but they must be either hormonal or neural. We know that satiety and satiation are not mediated by one of the hormones currently known to arise from the upper stomach.[16] Ghrelin is a hormone that stimulates appetite. A number of hormones that can be derived from the cardia of the stomach are known to reduce appetite. None of these hormones are found to be raised in the basal state after gastric banding and none can be shown to rise significantly after each meal.[16] Vagal afferents are plentiful in the cardia, and one group of afferents has a particular structure that lends itself to recognizing the compression of the gastric wall associated with squeezing of the bite of food across the band. In my opinion, the intraganglionic laminar endings, better known as IGLEs, are the most likely candidate as mediator of the background of satiety throughout the day and the early satiation after a meal. The IGLEs lie attached to the sheath of the myenteric ganglia and are known to detect tension within the wall of the stomach. They are low-threshold and slowly adapting sensors and therefore are optimal for detecting continued compression of cardia of the stomach over a 24-hour period. The several squeezes that go with the transit of each bite stimulate the IGLEs further. The signal passes to the arcuate nucleus of the hypothalamus and the drive to eat is reduced. The lower esophageal contractile segment. Burton developed the concept of the lower esophageal contractile segment (LECS). It is made up of four parts: the esophagus, the lower esophageal sphincter, the proximal stomach (including the 1cm or so above the band and the 2cm of stomach behind the band), and the band itself (Figure 3). As the esophagus squeezes the bolus of food down toward the band, the lower esophageal sphincter relaxes as this peristaltic wave approaches. It then generates an after-contraction, which can maintain some of the pressure of the peristaltic wave as a part of the food bolus is squeezed into that small segment of upper stomach. The upper stomach, including the area under the band, is sensitive to these pressures. It generates signals to the hypothalamus. These signals may be hormonal but are more likely to be neural. A correctly adjusted band will generate a basal intraluminal pressure of 25 to 30mmHg, providing a resistance to flow. The segment of the bolus that is squeezed through generates more signals from that area. Keeping the LECS intact is a key requirement for success with the gastric band. Bad eating habits (e.g., insufficient chewing, eating too quickly, taking bites that are too large) hurt the LECS. If those bad habits go on for long enough, stretching occurs and the power of peristalsis is lost, leading to the return of hunger (Figure 4).[11,12] The Fine Art of Eating A quality aftercare program is essential to successful weight loss in patients after LAGB. Before making the decision to proceed with LAGB in patients, I promise my patients three things: 1) to place the band in the optimal position safely and securely, 2) that they will have permanent access to a skilled aftercare program, and 3) that I will give them the information they need to obtain the best possible weight loss from the band. In return, I ask for three commitments from my patients: 1) that they follow the rules regarding eating after undergoing the procedure, 2) that they follow the rules regarding exercise and activity, and 3) that they always come back for follow up no matter how many years have passed.[6] The “Eight Golden Rules.” At my facility, we summarized guidelines for eating after LAGB into what we call the “Eight Golden Rules” (Table 1). These rules are included in a book and DVD given to every patient who undergoes LAGB at the facility.[6] The rules are also posted on www.lapbandaustralia.com.au and are reinforced at most aftercare visits. These eight golden rules must become part of each patient’s life. The effect of the LAGB procedure on hunger facilitates a patient’s adherence to the rules, making it more likely that he or she will follow them. However, achieving positive results with LAGB requires a working partnership between the physician and patient. Adhering to these rules is the patient’s part of the partnership, and he or she ultimately is responsible for the success or failure of weight loss following LAGB. What to eat. After undergoing LAGB, patients should eat small amounts of “good food,” meaning food that is Protein rich, of high quality, and in solid form. Each meal should consist of 125mL or 125g (i.e., about half of a cup of food). This measure of “half a cup” is a concept rather than a real measure of food, as some foods, such as vegetables and fruit, are composed largely of Water and this has to be allowed for in some way. Thus, I allow exceeding the “half a cup” limit a little for vegetables and fruit. We instruct patients to put each meal on a small plate and to use a small fork or spoon. The patient should not expect to finish all of the food on the plate, but rather he or she should plan to stop when he or she is no longer hungry. Any food left on the plate should be discarded. Protein-rich foods. Protein is the most important macronutrient in the food a LAGB patient eats. At our clinic, we recommend that our patients consume approximately 50g of protein per day. We have measured protein intake of our patients (Table 2) and have monitored their blood levels. We have not seen any protein malnutrition after LAGB, indicating that a daily intake of about 50g a day is sufficient. Table 2 shows the energy and macronutrient intake of 129 consecutive patients measured before and at one year after LAGB. Note the mean energy intake is reduced by approximately 1500kcals.