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I have the Paraguard IUD and have had it for over 6 years. I love it. Set it and forget it. I don't have strings (they think they went up past my cervix right after I had it inserted) so I have no clue if anything has changed. You're supposed to check once a month to make sure all is well. Yes, it is possible for the IUD to shift with BOTH weight gain and loss. I get ultrasounds every once in a while to make sure mine is still in the correct position. So I would say, if you want another one, make sure to be responsible and check! I can't take bc cuz they make me extremely nauseous and I can never remember to take them so I always worried.

Sunday, October 11, 2009 Celebration! Fun Without Fighting Fat and Food! Went to 125th Anniversary celebration of Roseland Christian School yesterday. Sang in the gospel choir and led the congregation in a song as an alto in a women's trio. Great speaker, great music. The 5th grade girls did a praise dance that was beautiful. I had to wear a black bottom and bright top for the choir. I wore form fitting low rise charcoal pants and a form fitting sweet-heart necked top. I couldn't believe it fit and I looked good. I had to wear an old strapless bra I never thought I'd fit in again. Then I went straight to my 40th class reunion. Fun in a different sort of way. However, hardly anybody I ever hung out with was there. I was not exactly Miss Popularity back in high school. However, three people I'm friends with on Facebook (though I never hung out with them in high school) did come up and mention how much they enjoy my blog. One of them is having LAP-BAND®® himself in December. His wife had a band which had to be removed and now she has a sleeve. She looked great. Like me, it was only 70 lbs but it was killing her emotionally as well as physically. I did my 2 protein shakes and nothing else so that I could eat normally at the banquet. By which I do not mean I ate the way I used to. But I ate some of everything served that I liked and went ahead and drank punch, water, and coffee while I ate, took tiny bites, and thoroughly enjoyed my food. No weight gain this morning so I must have done well. However, I will walk again today (once it warms up, brrrr) and will really watch my food as well. I'm going to tell the Dr. on my next fill that I want it filled to point where the food squeaks on its way through. I have no desire to ever go back to the old me. Celebration! What fun when you're not fighting fat and food!

I have not seen an endocrinologist. In 2007 I had my gallbladder removed and weighed 240 pounds. Even though I was overweight, I still rode a bike 30 minutes a day, walked about a mile a day, and was very active. Since then, I have nearly doubled in weight. I'm having digestive issues as well as my bloid pressure so my doctor and I have been focused on that. I plan to bring up weight loss surgery on my next visit. I just started seeing this doctor so she is unaware of my rapid weight gain.

The meds I was taking before surgery did not include any antipsychotic or mood stabilizer only gabapentin for nerve pain and anxiety (separate issue) and an antidepressant Wellbutrin. Physically the pills were hard to swallow after surgery but as far as affecting weight loss there was no affect. Six months later I have a car accident, am diagnosed with traumatic brain injury and go thru 9 months of in and out hospitals with doctors trying to put me on all these different meds I had never been on before, antipsychotics that were not even needed in the first place and were causing really bad side affects. I’m not sure if the side affects were so bad becuz my stomach was cut down 80% or what or if becuz they switched to a new med so quickly every couple weeks or month either way bad experience. It also caused in the end within 2 months a 25lb weight gain which then started me picking up old eating habits and gaining another 8 lbs. now I feel stuck. Not sure if that helps or not. I’m against antipsychotics or mood stabilizers after surgery!

I have the same fear! I know it's irrational, but still ... I think I've internalized one bariatric doctor's comment that I will not be able to go below 200 unless I have bypass surgery. I chose the sleeve, of course! For the record, the doctor wasn't trying to be mean. I believe her comment was based on some of the medical/physiological issues that prompted huge weight gain years ago. But I still hope to prove her wrong.

I've been through it, I know how you feel. I had to ahve all my Fluid removed for a big surgery to remove my rectum and part of my colon and to form an ileostomy. Part of this was several colonoscopies and bowel preps, a fair bit of fasting pre procedures and a whole lot of fear and stress, then it took about seven days to get back onto solid foods following the surgery, followed by a couple of weeks of very very high stoma output, diarrhoea. As you can guess, i dropped a fair bit of weight during this time, and had also done so during the pre op chemo and radiation so all in all, I finished up at a BMI of 19, from my previously healthy 21 or so. I've been in contact with my lapband clinic regularly. From telling me when they emptied my band that I could begin refilling 3 weeks after surgery (and then unfill again for the second surgery to close the ileostomy some months down the track), my doctor has steadfastly refused to give me ANY fill at all because of my low weight. I get this, I havent truly asked for it, but most people will need fill to maintain their loss and I'm no exception. Anyhow, today I finally got some, six months later. I've worked so so SO hard over the past six months to not gain weight and all I've regained is just enough to bring my BMI up over 20, but with chemo finished, full recovery complete, my appetite is returning to normal and its been getting easier and easier to gain and I've had several weeks of "dieting" after small gains to get them off before they stick around. Today I had to absolutely do my block in the surgery because my doctor didnt want to give me any because she said "you're a healthy weight". Well, duh, it was that same doc who told me to expect a weight gain with the unfill, that virtually nobody could keep the weight off long term without it. I wasnt looking for tight restriction to lose, just enough to maintain my weight. After I kind of yelled a bit and said that I had this damn band and I wanted to use it, she gave me a 1cc fill, with another 1cc sheduled for 3 weeks time. So...... it IS possible to keep the weight off for quite a long period of time. I simply "dieted" the whole time. I finished eating when I knew I should, i stayed away from bad foods, I filled up on fruit and salads, I exercised, and overall tried to eat not much more than I did with restriction. I found I moved from a pattern of little and often eating to 3 square meals, but overall calories remained about the same. You can do it, its simply a matter of how much you want it, harsh as that sounds. But six months was stretching the limit of my abilities, I'm finally starting to crack and am very very glad to have had some fill. Good luck to you!

