Irish Proverb: If you don't know the way, walk slowly.

The Three-Month Lapband Update

Over the past week I’ve had two different friends ask me details about my Lapband surgery — how the surgery went, how things are going, and would I recommend it. When I mentioned this coincidence to Susan, she pointed out that I haven’t blogged much about my surgery at all (which is unlike me). So, for my friends, and for you, here is my “three-month Lapband update.”

I had Lapband surgery on December 3rd, 2007. It’s an easy date to remember; it was nine years (to the day) that I got hit by a truck. December 3rd has become my second birthday — twice now. Prior to having Lapband surgery there are a series of hoops everyone must jump through. Every single place that performs this procedure has different rules and requirements, so I would be surprised if anyone else’s experience was identical to mine. Here are the eight things I had to complete before having surgery:

– Attend the initial seminar: This was more or less a two-hour sales pitch. During the event they explained and compared the two most common surgeries (Gastric Bypass and Lapband). At the end of this seminar, attendees submitted their insurance information and were later notified if they qualified for either of the surgeries.

– Attend the introduction: After being accepted, I had to attend this introductory meeting. During this meeting they explained the general process, allowed us to sample different types of food, and gave us notebooks full of information. They also scheduled my surgery date during this meeting, approximately six weeks out.

– Make a food order: For ten days prior to surgery and a week afterwards, I was on a liquid diet. The place I had surgery sells protein-rich drinks intended for this period. Purchasing my food elsewhere was not an option; their food is part of the program. Protein shakes and packets average $3 per meal, and I had to buy 3 weeks worth. (If you want to buy protein mix in bulk, it is cheaper.)

– Meet with a shrink: During this 1 hour session, a shrink tries to determine whether or not you are crazy. I suspect the purpose for this is to determine why you are overweight; I think they are looking for eating disorders here.

– Meet with a dietary consultant: During this session I met with a dietary counselor who explained to me the changes in food intake that were about to occur. We talked a lot about measuring food and monitoring daily protein levels. I actually thought this was one of the more interesting and productive hoops.

– Meet with a physical therapist: During this session the physical therapist explains to you why you are fat and helps you develop a workout schedule.

– Attend a support group meeting: Personally for me this was the least helpful and most annoying hoop, but others may find it more helpful or interesting. The group meeting I attended consisted of three groups of people: people who were there to whine, people who were there to help the whiners, and people like myself who were forced to be there and didn’t say a word. The whiners whined (“I just can’t do it! I love ice cream too much!”), the helpers helped (“You can do it! I did it! If I can do it, you can do it!”), and the rest of us sat around looking at the clock. If I need support, there’s this thing called the Internet and there are several large websites and forums designed for people to ask and answer questions. Hanging out in a room full of strangers talking about my addiction to Peeps ain’t my thing.

– 10-day pre-diet: Both Lapband and Gastric Bypass surgery are stomach-related surgeries, so it makes sense that your stomach should be as empty as possible beforehand. Lapband surgery is laparoscopic, which means it is performed through a series of tiny cuts instead of one big incision. To get to the stomach easily, the liver must shrink, which is another reason for the diet. Some people suffer terribly through the diet but I personally found it not too bad. One of the meal replacements I purchased was a big bag of Cookies and Cream mixed, which is prepared by mixing a big cup of mix with 8oz of water or milk. I added ice and threw it in the blender, making a giant shake. Who doesn’t like Cookies and Cream shakes for lunch?

All of this was not as bad as it sounds. I know at least four of them all took place on the same day, so it wasn’t as time consuming as it may seem.

On the day of my surgery, I checked in to the hospital at 6am, with a scheduled surgery time of 9am. My surgery actually took place sometime around 1pm (routine hospital delays). Before the surgery, I laid in a waiting bay with my parents and my wife at my side. Once I finally went back, the surgery went quick and within an hour I had woken up in recovery. I moved back to my room shortly after that. Some insurance companies will not pay for an overnight stay; mine did, and I had a stack of electronic things around me to keep me entertained.

Around 6pm that night (approximately three hours after returning to my room) I was served my first meal, in paper cups the size of shot glasses. I think I had broth, pudding, and Jell-O. Surprisingly, it filled me up. Another two hours later at 8pm I got up and walked around a bit. My stomach was sore but not unbearable. I spent the last couple of hours of the night watching Funniest Home Videos (which seems to always be on in the hospital) and a football game. The next morning I took a shower on my own, got dressed in loose clothing, and went home around 9am.

