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5/12/11 10:55 P

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these are all the articles in the library

article ----1-----

LAP-BAND® Frequently Asked Questions

article ----2------

Surgery for Weight Loss - 21 Questions to Ask
by Brandon Cornett

article-----3---- guidelines.....things you should know once you are banded.....


The 5 Day Pouch Test by Kaye Bailey

article -------5--------

of Gastric Bypass Surgery


Adjustable Gastric Banding


Pre/post-Op Diet for LAP-BAND Surgery


Weight Loss Surgery: What to Expect the First Year

article ..............9....................

Medical Alert Id Cards


Laparoscopic Sleeve Gastrectomy Surgery




LapBAND Frequently Asked Questions


Pledge to Change

article ...............14.................

Having a difficult time check this out

article .................15.......................

NYC_PAULA's shares her article on her lap band journey with us here on the teams....

There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
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L*I*T*A*'s Photo L*I*T*A* SparkPoints: (599,141)
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7/29/10 8:00 P

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In addition to my full time job, I'm also a freelance writer.
AOL published an essay I wrote on my decision to get the lap band and the amazing experience I've had with NYU medical center so I thought I'd share.

she has written an awesome article about her journey and so am putting in our library to share with everyone here....

Edited by: L*I*T*A* at: 5/12/2011 (22:54)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

 January Minutes: 2,040
L*I*T*A*'s Photo L*I*T*A* SparkPoints: (599,141)
Fitness Minutes: (413,469)
Posts: 223,261
6/12/10 10:47 P

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article 14

Read this if you are struggling or having a difficult time.....

There is not a thing I need to add to this, it speaks for itself, kinda makes me think twice before feeling sorry for myself though

Edited by: L*I*T*A* at: 7/29/2010 (19:58)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

 January Minutes: 2,040
L*I*T*A*'s Photo L*I*T*A* SparkPoints: (599,141)
Fitness Minutes: (413,469)
Posts: 223,261
6/12/10 10:45 P

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Pledge to Change
10 Steps to the Body You Want
The shortest path is through your brain. Here are the tools you need.

By Pamela M. Peeke, MD, MPH, Prevention

"I was doing really well until..." As a doctor who counsels women trying to lose weight, I've heard this too many times. An upset patient settles into the overstuffed armchair across from my desk, and utters her tale of defeat.

You've probably said those words yourself, dozens of times. You're doing great, eating right, working out regularly, and something happens. You hurt your back or shoulder and find it difficult to train. Maybe life just gets crazy and suddenly you're missing workouts and turning to food for comfort. The hell with minimeals and lean protein What you need is a pile of cookies.

I sympathize—I've had my share of those days. But life happens. I have no doubt that you're a master at helping the people you care about get through tough times. But when things get funky in your life, do you give yourself the same treatment?

The following 10 steps are all about turning that feminine impulse to nurture inward and becoming your own best caregiver, regardless of the obstacles life places in your path. These principles will help you stay on track, no matter what life throws at you.

Pledge to Change
You've had it. You're tired of feeling like crud every day, and you're determined to get in shape, mentally and physically.

Hold on. You may be champing at the bit to overhaul your diet, start exercising—become the new you. But if your positive changes are to be permanent, you need to recognize the adversity you'll face. I want you to put your intentions in writing and acknowledge the difficult times to come. On the best stationery you can find—no scrap paper—write out and complete the following contract.

I, ______________________ , commit to starting my weight loss program on ___________ (date). I believe that I can accept and complete my challenge to the best of my ability.

I realize this is work and accept the self-care price I must pay to achieve my mental and physical transformation.

I commit to keeping a daily journal that tracks my progress and forgives my slipups.

I will practice these 10 principles to help myself stay the course.

I will expect and adapt to adversity and see tough times as learning opportunities.

I will strive to take action and not to ruminate, bitch, moan, or whine.

I will be self-assertive and fight for the right to take care of myself.

I will acknowledge and reward myself for my achievements along the way.
You will do battle with your inner demons that try to pull you back into your familiar, self-destructive ways. But in the end, you'll win. Every time you embrace this challenge, you're one step closer to the best woman you can be.

Find Your Motivation
When I was in medical school, I was taught that the greatest motivation to change an unhealthy lifestyle is the desire to prevent or treat a disease. But I have a vivid memory of a woman I sent packing after a coronary bypass, who told me she couldn't wait to load up on her favorite fast food and light a cigarette to celebrate.

Often, getting healthy isn't enough motivation. That's why I'm asking you to create a Motivational Target—like an archery target with inner and outer rings. The outer rings include the reasons you feel obligated to make a change, such as your health, and the inner rings are the deeply personal, maybe even hidden reasons that make you want to change. Here's how to do it.

Sit down with a piece of blank white paper. Draw an archery target—at least four rings and a bull's-eye. Ask yourself one question: Why do I want to change my body? Write down the first three answers that come to mind.

Chances are, they represent your Global Motivations: I want to change because I want to be healthier. I want to change because I'll die if I don't. Distill your answers into simple phrases and write them in the outermost ring.

Now go deeper. Ask again: Why do I want to change? Look for answers that stop you in your tracks. They might be serious or humorous. Write out the first three you think of and turn each into a key phrase.

These are your Target Motivations, and you need to anchor them with a Mantra that will conjure up its power when you need it most. It should be simple, contain a powerful visual image if possible, and smack you in the head like an invisible two-by-four so it will knock you out of your "I gotta eat" trance. It should also contain the phrases "run from" and "run to." Here's an example of how you might come up with a Mantra.

Say your Target Motivation is to be happy, fit, and free, living life to the fullest. But right now, there's a package of Oreos screaming at you. So what's the consequence of giving in? How about this: You're standing in the hot summer sun, dressed in dark, shapeless clothing that feels like a shroud. You're sweating as you watch others jog in shorts, bike in colorful clothes, and enjoy life. So "sweaty shroud" is what you run from. What do you want to run to? After some thought, you might conjure up a vision of yourself on a bike, clad in a pair of clingy biking shorts, riding up a long hill on a country road. You look and feel fit and free. You're joyful, happy, loving life. Okay. You've got it.

Motivation Mantra: Run from sweaty shroud; run to bike ride on country road, feeling joyful and free.

Repeat this process for each of the inner rings. You'll end up with at least three Target Motivations, any one of which can function as your bull's-eye.

Learn to Let Joy In
When I meet a patient, one of the first questions I ask is, "What in your life gives you joy?" Women often say, "My partner" or "My kids." My response is, "Aside from your family, what gives you joy?" Too often, the reply is a blank stare.

Caring for a family is one aspect of what makes you whole. You must find what else brings you joy, whether that's returning to school, writing, growing a garden, or cooking gourmet meals.

One way to start along the path to joy is to stop each time you're confronted with a demand on your time and ask yourself this question: "Will this thing, event, or person bring me joy?" If the answer is, "Absolutely," congratulations—you've discovered what you need. If you answer, "I don't know," then give it a try. You'll know soon enough. But if the answer is, "No," why would you let it into your life? If you can't avoid it, limit the time you devote to it.

You may have to put in some work to find joy. At the age of 40, I laced up my sneakers and gave running a try. Now I'm in training for my third marathon

Whine But Get the Job Done
Next to the armchair that my patients use during their appointments sits a ceramic jar labeled "Dr. Peeke's Early Retirement Fund." When a patient starts in with the negative self-comments, she has to put $1 into the jar. At the rate some of my patients are going, I'll be playing golf 24-7 in no time.

Listen to yourself: "I'm stupid, I'm fat, I'm ugly, I'm a failure, my legs are too short..." I call this a Rumination Rut. The dictionary definition of ruminate is "to go over in the mind repeatedly." The next definition is "to chew repeatedly for an extended period." Let's see, stewing and chewing in response to stress—boy, did Webster get that right. This leaves you vulnerable to BMW—bitching, moaning, and whining—about your body, your willpower, your behind, your this, your that. The biggest source of BMW-ing is refusing to accept that transformation takes mental and physical sweat, intensity, mindfulness, and focus—all the things, by the way, that you apply to your job, your kids, and your relationships.

Getting out of the rut is straightforward: Employ any distraction technique at your disposal. Get off the couch and go for a walk. Take the kids bowling or roller-skating. Clean out your closets. Do anything but let your brain hold your butt hostage.

Forget Perfection, Embrace Progress
Some women have a huge problem with this principle because all their lives, they've tried to be perfect—perfect wife, perfect mother, perfect employee, perfect friend. Is this your story, too? Look, no woman—no human—diets and trains perfectly day after day, so striving for perfection is a prescription for guilt. It eats away at the positive energy you need for making progress.

"Progress, not perfection" means that if you work hard and keep your focus 80% of the time, you're doing great. The other 20% of the time, you get to be human—fallible. Did you miss your workout today? No worries. You'll regroup and bounce back tomorrow.

Here's where keeping a journal will come in handy. Reflect on your day and write down at least three things that you did well and that helped you move forward. This gives you positive reinforcement and helps you build momentum because you're giving yourself credit where credit is due.

Control Stress, Find Peace
For most women, stress is a constant companion. It's there as they speed to work, pay the bills, or pick up a gallon of milk at 10:30 at night so everyone can have cereal the next morning. In one survey on stress conducted by the National Women's Health Resource Center, nearly 93% of the 681 people surveyed described the level of stress in their daily lives as moderate or higher. Fewer than half said they always felt capable of coping with it.

There are two main categories of stress in a woman's life. Everyday stress is the kind we expect and should be able to manage: the daily commute, the parking ticket, the computer malfunction; stresses from major milestones, like getting married or having a child, are tougher but also manageable.

Toxic stress, on the other hand, grinds you down day after day, year after year. It erodes your immune system and makes PMS and perimenopause a living hell. It also ramps up your appetite for comfort foods and can pack on pounds of fat deep inside your tummy, expanding your girth and making you more vulnerable to heart disease, diabetes, and cancer. Work is a huge source of toxic stress for women—perhaps the biggest. In one study of more than 21,000 nurses (the ultimate caretakers), Harvard University researchers concluded that on-the-job stress weakens a woman's health as much as smoking or a sedentary lifestyle.My Stress Rx signs will help. You can make these signs and photocopy several. In really big, colorful letters, write:

The Answer Is NOT in Here.
Tape these to your fridge, kitchen cabinets, pantry—even on the vending machine at work, if you dare. When you confront this sign, close your eyes for a second. Take a deep breath and say, "The answer is not in this fridge/vending machine/pantry."

Your second sign should read:

The Answer Is Here.
Tape this to your workout bag or your dumbbells at home, your bath salts, your favorite relaxing CD, your treadmill, your favorite herbal tea, or your phone. After stopping at the first sign, walk quickly toward this one. This is what will truly soothe you. Sip a mug of your favorite tea. Be with your feelings. Honor that new voice inside you. It's the voice of empowerment, and each time you withstand stress in a positive way, the voice will become louder and stronger.

Give Yourself License to Chill
Buddha said, "We are what we think. With our thoughts, we make the world." If you're in a continual state of depression, anger, frustration, or fatigue, your world will feel pretty small and unfulfilling. That's why I want you to commit to practicing relaxation techniques.