I had the lab band removed after 9 years in 2012 little success I was 220 and got down to 170, then the reflux started and the weight gain. Had it removed and then had my stomach plicated with no success and still reflux and pain. I weight 199 now and 5'6, currently I am back on two meds for my diabetes, and I have high bp. Doctor said the only way to relieve my symptoms is to have a gastic by pass. Any one else been through this.

<TABLE class=ThmBgStandard cellSpacing=0 cellPadding=10 width="100%" border=0><TBODY><TR><TD>I was a healthy attractive athlete until my mid 40's. I developed Type 2 diabetes and things exploded after that in huge weight gains that I did not monitor. By the time I had Band surgery in 2005 I was 58. My brain remembered the good old days, so I started behaving like that again. The weight peeled off. I started by training and completing a half marathon. Now, after plastic surgery, my old self is coming back. I still have more surgeries and work to do, but I'm now on a positive roll that will not quit. My heart breaks over obese people who have NEVER been popular, had lots of dates, rode a horse, ran a marathon, etc. It's never too late to learn and go on. </TD></TR></TBODY></TABLE> Just i came across this i found it offencive, May be i read into it to much but to me i read that Obese people are unatractive cant or dont gets dates. dont have lifes and that the poster didnt have a lifetime battle with there weight so in my opinion WLS was very much a first rather than last option, Were as MOST of us who are big try every other available method of weight loss before resorting on surgery. The person who posted that didnt try anything just gained weight and had surgery to fix it. And while they claim to be heart broken for obese people they have some very derogotary opinions of obese people. Thats how i read it. I feel there is a huge difference between suffering a lifetime of true obesity and just gaineing a few lb's in later life. We all hear that years of yo yo dieting can mess up your matabolism. So may be the person who posted that found there banding jurney fairly easy because there matabolism had not been shot to peices like most of us who have tried basically everything else all our lifes.

Was pretty simple for me, I have never been afraid to die, I am just not ready. I gained ALOT of weight after quitting smoking 9 years ago. Because of the weight gain I have HBP, High Cholesterol, sleep Apnea, Diabetes, Neurapathy in my feet terribly. I have degenerative joint disease in my back and knees and my knees are shot now that the doc said if I do not get the weight off I will be in a wheelchair in a year or so. I also have a collapsed arch in my left foot and lots of preblems there. I lost both parents at a young age due to massive heart attacks and my Dad was in great shape when he died. I lost my Mom 4 years ago and 5 months later my sister gave birth to the greatest thing to ever happen to me and that was a little Boy. He is my pride and Joy, I watch him every day while she works and miss him when he is not around. I want to be able to go to his baseball games that will be starting in a couple years. Right now I cannot walk far to get to the fields and cannot go to his older Brothers games. Just about my whole family is obese and I went over to talk to my Uncle and Aunt about my decision to have this surgery 2 months ago. I told him that I did not want to end up like him, in a wheelchair and never leaving the house. I did not want to be like my Grandma, 2 other Uncles and my Mom and two other Aunts. So I was going to do something about it. He was all behind me and so very supportive...Well he passed away a week ago today from heart problems brought on by his obesity. He was over 500 lbs. Everyone has passed away now because of problems that came up by their obesity. I have one Aunt still alive, but she does not leave the house. So for all those reasons and to see my sunshine grow up into a man and marry and have children of his own is my dream and focus now. With my determination and support I know I will do it.... Thanks, Rob

I was asked if I had reflux and I said I've had a bit of it but it's not bad at all. And I believe I got only because of weight gain anyway. I'd never had it prior nor with my 3 pregnancies, apart from one 10 min. episode with my 3rd pregnancy and it was awful. I haven't experience anything like that again. I don't want bypass for many reasons -but the main one is the bowel issues, dumping. I have bowel issues (all my life). The surgery would just make life even more miserable for me. I'll discuss this with the surgeon. But I would imagine they'll want to do the probe on me too.

I was sleeved on may 2015 with a low bmi of 31. Im male 6"1 and was 230 pounds. I went down to as low as 177.. i had maintained a very balanced weight approach of 180-182 throughout time but since october of this past year the weight has slowly gone back up and im going insane because i dont know what is happening. I have gained 12 pounds now and have gotten alot of testing done to see if there are any abnormalities with the sleeve pouch itself and all has come back normal. The only minor thing that was found was a slight dilation but it is minimal so i dont think that it has to do with the weight gain. I drink plenty of Water daily, consume Protein ranging from 100-125 grams daily along with exercise as well. Not taking any medication that could trigger weight gain. My surgeon is lost in words and doesnt know why or what is triggering this weight gain. Dont know if any sleevers out there have similar experiences but i would appreciate all the feedback from everyone. This is truly stressful and i just want to go back to how things were not to long ago. I am aware that im almost 2 yrs out but is not to the point where i should be having issues or complications with the sleeve soo soon. Sent from my iPhone using the BariatricPal App