[17] The best source of protein is meat; however, red meats, such as beef and lamb, tend to be difficult to break up with chewing in order to be sufficiently turned into mush. It is much easier to break up fish with chewing, and many fish are high in protein, including shellfish. chicken, duck, quail, and other birds can also be cooked to be easily chewed to mush before being swallowed. eggs and dairy, including cheese and yogurt, are also excellent protein sources. For nonanimal sources of protein, a patient should consider lentils, chickpeas, and Beans. Half of the “half a cup” allotment per meal should comprise protein-rich food. The other half should be made up of vegetables and/or fruits. I recommend to my patients that they eat more vegetables than fruit because vegetables have less sugar. Any space left in the “half a cup” can be used for the starches, (e.g., bread, Pasta, rice, cereals, potatoes), though I recommend to my patients that they eat a minimal amount from this group of foods as they tend to provide no important nutritional benefit. High-quality foods. High-quality food are foods that are minimally processed, natural, and whole. We encourage our patients to look for quality over quantity—for example, they might try sashimi-grade tuna, smoked salmon, duck breast, lobster, or even a simple poached egg. It is also important to remind your patients that there is no limit to the amount of herbs and spices that can be used to enhance the flavors of their foods. Solid foods. The patient should choose solid foods over liquids whenever possible. Liquids pass too quickly across the palate and, more importantly, too quickly across the band. There is no need for the esophagus to squeeze liquid, and without the squeeze, there is no stimulation of the IGLEs and no induction of satiety; therefore, eating calorie-containing liquids may negatively impact a patient’s weight loss. When to eat. After undergoing LAGB, a patient should eat three or less times per day. If the patient is in the green zone, meaning that the band is adjusted correctly, there should be no need for him or her to eat between meals. In fact, even three meals a day may be more than needed for satiety. In my experience, patients have little interest in eating in the morning. By late morning or early afternoon, patients may start to notice some hunger, which indicates that it is time to have a first small meal. In the evening, patients may have another meal. Most importantly, patients should be instructed that a meal missed is not to be replaced later on. The typical human body is satisfied with a maximum of three meals per day but often is happy to accept two or even one meal per day. Patients should be reminded that there should be no snacking between meals. If a patient finds that he or she is hungry by late afternoon, encourage him or her to eat something small and of high quality, such as a piece of fruit or some vegetables, just to tide him or her over until the evening meal. The patient should then visit the clinic to check whether or not he or she is in the Green Zone. It is important that the patient adhere to the aftercare program to monitor whether or not he or she is in the green zone. If not in the green zone, the patient will need to have fluid in the band increased or decreased. How to eat. Take a small bite and chew well. The “half a cup” of food should be placed on a small plate. The patient should use a small fork or a small spoon to eat. A single bite of food should be chewed carefully for 20 seconds. This provides the opportunity to reduce that bite of food to mush. It also provides the important opportunity for the patient to actually enjoy the taste, the texture, and the flavor of the food. Encourage your patients to enjoy eating more than they ever have. After chewing the food until it is mush, the patient should swallow that bite. Swallow, then wait a minute. The patient must wait for that bite to go completely across the band before swallowing another bite. Normally, it will take between two and six peristaltic waves passing down the esophagus, which can take up to one minute. This is probably the biggest challenge of educating the patient who has undergone LAGB. You must instruct the patient to eat slowly—chew well, swallow, and then wait one minute. A meal should not go on for more than 20 minutes. At one bite per minute, that is just 20 small bites. The patient probably will not finish the “half a cup” of food in this time. In this case, the patient should throw away the rest of the food. After undergoing LAGB, the patient should always expect to throw away food and to never eat everything on the plate. If it takes between two and six squeezes to get a