undecided

[keithf 2]

Thing is... we all have food issues or we wouldn't have gotten fat. So while it is true that some target groups will try harder and put forth more effort, I don't think anyone goes into this thinking that they aren't going to put some effort into it.

I've seen at least one recent post here where someone was PO'd because he was going to have to, you know, change eating habits. That was one person, who managed to find this place. Undoubtedly there are more, finding surgeons who aren't engaged beyond collecting a few bucks.

Most people I have seen fail any WLS type goes into this determined to change their eating habits and food choices just to discover that maybe they can't do it afterall. The band or sleeve or any other WLS type doesn't do a thing to fix your head.

Absolutely.

So you can't really take just those that are able to change food habits and use that as a target group for average bandsters because they aren't average, they are above average.

Absolutely.

Then there are issues of another nature. One problem with banding is that each time you have a complication the fill is removed and you are put on liquids for a time and then solids but with no fill. Esophageal dilation, pouch dilation, slip, etc., it's an unfill. That puts a dead stop to weight loss and actually turns into weight gain for most. Then the problem is resolved and you are back to getting fills again and finding a sweet spot. This is one reason banded folks have slower weight loss on average.

And yet it's seen as a feature. The ability to do an emergency unfill because of some illness that changes priorities (getting fluids and nutrition is always more important than weight loss) is an option I want to have. In the event I wake up and Tina Turner's saying she don't need a hero, I'm definitely unfilling (finding a doc under those conditions.. that's a different question /g/).

The problems with slippage are mechanical, and I'm not convinced they are inherent in the band itself, but rather in the ability to anchor it. They've taken to using part of the stomach to do so, but I wonder what else they could use. Nothing they do, of course, will be 100% effective, if for no other reason than stitches need to be able to give before the tissue they're stitching does.

Then you have mechanical failure. Leaks in the tubing, port, or band itself.

.. leaks in staples. These happen. My doc's had two bypass cases where leaks happenned far out from "the day after". One was about 2 weeks after, the other was almost 2 years. Overall, as I mentioned, he sees roughly equal re-operation rates.

I guess my point is that you can't just take successful bandsters and use that target group as the average WLS person. They aren't average, not in the least.

My point, too.

LOL! You are in for a big surprise. Banded and sleeved people make cheap dates too. ;o) It's also a matter of less food in your body to slow down absorption of alcohol.

Oh, you have no idea what I tend to drink. I have a $200 bottle of Tokaji that I intend to nip at every year or so. I couldn't get my birth year, so I got the year of my conception (yeah, that's it). I'm the sort to nurse a drink all night.

Except when I actually *do* want to get drunk. Which is maybe once or twice a year.

But I am aware I'll be doing it on a mostly empty stomach. However, I won't be fast-tracking it directly to my intestines for mass absorption.

[WASaBubbleButt 41]

I've seen at least one recent post here where someone was PO'd because he was going to have to, you know, change eating habits. That was one person, who managed to find this place. Undoubtedly there are more, finding surgeons who aren't engaged beyond collecting a few bucks.

When I was banded the sales pitch by Inamed was... eat your usual diet, just less of it. It was my doctor that made sure I realized I needed to change eating habits. I'm not so sure the marketing really isn't the same. It's basically, "Eat normal foods, just less of them." Well, what is normal to us isn't necessarily normal to naturally thin people.

And yet it's seen as a feature. The ability to do an emergency unfill because of some illness that changes priorities (getting fluids and nutrition is always more important than weight loss) is an option I want to have. In the event I wake up and Tina Turner's saying she don't need a hero, I'm definitely unfilling (finding a doc under those conditions.. that's a different question /g/).

This is exactly one of the reasons I got rid of the band, I don't want to need an emergency unfill. I don't see it as a feature at all, I see it as a dangerous necessity because it's an implanted device that can cause problems requiring an unfill.

People have the attitude that they want the ability to overeat again if need be. When we are ill, old, whatever... and we are not eating enough that usually means we are not eating at all. There is no reason someone needs to be able to overeat. With a band or sleeve you can eat portions that you need to maintain your health.

I've seen countless posts over the last 2-3 years by people writing that they want a band because if they ever get cancer and need extra nutrition they can have the band removed. They really don't understand what they are talking about when they write this. When a cancer patient needs extra nutrition it is because they aren't eating anything at all. A band or sleeve is more than enough to give them the nutrition they require. Even an ounce of food is better than no food at all (which is what they are typically consuming) and that can be done quite well with either procedure.

They don't want bypass because they'll malabsorb calories needed in their old age. No they won't, bypass really only malabsorbs for the first 6-18 months. They malabsorb nutrition forever but not fat and calories. Thus, the honeymoon period of bypass.

