Oh, no... not the dreaded "End of the Road" speech (<-- Lengthy)

[DiDi 0]

Perhaps it's because you just had a Tummy Tuck in december & he wants you to heal just a bit more before doing another fill? Maybe he thinks you're trying to do to much right now. If you still feel you need more restriction, there are several really good doctors here that may give you a second opinion, or a fill. Let us know.

By the way, I'm not even banded yet, so what do I know anyway?

[I'llsucceed 1]

I believe what many have already stated that "he may have simply had a bad day or miscommunicated his thoughts" Either way you can go get fills if it is a must from other Doctors down the road. There are Doctors out there that take on other patients, although few & far between. On a side note, even though I do not know your journey, I too believe whole heartedly that you can loose this last 17 pounds without more of a fill. But than again its always easier being the cheerleader than the player. I wish you continued success!

[Arnie1269 0]

Is it possible that there was something going on in your body that day that made you seem more restricted than you actually are ?

IE, Water retention, Constipation, gas, or menstruation??? I am just thinking maybe if he really is taking the position that you're full.. you should ask if he can check again under floro at a different time of the month to make sure he's really getting an accurate read of what's going on...

Also - did he unfil and refil. Maybe there's even less in there than he thinks and that's why you feel like you're not restricted enough...???

[Jachut 487]

There is another side to the equation of fills and weight loss and that is exercise. Enough of it and the right kinds can work absolute miracles. Get scientific about heart rates and interval training and putting more muscle on your body. Its hard time wise but I just think that if I was prepared to have surgery I'm prepared to make that a priority too. I want to do this with the least amount of fills possible because I enjoy my food. I dont want to overeat but I dont want to starve either.

I think you're being a bit hard on yourself too. If I was given the opportunity to speak I'd love to share the joy and amazement that this journey so far has inspired in me and I'm only at the beginning! Of course you've been successful!

[bandayed 0]

I just don't get this at all -- isn't the band supposed to be a life long tool? What gives surgeons the right to say you're done? I've heard if you unfill and refill the restriction is even greater....surely there's more he can do???? I think it is totally unprofessional of him to shut you off! Have you considered still working your band, but travelling to do so? Maybe there is a Dr within 100 miles that could take you on. I know I'd drive an hour or two to keep using my band as a tool......hang in there. I think your Doc is the exception rather than the rule!

[Alexandra 55]

Your doctor's approach is quite perplexing, to say the least. It's one thing to think someone doesn't need a fill--that's an opinion expressed all the time. And I know there is a point at which doctors may say that the band has done all it can do; perhaps additional adjustments could cause esophageal damage, or there's a reflux issue evident. But to tell a patient that she won't lose more weight? That's bizarre. And a certified letter severing the relationship? That seems even more bizarre. Is there something more going on here?

I never thought I was the biggest failure in the history of LapBanding but I don't think doctors like seeing their professional fiascos around to remind them that even when the doctors do their medical best, and the patient does his/her best, things don't always work.

FWIW, you are NOT a "professional fiasco." A BMI of 30 is not unhealthy if you're in good shape. My BMI is higher than that and I'm held up to preop patients as a surgical success. So don't think he's embarrassed by your progress.

This is probably a result of some specific issue or personality clash that he felt couldn't be resolved. It doesn't mean that another doctor would feel the same way. But it is VERY unlikely that you'll be able to get an RNY revision with a BMI of 30. That is not, by any measure, obese enough to merit a gastric bypass.

[Nykee 13]

I tried to read all this over and over to see what I was missing.

what I see, is someone who lost like 35 pounds and needs to lose another 20 or so.. and thinks she is obese (but obese is 50 pounds or more overweight)

I cant imagine have even gotton the band to begin with much less even considered a gastric bypass..

I Would LOVE a BMI of 30.

She already got the tummy tuck..

And she is like in panic mode..

I dunno.. I just dont get it..

[Nykee 13]

I have received a certified letter from a doctor kicking me out of care..

And I deserved it..

It had nothing to do with the band or weight (or drugs)

It was because I wouldnt take care of myself, I hated going to the doctors, I didnt take my meds and I always hid everyting.... I would break my foot and be black and blue for months and never go to the doctor.. I wouldnt take my pain pills and gave my self injuries by doing too much when I was told to stay in bed.. blah blah blah..

I was totally unrealiistic back then and didnt see it one bit.

This was years ago and I am a goooooood patient now. I know how to listen and heal myself VS, abuse myself.

[babsintx3 0]

Hi New sho,

I am really trying to figure this one out. A doc doesnt send a certified letter terminating the relationship unless:

1) He truly is an insensitive clod, inexperienced or worried about a liability issue

2) The two of you are not getting a long and you are not sharing information with us.

If you want us to comment about a certified letter, then we would need to see the contents of the letter. We only have your side of the story and it would be unfair to comment about the doctor.

