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I have a wonderful young and I might add beautiful female dr. as my primary physician. She, herself, had been researching the surgery and suggested it to me. She said she would not in any way give the OK for RNY but she thought this might be something for me to look into. The only problem we both knew was getting my cardiologist to agree....Wow, the guy had also done his homework and was all for it. It turns out he was in the building with one of the doctors that does the lapbanding and they were friends. I got the go ahead. The road got harder from there as the dr. here did'nt take Medicare. Not to be deterred, I mentioned it to my daughter who called around her hometown and lo and behold there was a dr. that had done over 1000 lap bands....and so I see him on Apr. 13 and hopefully after seeing the dietitician and perhaps 2 weeks later will have the surgery. I had the complete support of both of my doctors, so it's nice to know the medical world is keeping up. They are probably both tired of my glum and depressed face over the weight gain since I stopped smoking. My mom had two sayings "Where there is a will there is a way" and "God helps those who help themselves". I've found both to be true. Sometimes we have to fight for what we want and find an alternative route. I'm staying with my daughter for mo. throughout my fills and untill I feel ready to come home, and looking forward to it.

When I flew to London, I stopped over in Paris, and in the airport, they had these little lunch places. The French people were sitting in there eating these tiny slices of pizza, like the size if you cut one of our regular slices of pizza into three, and that was their one piece. The yogurt containers were about three ounces, and the sodas were about 6 ounces. I never saw anything like it. I also read an article once that said the average caloric intake for a French person is 1,200 per day! When they're not on a diet! In the same article, it said these French people went into a Mcdonald's and ordered a happy meal and they were "stuffed". In another article I read, a British woman and her mother came here to the states and went out to dinner, and when the plates came out, they burst out laughing because they thought it was a joke because the portions were so enormous. They were horrified to find out that it was a "normal" restaurant portion. When a friend of mine (who is very slender and eats very sparingly as it is) went to Paris, he stayed with a friend, and the friend would give him a tiny slice of quiche for breakfast, and my friend was ready to pass out! His friend was disgusted with him for being hungry all the time. The French also do not snack in between meals, ever. In my old job a few years ago, there was an intern from France, and one day we ordered Chinese food. It came in one of those round metal containers (about 10 inches in diameter). She said to me "no offense, but I have to say, you Americans wonder why you're all so fat, and the reason is this" (she pointed to the container) "Back home", she said "this would be lunch for me and four other people. Here, it's lunch for one person." Also, I met a girl from Germany who had moved here to the states, and she said that since coming here, she had gained 18 pounds without changing her portion sizes or the type of foods she normally ate back home. She attributed this weight gain to the fact that all of our food is so heavily processed. She said in the UK, all foods are fresh and often organic, and that they purchase foods fresh every day instead of relying on canned, frozen, and boxed foods like we do here. So, my two cents is that yes, we eat waaaaay more than the rest of the world and our food is crap. My best friend is Indian, and she said their plates are much, much smaller, and their large pizza is the size of an individual pizza here. Also, she says all their food is fresh and unprocessed. I believe that if Americans ate like the rest of the world, a large percentage of obesity would go away.

Hi! I've been on Zoloft for about 12 years now. I take 200mg a day and when things aren't real rough at work I lower it to 150mg. Chemical imbalance as well as depression runs in the family. I can definitely feel the difference if I miss a couple of days. Easily angered, fidgety, anxiety - the whole works. I went through a period of time all I did was cry (post partum after my youngest), couldn't write a check, couldn't decide what to wear to work and changed clothes 3 or 4 times each morning. Couldn't make EASY decisions that were basic to running a household with 2 little ones. SuperMom syndrome also as well as guilt that I worked and wanted a career. In a positive, people are always amazed if I tell them I'm on Zoloft and I'm clinically depressed. For me, it keeps me on an even keel and allows me to think calmly and rationally. I don't have the "lows" I used to have and there isn't a feeling of a "high". Just stability. The only two side effects that have happened to me are the low sex drive (can still have the BIG O though!!) and my general practitioner told me anything over 100mg can cause weight gain. With that in mind, I much rather be on my Zoloft and work with the band than to decrease my dosage below 100mg. I was on Prozac (made me EAT constantly because it made my stomach upset), Wellbutrin (made me NUTS - I constantly shook like I was going through some sort of withdrawl) and Paxil. The Paxil was ok and I can't remember why the doctor changed it. So Zoloft is my magic pill and I couldn't live without it. I did at first become angry and felt like a "mental case" and a "pill popper" to be able to get through the day. Angry that I had to rely on medicine but as my doctor said "Would a diabetic not take insulin if they needed it?". He reminded me I have a chemical imbalance and I will more than likely take it the rest of my life. It did take initially several months to get the right dosage and feel the full effects. I also went through counseling for 18 months to work out some of my guilt and anxiety issues as well as trying to overcome the "SuperMom" syndrome. Like my counselor said "Will your kids remember their socks were folded and the house was clean or will they remember Mom was there when they needed her for support or play?" Really hit home and I've tried to keep that in mind anytime I feel pulled in all directions. I unfortunately also have a very demanding, stressful job and it helps me deal with that also. Good luck and PM me if you need any other info. I swear by the stuff! Take care!