Hey all! Update on me. (And thank you all who have been supportive by the way) I'm doing AWESOME. My weight is extremely stable. I don't weigh myself if I can avoid it (I find numbers upsetting and triggering and pointless) but my clothes all fit and my measurements are the same. That said it's honestly a non issue because I don't care if I get smaller or bigger or whatever because weight just isn't what defines my happiness anymore. I've just finished my second round of plastic surgery in Mexico. I had a lower face lift (for a slight turkey neck and early jowling) and a Brazilian butt lift and I had fat added to my hips to give me a more womanly shape. I LOVE the results I am seeing. In my eating disordered days I always wanted a stick straight and boy like model body. I have changed that mindset and am embracing my Latina heritage and embracing what my body is more inclined to look like. Through the surgery I continued eating intuitively and my recovery has been wayyyy easier this time. I feel it is because I am much healthier and my body is well nourished and strong. I have repaired a lot of the damage dieting did to me. I'm in a new relationship and he has been super supportive. In my dieting days I would tend to pick abusive assholes. This time I have picked someone who supports my choices and builds me up. It's amazing what a well fed mind can do!! I don't live on the edge any more and I don't keep people around who encourage my self esteem and body image issues. My eating behavior has not changed. Once in awhile I will loosely tally up my calories (sadly I still have every single item of food calories burned into my brain) and I find I eat around 2000-3000 calories a day. Usually right around the 2500 mark. I don't do this by thinking about it. That just seems to be what my body needs to be satisfied. What funny is I actually TRIED to put on some weight for my Brazilian butt lift and I FAILED. I don't have much fat in my body, which they needed for the surgery, so I tried to eat more by adding in breakfast and higher calorie foods for about a month before my surgery. I didn't do anything that felt harmful or excessive- just encouraged myself to always eat breakfast, a lot of avocado, adding cheese and mayo more, that sort of thing. And.... Nothing happened. No weight gain. In fact it felt like I LOST weight. [emoji23] In my dieting days with a wrecked metabolism I was able to put on 5lbs in 3 days!!! My body is now at its set point and it just won't allow me to change that so easily. God knows what I would have to do to gain weight at this point. Anyway my butt lift isn't as big as I would have liked it but it still looks great! A few weeks ago I also went on a cruise with my kids. It made me extremely sad to see all the people on the boat gorging themselves and looking so miserable. I've been on 3 cruises in my life. The first one I was 27 thin and bulimic- I threw up everything I ate on the ship and was super sick. The second one I was 33 and obese. I ate till my stomach was going to pop and was super miserable and depressed. This time I'm 37 and a healthy intuitive eater. I ate whatever I wanted to satisfy my hunger and tried not to worry about the food at all. And I was happy. Roughly what I eat: Bagel with avocado for breakfast (Or something like an omelet with tons of Ketchup my favorite food) Maybe some Thai food or tacos or fried calamari for lunch, or salad and sandwich (usually eat out for lunch) Dinner I eat out a lot too or at home rarely. I like all kinds of restaurants. I don't like too cook, it takes up too much time and I work a lot. I like Italian, Mexican, sushi, salads... whatever. [emoji4] so I get a salad and an entree. Entrees are so crazy huge, I almost always have leftovers. Big snack at bedtime. Either the rest of my dinner or a burrito or sandwich or something. This is probably my largest meal of the day. Sometimes dessert. I eat chocolate a lot at like 3 am. I dunno why but my body craves it. And wine. I love wine. All though I have been cutting back lately because it does make me tired and not sleep as well. I'm attaching some fun photos for you all and much love and many blessing to you in your journey!!! It's a journey worth taking to get healthy with food. My life is 1000000x better. Trying to get that booty haha!! Bahahahaa. Cruise photo. All of these are taken within the last month.

I went to a lake house this weekend. I grazed, drank beer and had about 7 beers and 7-10 shots over he whole weekend. I ate whatever everyone else ate (just small portions). I wasn't worried about weight gain. I had figured that when I got home I would have gained ten pounds. I came home stepped on the scale and I had lost two pounds. I don't know but I am definitely motivated to get back on track. Going to the gym tomorrow and gonna be a beast!!!

http://www.smh.com/sections/services-procedures/medlib/docs_articles/Bariatric/bariatric_pdf_articles/bariatric_surgery/Spivak%20&%20Favretti%20-%20Avoiding%20Postoperative%20Complications%20with%20the%20LAP-BAND%20System.pdf In many cases, the first indication of possible erosion is an infection at the access port site. The connecting tube provides drainage of gastric content to the port site, which causes the infection. Erosion should be ruled out at the first sign of port infection. http://www.inamed.com/pdf/health/94800-12_LB_Product_Data_Sheet.pdf Erosion of the band into stomach tissue has been associated with revision surgery, after the use of gastric-irritating medications, after stomach damage and after extensive dissection or use of electrocautery, and during early experience. Symptoms of band erosion may include reduced weight loss, weight gain, access port infection, or abdominal pain. Re-operation to remove the device is required.