Research supports meditation's positive effects on mood. What's more, it appears to literally change the minds of those who practice it. In a study published in 2002 in the Journal of Psychosomatic Medicine, brain scans of new meditators who were guided in meditation 3 hours a week for 8 weeks showed significant increases in activity in a part of the brain associated with positive emotion. What's more, the heightened activity persisted for at least 4 months after the experiment, when the study participants were scanned again.

Meditation, yoga, tai chi, progressive relaxation—it doesn't matter which you choose, as long as you like it and do it regularly. I recommend that you take a class, but if you can't, buy a book or video Taking a class serves three purposes: You get correct instruction, meet other like-minded people, and automatically build some "me" time into your day.

If you want to experiment on your own, try walking meditation. It's just what it sounds like: combining a walk with quiet reflection. Don't think about a destination. Simply turn your full attention to the movements that make up the act of walking. Break it down to its basics. For example, as you lift each foot, silently say to yourself "lift." As you move your leg forward, say "move." Then say "step" as you place your foot on the ground. The more you focus on these movements, the calmer you'll feel.

Learn to Stay Calm in a Crisis
You must practice your self-care as best you can in the worst of times. The ability to regroup allows you to continue a healthy eating and activity plan no matter what the crisis. Your goal is to keep regrouping until you achieve a new plan that works for you.

Plan A is your life on schedule. You eat breakfast every day at 7 am, you walk on your lunch hour, you have your "me" time every night after 9, when you put the kids to bed. Plan A goes seamlessly about once a year. Relish the moment.

Plan B is your life on stress. You've been up all night with your youngest, who has a nasty bout of stomach flu, so you're sleeping when you usually eat your egg-white omelet. You're under the gun at work, so the big report takes precedence over your walk. Your mom and sister are having another one of their interstate wars, so you've been on the phone with one or the other every night, instead of cozying up with a book. So how do you tend to your self-care?You go to Plan Me.

This is your fallback, the way to take care of your needs in the midst of chaos. To prepare this plan, write down what your healthy eating and activity plan would look like on a low-stress day. That's Plan A. Now make a list of everything that could wreck that plan and rewrite it, devising ways to work around these problems. Here's a simple example: It's too cold to take your Plan A walk. Go to Plan Me—walking in the mall or on the health club's treadmill.

If you really get off track, Plan Me can be 3 days of withdrawal and regrouping to regain momentum. In those 3 days, you'll refocus on Plan A, practice it, and let it gel before diving in again.

Fight for Your Self-care
I see women try to get their partners and family to help create time for their self-care. Meeting resistance, the women simply give up. Not anymore. You're learning to stand your ground and make it work. You realize you're not being selfish, you're just asking for balance.

Every successful company has a mission statement—a paragraph or two that states why it exists, whom it serves, and what it hopes to achieve. Knowing your mission teaches you to set boundaries, draw a line in the sand, and say, "This is my time, and I'm here to defend it." You're on your treadmill and the phone rings. That's why there's voice mail. The call can wait. Your self-care can't.

Write down no more than 10 sentences that describe what you want to accomplish in your life and what is important to you, both personally and professionally. You could focus on being the best spouse, mother, and daughter you can be. But don't forget to commit to honoring your intellectual, physical, and spiritual needs—and above all, your rights as an individual.

To cure a chronic case of "yes-itis," here's what to do the next time you're asked to do something that you can't or don't want to do:

1. Ask yourself, Will saying yes further my mission statement? For example, if you've already volunteered for countless PTA events in the past year, do you really need to take on another?

2. If the answer is no, say in a calm and caring tone, "I'm so sorry, but that doesn't work for me right now. Maybe next time." Wow. Saying this shows that you know what works for you. Now, once you've said it, stick to it. Stand up to anyone who tries to argue you down. Keep your refusal courteous but definite, short but sweet, and don't get into a debate.

Form a 911 Squad
Research shows that people trying to make healthy lifestyle changes are more likely to succeed when they have a strong support network. With a minimum of effort, you can assemble your very own Estrogen Squad.

Call one or more members of your Estrogen Squad when you're about to do something self-destructive—like blow off your workout or embark on a binge. Choose one or two people you most depend on, with whom you feel comfortable sharing your deepest feelings—your mother or sister, a special aunt, maybe even a teenage daughter.Then choose the one or two friends who have given you the most support and encouragement, or who might like to join your efforts. Consider including a personal trainer, a therapist, or your family doctor, if he or she is caring and supportive of your goals.

Those in your squad should be kind, of course, and willing to reply to your calls, e-mails, and more. They should also be able to look you straight in the face and tell you that dress doesn't work for you, or that you're making everyone nuts with your endless BMW-ing. A sassy sense of humor never hurts, either.

A woman's efforts are most successful when supported by her assertive, witty, loving, and nurturing sisters. Armed with her Estrogen Squad, a woman will see her quest for mental and physical transformation become a reality.

One of my favorite maxims is "In the midst of difficulty lies opportunity." I don't see mistakes—I see opportunities to learn. Open your heart to the lessons. If you view challenging life events as opportunities to recommit to your self-care rather than as overwhelming obstacles, you will overcome them. If you should lose your footing along the way, review these principles. You know the answers are here and inside of you.

Edited by: L*I*T*A* at: 11/25/2011 (20:48)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

 January Minutes: 2,040
L*I*T*A*'s Photo L*I*T*A* SparkPoints: (599,141)
Fitness Minutes: (413,469)
Posts: 223,261
6/12/10 10:43 P

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article ...................12.............

LapBAND Frequently Asked Questions

How much weight will I lose?

Weight loss is more variable with LapBand than with other operations. Some patients lose all their excess weight, and some lose very little. Since the Band is only a tool, your weight loss will depend on how well you use it. You can easily cheat by drinking high-calorie liquids. That said, average weight loss is 50% of excess weight at 5 years. But this includes all patients, including those who have lost little or no weight.

How is the Band adjusted?

The Band is tightened by accessing the port with a needle. This is most commonly done in the office. Some surgeons do it at the hospital under x-ray guidance, but this is generally not necessary, and makes the procedure much more expensive. For patients with very thick abdominal walls, it may be more difficult to find the port. In our office we have an ultrasound machine which makes it possible to access most ports without need for x-ray.

Can I adjust my own Band?

In theory, yes. But the answer is NO. NO. NO

Why do I have to take vitamins?

The LapBand operation is purely restrictive, so technically you don't need to take vitamins if you are eating a healthy diet. On the other hand, by definition you are eating a hypo-caloric diet, one which will cause you to lose weight. Because of this, we worry that you won't get all the vitamins and minerals you need. This is the main reason we ask you to take vitamins after the surgery.

What about the gallbladder?

We don't remove the gallbladder unless you already have gallstones that are causing symptoms. Weight loss is slow and natural, so the risk of gallstones is not sufficiently elevated as to make gallbladder removal worth doing.

Can the Band be rejected by my body?

The Band is made of silicone rubber, and cannot be rejected. Of course it can become infected and require removal, but this is not the same as being rejected like a transplanted organ.

What happens after I lose my weight?

The Band causes you to lose weight by restricting your caloric intake to less than your caloric expenditure. As you lose weight, your calorie requirements diminish. Once intake matches expenditure, you stop losing weight.

How long does the Band stay in?

The Band stays in forever. If it is removed you will regain all the weight you lost.

What is a slipped Band, and what causes it?

There are two types of slippage; anterior and posterior. This refers to whether the front or back side of the stomach slips. There is something else called concentric pouch dilation, but this is not the same as slippage. Slippage or prolapse is when the stomach slides up through the Band, making the pouch bigger. If this happens the Band usually becomes too tight, and patients experience symptoms of reflux (heartburn) as well as nausea and vomiting. This is because the amount of stomach being “squeezed” by the Band is increased, thereby obstructing the Band.

There are several causes. Posterior slippage was more common when the Band was placed by the “perigastric” technique. With this technique the back side of the stomach was free to slide up through the Band. These days most surgeons use the “pars flaccida” technique, which was developed to prevent posterior slippage, and has more or less eliminated the incidence of this problem.

Anterior slippage is when the front of the stomach slips up through the Band. We try to prevent this by suturing the stomach below the Band to the stomach above the Band, “locking” the Band in place in the right spot. In spite of this, slippage still occurs. It can happen because we haven't placed enough stitches, or they haven't been placed in the right place. Slippage can also occur if patients eat too much and vomit frequently.

How is a slipped Band diagnosed?

Fortunately, this is very easy. Often the diagnosis is made based on the history alone. A patient who has been going along fine, with no problems, and then suddenly develops reflux symptoms or symptoms of a too-tight Band will most likely have a slipped Band. The diagnosis is easily confirmed with an x-ray and barium swallow examination. Endoscopy is rarely necessary.

How is a slipped Band fixed?

A slipped Band needs to be fixed with an operation. The Band has to be dissected out, all the sutures removed, and the position of the stomach made right. Some surgeons remove the Band and place it back through a new tunnel. Others just straighten things out and re-suture the stomach over the Band.

What happens if the Band slips again?

That's a tough one. One could certainly try to fix the slip again, but my personal view is that, for whatever reason, the Band is just not working for that particular patient, and ought to be removed.

What is a Band erosion?

This is when the Band actually erodes into the stomach. It is a more serious problem, and generally requires removal of the Band. Band erosion is thought to be related to placing too many sutures (or too tight sutures) at the time of Band implantation. Surprisingly, Band erosion is often unnoticed. Occasionally the port will become infected if bacteria track along the catheter out to the port. Other times patients will stop losing weight. Diagnosis often requires an endoscopy.

What is concentric pouch dilation?

This is technically not the same as slippage. In this case the pouch just seems to be enlarged. Sometimes partial emptying of the Band may help with this.

What is esophageal dilation?

This is when the esophagus enlarges over time, and is probably related to either too tight a Band, or possibly improper placement of the Band around the junction of the esophagus and stomach. This requires loosening or removal of the Band.

What happens if my Band has to be removed because of complications or failure to lose weight?

One option, of course, is to give up on weight loss surgery. Another option is to convert to another procedure such as Roux-en-Y gastric bypass. This can be done at the same time the Band is removed, and is generally done laparoscopically.

There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

 January Minutes: 2,040
L*I*T*A*'s Photo L*I*T*A* SparkPoints: (599,141)
Fitness Minutes: (413,469)
Posts: 223,261
8/6/09 11:03 P

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this was posted on another site i'm on and thought it was worth sharing..........

Tomorrow starts year seven of my journey and there is good and there
is bad.. but I know the light at the end of the tunnel is never a
train carrying cupcakes.... I know the keys of my success are in the
basics and going back and getting them in order will help put me back
in order.

After seven years of banding there are things I know as truths, things
I know as myths and in all of that the truths and myths I am sure of,
only apply to myself. Things have changed greatly in the time I have
been banded it is kind of like the parent who walked twenty miles to
school in four feet of snow uphill both ways. When I was banded there
was no clinic, no post op support, no pre op support, no web sites, no
weighing, no advice from the surgeons since this was new to them too,
nothing really but Yahoo groups and people who were going through what
I was going through in varying stages and ways. And even for that lack
many of made our goals and have maintained them through the years.
I know to me fill isn't that important, having one is, just not having
a tight one, losing for me was never about what and how much I could
it, it was about the scale and my dress size moving. I know that for
any excuse I or any one else can make this journey is all on them, if
they fail or succeed it is not the clinic or the surgeons it is all
theirs, claim it and be responsible for it either way succeed or fail.
It is all about me…. and always will be all about me because in this
book there is only one character that matters and her face is there
every time I look in the mirror and she is responsible for everything
she eats, everything she moves and how she does it.