the only thing i can tell u is that over time the redness will fade to a color that is white and "less noticible" then the red ones. of course they will always be noticable and probably look 'horrible' to u... but they really will start to look better. I rememeber the first ones i ever got on my stomach when i was 19! I cried soooooo hard...really u would have thought something really horrible happened to me! It was one of the most shocking and painful 'realisations' i have ever been thru in my weight gain/loss journey. I couldnt beleive it was happening to me!!!! I thought WHYY IS GOD PUNISHING ME...first im FAT thhhhennn to top it off I HAVE STRECH MARKS. I was sooo mad!!! lol I too went thru EVERY possible creme and remedy on the planet. Keeping ur skin mosturized does help...so try and do it everyday. I used to look at them in disgust (sometimes i still do if im having a bad day)...but most times i think of them as battle scars...a reminder of what used to be and what is now. They never look pretty but i dont let them stop me from feeling good about myself.

No help for us. We are fat, we are gluttons, we are weak and undeserving of help, sympathy, or adequate medical care. Like Orson Wells said, “Gluttony is not a secret vice.” Do I believe that? Some days I do in fact believe it, when I’m down, and lately more because of how ill I have been. Mostly it is a load of hog wash. Fat does not equal ugly. There has long been a weird relationship with food, the body and the Christian church. And of course, we all know the impact that both Protestant and Catholic sects have had on Western Civilization… Some of the Christian based weight-loss schemes are screaming “fat people don’t go to heaven,” and “use our program based on Leviticus and you will loose weight and be closer to God!” Sorry, I’ve read Leviticus, and I am NOT eating bugs…. (I call them schemes because I think we all here have come to the understanding that “diets” are just schemes…) If you had better self-control, more self-esteem, more will-power, were a better person, loved God more…. You would lose weight and be a better person. There is no understanding for the overweight from most doctors. Before my husband had his band installed, the cardiologist said “Have you just tried cutting out sweets?” Now, on the face of it, this is good advice, advice we could all use. However, this showed a complete lack of understanding on the part of the doctor. You see, before my husband had his band installed, he weighted 596 pounds with a BMI in the high 80’s. Cutting out sweets would have certainly helped, it wouldn’t have stopped my husband from eating two or three fast-food meals at one sitting, or any of the other overeating behavior some of us know intimately, and other behaviors we are only starting to understand in ourselves and others. I am currently having difficulty with my asthma: hospitalizations, steroids, greatly reduced lung function, other things as well. What am I told? Well, just lose some weight, we aren’t going to help with this, we are just going to pass judgment on you. Sudden and unexplained weight gain? Well, just don’t eat as much… (never mind that I gained 10 pounds overnight with severe edema…). I have to suspect that part of Delarla’s current adventure with gauze might have been caught earlier if she was thin. I was told by my doctor that I just need to take up running. Yes that’s right, take up running. Can you imagine a woman with a BMI in the high 40’s running? (Please see the thread about giving one’s self black eyes…) Being fat or overweight or big boned, or under tall, or metabolically efficient or famine resistant doesn’t make us failures, bad people or jerks. We might be over sexed (skin is the largest sex organ…), but we are not failures, or bad people or jerks. If we are failures or bad people or jerks, it is independent of our weight or size.