single bite of food across the band and each squeeze generates satiety signals, then 20 bites should be generating 40 to 120 signals. The actual number will depend on the consistency of the food, the tightness of the band, and the power of the esophagus. With good eating practices and optimal band adjustments, the patient should not be hungry after 20 bites or less. As soon as the patient is no longer hungry, he or she should stop eating. After undergoing LAGB, the patient should never expect to feel full. Feeling full means stasis of food above the band and distension of that important part of the LECS above the band. This destroys the LECS, the mechanism that enables optimal eating behavior and appetite control. A patient should always keep this process in mind. If the patient finds that after eating the “half a cup” of food he or she is still hungry, he or she should review his or her eating practices, correct the errors, and consider the need for further adjustment of the band. If this is occurring, it is usually an indication that the patient is not in the green zone. Eat a small amount of good food slowly. These eight words are the key to success. Small amount refers to small bites, the small fork (e.g., oyster fork), and a total meal size of half a cup. Good food refers to protein-rich, high-quality, and solid food. Slowly refers to chewing well, swallowing, and waiting a minute. Try to repeat these eight words to every patient every time you see them. Get them to repeat it at every meal. The failure of the gastric band can almost always be traced to failure of this process. Addressing the Challenges The two principal challenges after LAGB are weight loss failure and the need for revisional surgery due to proximal enlargements above the band. Weight loss failure will occur if the band is not placed or adjusted correctly or if the patient does not adhere to the guidelines of proper eating and exercise. When a patient is not achieving results after his or her LAGB operation, the doctor should check to ensure that the band is correctly and safely placed. The most common reason for weight loss failure is poor eating behavior, which leads to enlargement above the band. There are three common eating errors: 1. The patient is not chewing the food adequately. Food must be reduced to mush before swallowing. If it cannot be reduced to mush, it is better for the patient to spit it out (discreetly) than to swallow it. 2. The patient is eating too quickly. Each bite of food should be completely squeezed across the band before the second bite arrives. 3. The patient is taking bites that are too big to pass through the band. Each of these errors leads to a build up of food above the band where there is no existing space to accommodate it (Figure 4). Space is then created by enlargement of the small section of stomach or by enlargement of the distal esophagus, both of which can compromise the elegant structure of the LECS. If the LECS is stretched, it cannot squeeze. Without the squeezing, satiation is not induced. When satiation is not induced, hunger persists, more eating occurs, and stretching continues. If our patient continues this each day for a year, it is inevitable that chronic enlargement will occur, the physiological basis for satiety and satiation is harmed, and stasis, reflux, heartburn, and vomiting supervene. The doctor should continually review the Eight Golden Rules for proper eating and exercise with each patient. For optimal weight loss following LAGB, the patient should have access to a comprehensive long-term aftercare program for clinical support and optimal band adjustments and he or she must follow the guidelines regarding eating and exercising for the rest of his or her life. “Eat a small amount of good food slowly” is the key to optimizing the gastric band.

I found out today that tricare denied the revision request they say it would qualify for revision but the Dr that took the lap band out did not show medical necessity for removal. I have ask his office to review his notes and see if they can correct or add to my reason for removal because it was a necessity... bummed I still have hope a little

Hi when were you sleeved? I'm 9 weeks post op and had hair loss at the beginning and no more I've been on biotin months before my sleeve and I also put these drops on my scalp to prevent hair loss. @ajsI was revision band to sleeve 4/9/2014 and banded 9/2005

@@sandeebYes, i will be having one. Im now keani g towards the gastric bypass, i dont want,anymorw surgeries after this, like a revision that so many people have to get. Sent from my SM-N920P using the BariatricPal App

It's a great list for surgeries that go well, which is most of them! But, in cases where it goes wrong, not only is there the whole "risk of death" thing, but there are a bunch of other possible complications. Not that it's something to focus on pre-op, but if you really want to know what you could be getting into, best to cruise the complications forum. A leak could mean months in the hospital. A stricture could mean multiple procedures to dilate. Complications could lead to revision to another surgery. Just something to keep in mind when going over "worst case scenarios."