Here is what I know, just because you spend the money it doesn't mean
you are ready to change your life and become the person you need to
be. If you are eating big macs, the question isn't why can it is why
are you? Why would you even want to try, you spent the money not to
figure out what you can eat but to try and change your life and eating
pizza, big macs, fries etc is not changing your life it is what got
you to this point of needing surgery in the first place. Even if you
do the head work and think you are getting it… you may not be, I know
for me a large part of this weight struggle was coming to terms with
my own demons.

People will tell you they know the right way… there is no one right
way but there are wrong ways to many to record but there are some
standouts. I hate hearing the terms PB and sliming I think they are
some of the stupidest misnomers ever created… to give you a false
sense of security that by only pb'ing or only sliming you aren't doing
damage to yourself or your band and sliming isn't vomiting. To me it
is, if it is created by my body, if I ingest it and have to expel it I
am vomiting. As someone who has slipped four times without excessive
fill or vomiting I know the damage misnomers can do, I have seen it at
lunches, at fluro appointments, on surgery repair days. I hate going
to lunches, dinners or getting emails about people who eat until they
vomit and go back for more how they tell the newer bandsters this is a
great part of banding you can vomit and eat again and not absorb the
calories. It makes me angry and sad, this is not self induced bulimia
or a condition to be desired, it makes me sad that people who are
willing to outlay so much money to make themselves better are so
stupid that they don't realize or care about the potential damage they
are doing to their bodies.

I have long said this is a great group any group is great and to take
what you need and throw the rest away… and for those who are
successful and those who are struggling with their journey to both
post early and often and frequently. I encourage this because you
never know when what you write will help someone else will inspire
someone, will help narrow down a problem for them.

I haven't had a smooth journey but I can say it has been fairly easy,
and I have seen all types of journeys, those who lie to themselves
that they can't feed their families what they eat, they can't give up
something they love like pasta or bread, they can't exercise, they
can't they can't they can't… there will always be excuses, my
favorites are the ones who see the change run from the change, embrace
the change, run again, embrace again and meet their goals whether it
is long term or short term I love seeing goals met, exceeded and new
ones set. By no standards am I perfect… I have had my issues recently
and surprises we all do some big, some small, some happy, some sad.

About 6 months ago I got news and I just went screw it I don't care
right now, so I ate whatever I wanted, worked out once in a while, and
made sugar my constant companion and put alfredo sauce on redial for a
good time, martinis and wine were never far away when hanging with
friends. And even knowing what I know is true for me which is the
largest part of me maintaining and losing was figuring out a good diet
and working with it on a consistent basis making sure I took advantage
of my body and worked out a few times a week no matter how much I
loathed it, I ignored my hard fought and won truths and did whatever I
wanted because at that time life sucked. Have I gained yes, sure, do I
care yes of course, can I fit into my clothes most of them yes, is it
time to get back to my basics and what works for me absolutely. It is
funny I don't look like I gained only I know it by the way my clothes
fit and the scale who never ever lies to me.. the rest of the world
keeps asking if I lost more weight… So never go by appearance… it can
fool you.

Now I have a new challenge… after seven years I forget, how did I say
goodbye to my one true love sugar once upon a time and whatever
prompted me to take it back and listen to the sweet lies it told me…
how do I do it again? Sugar is my most desired evil in many forms,
booze, chocolate and just about any form that makes me go ooh and
ahhh…. Added to this challenge is an additional thought… how do I
learn to love working out…like I love sugar? I don't mind working out
getting on the treadmill, yoga, hiking but how does someone who is
seriously perfectly content to sit and watch tv learn to work out and
LOVE it?

Every year at this time I look at where I was, where I was headed,
where I am, where I want to be, and where I am realistically going.
And this year I have been headed to Hansel and Greta's house by way of
chocolate lane and bypassing all the good habits I spent years
developing. So for me going into my seventh year I need to figure out
how to say goodbye to chocolate and not crave it… (after about 10 days
I stop being a complete and utter wench) And my biggest challenge
figuring out what I love that is moving my body at a rate I need to
for maintaining my fitness… It isn't classes, it isn't dancing, it
isn't organized sports, it isn't the treadmill… while all those have a
place they are not my loves. I do adore yoga and how it makes me feel
and plan on going back immediately. . but I am pondering the rest and
will start to try new things until I stop and go wow that was amazing.
The other area is to make time, I have no lack of it I find time to
read a book, knit, watch tv, go out to dinner, do things for and with
friends… now I have decided to make me a priority and my health. So
first and foremost I need to make myself take the time to work out
before I commit to other things. Time to live like there is no
tomorrow and make the best of the rest of today.

For me, much of my journey was spent figuring out a lot of things much
self reflection and admitting my faults and flaws (excessive time in
hotel rooms and traveling on your own gives you a lot of time to work
on lots of things) I spent the time working on knowledge and beliefs
learning that I am a damm good person, pretty hot, and really smart so
why not be the best I can be whether thin or fat… some things are just
easier to do thin. Then I started asking my self the 5 w's, who do I
eat with, where do I eat, when do I eat, why do I eat, what do I eat
and how do I eat… those answers weren't easy and the reasoning to get
to them even harder but they helped me change my habits and I am going
back to my basics that worked for me the first time and adding in a
movement component. Who do I move my body with, where am I moving my
body, when am I happiest and most comfy moving my body morning noon or
night, why is moving my body making me better, what is making me happy
about moving my body and how am I meeting my goals through moving my

I will let you know how the making and taking time for my movement is
working after seven years it may be just the ticket to get me excited
again. But I hope this goes to show everyone that we all struggle in
different ways, on different days no matter how long we are fighting
this war and even when we give in.

Your goals are achievable and maintainable only when you are ready to
make the changes and embrace what you are gaining and forget what you
think you are giving up.


Edited by: L*I*T*A* at: 6/12/2010 (22:42)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
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3/27/09 11:43 P

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this topic came up so thought i would post this for your imformation...........

Laparoscopic Sleeve Gastrectomy Surgery

Gastrectomy is a combination of two Latin words: gastro, meaning “stomach,” and -ectomia, which means “to cut out.”

Sleeve gastrectomy is a restrictive surgery that permanently reduces the size of the stomach by about 85 percent. This procedure is helpful for patients who wish to lose weight but have health conditions that make combined restrictive/malabsorptive surgery less safe at this point in time. These patients may want to consider a malabsorptive procedure like duodenal switch (DS) later to lose more weight.

During sleeve gastrectomy, the surgeon will remove the larger, rounded part of the stomach.

The remaining stomach looks like a sleeve (or hose or tube) and holds about 15 percent as much food as the original stomach.
The surgeon will remove the larger, rounded part of the stomach from the body. (This is the only gastric surgery in which part of the stomach is taken out of the body.)
Unlike gastric bypass, which changes stomach openings, sleeve gastrectomy leaves the openings intact.
It may be a safer and more effective option than gastric bypass for patients with very high BMI, those with medical problems like anemia, Crohn’s disease, osteoporosis, extensive prior surgeries and other complex medical conditions.

Sleeve gastrectomy may be safer than gastric bypass for patients who have a number of health risks.
It lowers the risk of ulcers compared to gastric bypass.
The surgery cuts away the part of the stomach that produces grehlin, a stomach hormone that stimulates hunger.
Though the stomach is smaller, the openings are left intact, so digestion can go on as normal.
The body is free of foreign objects like the LAP-BAND®.

Sleeve gastrectomy is more common in Europe, but most American health insurance carriers still consider it an investigational procedure and do not cover the cost.
Anytime you have anesthesia or surgery, there is a risk of blood clots, other complications or death.
Do not smoke. Smoking would put you at high risk for infection, blood clots, slow healing and other life-threatening complications.
Complications can occur with the stapling, such as leaks or bleeding.
You may need malabsorptive surgery – intestinal bypass or duodenal switch – in addition to your sleeve gastrectomy in order to lose all the weight you need and want to lose.
The smaller portion of the stomach may stretch.
Foods that you eat now may cause discomfort, nausea or vomiting after your surgery.
Gastric surgery puts you at higher than normal risk of developing gallstones and gallbladder disease.
You will not lose weight or maintain your weight loss unless you eat a healthy diet and exercise regularly. This is the reason we stress long-term follow-up with our center and your doctor.
It is suggested that surgeons performing sleeve gastrectomy inform patients regarding the lack of published evidence for sustained weight loss beyond 3 years and provide them with information regarding alternative procedures with published long-term (greater than or equal to 5 years) data confirming sustained weight loss and comorbidity resolution based upon available literature at this time.

Edited by: L*I*T*A* at: 8/6/2009 (23:02)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
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3/24/09 11:20 P

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article 9

Medical Alert Id Cards

hi ....for those who want an id card/or didn't get one from their drs,you can view the card on my spark page..............

just click on my spark page and you will see it and if you want to see a larger image search under my user name L*I*T*A*
if you want one i can email the image to you ............just send me your email address by sparkmail..............on the back of the card should be the dr's name and address etc.hope this is helpful......

Edited by: L*I*T*A* at: 3/27/2009 (23:41)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

 January Minutes: 2,040
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Posts: 223,261
3/24/09 11:16 P

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article 8

Weight Loss Surgery: What to Expect the First Year

With bariatric surgery, the most dramatic changes happen in the first year. Here's what to expect.
By Jeanie Lerche Davis

Reviewed by Brunilda Nazario, MD

If you're considering weight loss surgery, prepare to make changes that last a lifetime.

"When you're seriously overweight, it affects your social life, your health," says Atul Madan, MD, chief of bariatric surgery at the University of Miami School of Medicine. "This surgery helps people get past their cravings. They're much healthier, their social interactions get better. It affects them in so many ways."

But bariatric surgery is only one tool to help achieve weight loss. You’ll still need to make many lifestyle changes to stay healthy and keep the weight off.

"The most successful people do not look at this surgery as a quick fix," says Madelyn Fernstrom, PhD, director of the University of Pittsburgh Medical Center's Weight Management Center and a frequent contributor on NBC's Today Show. "It does not replace lifestyle. You've got to be willing to face lifestyle changes that last forever."

To make those changes successfully, it helps to understand the milestones you can expect three months, six months, or a year later. To learn about these, WebMD talked to the professionals, and to people who had bariatric surgery.

Preparing for Weight Loss Surgery
Well before having bariatric surgery, patients begin taking steps in the right direction. Most insurance companies now require six months of presurgical patient education to prepare them, says Fernstrom.

You must come to grips with eating patterns that have doomed you in the past, she explains. "Every severely obese person says they eat because it's fun, they're bored, they're at the movies and it's a social thing. They eat when they're happy, they eat when they're sad."