Hello All, It has been a really long time since I have been on the message boards. The last time I posted I got some what negative or no feedback but I am desperate and going to try again. First of all I got banded in May of 2012 and since then I have lost about 50lbs. I was so excited when I hit the 299 mark! Well the holidays threw me off track and I did not get a fill since like October. When I finally went for my fill 2 weeks ago I had only gained 5lbs since my last visit so I was dissappointed about the gaining weight...but psyched that I didn't gain way more because I basically ate whatever I wanted over the holidays. So since getting the fill in January I feel so very uncomfortable. It feels like Water trickles...every meal hurts and I am resorting to soft foods just so I can get things down because it takes forever to eat anything. I really feel like I am in the red zone. I called the doctor about getting an unfill but was basically told "no chew slower". I know my body and my weightloss has been pretty good but this just doesn't feel right. Prior to my fill I actually lost 2lbs. But since then...only been gaining! I am back above 300....306 to be exact and not pleased!!! Now on to my second "problem". I have recently found out I am pregnant!!!!!!! Needless to say it was not planned. I am sad and happy at the same time. I was in a relationship for almost 10 years and could not get pregnant. After all that time he tells me he is now too old to have kids (43yrs). We broke up almost a year ago. I since then had found a "special friend" and low and behold...when I gave up on every being pregnant here I am 37, banded and 6 weeks pregnant! I can only assume the weightloss led to an increase in fertility...I knew that could happen but assumed after all that time I just couldn't get pregnant. So now I am freaking out because I don't want to tell my Band Dr that I'm pregnant because he might remove all the Fluid in my band. I want to go in and tell them to take some fluid out due to the "red zone" feelings....but definitely not all...and most important...I don't want to gain all of my weight back because I am now pregnant. At this point my mind is spinning and I'm scared to gain back weight when I was so close to being under 300lbs! I don't want to gain any weight during my pregnancy but I also want to do whats best for the baby. Not even sure if weight gain is baby related, band related or what....definitely think its too early to be baby related. So that is my novel!!! Help me with Red Zone thoughts, help with dieting while preggers, and help with worries about gaining...just help!

Hey girl! I am so sorry I didn't see this earlier. First of all, congrats on your pregnancy! It sounds like being a mom is something you wanted for a very long time, but its still a shock the way that it happened when you least expected. I think once a few months go by and you see this living thing growing inside of you, you will just fall in love with your baby! It's a blessing! I can understand the fear and panic of gaining weight, especially when you worked so hard to get the band and lose so much! You really need to talk to your doctor and express those concerns. Your primary concern for the next year will be getting adequate nutrition that you AND the baby needs.. That may mean an unfill and weight gain. This will mean a short detour in your weight loss goals but it does NOT mean its gone totally off the rails! With less Fluid in your band you might need to eat more often but can still make healthy food choices through the pregnancy, and keep exercising (as long as Dr says its safe). Sorry I cannot give you better advice but I have seen a few here who've been pregnant with the band. Maybe you can send them a private message. Wish you all the best & please keep me posted.

So now that I have "officially" accepted responsibility for my weight gain over the years, now I'm trying to figure out what led to this roller coaster life I lead! My last blog, I talked about being on phen-phen and loving it... then getting married and 2 kids later - poof I'm topping 259.6 lbs! But there is a lot in between that time span that I need to reflect on! So - in my late 20's and early 30's - newly married, fabulous job, living in DC - smoozing with the politicians, climbing the work latter, away from my mom.... hmmmmm - can't think of a single reason emotionally that I should have gained weight... I think I stayed a size 10ish - wavering between an 8 and 12 probably - so not too bad. Though, again, I thought I was HUGE! But honestly, other than eating out, and enjoying an adult beverage (oh and not working out) - I'd say life was even for me during this time! Moving into my 30's - 2 kids now! Moved to Atlanta - lived in the burbs with the white picket fence (literally, a white picket fence)... hanging in the cul-de-sac in my sweater sets.... I gained about 40 - 50 lbs with each kid - though I lost "most of it" each time - but stayed in the 170s - 180's for the most part. I played tennis on the neighborhood tennis team - and in my late 30's, started running... I got down to a size 8 - 10 again and looked and felt good! Then BAM! It hit! My daughter is in kindergarten - teachers think something is "not quite right"; tests begin... nothing unusual - but still something "is off".... she enters 1st grade... and now the fun begins.... without going into the details of how we got there... we found out my daughter was dyslexic! The end of the world!!! We thought we had to brightest (her IQ by the way is 1 point below Genius), most perfect child... oh my god... what are we going to do? What did I do? I went into Mamma Bear mode.... started looking at private schools that specialize in dyslexia, started taking her to special tutoring sessions (driving an hour home from work to pick her up, then driving another 45 minutes to the tutor, waiting an hour, then driving an hour back home (rush hour). We started eating in the car - snacks on the way there, dinner from Mickey D's or Chick-fil-a on the way back... 3 x per week!!! I stopped running - who has time for that when you have a full time job, 2 kids, and this new "the world has ended" weight on my shoulders? My daughter was accepted in the top school - whew!! but that meant commuting 1.5 hours each way every day... but I was willing - because it was only supposed to be for 2 - 3 years (a transition school, where there is remediation and you go back to the "real world"). So we ate in the car...ALOT!!! My daughter isn't gaining weight because she is active (see a pattern from my mom here?)... but she is also on ADHD meds with acts as an appetite suppresent. I however, am gaining weight... not on the tennis team anymore, and definitely not exercising! Now add in my son - the pre-schools are saying he has some issues too - oh here we go again - at least we know what to look for this time - right? But we have him in a pre-school that is for advanced kids - and he is falling behind - and the teacher is bullying him - yes bullying a 4 year old. He went into a depression - 4 year old!!! He was the happiest kid - every day is a good day - and then boom - depressed! We pulled him out of that school and went to another school - he was happy, but not learning - but happy :-)! In Kindergarten - we decided to nip it in the bud - have him tested and boom - he is dyslexic too (it is hereditary and I probably had it but overcame it with my intellect and my dad is). We enter him into the same private school as my daughter - and now have $50,000 in tuition plus uniforms... plus the commute... and eating on the go! But - it was only temporary - right? So we did it... and then.. came the time for my daughter to be retested (every 3 years) and to start thinking about the next school..... I remember it clearly... I had just started a software development leg of my company... I was 30 minutes from walking into a board room filled with CEO's and CIOs from major companies (7 of them) to pitch my latest product.... and the psych called.... "Hey Krista - just wanted to let you know I'm coming up with some "weird" results for Natalie".....pause...."I'd like to run some additional tests"....pause...."I think she may be on the autism spectrum...and by the way I think she comes by it from her dad"! THUMP!!! OMG!!!! Did she just say AUTISM? OMG!!!!! So I compartmentalize that, and do my presentation... them come out and just CRY!!!! Turns out... after the initial testing and 2 second opinions... she is on the spectrum... and my husband is accepting that he may be too - but what is he going to do about it at almost 50 years of age?... Now my world is crumbling... AGAIN!!!! I have to find a new school, I have to put her in a "social skills" class (she was "shy" all this time - not autistic), I have to rearrange my life... AGAIN!! My world ended during this time - how can this be? So I started taking Lexapro to "deal" - and I probably drank way more wine than I should any given week... and I most definitely ate out every meal and did not exercise! OK - so, I found a school - only it is 2 hours from our house... my son is still at the dyslexia school - the complete other direction... so now what? Oh - sell our house and move closer! We also decided to go ahead and move our son to this school as it is a school for all types of learning differences! So - we move, move schools, and I also decide to sell my businesses.... I had to make changes - I had to do something!! But selling my business turned out to be a VERY bad idea (I'll write more on that another time)... and turns out, my son has Asperger's too - OMG - TWO KIDS on the spectrum!!!! Though actually with my son, they don't know how to diagnose him - so they just gave him that DX - he really has more working memory issues and his IQ is on the low side! So - moving from my past - I think I did very well overcoming my mother and childhood stuff... I did very well with moving up the corporate ladder, and I did well early in the childhood raising area.... My weight gains - major weight gains started when trouble hit my perfect little life! I turned to food (and alcohol - though I wouldn't call myself an alcoholic) to solve my problems - to comfort me! Food was the one staple that was there - no matter what - I could count on a drive-thru... I could count on a good sushi meal (I mean like $50 - $60 of sushi for me alone)... I could count on a bottle of wine! I can see the crisis that hit - I can see how I used food - but what I don't know yet, is how will I overcome the "next" crisis?????? More to come as I figure out this journey! Look for my scary boss story coming next - this is when I hit the top of the scales!!!

