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New Here - Decision Made



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Hi Everyone!

I have made this very scary decision, and I am hoping reading all your posts will help me through. I see a lot of common positive feedback, but I am really anxious about the first month, and also, about "what will people think?".

I asked my surgeon if he felt people would be predjudiced if they knew THIS was why I was having time off work etc. And advised me that it was probably best not to tell people of my procedure (I'm get panic attacks anyway) as they do tend to be a little prejudiced about weight loss surgery. I have enough questions to fill a book!

I'd love to hear your thoughts and experiences, and how you got through the first days.

Also, having no desire to overeat - is this true?

As you can see, although I know I am doing something that I really want and need, I am pretty anxious about the actual process and dealing with people!

:omg:

Coo

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It has changed my life! Given my life back actually! Congratulations on the best decision you will ever make for yourself. I am not tempted to overeat for two reasons--the band helps me feel satisfied so that it is EASIER to push away from the table and it HURTS if I overeat since it stretches the pouch. It is STILL a choice I must make everytime I sit down to eat. It has helped me learn the feeling of truly being hungry as opposed to just having the desire to eat. Having the band is NOT a magic solution rather a tool to help us learn how to eat to live instead of living to eat and that is EXACTLY what I have done all my life! I was also VERY nervous before AND just after my surgery but I have not EVER regretted the decision. As far as dealing with other ppl I have found them to be very interested in the surgery and supportive of my decision. It was actually more stressful for me to try to keep it a secret and after I told my co workers I was very surprised at how excited they were for me. Their encouragement and support have been so helpful! Welcome to the Losers Club my friend!

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Hi Everyone!

I have made this very scary decision, and I am hoping reading all your posts will help me through. I see a lot of common positive feedback, but I am really anxious about the first month, and also, about "what will people think?".

I asked my surgeon if he felt people would be predjudiced if they knew THIS was why I was having time off work etc. And advised me that it was probably best not to tell people of my procedure (I'm get panic attacks anyway) as they do tend to be a little prejudiced about weight loss surgery. I have enough questions to fill a book!

I'd love to hear your thoughts and experiences, and how you got through the first days.

Also, having no desire to overeat - is this true?

As you can see, although I know I am doing something that I really want and need, I am pretty anxious about the actual process and dealing with people!

:omg:

Coo

Hi Coo,

I have also made the decision to have the surgery and now just have to see the surgeon and hopefully get a date.

My husband is the only family member that knows but I have told my boss at work as I knew I would need time off before and after the op. They are so supportive and positive about it and every time I have an appointment about it they want to know what happened etc.

If you have doubters perhaps you can print the following article out and get them to read it. I found it explained my situation and was truly motivational as well.

Medical Weightloss - world leader in gastric banding lapband surgery - Surgeon George Fielding talks about obesity surgery - NYU Medical Center, New York

This doctor has had the surgery himself and talks of his attempts at weight loss.

I think that you only tell the people you feel confident in telling. You can always tell your boss it's an op for something women don' really want to talk about (well that's not a lie - most women don't want to talk about their weight) and if you boss is male he probably won't want to know any more!!

:confused:

Anyway, in my opinion I think you have made the right choice and if you are sure this is what you want then don't let anyone else's attitude stop you.

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Hi Coo,

I have also made the decision to have the surgery and now just have to see the surgeon and hopefully get a date.

My husband is the only family member that knows but I have told my boss at work as I knew I would need time off before and after the op. They are so supportive and positive about it and every time I have an appointment about it they want to know what happened etc.

If you have doubters perhaps you can print the following article out and get them to read it. I found it explained my situation and was truly motivational as well.

Medical Weightloss - world leader in gastric banding lapband surgery - Surgeon George Fielding talks about obesity surgery - NYU Medical Center, New York

This doctor has had the surgery himself and talks of his attempts at weight loss.

I think that you only tell the people you feel confident in telling. You can always tell your boss it's an op for something women don' really want to talk about (well that's not a lie - most women don't want to talk about their weight) and if you boss is male he probably won't want to know any more!!

:confused:

Anyway, in my opinion I think you have made the right choice and if you are sure this is what you want then don't let anyone else's attitude stop you.

Great article! Thanks!