There is also the commitment to eating very small portions. If you overeat, you risk vomiting. Also, too frequent overeating can eventually stretch the new stomach pouch, which means you won't lose weight -- and could regain weight, explains Madan.

"It's not a punitive lifestyle ...You simply become a taster of many things," Fernstrom tells WebMD. "You find that you're perfectly full with one egg, maybe a couple of strawberries for breakfast. It's just enough."

Immediately After Weight Loss Surgery. For the first two weeks after surgery, Madan prescribes a liquid protein diet. Then, patients start eating pureed and soft food -- food the consistency of scrambled eggs.
You'll start walking -- even just five minutes at a time, working up to 30 minutes a day, he says. "That can be a huge deal for some people." If you have arthritis, especially if it's in hips and knees, he advises water aerobics.

One to Three Months Post-Surgery. At this point, people start trying "regular food" to see what they can tolerate. The timing depends on the type of weight loss surgery. "Try different foods, to see what will go down easily," says Madan. "If it doesn't, just stay away from it for awhile. Wait a month and try again."
Don't set yourself up for disappointment, says Beverly P., a Memphis patient who lost 200 pounds with gastric bypass surgery. "It takes awhile to train your mind not to want much food. Don't fill up a big dinner plate, use a smaller plate. Eating can still be enjoyable -- but you don't need to eat enough to feed several more people."

Six Months Post-Surgery. At six months, you'll have lost a lot of weight. If you've had gastric bypass surgery, you will have lost about 30% to 40% of excess body weight. With gastric banding surgery, you lose 1 to 2 pounds a week -- so by six months, you'll have lost 25 to 50 pounds.
Nine Months Post-Surgery. If you had any problems at the six-month visit, your surgeon will want to see you at this milestone, too. Vitamin deficiencies or lack of sufficient weight loss are the typical issues being addressed at this point, says Madan.
One Year After Surgery. Between 12 to 18 months after surgery, you will have lost a great deal of weight, says Madan. With gastric bypass surgery, you likely are close to your goal. If you had gastric banding surgery, you should have lost over 100 pounds. If weight loss has lagged, it's important to find the cause -- like eating too many snack foods.
Medical Milestones After Weight Loss Surgery
Follow-up with your surgeon is critical after bariatric surgery, says Madan. "These checkups help to identify nutritional deficiencies and to ensure you're losing weight at a normal pace."

With gastric bypass surgery, visits are scheduled for the 3-month, 6-month, and 1-year mark (and possibly at the 9-month mark).
With gastric banding surgery, follow-up visits occur more frequently, typically monthly -- especially during the first year, says Madan. "We see patients often to make sure it's not too loose or too tight -- and to make sure they're eating right." If the band is too tight, it can cause vomiting.

2 Keys to Surgery Success: Healthy Food and Exercise
Your food choices must change, too, to ensure that you're losing weight -- and that you're getting proper nutrition. Too much of a sweet, sugary food will move through the small intestine too quickly. This causes "dumping" -- running to the bathroom with diarrhea, or simply a feeling of nausea.

You can't ignore exercise any longer. "If you've always been a couch potato, you'll have to do things differently after surgery," she adds. "When you expend more calories, you keep weight off. We see people who have gotten their lives back. They're in aerobics classes, yoga classes. They become an inspiration to others."

Getting moral support is definitely a plus. Organize a circle of friends to cheer you along the way, advises Joy R., a member of WebMD's message boards. "My friends made it much easier ... just being there and telling me I was doing great!"

Your Relationships After Weight Loss Surgery
Be prepared to explain your new eating habits to family and friends, Madan says. "No matter what you tell Grandma, she's going to know better. Be respectful, but learn to ignore it."

Tell them: "Four ounces is the normal amount of food I can eat now. Be glad that I'm going to lose this weight. If I don't lose the weight, there's a good chance I'm going to get diabetes [if you don't have it already]."
Emphasize other positives: If you have sleep apnea, you likely won't have to deal with that anymore. If you've been too heavy to play with your kids, that will change.
If a friend or family member is overweight, you may feel their jealousy, Madan says. If your social life has been built around food, things will have to change.You may need new friends. You definitely will have to change your social activities.

Go to the movies instead of a restaurant. Find interests and activities that aren't focused on food. You can still dine out, but order an appetizer as your entrée -- or box most of your dinner to take home, he suggests.
Prepare for changes in intimate relationships. A bad relationship may get worse. A good one will become stronger. If your mate liked your old weight -- or liked the control they had because you were overweight -- he or she may feel insecure or jealous. You may need a counselor to deal with these changes.
Your children will be affected -- in a good way. "They develop healthier eating patterns, eat healthier food," Madan tells WebMD. "A teenager is smart enough to see that if Mom or Dad is going through major surgery to lose weight, they don't want to be there themselves."

Edited by: L*I*T*A* at: 3/24/2009 (23:17)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
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3/24/09 11:11 P

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article 7

this not meant in any way to replace your dr's protocol.................

there are so many different protocols as there are dr' please take this with a grain of salt.....and of course follow the plan outlined by your specific dr........

i have only posted it as there seem to be so many quetions re:diet that this may be of some help ...........

Pre-Op Diet for LAP-BAND Surgery
About two weeks before your LAP-BAND surgery, your surgeon will have you begin a special diet. The pre-op diet is important because it is designed to get your body ready for surgery and make recovery easier. You will need to lose fat around your stomach and liver, as well as shrink the liver itself. If the liver is too large, the surgery may have to be postponed. The diet helps reduce potential bleeding that can accompany surgery by reducing fatty triglycerides from around the liver and spleen.

A primary part of the pre-op diet is a protein supplement. Myocel, a protein powder, is designed to lower the fat content of the liver, maximize recovery, and promote weight loss. Myocel can be mixed in with skim milk, water, fruit juice, or fat-free yogurt.

Foods that will need to be decreased in your diet include high-sugar foods, high carbohydrate foods (including bread), fats (such as butter), fatty meats, fried foods, whole milk products, and alcohol. Your diet will be limited, but foods that may be included are yogurt, fruit, cereal, eggs, oatmeal for breakfast and lean meat or fish with green vegetables for dinner. Pre-op diets may vary between surgeons and patients, but you should always follow the recommendations of your doctor.

Post-Op Diet for LAP-BAND Surgery
After surgery, your surgeon will have you slowly advance thru varying stages of the post-op diet. It is important to follow your doctor's recommendations in order to heal properly, be properly nourished, and avoid complications. Your doctor will monitor your healing process, which will take about 4 to 8 weeks.

With the Lap-Band, you will need to sip fluids slowly, avoid getting overfull, and keep portion sizes small. Your surgeon will go over new eating behaviors and appropriate food choices with you.

The first week or two after surgery you will be on a full liquid diet. This is to keep the stomach from working too hard and to decrease pressure on the band while the body heals.

The first couple of days will be limited to clear liquids, such as diluted apple juice, chicken broth, beef broth, sugar-free gelatin, and artificially-sweetened non-carbonated beverages.

Once you are able to handle clear liquids, full liquids will be added to your diet. Full liquids include cream broth and soups, protein shakes, milk, yogurt, and sugar-free puddings.

After a couple of weeks, you will progress to pureed foods. It is important to proceed slowly to see what your body will allow. Keep your meals small and focus on high-protein foods. Gradually you will be able to add soft foods such as oatmeal and eggs.

After 4 - 8 weeks, depending on how your body is responding and healing, you will be able to start eating normal foods. It will be important to choose healthy foods, eat slowly, chew food thoroughly, and to stop eating when you feel full.

click on the link below for more information................

Edited by: L*I*T*A* at: 3/24/2009 (23:12)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

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3/24/09 11:08 P

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article 6

this is not carved in stone only meant to help those contemplating the surgery and to perhaps assist in providing some knowledge...............your own good reasearch should still be done.........

Adjustable Gastric Banding

What is it? Gastric banding is among the least invasive weight loss treatments. This surgery uses an inflatable band to squeeze the stomach into two sections: a smaller upper pouch and a larger lower section. The two sections are still connected; it's just the channel between them is very small, which slows down the emptying of the upper pouch. Gastric banding physically restricts the amount of food you can take in at a meal. Most people can only eat a half to one cup of food before feeling too full or sick. The food also needs to be soft or well-chewed.

There are several brands of adjustable gastric bands available. They include LAP-BAND and REALIZE.

A similar weight loss surgery is called vertical banded gastroplasty.

Like adjustable gastric banding, it divides the stomach into two parts, although with both a band and surgical staples. Because the results weren't as good as other techniques, it's now less common. An even earlier procedure, original (or horizontal) gastroplasty -- or "stomach stapling" -- is no longer performed at all because of low success rates.
The Pros. The advantage to gastric banding is that it's simpler to do and safer than gastric bypass and other operations. It's routinely done as minimally invasive surgery, using small incisions, special instruments, and a tiny camera called a laparoscope. Recovery is usually faster. You can also have it reversed by surgically removing the band.

Because the band is connected to an opening just beneath the skin in the abdomen, it can be easily loosened or tightened in the doctor's office. To tighten the band and further restrict the stomach size, more saline solution is injected into the band. To loosen it, the liquid is removed with a needle.

The Cons. People who get gastric banding often have less dramatic weight loss than those who get more invasive surgeries. They may also be more likely to regain some of the weight over the years.

The Risks. The most common side effect of gastric banding is vomiting, a result of eating too much too quickly. Complications with the band aren't uncommon. It might slip out of place, or become too loose, or leak. Sometimes, further surgeries are necessary. As with any surgery, infection is always a risk. Although unlikely, some complications can be life-threatening.

to learn more click on the link below:

There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

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3/24/09 11:04 P

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article 5

this is not carved in stone only meant to help those contemplating the surgery and to perhaps assist in providing some knowledge...............your own good reasearch should still be done.........

of Gastric Bypass Surgery

Benefits and Risks of Surgical Treatment of Serious Obesity
For someone who is interested in the ideal of surgery, to get control of serious obesity, the key question is the benefits to be gained from surgery, versus the risks that one must go through, in order to have an operation. Usually, the risks are taken right away, when the surgery is performed, and the benefits take a while to pay you back, in the form of improved health, reduced long-term risk of illness, and enhancement of your lifestyle.

It’s a personal decision, as well as a medical one. The doctors can teach you about the risks, and help you measure the likelihood of benefits, and will tell you frankly, if they are out of balance for you. Still, the final decision is up to you. To make it intelligently, you need to know all about the risks, and the benefits, of the operation.

Risks and Complications of Surgery

The risk of a weight control operation is mainly the risk of having any abdominal operation. It is the act of having an operation, not the particular operation which is done, that causes most of the risk. Severely obese persons are well known to be at a disadvantage, when having surgery, and their risks are higher than they would be at a normal body weight.

The risk of surgery comes mainly from its complications: things can go out of control, causing serious problems, often without any good reason. Having an abdominal operation places a lot of stress on the body. It creates an open wound, which can bleed or fail to heal, and it opens the door to potential infection. The emergency reaction of the body to injury can itself by harmful, when it leads to reactions such as increased clotting of blood, which can cause a fatal pulmonary embolism. Let’s look at the risks in detail.