No help for us. We are fat, we are gluttons, we are weak and undeserving of help, sympathy, or adequate medical care. Like Orson Wells said, “Gluttony is not a secret vice.” Do I believe that? Some days I do in fact believe it, when I’m down, and lately more because of how ill I have been. Mostly it is a load of hog wash. Fat does not equal ugly. There has long been a weird relationship with food, the body and the Christian church. And of course, we all know the impact that both Protestant and Catholic sects have had on Western Civilization… Some of the Christian based weight-loss schemes are screaming “fat people don’t go to heaven,” and “use our program based on Leviticus and you will loose weight and be closer to God!” Sorry, I’ve read Leviticus, and I am NOT eating bugs…. (I call them schemes because I think we all here have come to the understanding that “diets” are just schemes…) If you had better self-control, more self-esteem, more will-power, were a better person, loved God more…. You would lose weight and be a better person. There is no understanding for the overweight from most doctors. Before my husband had his band installed, the cardiologist said “Have you just tried cutting out sweets?” Now, on the face of it, this is good advice, advice we could all use. However, this showed a complete lack of understanding on the part of the doctor. You see, before my husband had his band installed, he weighted 596 pounds with a BMI in the high 80’s. Cutting out sweets would have certainly helped, it wouldn’t have stopped my husband from eating two or three fast-food meals at one sitting, or any of the other overeating behavior some of us know intimately, and other behaviors we are only starting to understand in ourselves and others. I am currently having difficulty with my asthma: hospitalizations, steroids, greatly reduced lung function, other things as well. What am I told? Well, just lose some weight, we aren’t going to help with this, we are just going to pass judgment on you. Sudden and unexplained weight gain? Well, just don’t eat as much… (never mind that I gained 10 pounds overnight with severe edema…). I have to suspect that part of Delarla’s current adventure with gauze might have been caught earlier if she was thin. I was told by my doctor that I just need to take up running. Yes that’s right, take up running. Can you imagine a woman with a BMI in the high 40’s running? (Please see the thread about giving one’s self black eyes…) Being fat or overweight or big boned, or under tall, or metabolically efficient or famine resistant doesn’t make us failures, bad people or jerks. We might be over sexed (skin is the largest sex organ…), but we are not failures, or bad people or jerks. If we are failures or bad people or jerks, it is independent of our weight or size.

Why am I fat? Hmm, part genetics, my mom was overweight for many years. She had GBS last year. My sister grew up big. She also had GBS about two years ago. I have become less and less active over the years, due to poor self esteem because I have gained so much weight. Does that contradict itself? It sure doesn't help that I am married to a very physically fit man who is damn sexy to boot! lol :biggrin1: I have tried in vain to put meat on his bones, but it only ends up on me. He is in the Army so of course he has to stay fit. My road to obesity started in 1996. I weighted 143 lbs at 5'6", the day I found out I was going to have a baby. By the time I had her, I was 215 lbs. I had gone from running 5 to 10 miles a day (in the Army) to practically nothing when I got out during that pregnancy. We lived in the desert at the time, I over heated too easily so I didn't go out much. Bad idea. I dropped 40 of it immediately. By the time I got preggo with my second 18 months later I started at 205 lb. With this weight gain also came VERY large breasts. I had a reduction thinking it would help me with exercising. Very glad I did that, but it didn't improve my motivation to exercise. What it did do was help my back problems and showed me just how HUGE my tummy really was. :omg: So, now I just had my third baby, luckily I only gained 20 lbs wiht him and dropped it all within the last month without trying. That is a good thing, but my husband is deployed at the moment and well, to compensate for him not being here, what do I want to do? Eat, but not at home. I just eat out WAY TOO MUCH! This is just not good for me, let alone my kids! I have researched GBS and now lap band for a while. It looks like this may be my savior, KWIM? So, we shall see. It will be so nice if I could just lose even 20 by the time my husband comes home for R&R in June!

I had my pre-op class today and I have gained 6 lbs. I was told I should lose it as fresh weight gain goes right to the abdomen and takes up the room they need to operate.If there is not enough room for the intruments, they won't do the surgery. Yikes! Also ran through the possibility of having the tube put in BEFORE you go nto surgery. I would defo panci. I hope they take it out before I wake up too.

I had my pre-op class today and I have gained 6 lbs. I was told I should lose it as fresh weight gain goes right to the abdomen and takes up the room they need to operate.If there is not enough room for the intruments, they won't do the surgery. Yikes! Also ran through the possibility of having the tube put in BEFORE you go nto surgery. I would defo panci. I hope they take it out before I wake up too.