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<p>

Hi Everyone!</p> <p> </p> <p>I have made this very scary decision, and I am hoping reading all your posts will help me through. I see a lot of common positive feedback, but I am really anxious about the first month, and also, about "what will people think?".</p> <p>I asked my surgeon if he felt people would be predjudiced if they knew THIS was why I was having time off work etc. And advised me that it was probably best not to tell people of my procedure (I'm get panic attacks anyway) as they do tend to be a little prejudiced about weight loss surgery. I have enough questions to fill a book!</p> <p> </p> <p>I'd love to hear your thoughts and experiences, and how you got through the first days.</p> <p> </p> <p>Also, having no desire to overeat - is this true?</p> <p> </p> <p>As you can see, although I know I am doing something that I really want and need, I am pretty anxious about the actual process and dealing with people!</p> <p> </p> <p><img src="http://www.LapBandTalk.com/images/smilies/omg.gif" border="0" alt="" title="Omg" smilieid="167" class="inlineimg" /></p> <p> </p> <p>Coo
</p> <p> </p> <p>Coo</p> <p>Congrats on making the decision that is the 1st step to the new you..</p> <p> </p> <p>As far as telling people at work &/or friends - only you can make that decision as you know them we don't - I told my friend who is also my supervisor and she told half the office - i didn't really care as I would have told - but to me it was my story to tell not hers. I had one friend say to another when she heard that i was getting the surgery that it was "cheating" I said well at least this for my health - What were your FAKE BOOBS for.. Some people are not informed and think this is the easy way out and it's not - the band will band your tummy but not your brain - I will be full but still want to eat (head hunger) You will have to change the way you eat and learn to make healthy food choices and add exercise into your life - Us fat people don't do much of that <img src="http://www.LapBandTalk.com/images/smilies/ponder.gif" border="0" alt="" title="rolleyes" smilieid="40" class="inlineimg" />.</p> <p>We eat to sooth our feelings - to fill time whatever your triggers are and once you can no longer use food to soothe those emotions you will have to find another way of dealing with them. I would self medicate with food to sleep at night (sugar makes me sleepy)</p> <p> </p> <p>Surgery for me was painful - some say it's not but - when i first woke up it felt like an elephant had kicked me in the stomach and still had his foot on it - but after being able to push the button to get more pain meds it was fine. the first 24 hrs you aren't going to feel like partying but by day 2 your are doing so much better and as each day passes you feel better - I was back to work on day 6 (desk job) most people will agree that what hurts the most after the 1st day or so is your port site and that hurts for about a week or 2 - can't remember now how long it was uncomfortable at times.</p> <p> </p> <p>You will find success stories here (go to thread near or at goal) and you will find people who arent as sucessful - this is no different than any other program (ww - jenny craig etc) - the band is only a tool - just because you have this little plastic belt around your tummy doesn't give you that 100% guareentee that you are going to lose weight and never gain it back - it will only control your portions by making you feel full faster and on alot less food. but you can still eat around the band by choosing high fat high surgar foods. Weight loss and more importantly maintaining that loss is more about your brain than your tummy... 75% of the work will be you (good food choices - exercise) and 25% will be the band..</p> <p> </p> <p>I gotta run and take GS to football game. so gotta close for now - but any questions just ask - read read read the more info you have the greater your sucess...</p> <p> </p> <p>Good luck</p>

Just wanted to add that I am very happy with my band - 2 months 35 lbs - I am on my way - I would do it again in a ny minute - I feel that the band has helped me gain control of my eating by limiting my portions as i was a volume eater...

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Congratulations Indigogirl, 35lbs in 2 months is a terrific weight loss. You must be so pleased! Keep up the good work.

:clap2::whoo:

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Hi Coo:

My name is Francine and I was Banded on 9/24/07.....I feel great... Today alittle sore...but may have done more than my body could handle.....Surgery went really well... no problems, like you I didn't really tell any one about the weight loss surgery except my family... loosing weight, not sure of how much, I don't really want to get obsessed w/ the how much weight lost or the well why am I not loosing etc..... just going w/ the flow...You have good days and Sore days..Im not really hungry at all. I have to make myself drink my protien shakes, Water, popsycles and my sf Jello, the key thing is to drink, drink, drink, sip slowly... and walk, walk, walk it helps w/ the gas alot. Hardly use my pain meds. But the overall is I feel great, don't worry you will be fine and feel GOOD ABOUT YOURSELF, I had my surgery for health reasons.....But I know things wil get better w/ time..... Good Luck w/ your journey !!!!!!!

~ Francine ~

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Thank you for your replies, support, encouragement and knowledge :)

And IndioGirl55 I really appreciate your honest pro's and con's for this surgery. I truly wish they banded the brain too - wouldn't that help?

I have not yet read why the gas/wind thing happens. I had been wondering about the cravings and comfort eating - after all, that's why I'm the size I am.

I am hoping that as the size of me drops (assuming I can cope with the not eating, the liquids, the nausea and portion control) I will regain some self esteem, confidence and pride.

I do feel acutely uncomfortable telling people, and at this point won't be telling my adult children. I did read where you can't really eat in public - as its fairly obvious there's something not normal LOL going on with the chewing and only consuming 2 tablespoons of food. Which to a great degree won't worry me, but family events leave me wondering! I am thinking that considering what's ahead of me, that its good I'm of a hermit-ish nature!