Lung Problems

Atelectasis: This condition is a partial collapse of a part of the lung, caused by lack of motion of the chest wall. Normally, your lung is filled with tiny air spaces, like the tiny spaces in a loaf of bread, only much smaller. Picture what happens, when you take a loaf of bread and sit on it, and you get an idea of how the lung collapses. The best treatment is to prevent it, by deep breathing and lung exercises. We teach you these before surgery, and encourage you to do them again and again, after the operation. We also have special treatments, and even pulmonary medicine specialist consultants, to help you and your lungs recover, if atelectasis occurs. Atelectasis can cause a fever after surgery, and can also lead to developing pneumonia.

Pneumonia: Pneumonia is an infection in the lungs, and after surgery it can be especially serious, because the infecting organisms often come from the gastrointestinal tract, and they can be very destructive. We prevent pneumonia by clearing out the GI tract ahead of surgery, by using antibiotics at the time of operation, and by generally using good anesthesia and respiratory treatment, to prevent atelectasis.

Pulmonary Embolism: This problem affects the lungs and the heart, but it usually starts in the legs, with the formation of blood clots. Although these can occur at any time, and are more likely in overweight patients, they are especially likely at the time of and soon after surgery, because people who have an operation don’t like to move around, or exercise their legs. The blood becomes stagnant and clots in the leg veins, and if a clot breaks off and floats through the veins to the lungs, it is called a pulmonary embolism. The blood clot blocks the arteries in the lungs, and can cause a part of the lung to lose its circulation and die – a pulmonary infarction. If the circulation to a large part of the lung is affected, the heart is placed under a lot of strain, and it may fail suddenly, which can be fatal.

They can prevent a pulmonary embolism, first, by thinning the blood with heparin, which makes it less likely to clot. They also prescribe elastic stockings, to compress the legs and keep the blood flowing faster in the veins. We try to keep the operation short, by operating efficiently (not hurriedly), and by getting patients up to walk as soon as possible.


Abscess: An abscess is a collection of infected fluid, or pus, which occurs somewhere in the body. After an abdominal operation, a pocket of fluid may develop, and if any bacteria are present, they may infect it and create an abscess. The treatment of any abscess is to drain away the infected fluid, and kill the bacteria with antibiotics.

They prevent abscesses by trying to avoid any collections of fluid or blood in the abdomen, at the time of surgery, and by placing a drain if one might possibly occur. If an undrained abscess develops, we now have very skillful specialists, called interventional radiologists, who often can achieve drainage, and resolve the problem, without a need for an operation to drain it.

Wound Infection: A wound infection is a type of abscess, and is treated the same way, by drainage. Seriously obese persons have a very deep layer of fat under the skin, and the usual methods which surgeons use for treating infection there do not work very well in the obese. We have developed special methods, and using these, most such infections are relatively easy to treat, although they can cause discomfort and inconvenience for a while.

Urinary Tract Infection

Urine flow is altered after surgery, and patients also have trouble straining down, to void. Use of a tube, or catheter, may be necessary to drain the bladder. In a rare case, this can lead to infection of the bladder. Usually such an infection can be readily eradicated with antibiotic treatment, without any additional hospital stay.


Heparin Effect

They use heparin to prevent blood clotting and pulmonary embolism. At the same time, if blood does not clot at all, bleeding will occur, when surgery is performed. They have to try to find a middle ground, but because the sensitivity of different individuals may vary, delayed bleeding may occur after surgery in some persons. We observe closely for this, and can stop the heparin if bleeding gets to be a bigger risk.


When surgery is performed, blood vessels must be cut. We handle these by tying them with a piece of thread, called a ligature, or by using a device called an electrocautery, which coagulates the blood, and the end of the blood vessel. Sometimes, a blood vessel may escape, and then begin to bleed again several hours later. This can cause a hemorrhage, either inside the abdomen, or at the skin level.

Hemorrhage must be stopped. We have several strategies for this, but in some cases, a return to the operating room may be needed. This is a rare event.


When blood loss occurs, that tend to make the pulse and blood pressure unstable, a transfusion may be needed. The blood bank has very high quality standards, and the blood is quite safe, but there is still a possibility of getting hepatitis, and a very small risk of receiving the AIDS virus (about 1 in 500,000), from a transfusion. These risks can be reduced, by donating your own blood and having it saved for your surgery – a procedure called autologous donation. This costs quite a lot (about $125 per pint), and we feel it is probably not economically sound, since the likelihood of needing the blood is quite low.

They also have performed surgery successfully on many occasions under the Bloodless Surgery Program, when patients decline to receive blood or blood products for religious reasons. We will honor a commitment to avoid transfusion, on your instructions.

Bowel Obstruction

After any abdominal operation, scars called adhesions will form in the abdomen. These look like strands of latex, or sometimes like a piece of fibrous cord, and can snag a piece of bowel – just like your garden hose can wrap itself around the smallest bump, when you pull on it. Sometimes, even many years after the original operation, the bowel becomes kinked around an adhesion, becomes obstructed, and nothing can get through. This must be relieved, especially before the bowel loses its blood supply and dies, which can make the bad situation even worse. Usually an emergency operation is necessary.

Occasionally, a bowel obstruction can occur within a few days after surgery. In this case, the adhesions are much softer, and will often come apart on their own, if conditions are made right.

Leakage of Bowel Connections

When the surgeon fastens bowel to bowel, or bowel to stomach, the connection is called an anastamosis. If it does not form a complete seal, and leakage of fluid from within the bowel occurs, it is called an anastamotic leak. Fluid from the GI tract, containing at least some bacteria, leaks out into the abdomen where it doesn’t belong, and causes a serious infection, accompanied by much swelling, a rapid pulse rate, and sometimes, formation of an abscess. This is always a very serious complication, and its diagnosis and treatment are made much more difficult by severe obesity.

Conventional wisdom indicates that an immediate operation is required, to seal the leak and drain away the infection. Our experience has taught us that, more than half the time, such an operation may cause more harm than good, and that it can and should be avoided. Drainage may already be present, and if not, it can often be obtained by the interventional radiologist, without surgery. When this is possible, the insult of surgery, and the spreading of infection through the rest of the abdomen, can be avoided.

Anastamotic leak almost always causes some increase in hospitalization, and increased discomfort from the drain, and the need for repeated X-rays.

Obstruction of the Stomach Outlet

In performing the Gastric Bypass, when the stomach is connected to the bowel, to opening is deliberately made small, about ½ inch in diameter, to slow the flow of food out of the small stomach pouch. All healing occurs by scar formation, and scars always have a tendency to contract. This may cause the opening between stomach and bowel to become too small, so that no food can get through. This causes repeated vomiting, and must be corrected.

This type of problem used to occur in about up to 10% of cases, and many surgeons continue to be troubled by this complication. The treatment is quite simple, and can be done as an outpatient procedure. However, as we have worked to refine the Gastric Bypass, we have noticed that the incidence of this problem has declined, almost to the vanishing point, less than 0.5% of both open and laparoscopic operations. We believe this may be due to improved anatomy, and improved blood supply to the affected bowel, and we recently reported our findings to an international meeting of bariatric surgeons.

Chronic Nutritional Problems

Nutritional problems are quite rare after the Gastric Bypass, and are quite readily avoided by use of the proper vitamin and mineral supplements, and by eating a healthy diet. One of our most important objectives during our long follow-up is teaching food values, and the content of a healthy eating regimen. A remarkable effect of the Gastric Bypass is the progressive change in attitudes toward eating. Patients begin to eat to live - they no longer live to eat.

Protein Deficiency

Protein is the essential stuff, of which our muscles, organs, heart and brain are all constructed. Our bodies require a constant supply of protein building materials, to repair and replace tissues which become worn out or damaged. The Gastric Bypass and the Gastric Banding both reduce the capacity of the stomach to a very small volume, so that protein-containing foods must be carefully eaten with each meal, to be sure that the body gets enough to maintain itself. If the first half of each meal is taken as protein-containing foods, deficiency is very unlikely to occur. We do not advise the use of protein supplements or beverages.

Vitamin Deficiency

Conventional nutritional teaching has been that vitamins are contained in adequate amounts in a well-balanced diet, and supplements should not be required, provided that one eats a well-balanced diet. After weight-control surgery, the diet is initially much less than enough to supply complete nutrition – that’s why you lose weight. In order to have any chance of getting enough vitamins, a high potency multivitamin supplement must be taken daily. We think its safest to do this for the rest of your life, after this type of surgery.

In addition, we have seen a few persons develop deficiency of Vitamin B-12, even when taking a multi-vitamin supplement. B-12 is absorbed in the stomach and duodenum, which are largely bypassed with this surgery. Simple use of a sub-lingual (under the tongue) tablet of B-12, once a week, maintains very adequate vitamin levels, and prevents deficiency, which can develop without warning, until it becomes very dangerous.

Mineral Deficiency

They recommend multivitamin preparation contains mineral supplements in generous amounts. They also recommend daily use of calcium, and many patients, particularly women, will require a special iron supplement, to maintain adequate iron stores and prevent anemia of iron deficiency.

The total cost of all the needed supplements is about $20 per month.

Side-Effects of the Gastric Bypass, and the Gastric Banding

Side-effects occur with any operation. Although they are less serious than complications, they may be permanent, and may require a change in lifestyle, to avoid continuing discomfort.


After gastric restriction, if one gets a full feeling, and continues to eat, chances are an episode of vomiting will result. Most patients have this happen several times, and most quickly learn to follow instructions to eat slowly, chew food well, and avoid that last bite when fullness occurs. Typically, with the gastric Bypass, a profound feeling of satisfaction follows the fullness within a few minutes, and makes further eating a matter of indifference. The Gastric Banding does not produce this sense of satisfaction as quickly, or as intensely.

During the first few days to weeks, another kind of nausea may follow the gastric bypass. This results from delayed function of the Y-limb, and spontaneously resolves with time.

Food Intolerance

Red Meats: After either the gastric bypass, or the gastric banding, red meats are not well tolerated, and may cause vomiting. This is purely a mechanical effect – your stomach cannot tell steak from chicken, except that steak is much harder to break down so that it will fit through the small stomach outlet. If the outlet gets plugged, vomiting will result. We advise patients to avoid red meats until their stomach is functioning very well, usually after at least 3 – 4 months.

Sugar: Refined sugars and candy consist of many small molecules, which tend to draw fluid into the intestine. After the gastric bypass (not after the gastric banding), a condition called "dumping syndrome" may occur, when sugar is taken on an empty stomach, passes rapidly through the stomach into the intestine, and draws a large amount of fluid into the bowel. The physiology is complicated, but the result is a condition like shock: one turns ghostly pale, breaks out in a profuse sweat, feels butterflies in the stomach, a rapid pulse, and a feeling of prostration. Nause and vomiting, cramps and diarrhea may follow. Most people who have this reaction never try to sneak another candy bar – and we think that’s not such a bad effect, if you’re trying to lose weight.

The problem of dumping is avoided by avoiding sweets, candies, and fruit juices on an empty stomach. Certain dressings, barbecue sauce and mayonnaise may also cause problems, and need to be avoided.