Hey there Bermy: I am no longer banded since Dec 2005. I lost my band to erosion. So the weight gain is from no band and eating like a pig. I am struggling every day with the head demons but eventually I WILL WIN!!! Now back to the regularly scheduled program,... I made a comment that the title was harsh. I didn't mean the content was harsh. I tthink the content is "spot on" as Gordon Ramsey would say. He was the chef from "Hell's Kitchen". Anyway, the only thing I am ever so gradually getting around to saying is that in the rush to post sometimes we all need to think about how things are worded. I think we should all do our research. As Photonut commented about the thread I started "Be your OWN patient advocate" it gives the researcher some tools and questions to ask. But then again even doing the research you can NEVER answer all the questions or you might not be ready to hear the answers at that time. Life is a learning process and sometimes you just gotta roll with it. Tricia isn't asking us to conform to her way of thinking. I believe that she is just frustrated with the repeat questions at times. But let me clarify that she is NOT frustrated at the person but at the situation. Then again I don't wanna put words in her mouth either. That is my perception of the situation.

Hey all, I had my pre-op class today and I have gained 6 lbs. I was told I should lose it as fresh weight gain goes right to the abdomen and takes up the room they need to operate.If there is not enough room for the intruments, they won't do the surgery. Yikes!

All of the above... I think mostly I gained steadily, but then there were the bursts, too... My first really big weight gain was when I was in highschool and started working at McDonalds. I went from a size 16 to a 20/22 in about 6 months... My first couple of years of college I hung around 185. Gained to 200 when I fell in love with my gay boyfriend. Lost 45-50 when I withdrew from college to deal with the fact that my gay boyfriend could never love me in "that" way... :doh: Steadily regained after returning to college. The summer of 1984 I think I put on 30-50 pounds. Left college in 1985 about 230. Got up to 300+ while living with the same gay boyfriend between 1990-1992. Got down to 220 or so and holding while in Europe, 1993-1994 Gained at least 50 pounds from 4/98-11/98. Got down to 200 in 2001. Between 6/2001 and 1/2003 regained to 303. Banded 1/03-7/04 - lost 103 pounds. And the 80 some pounds I've regained since unbanding has been over the last 15 months. Of course there were many more ups and downs over the course of those years, lowest being 185ish in 1986 or so, to highest of 3?? in 1992. The sad thing is, before banding, I habitually ate a large, deep-dish pizza Hut pizza every weekend, OR a bucket of KFC. That was the Friday night/Saturday am binge fest. I don't eat like that anymore, and yet the weight has come back just like I was eating out of control... OY VEY....

Hi All! I'm 51, born and raised in Massachusetts, and married 28 years. Like so many of you I've battled being overweight ALL my life. I have NO "skinny" pictures in my family album. "Chubette" was a word I grew up with (pre "plus size" lingo for those yunguns out there...). I have lost over 100 pounds TWICE in my lifetime with the disappointing and devastating weight gain occuring within two years afterward. (Neither time did the 100 pound loss actually put me in the category of "thin".) There have been MANY MANY in-between weight losses ranging from 10-60 pounds at a time, NONE of them have obviously "stuck"! :faint: That is why I AM SO EXCITED :biggrin1: to DARE to BELIEVE that THIS time it will stay GONE FOREVER! I am not so ignorant to believe that it won't come with hard work and persistence, (As my history shows...) but what I needed most before banding was HOPE! Hope that THIS time will be different! That THIS time, even if not "thin" by the world's standards, I CAN BE less heavy and healthy (and STAY that way!) I read about the lap band on the internet years ago when I was in behavioral counseling for weight loss (which didn't work, obviously)... the hospital was just introducing the gastric bypass at the time which was offered to me, but I refused. I told them, SOME day, when this band comes to the U.S. (they had never heard of it) MAYBE I'll consider it! Well, SOME day has finally arrived for me and I feel wonderful, grateful, and HOPEFUL! A great BIG thank you to everyone who posts, I have "devoured" every wonderful word over the past couple months! This is a place of HOPE and I so appreciate you all! :clap2: :clap2: :clap2: :clap2:

Hi All, My name is Holly. I'm 46 (actually had to think a bit before I remembered!! - Just shows I really am 46!), have been married to the same wonderful man for 27 years, and have a beautiful, kind, intelligent, hard-working 16 year old daughter. We are a homeschooling family living in southwest Louisiana and I am a licensed florist - currently unemployed by choice. I'm get tired of talking about my weight gain/loss/gain/loss/gain history so if it's ok I'll just post my stats. highest/surgery/current (total loss) 400+/403/343/ (-60) (Edited because I forgot to say some things)

Thanks for starting this thread! I gained 65 pounds in three months due to a horrible psychiatric misdiagnosis and being a guinea pig for every medication under the sun. I have no psychiatric problems, just a 15 year undiagnosed case of RLS. And the meds that would have helped with that problem wouldn't have led to the weight gain. And yeah, I DID say 65 pounds in 3 months. I went from 135 to 200 in three months. Then, almost immediately, I went down to 185, where I've been for the last 4 years.

Here's the deal, I see this over and over in people's posts, and it just doesn't make sense to me. It's along the lines of "you didn't gain it fast, why would you lose it fast?" That doesn't make sense to me, because you see, I did gain it fast. One month I gained 25 pounds, another month I gained 18 pounds, one summer I gained 50 pounds. When I was really sick with asthma, and have to be put on steroids, I would automatically gain 10-20 pounds, 10 of which would be a killer to lose. My calories didn't change drastically, nor did my activity levels change. So, my question is how did you gain the weight? did it just sort of sneak up on you? did you gain steadily did you gain in small bursts did you gain in large bursts

This is not going to be your favorite reply. Please understand that I'm not being judgemental in ANY way. I'm at my max weight as we speak. You have to save yourself (and your SO) by losing the weight you've regained. Don't throw things at me. I SOOOOO know it's easier said than done but you've got to try. Has the snoring resumed in the last 5 - 10 pounds of weight gain? Try to get just those pounds back off. You can do it. You've done it in the past and you can do it again. I've heard that some people are having good experiences with controlling their appetite and/or head hunger by going on anti-depressants. Effexor is the one I've heard mentioned recently but I understand Wellbutrin has been effective too. Please don't be upset with me I just want to encourage you to help yourself in the only way I can think of. Spray snore relief didn't work for me but I couldn't tolerate the taste/feel of it. I'm being banded on March 7th and I'd like to believe that the lessons I will learn will help me if I ever have to have the band removed. Don't wait - try to nip this thing in the bud. Best wishes to you.

Initially I didn't even tell my DH that I was going to a WLS seminar because I was sure he would disapprove and try to talk me out of it. Surprise...!! The night I returned from the seminar and showed him the Inamed booklet and told him all the GOOD things the band had to offer his reply was: "I think it's a wonderful idea. If you want to do this, I'll support you 100%". **Wow! And he's been a sweetheart ever since. Even with all my weight gain over the last 27 years he's never once complained or told me I needed to lose weight. The two of us together are like Jack Sprat and his wife. He's 6'3" and weighs maybe 200 lbs soaking wet...while me on the other hand at 5'2" and ....well over 200 lbs - we're a sight. I'm so looking forward to becoming a much smaller wife for my 'long tall drink of water' husband. As husbands go... I'm blessed - he's wonderful and I know that he is concerned over my health - if he wasnt' he would't have agreed so easily. He's watched me struggle with this practically my whole life. So anyway...that's my story.

Hi Everyone, My name is Becky. I'm 35 years old and was just banded on February 21st! I'm married to my wonderful husband Dave and have been for nine years this May. I have two cats, no childen. I live here in the City of Brotherly Love: Philadelphia! It's a most wonderful town and I encourage everyone to come visit! I am the Sales and Marketing Director for a Web design company and my husband is an IT Director with a national firm. I was a normal weight, if not downright skinny, child. When I look at pictures of myself from when I was really little, I can't even believe how thin I was. My weight gain started the very moment puberty started, and despite dieting for 25 years (you name it, I've been on it. Too many diets to list here!), I reached my heaviest ever weight a few months ago. One time in college I was able to lose 51 pounds with Nutri-System, but even then I still had an additional 30 to lose, so in my entire adult life, I have never been at an ideal weight. I'd been looking into the LAP Band since I first read an article about it a few years ago. But at that time, my insurance did not cover it. I had vowed to never get a bypass no matter how big I got, because it just is not for me. The second I found out that my insurance started covering the LAP Band in July of 2005, I enrolled in a seminar to get started. So I feel I have been waiting to be banded for years and years! Currently, I am 8 days post-op and starting to feel a bit better. I had a really rough first week. I have to say that without this board, I honestly don't know if I would have gone through with the surgery! I just am so appreciative and thankful for everyone on here. Nice to meet you all!