The worst pain I experienced throughout the entire ordeal was something called “phantom pain” in my shoulder. A day or two after my surgery I began feeling intense pain in my shoulder. During laparoscopic surgery, the stomach cavity is pumped full of air. Some people will tell you that the pain comes from those bubbles rising up to your shoulder, but the real cause of the pain is bubbles pressing up against nerves which lead up to your shoulders — that’s why you feel it there. Google for laparascopic shoulder pain and you’ll find a million cures. Believe me, I tried them all. Heating pads didn’t work. Drinking Peppermint Tea didn’t work. Laxatives didn’t work. Walking around didn’t work. The only thing that worked was pain pills, so stock up! The pain I felt in my shoulder was 100x worse than anything related to the surgery.

I had my surgery on a Monday. I was home Tuesday morning; Wednesday, Dad and I went out and did some minor shopping. Even though I scheduled a week off of work for the surgery, I could have gone back to work by Thursday for sure. One of the limitations after the surgery is not lifting 20 pounds, but that was not a major factor for me at work.

For those who aren’t sure how Lapband works, here’s a cute little image. As you can see, the band goes around the top of the stomach, creating a small 4oz (half a cup) pouch above it. If you think of it like a car’s gas tank, essentially you’ve moved the bottom of the tank all the way close to the “full meter,” so even after eating a small amount of food you feel very full. Another analogy — think about a plastic funnel. Even if you fill a funnel quickly with water, it takes a long time for it to flow through. The idea with Lapband is that your new pouch will fill quickly with food, but it will take a long time for that food to drain through to your real stomach. That rate of drain is controlled by how much saline is in your band. If you’ll notice in the diagram, there is a port hanging off of the band. That port sits underneath your skin, and the amount of saline in your band can be increased or decreased through simple injections.

And so, on with the injections.

Again, I preface this information with the note that every place is different. At my place, no saline was added into the band after surgery. Trust me, your stomach will be so sore at this point that you won’t need saline to keep you from over eating. Over time, small amounts of saline are added to the band. The goal is to find your “sweet spot,” a setting where you feel full after eating only 4oz of food, and the fullness lasts three or four hours. Unfortunately that setting is different for every single person so the only way to find it to get a fill, wait two weeks, get another fill, wait two weeks, etc.

I should note that there are three main sizes of Lapband devices — 4oz, 10oz, and 14oz. Between that and the fact that everyone’s stomach lining is a different thickness, it’s really difficult to compare fill levels with other people.

I have a 14oz band, and to date I’ve had four fills. On the first fill, they added 4 ½ oz. After each fill I am instructed to have liquids for a day and then soft foods for a day before venturing back to solid food. My first fill did not restrict my eating at all. After one fill I was able to eat a salad at Golden Corral covered in steak, chicken and shrimp, and follow it up with another full plate of meat and veggies. My second fill, which added two more CCs of fluid, was much the same.

After my third fill, which brought me to 8 CCs, I began feeling major restriction. All of a sudden, all of the rules I previously thought of as “suggestions” became rules. All of the things they told me to stop doing (like drinking during meals) started making me puke. I’ve only thrown up a handful (ew) of times since the surgery and they have all been due to me breaking the rules so it’s tough to fault the procedure.

It was only after my third fill that I really felt like I had had the operation. My fourth fill, which brought me to 9 CCs, has made a believer out of me. Finally, all the reasons that made me want to have the surgery are coming true. I ate a protein bar for breakfast this morning and I was STUFFED. For dinner last night, I had a small-sized frozen dinner and couldn’t finish the dessert. Over the past couple of months I have been kind of disappointed with the procedure because I felt like it really wasn’t working, but the past couple of weeks have changed my mind. I really feel like things may change for me.

One major thing that Lapband does is affect your social life. It’s amazing how much of our lives are tied to eating. When people come in from out of town, I take them to eat. When I catch up with old friends, we go out and eat. Eating = socializing in my world, and that’s something you should really consider before having this surgery. All of a sudden I am consistently the last person done eating at every meal. People will constantly ask you about your food. They’ll comment on what, and how much, you are eating. This goes with the territory; if you can’t handle it, don’t eat around other people. Your surgery will affect the people around you. Some people will feel self-conscious eating in front of you. Some people will make comments to you. Some people will make comments after you leave. People will comment on your weight loss, and how fast or slow it’s going. They’ll tell you horror stories about people they know who have had the surgery and how terrible it went for them. Although this surgery takes place on your inside, you had better have a thick outside to go along with it. Unfortunately there is no handbook that goes along with these things. You, as I have, will learn your own way to deal with these things. Some of them may bother you and others may not.