Thanks again

:kiss

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Hi Everyone!

I have made this very scary decision, and I am hoping reading all your posts will help me through. I see a lot of common positive feedback, but I am really anxious about the first month, and also, about "what will people think?".

I asked my surgeon if he felt people would be predjudiced if they knew THIS was why I was having time off work etc. And advised me that it was probably best not to tell people of my procedure (I'm get panic attacks anyway) as they do tend to be a little prejudiced about weight loss surgery. I have enough questions to fill a book!

I'd love to hear your thoughts and experiences, and how you got through the first days.

Also, having no desire to overeat - is this true?

As you can see, although I know I am doing something that I really want and need, I am pretty anxious about the actual process and dealing with people!

:omg:

Coo

Hi there! Welcome! I wrote this list a liong time ago. It's based on my own, personal experience, so it may not apply to you. Some of it that is not relevent any more has been cut out, so if you see numbers missing, that's what happened.

Best wishes to you on your journey!

INDEX:

1. Any question that begins with "Should I ask my Doctor about

2. "Should I tell my family and friends?"

3. "Is it normal to be REALLY NERVOUS and wonder if I will fail at this?"

4. "How can I tell if my band slipped?”

5. "Why can I eat this food one day, but not the next?"

7. "Is it possible to get pregnant while wearing a Lap-Band?"

8. "Will my tastes in food change because of this?"

9. "What food will I be able, or unable, to eat?"

10. "I weigh XXX pounds. Am I too big for the Lap-Band, and will I lose weight with it?"

11. "It's been XX days, and the scale hasn't moved. What am I doing wrong?"

12. "What are the slang words you use here, like "PB" or "SLIME"?"

13. "I had restriction, but it went away. Where did my restriction go?"

14. "Which surgery should I have?"

15. "What should I take to the hospital?”

16. "How many days should I take off work?”

17. "I'm "Stuck"! What do I do?"

18. "Do I qualify for surgery?"

19. "Will insurance pay for my surgery?"

20. "How much does surgery cost?"

21. "I'm sick, and have a fill scheduled for tomorrow. Should I cancel my fill?"

22. "How much food will I be able to eat at one meal? How much SHOULD I be eating?”

23. "How many fills will I need to hit my sweet spot?"

24. "What is the sweet spot?"

25. "How much exercise should I do?"

26. "I had a PB, when can I eat again?"

27. "What Is The Reason For A Pre-Op Diet?"

28. "My doctor said to avoid caffeine, why is that?”

29. "Can I have soda or a beer?"

30. "Can I use a straw?"

31. "Can I chew gum?"

32. "What is a "Soft Stop" and what will my "Soft Stop sign be?"

33. "How often should I weigh myself?"

34. "Why should I take measurements?"

35. "Why do I have to eat Protein first?"

36. "Why can't I drink with food, or for a half-hour after eating?”

37. "Will I have loose skin after the weight loss?"

38. "Why are there different band sizes?"

39. "Will I feel full with a Lap-Band?"

40. "How does a Lap-Band actually work?"

41. "How much Fluid should I be drinking per day?"

42. "Is the Lap-Band permanent?"

43. "What time should I stop eating during my day?"

44. "What is "Water-Loading" and why is it important?"

45. "Is it possible to stretch out the small stomach, or "Pouch"?"

46. "Is it normal to feel tighter in the morning than any other time of day?"

47. "How Important Is The Post-Op Diet?"

48. "Is it normal for a Lap-Band to feel tighter during my menstrual period?"

49. "Can I gulp fluids with a Lap-Band?"

50. "How long does it take to feel the effects of having a fill?"

1. Any question that begins with "Should I ask my Doctor about..." the answer is YES! It's their JOB to answer our questions!

2. "Should I tell my family and friends?" It's up to you. In an ideal world, everyone would love you and support your decision to have life-saving surgery. But this is the REAL WORLD, where some people just can't keep themselves from making nasty, hurtful, ignorant and insensitive comments to people. If you don't want those comments, or are not strong enough to NOT CARE what other people think, DON'T TELL THEM!

3. "Is it normal to be REALLY NERVOUS and wonder if I will fail at this?" Yes. All of us are lifetime failures at dieting and keeping off weight. That reality makes us question whether or not the Lap-Band will work for us, when we have failed so many times before. The Lap-Band is DIFFERENT, because it puts a physical LIMIT on how much we can hurt ourselves. Also, anyone who isn't nervous about having MAJOR SURGERY is very unusual.

4. "How can I tell if my band slipped?" You go to the doctor and have a fluoroscopic examination. People sometimes have slips with minor symptoms, and sometimes they have major symptoms. Band slips are indicated by sudden UNEXPLAINED RESTRICTION or sudden UNEXPLAINED LOSS OF RESTRICTION. If you have either of those symptoms, you need to call your doctor.