Thanks Julie. I have an appointment for a fill next Monday and I'm going to share my concerns with the PA. I'm just hoping I'm not denied a fill b/c of my weight gain.

I have pretty much every one as well; the weight gain, the difficulty losing it, the stupid little hairs that grow where they shouldn't, the skin condition, the messed up periods, the hormone imbalance, the thinning hair, the fertility problems... The list goes on.

Greetings All! I am happy to have found this site because all I had been finding is Lap Band sites with bad reviews and complaints :smile:. I am open to everyone's input, as I am in the decision stage of the process. I'm in a rut. I'm sick and tired of being sick and tired. I'm the heaviest I've ever been. My weight problems began with a sudden onset of weight gain 21 years ago. I had a two year bout of a mystery illness and packed on 40 pounds within three months. It's been a battle ever since. My body hurts; my knees, my back, my stomach, my self esteem, my spirit. I hate having photos taken. I discard most of them. I’m depressed and have become unsocial. My worse fear is that I'll just get fatter and fatter. I can't honestly say that diet and exercise doesn't work, because I just can't seem to muster up the will-power to actually stick with a portion control plan. As far as exercise goes, my body just hurts too much to do the simplest of exercise routines. I tried walking several times last and this week and I was in agony. My knees were hurting and my back went into spasms. I’m discouraged and disgusted with who and what I have become. :thumbup: If anyone out there has Tricare Standard, I’d appreciate your commentary regarding insurance coverage for the Lap Band procedure and how easy or difficult it was to get approval. Thanks!

If you have PCOS and most of your weight gain is from that then you may not need a band if you find a good PCOS Doc who will give you the metformin and hormone treatment you need. You do need to eat a Low GI diet though...that is an absolute must!! High quality, slow release carbs will stabilise your blood sugar and help you. I lost 20 kg with Metformin and hormone treatment and walking the dog. No band involved....then unfortunately my thyroid packed up and I put on 30kg in 12 months. That's when I gave in and had my lovely band. I was diagnosed PCOS at 42 and you are 11 years younger than me...I also had my first child at 32 so you have 12 months on me there too....Low GI...give it your best shot...it really is worth it. Oh and don't forget to push for that metformin...essential.

Hi. I have United Healthcare. My BMI is 37, a bit over the 35. I had to do a 6 month program prior to surgery. And today I finished the program but I gained 3 lbs from my starting weight. I was told to keep it steady and I really did. Will insurance deny me for 3lbs? :(

actually yes, I got diagnosed with a liver disease and during treatment for that, in order to keep my liver and kidneys from failing, I was put on HUGE amounts of steroids - which then caused steroid secreting tumors in my body, which created a huge weight gain. I gained weight from breathing. After the sleeve and having the tumors removed, life has been GRAND.

I do not believe that the hiatal hernia is the cause of weight gain.....i have GERD. And a hiatal hernia. This has not caused ne to gain weight and if anything it makes me NOT WANT to eat. The weight gain is more than likely due to overeating and stretching your pouch. And maybe the hormonal change from the hysterectomy could affect your weight Basically...weight gain is caused from eating too much of the wron g foods. Too many calories and carbs. Try a low carb diet. It works.

