Getting back on track... need advice

Hi everyone, I’d like to preface this post by saying a few things: Everyone’s journey is different. If you’re someone who is just getting started or is considering the lap-band, consider my post the deviation, not the norm (unless it’s more common than I think.) I know several people who have been, not just successful but wildly so, in their band surgeries & have not only achieved their goals but have maintained their loss for years. I am different. I hope to get sorted out and change that, but I think that it’s time I had some help and support in that goal. I’m not going to mention names or details here since I don’t want my experience to reflect poorly on the doctors, nurses, nutritionists, etc that I’ve dealt with. If you want to talk to me in more specific terms, please send a message   I’ve been overweight for a long time now… ever since I had my first child over 13 years ago. I went from 160 to over (well over) 200 and stayed there. The highest ever was about 280 and no matter what I’ve tried over the years the lowest I ever managed was 210. When I started looking into the lap-band I thought that it would be a great way to help me finally get over that wall. I knew a few people who had the band and were doing great (over 100lbs lost for each of them.) I started the process and was approved. I had my band surgery in 02/2009, 260 lbs at the time of surgery. Right from the start I had concerns since I NEVER felt any restriction, none. But I’m determined and I started out with high hopes and big plans. I watched every single bite of food & sip. I used tiny plates and cups. I logged my intake. I knew my basal metabolic rate and how many grams of protein a day was optimal for my weight. I worked out (and I’m not exaggerating here) twice a day – in the morning at the gym (elliptical, rowing machine, bike, treadmill and weights), in the afternoon – at home, walking, jogging, calisthenics you name it – I did it. I felt great but the $!$^!%@#$(% scale WOULD NOT MOVE. I went back for more fills, my Dr. was very cautious and even though I’d tell him that I didn’t feel restriction and the scale had only moved 2 lbs since our last visit a few weeks before, we’d never add much to the band. From 02/2009 – 02/2010, I lost a total of 35 lbs. That’s it. Never, ever broke 220. Before you ask about inches – I did lose some inches, only went down 2 sizes or so though. My (now EX) husband spent that year pointing out every glass of sweet tea or food I ate that was off my plans, every missed gym day… His mother liked to ask me if I was looking forward to not being fat anymore and take photos of me working out when we visited. She’d email them to me after we left (subject line: Motivation for when you get thin), if you’ve ever seen a photo of yourself at 230 lbs doing jumping jacks and didn’t weep then you’re made out of stronger stuff than I am.   I also went to the support group meetings. I found that the majority of the other patients there were much older than I was (by 20 or 30 years in some cases. I was 31 at the time) and where I was starting a couch to 5K program most of the group was really happy to have walked 20 minutes on the treadmill. (Please don’t kill me – I know that everyone is different and props to any one taking the steps to get in better shape. I HOPE that one day I’m as motivated as some of those people.) Eventually, I learned that my band was a 14cc band and the last time I saw my Dr. he said I was at 12cc out of 14cc. I asked why I had the larger band and was told that all their patients had that one since there was a previous patient who was “a big, 6’ tall guy" started with the smaller band and had issues. Now, I don’t know if I agree with that since I can still turn up a cup of water and put it away like nobody’s business. I think that if a 6’ tall guy had a problem with the smaller band, that a 5’ tall woman probably wouldn’t.  Eventually I became frustrated, I checked with the nutritionists to make sure that I was getting enough calories, I became a protein shake guru in my gym I’d tired so many. I also got really tired. I got tired of people asking me if I’d worked out today. Asking why other people had lost so much so fast and I hadn’t. Asking why others who worked with me and had the band months after I had, had lost more than I had in half the time. Mostly, I got tired of other people asking what I was doing wrong. I got tired of asking myself too. I called other surgeons in town and was told that they wouldn’t accept patients from a Dr. in town who already had the band. I stopped going to the meetings, I stopped seeing my Dr and finally I just stopped. As of this morning my scale is at 257. Since I had my surgery: I divorced my husband (and his hateful mother), I’ve taken a new job with more demands on my time and  was fortunate enough to have found a wonderful man who asks me why I ever thought I had to change at all. But I can’t shake the feeling that I’m wasting this gift (it is a gift to qualify and have the band, there are many, many people who don’t) and I want to get back on track. It’s been so long now since I tried I’m not sure where or how to start. I do have some restriction now, but with 12/14 filled I know that if I am able to start losing again that the band will loosen and I don’t have a lot of fill room left. I’ll be back where I was before… I’m putting this up to seek some guidance, advice, hopefully compassion and a shovel so I can dig out of this business. So. Anyone out there have any thoughts?