Milk and Milk Sugar: To digest milk sugar (lactose), our bodies need and enzyme called lactase, which is often in short supply in the lower small intestine. After gastric bypass (not after gastric banding), milk and milk products may not be fully digested. Farther downstream, they are fermented by bacteria, and this causes gas, cramps and diarrhea.

Milk can be treated, to make it tolerable. In the big picture, it’s probably better to avoid it. Many prepared foods (those that come in a box, or frozen entrees) contain milk sugar as an additive. It is important to learn to be a label-reader, or to avoid packaged foods, and especially junk food.

Changed Bowel Habits

After restrictive surgery, the amount of food consumed is greatly reduced, and the quantity of roughage consumed may be much smaller. Correspondingly, the amount of bowel movements will be diminished, causing less frequent bowel activity, and constipation. If this becomes a problem, a stool softener supplement may be needed, to avoid rectal difficulties.

Transient Hair Loss

During the phase of rapid weight loss, calorie intake is much less than the body needs, and protein intake is marginal. The body is in a panic state, like what would happen during a period of starvation. One of the side-effects, in some persons, is inactivation of 30 – 40% (rather than the usual 10%) of hair follicles, causing noticeable amounts of hair to fall out. This is a transient effect, and resolves when nutrition and weight stabilize. We advise patients to avoid hair treatments and permanents, and be sure of adequate protein intake. Sometimes a zinc supplement will help, and Minoxidil (a drug to prevent and reverse hair loss) may be tried.

Loss of Muscle Mass

When the body is in a panic state, and trying to combat starvation, it hoards its precious fat until any other usable fuel has been burned. Practically, the body will prefer to burn muscle mass, before consuming its precious fat (don’t ask us why – we didn’t write the rules). If muscle is not regularly used for exercise, like every day, it will be consumed to meet energy needs.

Loss of muscle mass is preventable. It is very important, during active weight loss after surgery (or even when on a diet), to exercise vigorously every day. We recommend at least 20 minutes a day of aerobic activity, and it is well to devote attention to upper body strength as well. Many persons find, after a few weeks or months of regular daily exercise, that they actually begin to enjoy it, and start to work out even more. Fairly vigorous exercise, for more than 30 minutes a day, can greatly enhance fat-burning, and hasten weight loss. It also builds a healthy and beautiful body.

Seriously obese persons are very strong, and powerful –after all, just getting out of bed, you lift more than some people pick up all day long! It’s a shame to let that power be lost, when you need it to enjoy your life, and to make up for all the excitement you’ve put off. Save the power, while losing the fat, and you can just imagine how much energy you can have, and how much more you can accomplish!


OK, so it’s not exactly their fault, but it happens often enough to give a special warning. Many severely overweight women are also infertile, because the fatty tissue soaks up the normal hormones, and makes some of its own as well, completely confusing the ovaries and uterus, and causing a lack of ovulation. As weight loss occurs, this situation may change quickly.

They believe it is important to avoid conception during the phase of rapid weight loss – about one year after surgery – to maintain adequate nutrition. This requires special attention to contraception, even by those who think that it can't happen, because "natural" infertility may not last – in fact, it can go away in one night.

Benefits of Surgical Weight Loss
Finally, we can talk about the good stuff. In their sections about the health consequences of severe obesity, we listed problems, or co-morbidities, which affect most of the organs in the body. The remarkable and wonderful fact is that most of these problems can be greatly improved, or will entirely resolve, with successful weight loss. Most people have actually observed this, at least for short periods, after a weight loss by dieting. Unfortunately, with dieting, such benefits usually do not last, because diets don’t last.

They all have shown that the weight loss achieved with Gastric Bypass, Roux en-Y can average 80% of excess body weight, and can be maintained for years following surgery. They instruct patients in a very simple program, which is much easier to follow when one is not constantly starving on a diet.

Weight Loss Results after Laparoscopic Gastric Bypass

Now let's look at the health benefits of weight loss: High Blood Pressure

At least 70% of patients who have high blood pressure, and who are taking medications to control it, are able to stop all medications and have a normal blood pressure, usually within 2 – 3 months after surgery. When medications are still required, their dosage can be lowered, with reduction of their annoying side-effects.

High Blood Cholesterol

Over 80% of patients will develop normal cholesterol levels within 2 – 3 months after operation.

Heart Disease

Although we can't say definitively that heart disease is reduced, the improvement in problems such as high blood pressure, high blood cholesterol, and diabetes certainly suggests that improvement in risk is very likely. In one recent study, the risk of death from cardiovascular disease was profoundly reduced in diabetic patients, who are particularly susceptible to this problem. It may be many years before further proof exists, since there is no easy and safe test for heart disease.

Diabetes Mellitus

Over 90% of Type II diabetics obtain excellent results, usually within a few days after surgery: normal blood sugar levels, normal Hemoglobin A1C values, and freedom from all their medications, including insulin injections. Based upon numerous studies of diabetes and the control of its complications, it is likely that the problems associated with diabetes will be arrested in their progression, when blood sugar is maintained at normal values. There is no medical treatment for diabetes which can achieve as complete and profound an effect, as surgery - which has led some physicians to suggest that surgery may be the best treatment for diabetes, in the seriously obese patient..

Abnormal Glucose Tolerance, or "Borderline Diabetes" is even more reliably reversed by gastric bypass. Since this condition becomes diabetes in many cases, the operation can frequently prevent diabetes, as well.


Most asthmatics find that they have fewer and less severe attacks, or sometimes none at all. When asthma is associated with gastroesophageal reflux disease, it is particularly benefited by gastric bypass.

Respiratory Insufficiency

Improvement of exercise tolerance and breathing ability usually occurs within the first few months after surgery. Often, patients who have barely been able to walk, find that they are able to participate in family activities, even sports activities.

Sleep Apnea Syndrome

Dramatic relief of sleep apnea occurs as our patients lose weight. Many report that within a year of surgery, their symptoms were completely gone, and they had even stopped snoring completely – and their spouses agree.

Gastroesophageal Reflux Disease

Relief of all symptoms of reflux usually occurs within a few days of surgery, for nearly all patients. We are now beginning a study to determine if the changes in the esophageal lining membrane, called Barrett's esophagus, may be reversed by the surgery as well – thereby reducing the risk of esophageal cancer.

Gallbladder Disease

When gallbladder disease is present at the time of the surgery, it is "cured" by removing the gallbladder during the operation. If the gallbladder is not removed, there is some increase in risk of developing gallstones after the surgery is performed, and occasionally, removal of the gallbladder may be necessary at a later time.

Stress Urinary Incontinence

This condition responds dramatically to weight loss, usually by becoming completely controlled. A person who is still troubled by incontinence can choose to have specific corrective surgery later, with much greater chance of a successful outcome, with a reduced body weight.

Low Back Pain and Degenerative Disk Disease, and Degenerative Joint Disease.

Patients usually experience considerable relief of pain and disability from degenerative arthritis and disk disease, and from pain in the weight-bearing joints. This tends to occur early, with the first 25 -30 pounds lost, usually within about a month after surgery. Of course, if there is nerve irritation, or structural damage already present, it may not be reversed by weight loss, and some pain symptoms can persist.

The Scientific Proof

Measurement of the benefits and outcomes of modern bariatric surgery is one of the most important areas of surgical research in obesity. We are proud to say that we have followed our patients with Laparoscopic Bypass prospectively, and have very solid information never before measured, on the effects of this operation. We have several additional studies in progress, to further measure the improvement in health and lifestyle that weight-control surgery can accomplish.

This information curtesy of Alvarado Center for Surgical Weight Control Clinic.. and In San Antonio, Texas, Dr. Paul M Selinkoff and Dr. John Pilcher at Surgical Consultants of San Antonio perform bariatric surgery, sometimes called stomach stapling, obesity surgery, or weight loss surgery and Thinner Times Gastric Bypass Surgery for the Obese.

to find out more,click on the link below:

Edited by: L*I*T*A* at: 3/24/2009 (23:05)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
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maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
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The 5 Day Pouch Test by Kaye Bailey

Does my pouch still work?
Have I broken my pouch?
Have I ruined my tool?

These are questions many weight loss surgery post-ops find themselves asking occasionally during their journey. Perhaps it feels like we can eat more food or we know that we are eating more food. Sometimes these questions are asked when there has been a weight regain.

This is the 5-day plan that I have developed and used to determine if my pouch is working and return to that tight newbie feeling. And a bonus to this plan, it helps one get back to the basics of the weight loss surgery diet and it triggers weight loss. Also, it is not difficult to follow and if you are in a stage of carb-cycling it will break this pattern. Sounds pretty good, right?

The 5 Day Pouch Test should never leave you feeling hungry. You can eat as much of the prescribed menu as you want during the day to satiate hungry and prevent snacking on slider foods and/or white carbs. You must drink a minimum of 64 ounces of water each day. A reduction of caffeinated beverages is suggested, but do not stop caffeine cold turkey.

Weight loss is not the intent of the 5 Day Pouch Test, however, many who have tried this plan report a significant drop in weight. More importantly they celebrate a renewed sense of control over their pouch and eating habits and easily transition back to a healthy post-surgical weight loss way of eating.

Understanding Hunger, Appetite and Satiety

Below you will find a brief list of the menu for each day. Please click the "Read more" links for further detail and hints and tips that will enable your success with the 5 Day Pouch Test.

Days One & Two: Liquid Protein
low-carb protein shakes, broth, clear or cream soups, sugar-free gelatin and pudding. Read more.

Day 3: Soft Protein
canned fish (tuna or salmon) eggs, fresh soft fish (tilapia, sole, orange roughy. Read more.

Day 4: Firm Protein
ground meat (turkey, beef, chicken, lamb), shellfish, scallops, lobster, fresh salmon or halibut. Read more.