Gastric Band- advice for week 5 onwards Weight loss You may lose some weight in the first 2 weeks post-surgery, but this is more due to the low calorie liquid diet and the fact that sometimes, appetite is reduced due to the area around the band swelling initially after surgery. Your weight is therefore likely to plateau or even go up slightly by 4 weeks post-surgery. By the time week 5 comes around, it is highly likely that you will be feeling hungry again; this is because the swelling will have most likely subsided, therefore the top of the stomach is no longer being compressed by the band to the same degree. The process of gastric band adjustments is required in order to ensure adequate compression of the stomach and hence adequate appetite reduction, reduced portion sizes and weight loss. However, the band needs very fine-tuning to provide optimal reduction in appetite and satisfaction on small portions (sometimes described as ‘restriction’), and you should expect to need 4-6 adjustments to the band in the first 6 months post-surgery before this is achieved, although everyone is different and a small minority of people can even feel the effects of the band with only 1 or 0 adjustments. Band adjustments One of the best features of the Gastric Band is its ability to be adjusted to ensure of a sensible and successful weight loss. The members of the multi disciplinary team will assess your need for the band to be adjusted during your follow up consultations. We do not perform adjustments unless they are genuinely needed. We will always carefully review your status before deciding on a ‘fill’ because the aim of the band is to reduce capacity, not completely restrict you. Problems related to the band are often associated with it being ‘over filled’. What is a gastric band adjustment? An adjustment is the process whereby Fluid is added to the silicone band, which then tightens the band itself and makes the stoma (opening) between the upper and lower parts of the stomach smaller. This results in food flowing through the stomach more slowly and therefore the band squeezes on the vagus nerve at the top of the stomach to a greater degree, thereby meaning you feel satisfied on less food. Fluid can also be withdrawn from the band at an adjustment – this may be needed if weight loss needs to slow down or if it is suspected that the band may be too tight. Everyone is individual and usually patients require several adjustments to gain and maintain optimum restriction. The members of the multi disciplinary team are trained to assess whether or not you require a band adjustment. You are likely to require a band tightening or ‘fill’ if one of the following is the case, usually in combination with lack of weight loss: 1) You are hungry sooner than 4-5 hours after meals. 2) You are able to comfortably consume a large quantity of textured food within a 20 minute period. You are likely to require a band loosening or ‘aspiration’ if one or more of the following is the case: 1) Symptoms of discomfort/pain on eating, regurgitation, night cough, acid reflux/heartburn (especially at night) 2) Difficulty tolerating solid foods despite appropriate eating behaviours, and reliance on soft/high calorie foods that are easy to eat, resulting in sub-optimal weight loss or even weight gain. If either of the above is the case, you MUST contact your local clinic without delay to arrange an appointment. A competent practitioner will add the amount that he/she feels is clinically required based on your weight changes, your appetite after eating and the volume of food that you can manage. There must be a minimum of 3 weeks between band fills in order to allow you to adjust to the altered level of restriction, and for the Dietitian to review your progress. What is involved? You will most likely be asked to lie on the couch, however sometimes it is easier to access the port whilst standing. The practitioner will ask you to expose the area where your port is sited. You may be asked to raise your legs or raise your head because this pushes the port closer to the surface, which can make it easier for the practitioner to feel it. The practitioner will wash their hands and then clean the port area with an antiseptic wipe. A needle will be used to puncture the skin and gain access to the port area and fluid will be added or removed using a syringe attached to the needle. You will be asked to drink some Water whilst the needle is in situ so that the practitioner can ensure there is adequate restriction or the band has been adjusted appropriately. Some patients may experience “burping” after the procedure. Will I be able to eat afterwards? It is essential you progress gradually with your diet during the initial 3 days after an adjustment. Phase 1: fluids for the first 24 hours • This minimises the risk of any complications associated with tightening the band. • The practitioner who performed your adjustment may advise you to extend this phase to 48 or 72 hours, especially if they checked how much fluid was in the band initially before replacing it and adding more fluid, as this can cause additional swelling to simply adding fluid. You will usually only require this ‘fluid check’ at your first adjustment to provide a baseline level. • Fluids are defined as anything liquid that can pass through a straw. • Fizzy drinks are not allowed during this period. • You should aim for about 2-3 litres of fluid per day, or enough to ensure your urine is pale straw-coloured from around 4 hours after waking onwards. • Follow the same regime as you did during the first 2 weeks after your operation. Phase 2: soft/pureed food for the next 24 hours • Follow the same regime as you did during the second 2 weeks after your operation. You should then start to notice a reduction in appetite and reduction in the quantity of food required to stop you feeling hungry when you first start to eat normal/textured foods again, although it should be stressed that an exact degree of appetite reduction and reduction in portion size can never be guaranteed following an adjustment, and if you are in the early stages of your weight loss journey, it’s important to remember that several adjustments are usually required to gain and maintain optimal restriction. Continue to take your Multivitamin and mineral supplement. The supplement and any medication will need to be crushed, soluble or chewable during the initial 2 days after a band adjustment. Are there any complications? There can be complications, which is why we ask that you do not eat normally for 3 days. There have been reports of band slippage or gastric erosion associated with over-tightening and hence we take the process of performing band adjustments very seriously and only arrange them when clinically