Yes, many thoughts, but first & foremost: time to get a new bariatric surgeon, even if you have to travel out of town to see him/her. Other surgeons may require you to pay a patient transfer fee (I had to pay about $300, but it was worth it); if a surgeon's office sounds reluctant to accept another doc's patient, ask them, "Even if I pay a patient transfer fee?"

Once you find another surgeon, I would ask him/her to check your fill level (if you never experienced any restriction, a 12 cc fill in a 14 cc band is hard for me to believe, and poor record-keeping is more common than you think) and to do an upper GI study to make sure everything's in the right place. 

It's possible that the 14 cc band was too "big" a band for you, but convincing your original surgeon to remove it and replace it with a different size band looks like an uphill battle, so I'd concentrate on working with a new surgeon to find ways to optimize the band you already have.

If your efforts to find a new surgeon stall, you might want to ask one of your other health care providers (PCP, GYN, etc.) to call the bariatric surgeons to ask them to take you on. When I was having a hard time finding a new surgeon, another one told me that often a doctor can persuade another doc more easily than a patient can.

Good luck!
Jean 

Thank you! It's nice to know that I'm not completely alone... Everyone I know who has had the band has been rather successful (different Dr., natch) and I'm tired of having the band and feeling like a failure. It isn't what I pictured..

I'm going to admit that in the past year I have not been mindful of the band and my diet. That divorce was no fun. :(  Now I'm trying to pull it back together. After those first months I got so frustrated that I think I was too quick to stop.

The last time I had a fill, the Dr. did a complete un-fill and said that he didn't like having so much in, but added another cc (bringing to 12)  *sigh*  I do have some restriction now.. but I'm relatively sure that it's just because I had that last fill 30lbs ago.. and now that I'm up it's noticeable.

I'm thinking that I need to do one more appt with my Dr. to review this, I've even thought about trying to do the sleeve, but I 'm wary of the "destructive" nature of that procedure (which is why bypass was never an option.)  Also, my Dr. hasn't been exactly sumapthetic to my concerns in the past.  

I'm going to make an appt with my primary Dr. and see what he says.. I'm concerned that I won't get a lot of help there either as both Dr's are linked via hospital affiliation and the other bariatric Dr's in town are affiliated with a different hospital. But who knows?

Was thinking that I should start this week from square one, pretend the whole process started over and follow my post surgery instructions again. A re-set of sorts.

Was thinking that I should start this week from square one, pretend the whole process started over and follow my post surgery instructions again. A re-set of sorts.

That's not a bad idea, if only because it can help break the link between you and the past year of personal upheaval (my divorce was over 30 years ago, and it wasn't much fun either) and lousy eating.

You're right that doctors tend to cover each other's asses, but if your approach to your PCP avoids outright criticism of your bariatric doc, he might be less likely to spend your time defending him and more likely to spend it helping you.

good luck!

Jean

 Jean's advice is spot on (as usual), so I don't think I can do any more there.  However, I do kow how you feel and I am in a similar situation.  

There are several of us trying to get our heads back in the game.  So, when you are feeling frustrated, confused or just plain mad, pay us a visit!  We are trying to help each other stay on track.  I don't know if I will ever make my goal, but I know that 50 pounds ago I looked better, felt better and was happier.  That has become my goal, the feelings I get from being healthier...I am not going to focus on a "magic" number.

Hang in there and you'll find a solution that works for you. 

Toni

A lot of ppl never get restriction. A LOT! If you never reach restriction it's just like trying to lose weigh without a band. I would suggest you join the failed band group!