Day 5: Solid Protein
white meat poultry, beef steak, pork, lamb, wild game
Read more.

to read more click on the link below

Edited by: L*I*T*A* at: 3/24/2009 (23:01)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
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article-----3---- guidelines.....things you should know once you are banded.....

this was a presentation .............. by dr j. ahroni
these guidelines were given to me..hope it may be of some help

calorie syndrome
b. Alcohol contains a lot of calories 7 calories per gram.(It's also a stomach irritant).

c. Fruit juice is just sugar water

4. Are you making healthy food choices from a wide variety of foods?
a. Are you avoiding soft foods
b. You can't just eat what's easy
c. Cheese is glorified fat

5. Are you drinking 6-8 glasses of water a day between meals?

6. Are you eating too much junk?
a. Chips, chocolate, nuts, ice cream, cookies and other highly processed junk foods are too calorically dense to be regular parts of a healthy diet. But don't avoid them completely to the point where you feel deprived.
b. Stay out of fast food places

7. Are you getting in two servings of calcium daily?

8. Do you always eat the protein first?

9. Then the vegetables or fruits
a. Five servings a day
b. Potatoes are NOT a vegetable

10. Is your portion size appropriate?
a. Meat or fish (3 ounces the size of a deck of cards)
b. Vegetables (½ cup the size of your fist)
c. Starch (If you eat the protein and the vegetables first you don't need much - Avoid: rice, potatoes, pasta)

11. You might try avoiding artificial sweeteners
a. Some people think that artificial sweeteners stimulate the appetite
b. They are HUNDREDS of times sweeter than sugar
c. They teach you to like things too sweet
d. There is no evidence that people who use them are any thinner than people who don’t

12. Avoid most diet foods
a. Real food usually tastes better
b. Real food is more satisfying than low calorie substitutes
c. When you are only eating a tiny bit the caloric savings is not that great (Use a teaspoon of real butter instead of a tablespoon of diet margarine.
d. The body has no way to break down artificial fats).
a. They may go into permanent storage
b. Some people think liposuction is the only way to remove
hydrolyzed fats from the body

B. You may need a behavior adjustment
1. Are you eating only when you are hungry?
a. If you're not sure drink 8 ounces of water and wait

2. Are you eating three meals a day?
a. With maybe 1 or 2 small snacks

3. Are you sitting down to eat?

4. Are you eating consciously?
a. No distractions, turn off the TV, put the book or newspaper away, pay attention to your food and your companions

5. Are you eating slowly?
a. Put the fork down between bites
b. Take 20 to 30 minutes to finish a meal
c. Taking longer might cause the pouch to begin emptying

6. Are you taking small bites?
a. Tiny spoon, chopsticks, cocktail fork

7. Are you chewing well?

8. Are you drinking with your meals or too soon after your meals?
a. Practice water loading between meals
b. You won't be thirsty if you are well hydrated before the meal

9. Are you stopping at the first sign of fullness?
a. Sometimes it's a whisper: not hungry, had enough
b. Hard stop versus soft stop

10. Do not eat between meals. Stop grazing.

11. Do not eat when you are not hungry

C. You may need an activity adjustment
1. Are you getting in 30 minutes of physical activity at least 3 times a week?
a. Over and above what you would do in the usual course of your day
b. Could you make it 4 or 5 times a week?
c. Could you make it 45 or 60 minutes?

2. Are you taking advantage of opportunities to increase your physical activity?
a. Taking the stairs instead of the elevators or escalators
b. walking on the escalators instead of riding
c. Parking your car further away from the entrance
d. Getting out of the car instead of using the drive through
e. Getting off the bus one stop before your destination
f. Washing you car by hand instead of the car wash
g. Playing with your kids

D. You may need an attitude adjustment
1. Are you committed to your weight loss journey?

2. Are you totally honest with yourself about how much you are eating and exercising?
a. Log your food and activity on for 3 days

3. Are you using food inappropriately to deal with emotional
a. Have you identified what the emotions are that drive your
b. Can you think of more appropriate ways to deal with those
c. Are you willing to seek help from a qualified counselor?

4. Are you attending and participating in support group meetings?

5. Have you drummed up some support from your family and friends?

6. Have you dealt with saboteurs realistically?

7. Do you have realistic expectations about the weight loss journey?

8. Are you still obsessing about food, weight, dieting, eating?
a. Obsessive compulsive thoughts (Obsess about something else)
b. Perfectionism (All or none, black and white thinking)
c. Patience with the pace of healthy weight loss

9. Are you acknowledging your successes with non-food rewards?

10. Have you learned how to take a compliment?

How to Tell When You Are Perfectly Adjusted:
You are losing 1-2 pounds per week.

If you are not losing 1-2 pounds per week:

A. You may need an eating adjustment
1. Are you eating 60 grams of protein a day?

2. Are you eating 25 grams of fiber?

3. Are you avoiding all liquid calories?
a. Soup can be sign of soft 11. Are you giving up diet mentality?
a. Stop weighing yourself several times a day or every day
b. Stop dieting
c. Stop depriving yourself
d. Stop defining food as good and bad
e. Stop rewarding and punishing yourself with food

12. How do you feel about all the changes taking place?

E. You may need a band adjustment
1. You feel like you are making healthy food choices in appropriate portion sizes but getting hungry between meals?

2. You can still eat white bread, fibrous vegetables and large portions.

3. You are having to struggle to lose

4. You are gaining weight in spite of eating right, exercising and having a good mind set.

F. You may need your band loosened
1. There are times when you can’t get fluids down

2. You are vomiting too much
a. How much is too much?

3. Do you have frequent reflux or heartburn at night?
a. Do not lie flat or bend over soon after eating
b. Do not eat late at night or just before bedtime
c. Rinse your pouch with a glass or water an hour before bedtime
d. Certain foods or drinks are more likely to cause reflux:
(1) Rich, spicy, fatty and fried foods
(2) Chocolate
(3) Caffeine
(4) Alcohol
(5) Some fruits and vegetables
(6) Oranges, lemons, tomatoes, peppers
(7) Peppermint
(8) Baking soda toothpaste
(9) Carbonated drinks
e. Eat slowly and do not eat big meals
f. If you smoke, quit smoking
g. Reduce stress
h. Exercise promotes digestion
i. Raise the head of your bed
j. Wear loose fitting clothing around your waist
k. stress increases reflux
l. Take estrogen containing medications in the morning
m. Avoid aspirin, Aleve and ibuprofen at bedtime (Tylenol is OK)
n. Take an antacid (Pepcid complete) before retiring
o. Try other over-the-counter heartburn medications
p. See your health care provider

4. See your health care provider immediately (or call 911) if
a. You have a squeezing, tightness or heaviness in your chest, especially if the discomfort spreads to your shoulder, arm or jaw or is accompanied by shortness of breath, sweating, irregular or fast heartbeat or nausea. These could be symptoms of a heart attack.
b. If your symptoms are triggered by exercise.
c. If your pain localizes to your right side, especially if you also have nausea or fever
d. If you throw up vomit that looks like black sand or coffee grounds. Or if your stool is black, deep red or looks like it has tar in it. These are symptoms of bleeding and need immediate attention.
(Note: Pepto-Bismol or other medications with bismuth will turn your stool black. iron supplements can also make the stool tarry.)
e. If your pain is severe

There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

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3/24/09 10:48 P

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Surgery for Weight Loss - 21 Questions to Ask
by Brandon Cornett

The popularity of weight loss surgery has exploded in recent years. In fact, the number of Americans undergoing surgery for weight loss has quadrupled since the late 90’s. As more and more people turn to surgery as the solution for their obesity, the need for consumer information becomes increasingly important.

In the spirit of consumer information, the Bariatric Learning Center has assembled this list of 21 questions a person should ask when considering bariatric weight-loss surgery.

1. Do I really need surgery for weight loss success?Is weight loss surgery the only answer for you, or is there a better path to losing weight? This should be the first question you answer before considering any other question on this list. After all, this is surgery we are talking about here.

Bariatric (weight loss) surgery has exploded in popularity over the last couple of years, partly due to all of the media coverage it gets. Many surgery providers have slick brochures and websites that make surgery for weight loss seem like a simple but effective solution. What you have to remember is there is nothing simple about surgery.

So before you can decide if surgery for weight loss is right for you, it’s wise to ask yourself the next question on this list.

More about this question

2. Have I exhausted my non-surgical weight-loss options?Only in very rare cases is surgery the only option for weight loss. For most people, surgery for weight loss is one option of many. Most physicians agree, for example, that good nutrition and exercise are a better and safer alternative to surgery. The question is … have you exhausted these other non-surgical options for weight loss?

More about this question

3. Have I really exhausted those other options?I’ve repeated this question to stress an important point about non-surgical alternatives to weight loss success — they are almost always better than the surgical option. Some people will make a half-hearted attempt to lose weight through proper nutrition and exercise, and then give up in frustration. Don’t make this same mistake.

Before turning to surgery for weight loss you should make a serious effort to lose weight naturally. Losing weight naturally (through nutrition and exercise) takes time and effort, but it should always be your first attempt.

If you have answered the questions honestly up to this point, and you have genuinely exhausted your other options for weight loss, let’s move on.

4. Do I know the basic concept of weight loss surgery procedures?Many people think of bariatric weight-loss surgery as a fat-removal type of approach (such as liposuction). But this is not the case. There are several types of surgery for weight loss, but they all seek to alter the gastrointestinal / digestive process in some way.

Basically, these types of surgeries reduce the stomach’s capacity for food, which has a weight-reduction effect over time. Obviously, this is an oversimplification of weight loss surgery. We will get more specific as we go. For now, it’s just important to realize that this is real surgery with physically altering effects. So it should be considered carefully.

* Learn more about the basics of weight loss surgery.

5. Do I qualify for bariatric surgery?If you have answered the questions in order, and you’ve determined that surgery for weight loss is the right option for you, the next logical question would pertain to surgery criteria. Most bariatric surgeons use certain criteria to determine whether or not a person is a good candidate for weight loss surgery. Though these criteria will vary from one surgeon to another, certain standards have emerged over time.

Generally speaking, a person will qualify for bariatric surgery when the following conditions have been met:

The candidate is severely obese with a body mass index over 40.
The candidate’s daily life is hampered by their obesity.
The candidate has tried but failed to lose weight through non-surgical means.
The candidate understands the risks associated with surgery for weight loss.
* Learn more about basic surgery criteria.

6. Do I understand the risks of weight loss surgery?Every type of surgery has certain risks associated with it, and that includes surgery for weight loss purposes. Even the laparoscopic techniques, which are considered minimally invasive, have potential risks and complications. When considering surgery as a weight-loss option, you have to look at the big picture and factor in the potential risks.

* Learn more about the possible complications of bariatric surgery.

7. Do I understand the life-changing effects I will face after surgery?Many people view surgery as a “quick-fix” approach to weight loss. But if you speak to somebody who has had such surgery in the past, they will likely point out that this is not the case. Surgery for weight loss is a life-changing event. After all, you are altering your stomach’s capacity and, in some cases, your entire digestive process. Such changes will follow you for life.

So before making your decision about weight loss surgery, be sure to learn about the long-term effects of your chosen procedure (gastric bypass, banding, etc.). These days, there are quite a few blogs and forums online that are frequented by people who have had surgery for weight loss in the past. This would be a great place to get some real-life input from somebody who has “been there, done that.” By gathering information from various sources (including previous patients of bariatric surgery), you will be better able to make an informed decision about your own surgery.

8. Have I researched the different types of weight loss surgery?As medical science advances, the diversity of surgery options will increase as well. This is true of any type of surgery, including those for weight loss. Over the past few years, for example, new types of surgery for weight loss have emerged, giving potential patients more options that ever before.

But this is not car shopping we are talking about here. This is surgery. So while it’s always good to have options, it also means you have more homework to do. Each type of bariatric surgery has its pros and cons. So in order to understand them all, you have to do plenty of research.

It’s important to conduct your research “far and wide,” as opposed to just reading one book or one website. For example, if you read articles on a surgeon’s website who performs gastric bypass only, those articles will naturally be skewed in favor of gastric bypass as a surgery option — since it is the surgeon’s specialty.

* Learn about the various types of bariatric surgery.

9. Do I understand minimally invasive versus “open” surgery?These days, many types of surgery have both a laparoscopic method and an “open surgery” method. Laparoscopic surgery is often referred to as “minimally invasive” surgery because it allows for smaller incisions than an open surgery.

Here is the primary difference between these two methods, as they apply to surgery for weight loss …

• Open surgery — The surgeon gains access through a long incision made in the stomach.