indicated. If you do require fluid removal or a review of the band, you MUST contact your local clinic without delay to arrange an appointment. We do not advise that you fly within 2 weeks of having your band tightened - this will ensure you have enough time to check the band is not too tight and to give you time to arrange an aspiration if necessary. Furthermore, the change in air pressure may affect the tightness of the band, and so it is recommended that you do not have fluid put back into the band for at least one week after flying in case the band has tightened up during the flight. Increased stress/anxiety can sometimes make the band feel tighter than usual, and the nurse will not be able to tighten the band in this instance. Hot weather can also cause the band to feel tighter than usual – with this in mind, we do not recommend you travel to a hot climate within 2 weeks of having the band tightened. Some women find that the band feels tighter during menstruation, hence it may not be appropriate to tighten the band at this time of the month. What are the risks of this procedure? Immediate • Slight discomfort/pain. • Bruising • Punctured port tubing. • Inability to access the port – in this instance, you will be referred to an alternative practitioner in the first instance. If the second practitioner is unable to access the port, we may consider referral for an x-ray guided band adjustment; charges may apply. Soon after • Bruising. • Heartburn and/or reflux. • Infection. • Over-restriction, characterised by sickness/vomiting, inability to swallow fluids, nocturnal acid reflux & pain Over 48 hours • Infection. • Over-restriction – as above. • The band may become “unclipped” – this can usually be rectified by a surgical procedure. • Port may become detached – this can usually be rectified by a surgical procedure. • The following (commonly caused by an over-restricted band): o Erosion. o Slippage. o Oesophageal dilatation. o Pouch dilatation. o Achalasia/oesophageal dysmotility – these are pre-existing conditions, the symptoms of which the band can exacerbate. How can I tell if my band is too tight/I am over-restricted? There are a number of signs or symptoms that might indicate your band is too tight. They would usually become apparent within 24-48 hours of a band adjustment. They include: • You cannot swallow your own saliva • You cannot drink sufficient fluids (leading to a risk of dehydration) • You are unable to eat solid food • You are experiencing frequent heartburn, belching and regurgitation • You are having reflux more than one night a week (when food or fluid comes into your mouth or nose when you lie down) • You are experiencing difficulty swallowing even well-chewed food In any of these cases, you MUST contact your local clinic without delay to speak with a nurse or dietitian as you may need to have some fluid withdrawn from your band. Do NOT struggle with an over-restricted band – doing so puts you at unnecessary risk of complications. Call your clinic within 48 hours if symptoms of over-restriction become apparent following a band fill. Choosing the correct texture From 4 weeks post-surgery onwards, it is essential that you progress onto a diet of solid/textured foods. Solid food requires thorough chewing, meaning that not only are you less likely to rush your food, but you are more likely to feel satisfied and enjoy your meals. In addition, firm/crunchy foods tend to be more nutritious and lower in calories and fat than softer foods. Opt for wholemeal/wholegrain products where possible, as these are higher in fibre and other nutrients. Most importantly however, the number of times the oesophagus has to contract to get solid foods through the band is greater than with soft foods, so you will experience a reduction in appetite far sooner, hence eat less. However, it is important to remember that appetite and portion size reduction is unlikely to occur to any great degree until the band is adjusted appropriately. Things to be wary of: 1. Dishes where lots of sauce is used as this will make the dish less suitable and more likely to slip through the band too quickly, so you can eat more and not stay satisfied for long. Good examples would be sauce on Pasta and gravy on a roast dinner. You can overcome this by reducing the amount of sauce used and adding chunky vegetables, Beans and/or lentils to the sauce to improve its texture. 2. Soft ‘complete meals’ e.g. fish pie, shepherd’s pie, lasagne. Ideally avoid these meals, but if and when you do choose them, they should only fill ½ of the plate; fill the rest of the plate with crunchy steamed vegetables or salad. Use the list below to help guide you to choosing the correct texture. Avoid – too soft Rice Krispies, Frosties, Weetabix, Porridge, Readybrek Mashed potato Stewed fruit / fruit smoothies Liquidised Soups Curries with lots of sauce Drier consistency Overcooked/soft vegetables, Mushy peas Overcooked/soft pasta Better choice All Bran, Branflakes, Fruit & Fibre, No added sugar muesli, Minibix, Special K –ensure only a splash of milk is used to ensure they remain crunchy when eaten. New potatoes (with skin), jacket potato (with skin), oven-baked potato wedges (with skin; use spray oil) Whole fruit (with skin) Stew/casserole – with chunks of crunchy vegetables & potatoes with the skin on curries e.g. tandoori, served with crunchy vegetables/salad Crunchy steamed vegetables Wholemeal pasta cooked so it retains some ‘bite’ (al dente) Caution foods There are some caution foods, which are more likely to cause discomfort and/or regurgitation when eaten, particularly if introduced into your diet too early. Always take care when introducing foods back into your diet and take note of any discomfort. It is important to experiment with these foods to identify how your body will react. If a food causes problems, remove it from you diet and then re-trial it again after a few weeks. The caution foods listed below should be the last attempted when progressing onto solid foods – try other foods first. They should also be avoided for two weeks after each band fill, to give you time to attempt other foods first. The main caution foods are: 1. Bread & bread products Try none of these foods until week 5 post-op and follow the below staged approach when introducing these foods: • Try 1st: low fat crackers (e.g. Ryvita, Crackerbread, Finncrisp, Krisprolls) • Try 2nd: well toasted wholemeal pitta bread • Try 3rd: wholemeal wrap • Try 4th: Weight Watchers/Nimble bread, toasted to begin with • Try last: normal wholemeal/granary bread, toasted to begin with • Try to avoid: soft doughy white bread 2. Boiled or steamed rice Do not try until week 5 post-op and ensure you have tried other types of carbohydrate first e.g. potatoes with the skin on, pasta cooked so it retains some ‘bite’ (al dente), couscous, noodles. • Brown rice is better. • Ensure you wash it thoroughly before and after cooking to prevent it becoming “sticky”. 