5. "Why can I eat this food one day, but not the next?" Some theorize that the Lap-Band is affected by the amount of dehydration of the patient's body. A person who is dehydrated may have a looser Lap-Band due to "Flatter" cells that are not fully hydrated. Conversely, a patient who is fully hydrated may experience a tighter lap-Band due to "Plumper" hydrated tissues. This is another reason to drink more Fluid that you did before you were banded.

7. "Is it possible to get pregnant while wearing a Lap-Band?" Yes. All normal precautions to avoid pregnancy need to be followed if pregnancy is not desired. It has been speculated that morbidly obese females experience weight-related infertility, or impaired fertility. Many women who experience weight loss suddenly become pregnant after many years of trying. If a patient becomes pregnant, their doctor may or may not decide to unfill the Lap-Band for the duration of the pregnancy. Some doctors do not unfill, some unfill some of it, and some unfill all of it. If a patient is unfilled for the pregnancy, they must receive a fill or series of fills after the delivery to regain effective restriction.

8. "Will my tastes in food change because of this?" They might, they might not. Many people report intolerance for a certain food that they previously enjoyed. Many people also report an increased desire for spicier or tastier food.

9. "What food will I be able, or unable, to eat?" People have different food tolerances after being banded. Some people report that no food is difficult; some say bread, rice or Pasta is difficult. It all depends on the individual, and the only way to find out is to try that food for yourself.

10. "I weigh XXX pounds. Am I too big for the Lap-Band, and will I lose weight with it?" My starting weight was 570 pounds. Whether you lose weight with any weight loss surgery will depend on whether or not you adapt to the lifestyle modifications that the surgery requires. Success is ultimately up to you, and depends on your effort.

11. "It's been XX days, and the scale hasn't moved. What am I doing wrong?" Scale weight repeatedly stalls during the weight loss process. Common reasons include the following: (A) Patient is eating more than they think they are. (:) Patient is retaining fluid for some reason, like salt intake or menstrual cycle © Patient's body is dehydrated, and is retaining fluid for that reason (D) Patient's body weight has increased due to muscle tissue increasing due to increased exercise (E) Unknown. The best way to not go insane about scale weight is simple: Stop weighing obsessively. Weigh in not more than once a week, because momentary weight fluctuations of as little as 1% of your body weight will wipe out a full week's weight loss. Take measurements before being banded so that when the scale weight stops, you can re-measure to see if your body size is shrinking while the scale stalls. EXPECT the scale loss to stall once in a while, this is NORMAL. Weight loss is a "Staircase, not a curve" that is, its stop, then drop, stop, and then drop.

12. "What are the slang words you use here, like "PB" or "SLIME"?" "Slime" refers to the uncontrollable production of saliva, which usually happens when a piece of food is "Stuck". "Sliming" can also occur as a reaction to eating too much food, or from not chewing food well enough. Sliming can lead to a "PB", or "Productive Burp", which is a small amount of vomit.

13. "I had restriction, but it went away. Where did my restriction go?" My experience with receiving fills has been a temporary restriction, caused by the swelling of the stomach post-fill. This temporary restriction is followed by a lessening restriction as the swelling subsides. That lessening restriction is usually followed by weight loss, which shrinks the residual fat-pad that lies between my Lap-Band and my stomach. The loss of the residual fat-pad causes a loss of restriction, due to increased space between the inside of the Lap-Band and the outside of the stomach. When I lose that restriction, the entire process begins again when I get another fill. I have had 7 fills now, and I go through the same process with every fill.

14. "Which surgery should I have?" The type of surgery that is best for you should be determined by you and your doctor. There may be underlying medical issues that you have that are not known to anyone but you and your doctor. Those medical issues may make a difference in which surgery is best for you. Every weight loss surgery has advantages and disadvantages. Doing the research into the different types of surgery is a very good idea. One more thing, weight loss surgery, in itself, does NOT guarantee the success of the patient. The patient who is determined to do whatever is required in adopting a new, healthier lifestyle will be successful, no matter what type of operation they have.

15. "What should I take to the hospital?” This varies from person to person, but the following are nearly universal: 1. Loose-fitting clothes for the trip home. 2. A pillow to cushion the tummy from the seat belt on the ride home. 3. Chap-Stick. 4. A CPAP if you use one, and the hospital permits patient's CPAPs instead of providing one for them. 5. Your insurance card and I.D. (You would be surprised how many patients forget this) you may decide to add items to this list.

16. "How many days should I take off work?" People will differ as to their recovery time. Most Lap-Band patients report that one week is sufficient time to recover enough to return to work, but if your job is physically demanding, you may require additional time off, or have restrictions placed on you. You may have restrictions on the amount of weight that you may lift. Please discuss this with your doctor, as they may be able to answer this question more accurately.