Now about restriction or failure of the band to do its job...... As a tenured bandster of 2 years and 7 months, I can tell you with absolute certainty that restriction is different for everyone. Even with extremely good restriction, I can eat toasted bread, regular bread, pancakes, Cookies etc...Always could through my whole banding journey. Yet with flouroscopy, my band was showing that I had good restriction and any more would be a detriment to me causing me potential problems with reflux or possibly other problems.

Most Bandsters always ride the fine line between too much and too little. The most I have had in my band is 2.6 and that was too much. One night of reflux and I had it removed and started again at 2.00. Like Melissa, I had all my fill removed (for different reasons tho)when I had plastic surgery last August. This was not intentional since my plastic surgeon was instructed to only remove .50 from my band, take me to 2.00 to allow me to eat more for my recovery. When I went back to my band doctor for a fill, he pointed out that I had nothing in my band, refused to fill me back to where I was before surgery, gave me 1.00cc and sent me on my way and told me to come back in 3 months. I think he was testing me to see how well I could comply. I got pissed off with him and went to another doc who filled me back to 2.20. I still dont have enough restriction, did gain some weight back and I am going back to fill doctor for another fill. My doc did not send me a certified letter, but he sure did let me know what he thought about me annoying him for more fill when I called a week later to let him know that the 1.00 wasnt doing anything. I might have been right, but I didnt make friends with my doc by annoying his staff daily and complaining.

So I would suggest this: Get a second opinion, but more importantly if your present doc thinks you are tight enough, find out why. He may be right. Ask him to explain why he feels the way he does. I would send it formally in writing because at this stage you have nothing to lose. Legally, your doc really cant do what he is doing unless there is something more going on here that you are not sharing with us. He is your surgeon and you have a right to know what is going on with your band.

I have never been a lightweight, so for me my present BMI of 29-30 down from 53.9 is a godsend. I know one thing for certain. You may think you dont have restriction, but I guarantee you if your band was empty for a few weeks you would notice the difference. You would be hungry all the time and its harder and harder to comply. It is possible that the band is doing everything it can for you. Maybe you are not doing everything you can do for your band. You might want to explore that possibility as painful as it may be for you to look at.

Babs in TX

334/180ish

-150 ish

[lljpaisley 0]

Well I am wondering if the doctor thinks that it will be unhealthy if you have another fill. You don't have that much more to lose. Maybe the doctor and you just have a difference of opinion. It might be a good idea to get a second opinion like it's been suggested

[Desi80 1]

i just don't get it either. how can you be 16lbs short of goal, had a Tummy Tuck, and yet still be obese. There are pieces of the puzzle missing here.

[NewSho 20]

...what I see, is someone who lost like 35 pounds and needs to lose another 20 or so.. and thinks she is obese (but obese is 50 pounds or more overweight)...

Um, I think I that's an error of calculation on your part. No problem, I was no Math major myself! I wish I was only 55 lbs overweight. Then that would certainly have made this a different story.

I cant imagine have even gotton the band to begin with much less even considered a gastric bypass..

We all have our set points of what pushes us to seek such a major surgery. For me, mine was BMI 40 or morbid obesity. For some it takes more weight to push them, for some people it takes being less overweight than I was. As I dieted and yo-yo'ed back up between 38 and 39 BMI, I realised I was in need of more serious help to fight being obese for life.

I put together a clear diet/weight history, started intense weight loss surgery research and got myself approved for RnY. (That was the more expensive procedure so I figured for most flexibility, I had better get the insurance to approve the more costly one and then I could later change it to the slightly less expensive procedure. I was right.)

So I although I was on paper, approved for the RnY bypass - the RnY was a worst case scenario. I actually wanted the LapBand, precisely because I didn't have (sounds funny to say it since I didn't achieve it) "that" much to lose and I thought it was a tool that would best for me and my lifestyle. To you, it might seem easy for someone else to say they couldn't imagine wanting a LapBand to lose XXXX amount of weight, but if it were just so easy, none of us would have been here, no matter how much or how little we hope to lose. So to you it may seem like nothing but to me it was weight I struggled with my entire adult life. That warranted me seeking weight loss surgery and not wanting to further postpone the difficult process might have chosen me to seek it earlier than some. Different strokes, eh?

Had I initially had the RnY, I was told I would have probably lost about 90-110 lbs (more than I thought was necessary for my comfort level, but I'd have just been 'normal', whatever that is.) Then, my doctor estimated that with my high level of compliance (and trust me I was VERY compliant and dedicated, especially since in the back of my mind, Band-bashers often point to the fact Bandsters lose far far less than RnY due to what they mistake for an ability to be non-compliant. I think any WLS can be beaten with non compliance, but although I know malabsorption can make a difference for success, I thought I could succeed without it) that I would lose 2/3 of that or approximately 66 - 70# lbs. That's why my goal was set to for me to lose 68# in by surgeon's terms, right in the midst of that range. I think that's more than reasonable amount to avoid a permanent malabsorption. Yes with the RnY I would have lost more, but I preferred the LapBand, and therefore I accepted this as a fair range of restriction-only surgical weight loss.