3. meat, particularly chicken breast, steak and pork chops You may have already tried lean (ideally less than 5% fat) minced beef/pork/lamb/chicken/turkey in the soft food stage post-operatively. If not, try this first before attempting anything more solid. Once you have started eating textured foods from week 5 onwards, start building in other meat products by following the below staged approach: • Try 1st: Lean (ideally less than 5% fat) minced beef/pork/lamb/chicken/turkey (N.B. as mince has a tendency to be soft and ‘easy to eat’ when cooked, aim to include chunky vegetables, beans and/or lentils when making meals from these foods) • Try 2nd: Stewing steak/casseroled/slow cooked meats • Try 3rd: “Wafer thin” sliced sandwich meats (ideally less than 5% fat) • Try 4th: Chicken or turkey leg meat (no skin) • Try 5th: Lean sausages (ideally less than 5% fat) • Try 6th: Lean bacon or turkey bacon (fat cut off) • Try 7th: Grilled/dry fried/barbequed chicken or turkey breast (no skin) • Try last: Grilled/dry fried/barbequed beef/pork/lamb Other caution foods • Stringy vegetables/fruit such as green beans, sweetcorn and pineapple. • Fruit with tough skin e.g. apples/pears or pith i.e. oranges/satsumas/tangerines. • Nuts. • Dried fruit. Discomfort/pain on eating and regurgitation These are common complications that can occur specifically in the first few months after gastric band surgery, but are not limited to this time period. They are usually triggered due to one or more of the following: 1. Taking too large a mouthful. 2. Not chewing enough. 3. Not leaving a gap between mouthfuls. 4. Leaving too long between meals – this can cause you to become very hungry, thereby increasing the chances of points 1 to 3 above. Furthermore, the oesophagus can become ‘lazy’ and sit heavily on the band if you leave too long between meals, meaning it can be difficult to eat. Alleviate this by ensuring you eat every 4-5 hours, and drink plenty of fluids between meals to keep the oesophagus active. Remember the 20, 20, 20 Rule: 1. Take a small volume of food onto your fork or teaspoon (no bigger than the size of your thumbnail/a 5p piece) 2. Chew the mouthful thoroughly (20 times) before swallowing. 3. Put your cutlery down and count to 20 before putting the next mouthful in. 4. Eat in this way for a period of 20 minutes. At this point, stop and walk away. Give yourself 5- 10 minutes and then consider whether you are still hungry; if not – stop eating. Discard any food that is left or save for another meal. Only go back to the meal if you genuinely still feel physically hungry - try 3-4 more mouthfuls eaten in the same way and then consider your hunger level again. If you are sure you are following the 20, 20, 20 rule, then discomfort on eating and regurgitation may be as a result of attempting caution foods (see above) too early. If a food causes problems, remove it from you diet and then re-trial it again after a few weeks. There are a number of other factors that can be associated with these symptoms that you need to be aware of: 1. Time of day – during the night, the oesophagus can become ‘lazy’ and sit heavily on the band, meaning it can be difficult to eat first thing in the morning. Alleviate this by having a few Hot Drinks throughout the morning and delay your Breakfast for a couple of hours – don’t eat immediately after waking. 2. Climate – some people find that the band feels tighter in hot weather. The best way to cope with this is ensure you are drinking plenty. 3. Menstrual cycle – some women have reported that the band feels tighter when they are menstruating. This can mean that only a soft diet is tolerated at this time of the month. 4. Stress/anxiety – some people find that the band feels tighter when they are particularly stressed or anxious. Relaxation techniques are useful in this respect, or the use of herbal teas such as camomile. 5. Illness – some people find that the band feels tighter when they have a cough/cold. This can mean that only a soft diet is tolerated, but if it lasts longer than a few days, it would be sensible to have the band loosened slightly to prevent complications. 6. Excessive vomiting – vomiting as a result of food poisoning/stomach bug or pregnancy can cause the band to tighten up. If vomiting continues for more than 24 hours, you should contact your local clinic without delay to arrange a band deflation (aspiration). 7. Flying – some people find that the band tightens up on flights, particularly long haul (>4 hours); there is a theory that this occurs as a result of the change in air pressure at high altitude causing any air trapped in the band to expand. There are a number of things to consider: 1) Band fills should take place at least 2 weeks before flying, as this will ensure you have enough time to check the band is not too tight and to give you time to arrange an aspiration if necessary. 2) You should eat at least 4 hours before flying. Don’t eat directly before boarding. 3) While flying, it is advisable to take fluids only; ensure you keep hydrated and consider purchasing nourishing milkshakes (e.g. Buildup, Slimfast) or soups at the airport if you are going on a long flight. 4) Any changes occurring with the band while flying usually go back to normal when back on the ground but take care when staying in high altitude areas. 5) If you do experience any discomfort whilst flying, consume liquids only for 1 day after the flight, soft foods for another day, and move back to normal challenging/textured foods on day 3. 6) Consider a small aspiration (deflation) of the band prior to a long haul flight if you are experiencing discomfort on eating and/or regurgitation more than once a week, as this may indicate that you are more likely to experience discomfort whilst flying. Finally, if you are experiencing these symptoms despite every effort to follow the 20, 20, 20 rule and you are sure it is not due to a specific food or any of the above situations, then your gastric band is probably too tight. You should contact your local clinic without delay to arrange a band deflation (aspiration). Balanced meals To make sure that your body is getting all the nutrients it needs and to help you maximise the benefits of the band, try and make sure you have the following 3 food groups at every meal. 1. Carbohydrate-containing foods (¼ of your plate) • Breakfast Cereal Bran flakes Minibix No added sugar muesli Fruit and Fibre Special K All bran • Bread and bread products – N.B. caution food (see above) Low fat crackers (e.g. Ryvita, crackerbread, Finncrisp, Krisprolls, oatcakes)