17. "I'm "Stuck"! What do I do?" Being "Stuck" means that a piece of food has lodged somewhere in your esophagus or stomach, causing extreme discomfort until the food dislodges. A "Stuck" happens because of a lack of chewing, or because the food was dry, or any number of reasons. The best way to prevent getting "Stuck" is the chew your food extremely well, and avoid dried-out foods. Unfortunately, there is no effective way to "Unstick" food. You just have to wait it out. The food will either eventually go down by itself, or you will "Slime" or experience a "PB". See number 12 to see what "Slime" and "PB" are.

18. "Do I qualify for surgery?" This depends on which surgeon you choose and where you plan on having the surgery. For example, some surgeons in other countries only require you to be 20 or so pounds overweight, while many American surgeons require a BMI of at least 35 with the presence of qualifying co-morbidities.

19. "Will insurance pay for my surgery?" I suggest you call you insurance company to see if they cover the Lap-Band procedure. If they do, then you will need to call your employer's human resource department to see if there is an exclusion for weight loss surgery that they have put in place. (Many companies exclude weight loss surgery as a means to save on insurance premiums) If the Lap-Band procedure is covered by your insurance, most companies require you to meet one of the following weight requirements: 1. Have a BMI of 40 or higher or be at least 100 pounds overweight; 2. Have a BMI of at least 35 with comorbidities (health conditions caused by obesity, such as high blood pressure, heart disease, diabetes, etc.) The insurance company may also have other requirements that you must meet, such as a medically supervised diet, meeting with a psychiatrist/psychologist or certain health clearances. This will vary from company to company, and the only way to find out is to ask the insurance company.

20. "How much does surgery cost?" This will depend on the surgeon you choose and where you have the surgery. If you choose to travel to a foreign country for surgery, you will usually pay a lower price than if you chose to have surgery in the United States. Most Mexican surgeons charge less than $10,000, while most American surgeons charge $14,000-$20,000 or more. While it is important, price should not be your only consideration when choosing a surgeon. After-care is extremely important for Lap-Band patients, and Inamed/Allergan states that lack of proper patient after-care is implicated in the majority of band revisions.

21. "I'm sick, and have a fill scheduled for tomorrow. Should I cancel my fill?" In general, unless you have been throwing up, (Which may cause swelling in the stomach tissues) the band would not be affected by common illness. If this is a concern for you, I recommend you call your doctor and ask them.

22. "How much food will I be able to eat at one meal? How much SHOULD I be eating?" Most Lap-Band patients report eating between one and two cups of food at one meal. You may eat less or more than this. If you are eating more, I recommend you be evaluated for a fill. Most Lap-Band patients consume between 1000 and 1500 calories per day. Eating very few calories may actually impede your weight loss due to your body going into "Starvation Mode" where it holds onto every calorie.

23. "How many fills will I need to hit my sweet spot?" I talked to Inamed about how many CCs in a Lap-Band made for a "Good fill". Their answer surprised me: "It really doesn't MATTER how many ccs are in the band. The only thing that matters is whether or not that CC amount provides EFFECTIVE RESTRICTION" (Emphasis added) So the trick then is NOT how many CCs are in the Lap-Band, it's whether or not the band works well at that level of fill.

24. "What is the sweet spot?" The phrase "The Sweet Spot" is just another way of saying "Effective Restriction". The problem is that people expect "The Sweet Spot" to last, it doesn't, and neither does "Effective Restriction". Not until the entire residual fat-pad on the outside of the stomach muscle is melted off, and that takes TIME.

24. "How soon should I exercise?" As soon as you feel able to, with attention being paid to any restrictions that your doctor may have put on you. When in doubt, call your doctor.

25. "How much exercise should I do?" That is going to depend on your ability and fitness level. Exercising to the point of pain is not advisable. Start slowly, and if you have any medical conditions, please consult your doctor. Walking is excellent exercise for newly banded patients. The type of exercise is not as important as doing the exercise on a consistent basis. A small amount of exercise daily is better than a large amount done once weekly.

26. "I had a PB, when can I eat again?" Many doctors advise going back to fluids with a slow re-introduction of food, starting with "Mushies" following a PB. My own doctor advises 2 full days of full fluids following any fill, PB or vomiting.