I notice that many people don't reach goal but have lost significant weight? Are all of the changes and the fears and the money worth it? Would you do it again knowing what you know now? I am deciding on WLS. I know my weight gain has made me feel old. I can't do activities that I love to do. I love to ride horses but my weight is too heavy for my horse babies and it makes me unbalanced. I love to run but my weight makes it so hard on my joints. My feet hurt daily. My back hurts all of the time. While I would like to get down to goal-I would be thrilled with 50% of excess Weight loss. I would be so much more able to be active. What do you all think? :paranoid

Hey Mvpo, I haven't really had any tests yet, they did one test, but according to what I've read, and what my aunt said (she's a doctor) they did the test wrong, so I'm not being treated in any way for the Cushings yet. I didn't know that weight gain was one of the primary, but I"m still learning about it. Not much that I've found, other than one support board that isn't like LBT, and a few other sites that just rehash the NIH site information, or quote it directly. I think being able to maintain any thing has been amazing.

VQ this is probably a silly question but have you had your cortisol level checked yet? I think until you get your Cushing's properly treated that you are kinda beating your head against the wall. I mean that WEIGHT GAIN is a PRIMARY symptom of Cushing's. So I think if you have been able to lose ANY weight without the Cushing's being under proper treatment is a testament to you and your model bandster behavior. M

Hi, all! Just talked to a good friend who is a pharmacist. She said that she has seen people on Prozac, Zoloft,---some of the older anti-depressants, as she puts it--gain a lot of weight. Gaining weight would definitely make me more depressed... She recommended Welbutrin XL (300mgs?) or Lexapro (?SP) because she has seen nothing but weight loss on these anti-depressants. I certainly don't want to get on anti-depressants that contribute to weight gain. Being obese is part of my misery. So--there are meds out there that help calm nerves vs. anti-depressants? I thought Valium would only be prescribed for severe, severe anxiety due to life altering events. Am I wrong? I don't know if I'm depressed or just severly irritable (nerves)...I don't feel hopeless and sad, but I do have insomnia at times and could sleep all day at times, too. The VERY WORST TIMES FOR ME ARE ABOUT 7-10 DAYS BEFORE MY PERIOD. Ahh--just want to feel calm. I've never had a panic attack--don't feel that anxious. I'm just on the edge all the time. Make sense? Any thoughts?

I had a massive (cantaloupe-sized) cyst removed, along with one ovary and the attached fallopian tube, years before being banded. Actually, I think my obesity prevented me from identifying the problem early on; I assumed the newish protrusion was just a symptom of uneven weight gain. I'm sorry to tell you that you won't lose much permanent weight if your cyst is the size of mine or smaller. This surgery was done before I got my band, so I don't have any band-related tales to report. But last year, one year post-band, I had a hysterectomy. The band did not get in the way at all, and in fact the surgeon reported that my recovery would be easier than with the first surgery since I was nearly 70 pounds lighter this time around. I lost about 6-8 pounds in the first weeks after I left the hospital, due not to the weight of the fibroids (etc.) that left my body but to my lack of appetite. That little side effect didn't last long, though. Good luck to you. The surgery is no fun -- band placement is a lot easier on the body -- but you'll feel much better without that grapefruit pressing on your internal organs.

Well, since I hadn't tried to buy it for personal use yet, I didn't know it took a doctors prescription. I would suppose that your Mom could get a prescription from her doc then. Just take him some information from the web site on how good it is for skin, since she is having problems with her skin. A lot of older folkes have skin that tears easily, and the extra nutrition would be wonderful for them. It isn't high in calories, so she wouldn't have to worry about weight gain. From what I've read of the ressearch though, it can help to promote lean body mass, which a lot of older folkes need. I'll have to see about getting an order in and see if they ask for a prescription. A cs. is 24 bottles. At $1.99 a bottle, it may be considered a little expensive. She could probably just drink one a day or one every other day and get good results and stretch her use of it out. They sent us double cases, of 48, but I would imagine that they can break them in to 24 a cs. I was planning to order a cs.