So my current loss is about 48-51# (depending on which doctor's file I consult) and puts me right at BMI 30+. That makes me (and my BMI) to be considered obese. I wanted a tool that would assist me in the fight against obesity, not just help me be somewhat less obese. That's the truth.

After all I've done, and after doing my level best, being at BMI 30 now is a bit of a letdown for me. Even getting to a BMI considered just "overweight" (rather than "obese")would have been a better than nothing, but of course was aiming to be at something a bit lighter than that. It seemed that a BMI of 27 or 28 was doable so that was the goal set.

And finally, if I expressed "panic" it was not because of my weight (which is a big disappointment, true enough) but because I actually thought my surgeon and I were on the same page about my goals and my chance of achieving them. I know now we differ, but I still have to work on making this happen so it's overwhelming (and last night, obviously seemed panic-inducing) to have "change horses midstream" and find another surgeon.

Thanks!

[NewSho 20]

...how can you be 16lbs short of goal, had a Tummy Tuck, and yet still be obese. There are pieces of the puzzle missing here.

And what a puzzle it is.

It's so overwhelming that I'm still trying to put it all together in a way that makes sense to me, much less to my peers who I'm asking for opinions!

First of all, BMI is a ratio. Had I achieved the rather unambitious goal weight set for me (variously 18#-20# from my current weight) then I wouldn't have been obese anymore by BMI standards. That part is simple.

{As for the Tummy Tuck or Abdominoplasty -To those who have not have yet had cosmetic surgery: I did have an Abdominoplasty. This surgery is very different from weight loss surgery or Lipo. The traditional abdominoplasty is not a weight loss procedure - it does do not ultimately affect your scale weight either way. In fact after a Tummy Tuck, there is often an initial weight gain, due to Fluid retention and swelling. (I already factored that in with my latest weight issues.) I was told I was close enough to goal to be within range to have a this done and I knew with some effort, I could have it covered at 100%. So I was happy to seize that opportunity for a much needed procedure. I sought 4 different plastic surgery consultations and my WLS surgeon's advice before I had it and it was definitely the right move. But never ever think a Tummy Tuck makes will mean significant weight loss. It's a wonderfully complex procedure but it changes how your body contours, but although it might change your posture or even how your clothes fit, it may not change your weight. If you see Fatty meat on a butchers scale (ewwww ), you may see that the marbled fat doesn't weigh as much as the meat's muscle and bone, and Abdominoplasty surgery primarily removes skin and it's associated flab and repairs muscles if needed. Just an FYI! :straight }

I'm trying to clarify all the parts of the story because it seems a bit disjointed with the way I outlined it. Chalk that up to emotion. But I have to wait until my medical records are in my possession to put ALL the missing pieces together. There is much more to this for me to work through and the more information I have, the clearer I will be on what's really going on here.

So as I really do appreciate everyone's comments, I will take some of this very much appreciated and very much solicited advice under counsel. I posted here first because I needed to hear what other Bandster patients thought about how I should proceed next. I've been very grateful especially to those who contacted me privately and attempted to help me work through it. Yes, I had a very visceral, heartfelt emotional response to the letter (which just seeing a certified letter, much less one from a surgeon, nearly scared me silly :cry ) and I think my post reflected that.

I was upset (still am) overwrought (no longer that) and shocked. Now I'm justifiably upset but I am trying to look at my options. So, for now, I should remove my post before I make a bad situation even worse. It's bad now, so I should try to have enough presence of mind to not inflame things further or seem unclear, especially when I lack all the true details here.

I am crafting a measured written response to the office, but of course I have accepted his decision. I do accept that this is as much as I could have done (to whoever said that, I do realize they have no idea what I've gone through - hopefully I can expand on that later also) so such hold on to your hats. Once I get my medical records released I think I'll have a very relevant and thought provoking story to tell my Banded (and de-Banded) Bandster peers.

No one likes to admit they made a mistake. I am no different. I fully believed the Band could take me to an acceptable level of weight loss. Maybe it still can but it's a bit discouraging to hear your medical professional say you've come to the end of your road. (Again, those were his words.) If he thinks I should be satisfied to have come from where I was to where I am now, then he really didn't ever clearly hear my goals, aims, and wishes.

And if it sounds like belly-aching to say I did NOT undertake the time, money, effort and blood, sweat, and tears just to end up still obese - then a belly-acher I am. My goal was to get to a healthy, and satisfactory weight. This isn't it.

Again as I promised, I will first attempt to get the records released, get them analyzed by another professional and then know how to proceed next. Then hopefully I'll be in a position to put ALL the pieces together and then more clearly outline the details on why my journey with this surgeon, is being cut short.

No matter what my (former) surgeon thinks, I am not definitely through trying to succeed at this.

Again thanks.

[Nykee 13]

ok

but I am still confused..

good luck of course, I hope you get everything you want!!

[rorysmom 0]

new sho:

how long have you had your band?

how much weight did the doctor say you needed to lose?

how much weight did you want to lose?

what behavorial changes, emotional discoveries, healthy lifestyle (nutrition/exercise) changes have you made since you got your band?