27. "What Is The Reason For A Pre-Op Diet?" The purpose of a pre-op diet that precludes a binge eating session is to shrink the amount of fat stored in the patient's liver. A patient with a fatty liver has much higher risk in surgery, because the surgeon has the "Shove" that fatty liver out of the way. Possible complications of binge eating resulting in fatty liver include the following: 1. Conversion of surgery from LAP to OPEN. 2. Laceration of the liver. 3. Internal bruising of the liver. 4. More post-op pain for the patient. 5. A longer operation time. 6. *IF* the theory about hair loss due to time under anesthesia is correct, greater Hair loss. 7. Higher possibility of respiratory complications, pneumonia, etc., due to longer time under anesthesia. 8. Higher possibility of blood clots due to longer operation time. 9. Longer lingering side-effects from the anesthesia due to being under anesthesia for a longer time. 10. More stiffness and more pain from being on a cold operating table on your back for a longer period of time.

28. "My doctor said to avoid caffeine, why is that?” Many doctors believe that caffeine, because it is a stimulant, may stimulate a patient's appetite. Caffeine may also be a gastric irritant, which could be a contributor to GERD, acid reflux or eventual band erosion.

29. "Can I have soda or a beer?" Some doctors believe that carbonation may stretch out the pouch. Other doctors do not follow the "No carbonation" rule. I find it uncomfortable to drink carbonated beverages, especially if I try to drink them fast. In any case, the Lap-Band is not designed to restrict fluids, so the calories in any beverage must be counted as food.

30. "Can I use a straw?" Some doctors believe that swallowing air by using a straw will cause the patient's stomach to fill up on air, which leaves no room for food. Some patients find using a straw produces too much trapped air pressure, and some patients use straws daily.

31. "Can I chew gum?" Probably. Just don't swallow it. If you do swallow gum, be aware that it could cause a total obstruction of the stoma, the opening created by the band. If this happens, either the gum will eventually dislodge and pass through the stomach, or you may PB or vomit to clear the blockage. In rare instances, the blockage is so severe a trip to either the doctor's or the hospital is necessary to remove the blockage.

32. "What is a "Soft Stop" and what will my "Soft Stop sign be?" I wish I could answer that, but I can't. My experience is that it took me some time to recognize that that funny little hiccup was a stop sign. I don't even recall how long it took me to figure it out. What REALLY messes me up is when my body tricks me by substituting another sign for my hiccup. Many a PB followed when that happened, so now I look for ANYTHING different. A feeling of fullness, stuffiness, a runny nose, a hiccup or hiccups, watering eyes... ANYTHING that's different!

33. "How often should I weigh myself?" I have an opinion on scales for post-op patients: "Scales are NOT your friend!" Let me explain why. The typical Lap-Band patient loses between one and two pounds per week after obtaining effective restriction in the Lap-Band. Normal body weight fluctuations can, and do, wipe out a month's worth of scale weight loss. We can't do anything about those fluctuations, and higher scale weight sometimes triggers feelings of despair and hopelessness, which can lead to out-of-control overeating. I advise new post-ops who are fewer than 6 months out to not use a scale at home. Use the scales at your doctor's office when you go in for your checkups. After six months have passed, I advise people to weigh in as little as possible, but never more than once a week. (Note: Some people feel compelled to weigh in every day; I used to be one of them. Some people feel that weighing often helps them to "Stay Focused" on weight loss. If weighing in does NOT cause you anxiety that is compensated for by overeating, weigh in every five minutes if you like.)

34. "Why should I take measurements?" Taking measurements before your operation is one of the most effective ways to "See" a weight loss when those scales just are not moving. The typical pattern in post-op patients is for the scales to "Stop, then drop" when the scales stop suddenly, it helps to confirm that you are still losing inches, despite what the scales say.

35. "Why do I have to eat Protein first?" Eating the protein food first guarantees that you will not "Fill up" on other food and run the risk of a protein deficiency. Adequate protein is necessary for good health, and most post-ops find that solid protein fills the small stomach created by the Lap-Band faster, which helps them to feel fuller for a longer time.

36. "Why can't I drink with food, or for a half-hour after eating?" Drinking with food turns the food into "Soup", and "Soup" runs through the stoma quickly. The Lap-Band is designed to offer effective restriction when eating solid food. People who drink while eating will eat more and they will be hungry quicker after eating.

37. "Will I have loose skin after the weight loss?" Like so many things, this will depend on the individual. Skin tone is primarily determined by a person's genes. Some people's skin reduces with their body size, and some don't. Many people who have lost large amounts of weight will have excess skin. Currently there is no cream or drug that will reduce excess skin, the only way to get rid of it is by having plastic surgery. Common plastic surgeries post weight loss include the Tummy Tuck, thigh lift, breast lift, breast implants, face lift, neck lift, lower belt lipectomy, buttock lift and arm reduction.