The one thing I would stress to people considering Lapband surgery is, Lapband is not a solution in and of itself. There are cases where people have actually GAINED weight after this surgery. Lapband restricts the amount of food you can eat in one sitting. It does not stop you from snacking. More importantly, it does not make good food decisions for you. Even though you can are limited to eating 4oz of food at a time, that could mean 4oz of cake. Or worse, it could be 4oz of pudding or ice cream or shakes, things that slide right through the Lapband, add calories, and don’t fill you up.

Lapband and Gastric Bypass surgery involve many sacrifices. You have to give up carbonated drinks (that includes beer). You have to give up caffeine. I have all but given up white bread and pasta (it simply won’t go down). Whether or not the surgery is the right choice for you is a personal decision. It certainly is not “the easy way to lose weight,” as many people have told me (try giving up drinking 30 minutes before, during, and after meals and tell me how easy it is!). I am sure there are people who think less of me for having the surgery, but those who really care about me are glad that I will live longer because of it, and that for me was the ultimate deciding factor.

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7 comments to The Three-Month Lapband Update

  • Mom

    It took years before I felt like I could quit apologizing for having the gastric bypass surgery. There were people I just wouldn’t tell at all. Comments from skinny people like “anyone can lose weight… you just have to quit eating!” really burned me. Then after umpteen years, when some of the weight came back on, I felt like I had to apologize all over again for having somehow “failed” to stay thin. You finally come to realize that you didn’t do it for any of them. You did it for yourself and your loved ones. They want you around as much as you want to stay around, and for as long as possible. Now I’m so thankful that I had all these wonderful years of feeling good, and being able to do things with my family, and still being here and in relatively good health. If I had it to do all over again, I’d do it in a heartbeat. Do I have any regrets? Not a one! I had to make the same adjustments with social life. It gets easier. You learn how to answer people who don’t know about it, and the ones that do get used to the changes in habits. And eventually you substitute other activities for eating, and life gets more fun. I took up playing on a volleyball league, and I had to learn how to bowl without swinging the ball wide to get around my hips! Life is full of wonders! OK, I apologize for writing a book. I just get enthusiastic for myself and for you. Keep it up. Mom

  • Denise

    I am so happy you did this. If my insurance would pay, I would be there right with you

    Luv yu

  • Mom

    Hang in there Cuz. Our insurance just decided it would pay for lapband surgery. You may be next!
    Love, Auntie.

  • Hi

    Hi, I just got banded March 26th. I can still eat like a horse! I don’t feel like I even had surgery. I haven’t gotten sick, nothing! I know I am overeating, but I just get SO hungry if I don’t eat. Did this happen to you as well? I haven’t felt any restriction at all, and I am so worried I will fail at this. Sorry to lay all this on you, but no one around me understands. I would appreciate it if you would email me. Thanks so much!

  • Philly Girl

    Hey, keep the faith. I got banded on 2/18 and had to have port reattachment and my first fill surgically on 4/7. You will not feel restricted until after you have had a few fills. In the meantime it is important to eat foods that keep you satisfied, drink plenty of water, and do not drink with your meals, you have to learn a brand new way of eating. Protein, protein, protein…I can not stress that enough. Start every day with a protein shake!

  • cfila71

    Hi – was banded at the beginning of July and had my first fill today -between the surgery and first fill I lost 3 kilos – I thought I had failed ….. but it was explained to me that I should really only feel restircted in the next few weeks – I was wondering why I was able to eat everything and anything ?????? I have had a cup a soup for lunch and am already in pain ! did I overeat ?

  • victoria

    hello. im happy to see that your sugery went well! my aunt got the band a week ago and she her sholder has only gotten worse. shes very tough, and ive only seen her cry at funerals. tonight she cried; this is unbearble for her. i told her to call someone but shes stubborn. my uncle tried to take her to the ER but she yelled, “What are they going to do?!” and continued crying. shes all over the place, cant think strait, and shes mad at everything. she yells at me for stupid stuff. what should i do?