• Laparoscopic surgery — The surgeon gains access through one or more small incisions in the stomach. A tiny camera is inserted into one of the other incisions so the surgeon can see to perform the surgery.

* Learn more about laparoscopic weight loss surgery.

10. Do I understand restrictive surgery versus malabsorptive surgery?All forms of bariatric surgery can be classified as either malabsorptive, restrictive, or a combination of the two. It’s important to understand these terms, because they will have an impact on your lifestyle and long-term health after your weight loss surgery.

• Malabsorptive weight loss surgery — This type of surgical procedure alters your digestion process. As a result, it can lead to the incomplete absorption of certain vitamins and minerals from your food.

• Restrictive weight loss surgery — This type of procedure decreases food consumption by reducing the size of the stomach, usually by dividing the stomach into a small upper pouch (the usable part) and a larger lower portion.

• Combination surgery — Certain types of surgery for weight loss (such as the Roux-en-Y gastric bypass) are both restrictive and malabsorptive. The Roux-en-Y segments the stomach while also reshaping the intestines, thus it combines both concepts into one surgery.

The important thing to remember here is that malabsorptive and restrictive surgeries both have their advantages and disadvantages, and that they will affect your long-term health in different ways. When considering surgery for weight loss, be sure to consider these two concepts and the effects associated with them.

Also, keep in mind that a surgeon or surgery center that specializes in a certain type of weight loss surgery will often tout that type of procedure as being the best. Clearly, these folks are biased on the subject. So in your research, be sure to include less biased sources of information, such as governmental studies, university research and the like.

11. Do I know the cost of weight loss surgery and can I afford it?For most people considering surgery for weight loss, the cost of such procedures is a major sticking point. Of course, this is assuming that you’ve answered the other questions on this list, that you’ve exhausted your non-surgical options for weight loss, and that you are now ready to move ahead with surgery.

Depending on the type of procedure you choose, surgery for weight loss can cost anywhere from $10,000 to $40,000 … probably more by the time I finish this tutorial. So in addition to the health-related considerations you must make, there are financial ones as well.

Any discussion about the cost of weight loss surgery will inevitably lead to a discussion about insurance coverage. Thus, it is the next question on our list.

12. Will my insurance cover the cost of surgery (or part of it)?First the good news. Due to the ever-increasing popularity of weight loss surgery (and the increased demands for insurance coverage from patients and doctors alike), more insurance companies are beginning to offer coverage for these surgeries.

Now the bad news. With that being said, there are still plenty of insurance providers who won’t cover surgery for weight loss (or else they make it difficult to obtain such coverage by imposing various restrictions).

Fortunately, this is an easy question to answer. You simply have to ask your insurance provider if they would cover the type of procedure you are considering. Once you are certain you’ll have decent coverage of your surgery, you can move on to the remaining questions on the list.

* Learn more about insurance coverage.

13. Have I found a qualified weight loss surgeon?So, let’s assume that (A) you have exhausted your non-surgical options for weight loss, (B) you have researched the various types of surgery and chosen the one that’s best for you, and (C) you have determined that your insurance company will cover the cost of surgery.

Now you must ask the question: “Who is going to perform my surgery?”

When screening your potential surgeon, find out how much experience he or she has performing the type of surgery for weight loss that you’ve selected. Choosing the best surgeon may very well mean you’ll pay more for the surgery, but isn’t your health and wellbeing worth it?

You should also find out if the surgery center is part of a “co-op” team, or if they only provide the surgery itself. These days, many weight loss surgery centers partner with nutritionists, exercise specialists and other health professionals to treat the “whole person,” as opposed to just performing the surgery. If that kind of comprehensive treatment is important to you, you might consider one of these facilities.

* Learn more about choosing a bariatric surgeon.

14. Does the surgeon make me feel comfortable?In many regards, choosing a surgeon for your weight loss procedure is like choosing a surgeon for any other purpose. You want to find a surgeon who is experienced in the field, as well as one who makes you comfortable.

Some weight loss surgeons are highly skilled from a technical standpoint, but lack a pleasant “bedside manner.” While other weight loss surgeons are great with people but less experienced in bariatric surgery. You want to find a surgeon with a combination of these qualities, one who is both highly skilled and easy to talk to.

15. How many weight loss surgeries has the doctor performed?One of the best ways to pre-qualify a potential surgeon is to consider how many surgeries he or she has performed. In most states, surgeons are required by law to provide potential patients with their surgical history, success rates, etc. So don’t be afraid to ask. It’s your health, after all.

If your potential surgeon performs surgery for weight loss on a regular basis, he or she will be well versed in the latest techniques and technology (not to mention well-practiced in the actual process of surgery). Obviously, this is something you want in a surgeon.

16. Will my surgeon create a good follow-up plan for me?When choosing surgery as a weight loss option, it’s important to realize that the actual surgery is only the first step of a long path. You will also need to alter your eating habits and, ideally, increase your level of exercise. A weight loss surgeon should establish a post-surgery follow-up plan to help you through all of this, and to monitor your success.

17. What should I do before weight loss surgery to prepare for it?This is one of the most common questions for people who have decided in favor of surgery for weight loss: What do I need to do before the surgery? Are there any dietary restrictions I must follow? Et cetera.

What’s important to realize here is that your pre-surgery preps should be mental as well as physical. After all, you are making life-altering changes to your body’s chemistry, so you need to have the right mindset about what’s to come.

The physical part of preparing for weight loss surgery should be straightforward, because your surgeon should provide you with a pre-surgery checklist to follow. But the mental side of preparation is something that a surgeon may not be able to help you with.

Here are some tips for mental / emotional preparation prior to surgery:

Learn everything you can about the weight loss surgical procedure you have chosen, especially the steps you should take after surgery. By being a “quasi-expert” on the subject, you will put your mind more at ease.
Try to establish a relationship with somebody who has undergone surgery for weight loss in the past. This person can offer emotional support as well as firsthand insight into what you can expect afterward.
Journals are popular among weight loss surgery patients. Many people use them to chronicle their journey, record their reasons for having the surgery, etc. Consider starting one of your own.
18. What happens after weight loss surgery?This topic was touched on in question 17, but it deserves a closer examination. Life after surgery will be dramatically different for you, for several reasons. For one thing, your diet and food consumption will change — often dramatically. That’s the whole point of weight loss surgery.

Dietary changes are an important consideration after surgery, but there are others. You should also learn all you can about the average recovery process for your chosen type of surgery, so you will know what to expect (keeping in mind that different people recover in different ways).

Plastic surgery is another common consideration among bariatric surgery patients. By its very nature, bariatric surgery can result in significant weight loss (often in a relatively short period of time). This can lead to excess amounts of loose, sagging skin.

According to the American Society of Plastic Surgeons, about 15% of bariatric surgery patients go on to have plastic surgery after weight loss (also referred to as body contouring). Whether or not you will be part of this 15% is just one more question you must answer.

* Learn more about what to expect after your surgery.

19. What foods should I eat (and avoid) after my weight loss surgery procedure?As mentioned previously, your food intake after bariatric surgery will be dramatically different than it was before surgery. For one thing, you will be eating smaller meals / smaller portions, due to the reduction in stomach capacity.

Dietary considerations are also important for another reason. If you undergo a malabsorptive type of weight loss surgery (see question 10 above), you may have to take vitamin or mineral supplements due to a lack of natural absorption.

* Learn more about foods and diet after surgery.

20. Do I have a post-surgery exercise plan to improve my overall health?When researching and planning for weight loss surgery, many patients overlook a critical aspect of life after surgery — exercise.

Surgery for weight loss can help you with the gastrointestinal / digestive aspects of weight loss, but it cannot change the lifestyle that led to the weight condition in the first place. You will have to do that yourself, and exercise is a big part of it.

The patients who experience the best results from bariatric surgery enjoy those results, in part, because they have adopted more active lifestyles. When you think of the various costs associated with surgery for weight loss (financial, physical and emotional), it only makes sense to maximize your post-surgery success and wellbeing. Only with a good exercise program can you get the most out of your weight loss surgery experience.

21. Have I committed myself to further learning on this subject?If you’ve answered all of the questions above, you will have learned one thing above all else. Bariatric surgery is not a quick fix, but a life-changing event with far-reaching effects. It is therefore important to dedicate yourself to ongoing education on such topics as nutrition and exercise.

Remember, surgery for weight loss only addresses the gastrointestinal / digestive aspects of losing weight. It’s up to you to address the lifestyle factors that led to the excess weight in the first place.

to find out more click on the link below...

Edited by: L*I*T*A* at: 3/24/2009 (22:55)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
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maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
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here are some other questions from another site........

LAP-BAND® Frequently Asked Questions
How much does LAP-BAND® surgery cost?
The cost of Lap-Band Surgery and related expenses is approximately $15,000 to $20,000 in the United States.

What if I don't have health insurance coverage for LAP-BAND® Surgery?
Many LAP-BAND® patients do not have insurance coverage but have been able to obtain financing to cover the medical expenses. Many surgeons will assist patients searching for other payment options by providing information on health care lenders and payment plans to help cover the high cost of weight loss surgery.

What age do I have to be to have LAP-BAND® Surgery?
The Lap-Band procedure is generally indicated for people who are between the ages of 18 and 55.

Will I be able to eat regular food after LAP-BAND® Surgery?
After the recovery period you will be able to eat regular food, but you will want to make sure you plan a healthy and balanced diet and avoid high-fat and high-calorie foods. There will also be some foods you will want to avoid because they tend to cause problems with LAP-BAND® patients, such as: fibrous foods, some breads, pasta, dried fruit, nuts, coconut, popcorn, and fried foods.

How does LAP-BAND® Surgery help with weight loss?
LAP-BAND Surgery helps with weight loss by restricting the amount of food you can eat at any one time. The procedure decreases food intake by creating a small upper stomach pouch that only allows a small amount of food to enter. Digestion is also slowed which helps you feel full longer.

How fast will I lose weight with LAP-BAND Surgery?
Your rate of weight loss will be largely dependent on your compliance with the LAP-BAND guidelines, including: eat only three small healthy meals a day, no snacking between meals, drink only low-calorie beverages, exercise 30 minutes a day. Although your results may vary, the average Lap-Band patient loses about 1-1/2 to 2 pounds per week and about 50% of his or her excess weight within the first year of surgery.

What are the advantages of Lap-Band Surgery?
With LAP-BAND Surgery there is no stomach cutting or intestinal rerouting. It is reversible, adjustable, and less invasive. The recovery is usually quicker, the hospital stay is usually shorter, and there is a lower chance of malnutrition. LAP-BAND patients do not get dumping syndrome. The Lap-Band procedure also has the lowest complication rate and lowest mortality rate of weight loss surgeries.

to find out more click on the link below..

Edited by: L*I*T*A* at: 3/24/2009 (22:58)
There's a difference between interest and commitment. When you're interested in doing something, you do it only when it's convenient. When you're committed to something, you accept no excuses; only results.
When you get to a plateau, think of it as a landing on the stairway to your goal. And
maintenance is a lifelong plateau, so a bit of "rehearsal" for maintenance isn't the worst thing in the world
Breathe in love & compassion.. Breathe out peace & forgiveness.
Pacific time

 January Minutes: 2,040
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