38. "Why are there different band sizes?" The differences in the bands that are approved for use are: 1. The internal diameter of the band, and 2. The fill capacity of the band. The reasons for the differences are so that the surgeon can make a choice as to which band to use on the patient. That decision is made during surgery, when the surgeon is actually looking at the patient's unique anatomy. Because of this, the surgeon should have all the bands available to them during the surgery. In terms of restriction ability, there are very little differences between the bands. Here is some more information on stoma sizes. The maximum diameter of an unfilled VG band is only 32.86 millimeters. The maximum diameter of an unfilled 10cm band is only 26.46 millimeters. The maximum diameter of an unfilled 9.75cm band is only 25.23 millimeters. Remember, the entire, folded stomach wall has to fit in there too! And at maximum fill: 16.73 millimeters for a VG. 16.35 for a 10cm. 15.13 for a 9.75cm.

39. "Will I feel full with a Lap-Band?" A post-op WLS patient is probably are not going to have the same sensation of "Full" after their operation that they experienced before their operation. In my case, before my operation, when I ate (Which means when I "Overate") I felt sort of "Stuffed" as if I had eaten a full meal, and drank with it, until my stomach was so full that it felt as if I had eaten a smaller version of a Thanksgiving dinner. I felt slightly distended or bloated, and as if I couldn't (Or shouldn't) eat another bite. I routinely ate so much food that I would feel right on the edge of uncomfortably full. That was the only way I felt "Satisfied". I believe that as a pre-op, I had never really learned my body's "Full signal", so I just kept on eating until I felt physical discomfort from over-eating, which I interpreted as "Being full". Angela says that her Grandmother taught her one way to tell if you are full: "If the food stops tasting as good as it did when you first started eating, that means you are full". I think that is a good way to tell fullness, as I know that applies to me now. I will be eating a meal, and halfway through the meal, the food stops tasting good to me, so I put it away. Patients who are post-op report many different "Full Signals", some of which I have listed here:

A hiccup or hiccups.

Sneezing.

Stuffiness in the chest.

Watering eyes.

Coughing.

Burping.

Excessive saliva.

This is by no means a comprehensive list, as there are many more "Full Signals" than I have listed. In summary, part of the "Behavior modification" that is a requirement of the post-op care for WLS patients is learning to recognize their body's "Full signal".

When a person experiences any new signal, they need to see if that signal is consistent with their being full. Then a person will know when they are full, as opposed to the full signal they used before their surgery.

40. "How does a Lap-Band actually work?" This may help you in understanding the restrictive mechanism of a Lap-Band. The INAMED protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band. Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band. Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to two weeks. A “Delayed-Action” means that the fill may not become effective for up to two weeks after the fill. That is why the INAMED protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

41. "How much fluid should I be drinking per day?" To calculate minimum fluid intake requirements, take current (Not goal) weight and divide by 2.2 to obtain Kilos of body weight. Using a 150-pound person as an example: 150 / 2.2 = 68.18 (Kilos of body weight. Multiply the Kilos by 35 to obtain the minimum ccs of fluids needed per day: 68.18 X 35 = 2386.3 to convert the ccs into ounces, divide by 30: 2386.3 / 30 = 79.54 ounces, minimum fluid intake per day. The entire equation looks like this:

150 / 2.2 = 68.18 X 35 = 2386.3 / 30 = 79.54 minimum ounces of fluid per day.

A very quick and very close approximation for fluid intake is half of current body weight, converted to ounces. Once again using the 150-pound example, half of weight converted to ounces would be 75 ounces per day, as opposed to the equation's goal, which is 79.54 ounces of fluid per day. That is very close, and many people use the approximation, rather than doing this math.

42. "Is the Lap-Band permanent?" Many people are under the misconception that the

Lap-Band surgery is not permanent. The surgeon's instructions from INAMED, the maker of the only approved Bands in the USA states that the Lap-Band is a permanent operation, and should be presented as such to the patient. Lap-Bands can be removed under dire medical emergency, but they are not normally removed. Patients should also be aware that Lap-Band removal is actually a more complicated and therefore higher risk, surgery. Many Lap-Band removals are done with open incisions, which are considerably more complicated that laparoscopic implantation. Fewer than 3% of Lap-Bands are removed for ALL reasons combined.

43. "What time should I stop eating during my day?" It's a good idea to stop eating at least 2 hours before lying down. That assists in preventing heartburn because the food in our small stomachs is much closer to our esophagus. It's also a very good idea to drink a glass of Water before bed to flush any residual food from the small stomach.

44. "What is "Water-Loading" and why is it important?" "Water-Loading" is the practice of drinking to full capacity shortly before a meal. It is important because a person who is fully hydrated will be less likely to drink during a meal or shortly after a meal. Drinking with a meal or shortly after a meal will turn the food into "Soup" which will go through the band quickly and make you hungrier faster. In addition, many people confuse thirst with hunger; the practice of "Water-Loading" will help prevent eating when the patient is actually thirsty.