Bypass or DS isn't for me, I'm not into taking a fistfull of supplements throughout the day. I see malabsorption as a necessary evil for some just like chemotherapy. Unwanted but necessary for a target population.

The problems with slippage are mechanical, and I'm not convinced they are inherent in the band itself, but rather in the ability to anchor it.

Of course it is the ability to anchor it. You only have so many options when you are talking stomach tissue vs. silicone. Sewing through stomach tissue is like sewing through the inside of a melon yet sewing through the esophagus is like sewing through the hard part of your ear. Just how many ways are there to secure silicone to the inside of a melon? There will always be slip issues regarding banding.

The sutures are not what hold the band in place long term, it's the body and how the adhesions and scarring form. It's the adhesions that hold the band in place, not the sutures. This is the main reason the post op diet is so critical. Cheat on the post op diet today and you slip in 6-12 months. The stomach needs time for adhesions to form and when dumbasses out there are saying, "I ate a burger 4 days post op but it's okay, I chewed real good," they are the people that are likely to slip. They aren't letting the body do what it does best, forming the scar tissue. Those little strands of adhesions trying to form over the band are broken each time the stomach has to digest food.

I have seen a gazillion posts (Okay, maybe not a gazillion but close.) explaining what food they just ate that they know they aren't supposed to on the post op diet and AFTER they do it they come here asking if they just hurt their band. It's virtually impossible to harm the silicone band around their stomach but their stomach, the adhesions.... yeah, they probably did do a bit of harm. The post op diet is there for a reason. Just because one CAN jump off a cliff does not mean one SHOULD jump off a cliff. Just because one CAN eat a burger 4 days post op does not mean they SHOULD.

So it is a matter of anchoring it to the stomach.

.. leaks in staples. These happen. My doc's had two bypass cases where leaks happenned far out from "the day after". One was about 2 weeks after, the other was almost 2 years. Overall, as I mentioned, he sees roughly equal re-operation rates.

Another reason I'm not a fan of bypass but sleeves instead. I'm no longer a fan of the band either because of slow/low weight loss and the re-op rates. You are correct, they are about the same for bands and bypass. Sleeves... whole different ball game. ;o)

But I am aware I'll be doing it on a mostly empty stomach. However, I won't be fast-tracking it directly to my intestines for mass absorption.

I think you are in for a shock. ;o)

[keithf 2]

When I was banded the sales pitch by Inamed was... eat your usual diet, just less of it. It was my doctor that made sure I realized I needed to change eating habits. I'm not so sure the marketing really isn't the same. It's basically, "Eat normal foods, just less of them." Well, what is normal to us isn't necessarily normal to naturally thin people.

Hear hear. My surgeon was quite clear on a lot of things, as was the nurse, and our guest speaker. I really liked his attitude -- it wasn't a sales pitch.

I'm about to try to learn the joys of konjac-based noodles.

People have the attitude that they want the ability to overeat again if need be.

Right. But the emergency isn't to eat *more* -- it's to be able to eat at all. If you're in a situation where you're unable to keep things down (perhaps you're enjoying the effects of demerol, as I understand from a friend's experience), the medical motivation is not about overeating. Of course, that doesn't necessarily reflect in the patient's attitude.

I see malabsorption as a necessary evil for some just like chemotherapy. Unwanted but necessary for a target population.

Agreed. Unfortunately, I only have the two options if I get it through insurance. If I were to get a revision to an existing procedure it probably *would* be to a sleeve.

I did see a special (hosted by Alan Alda) demonstrating a "pacemaker", but that was effective against grazing, not gorging.

The stomach needs time for adhesions to form and when dumbasses out there are saying, "I ate a burger 4 days post op but it's okay, I chewed real good," they are the people that are likely to slip.

I actually don't know when the last burger I had was. I think it was a month ago. I can't actually remember what the mouth feel was like.

Just because one CAN jump off a cliff does not mean one SHOULD jump off a cliff. Just because one CAN eat a burger 4 days post op does not mean they SHOULD.

Yup. Themla and Louise was supposed to be a movie, not a way of life.

I think you are in for a shock. ;o)

I used to go to interesting parties in San Francisco. Pretty much nothing shocks me these days.

[WASaBubbleButt 41]

Right. But the emergency isn't to eat *more* -- it's to be able to eat at all. If you're in a situation where you're unable to keep things down (perhaps you're enjoying the effects of demerol, as I understand from a friend's experience), the medical motivation is not about overeating. Of course, that doesn't necessarily reflect in the patient's attitude.

Yep, that is a complication of the band. That's one of the reasons I don't miss it in the least.