45. "Is it possible to stretch out the small stomach, or "Pouch"?" The pouch seldom enlarges, because it is created in an area that is very resistant to enlargement. The esophagus above the pouch will usually stretch before the pouch itself does. That is almost always caused by repeatedly over-eating, AKA "Stuffing the pouch". Not very many people do this, but if they do, it can result in "Esophageal Dilatation" or stretching of the esophagus, which can be a very serious thing. The usual remedy for esophageal dilatation is to completely unfill the band for a period of time, in the hope that the esophagus will shrink back to its original size. In some instances, where the patient refuses to stop "Stuffing the Pouch" band removal is necessary.

46. "Is it normal to feel tighter in the morning than any other time of day?" Some people do, some people don't. There is a theory about mucus accumulating during the night and obstructing the stoma, resulting in morning tightness. Personally, I am VERY tight in the morning and find eating solid food to be impossible. I choose to drink a warm Protein shake, usually mixed with coffee, because of that morning tightness.

47. "How Important Is The Post-Op Diet?" It is critical. Most doctors prescribe a post-op diet of weeks of clear fluids, followed by weeks of full fluids followed by weeks of mushy food. My doctor said 2 weeks clear fluid, 2 weeks full fluids and 2 weeks of mushy food. The time following the operation is for your stomach to heal. The Lap-Band needs to form a groove on your stomach. That groove makes the Lap-Band resistant to slipping. Eating food during the post-op period before you are supposed to be eating food could cause the Lap-Band to slip, or increase the risk of a future slippage. Food causes the stomach muscle to "Work" to digest the food. The "Work" could cause the band to not seat properly on the stomach. Weight loss is NOT to be expected during the recovery time after the operation. If you lose weight, wonderful, but don't expect it. The time between the operation and getting an EFFECTIVE fill that causes restriction is called "Bandster Hell" for a good reason. Without an EFFECTIVE fill, our hunger is just as strong, but the band does not work to help us. Getting an EFFECTIVE fill sometimes takes multiple fills, it is not unusual for it to take 3-5 or even MORE fills to obtain restriction. Because the band has to seat into the groove to hold its position, and every time the band is filled the fill adds extra pressure on the band, most doctors choose to let time pass between fills. Most doctors will not fill a band before 4 weeks after the operation, 6 weeks is common and 8-12 weeks of healing time is not unheard of.

48. "Is it normal for a Lap-Band to feel tighter during my menstrual period?" Many women do report this, and some also report less restriction during their periods. "Normal" is whatever your experience is.

49. "Can I gulp fluids with a Lap-Band?" Yes, I can, and do, gulp liquids with a Lap-Band. (The exception is anything carbonated) Most patients don't have any issues gulping fluid, as long as it's not in the morning (Some people are "Tighter" in the morning) or ice-cold fluid. (Some people report that ice-cold fluid "Snaps the band shut") Soda is a subjective thing. Sugared soda is a poor food choice because of the calories, but diet soda is something that many patients drink. There is a concern by some doctors that the pressure from carbonation may stretch out the small stomach. Personally, carbonated beverages are PAINFUL for me unless sipped very slowly. I used to drink over 8 liters per day, but no more. Now I drink Kool-Aid sweetened with saccharine. As far as caffeine, many doctors view caffeine as an appetite stimulant, which is why they don't like patients drinking it. Caffeine is also a diuretic, and getting in enough fluids is already difficult for many patients. Myself, I drink coffee, tea and the occasional cola and it is not an issue for me, you may be different.

50. "How long does it take to feel the effects of having a fill?" It depends. Some people experience a feeling of increased restriction immediately, whereas some others have "Delayed Restriction" of up to four weeks, or more, after a fill. The effects of a fill may vary between fills, with one fill having immediate effect, while another may cause a "Delayed Restriction" or vice-versa. The important thing to remember is that a fill may not take effect immediately, which is why many doctors will not give an additional fill until four weeks after the previous fill.

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Great article! Thanks!

Longhorn- Thanks so much for that article by Dr. Fielding. I had tears in my eyes when I read it and can't wait to share it with my husband. I'm goin to be banded in 4 days and that is just what I needed to remind me this is the right thing to do!

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Wow Wendell get list! All my questions answered in one place

Thanks!!!

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Wow, thank you so much Wendell :rose:

I won't say its answered everything, but it answers so many, such a great list.

I'm a mass of emotions right now, so its something I can read and re-read.

thanks again!

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Longhorn- Thanks so much for that article by Dr. Fielding. I had tears in my eyes when I read it and can't wait to share it with my husband. I'm goin to be banded in 4 days and that is just what I needed to remind me this is the right thing to do!

Credit where credit is due! The article was posted by sewenup1:

http://www.lapbandtalk.com/f18/new-here-decision-made-41972/#post576619

And I agree with your assessment. :rose:

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