What You Should Know Before You Undergo LAP-BAND Surgery

My lifelong friend is a beautiful woman inside and out. Through a combination of genetics and some admittedly poor eating habits, she ballooned to 330 pounds. Only her closest friends and family know she underwent LAP-BAND^® surgery on March 25, 2010. In this frank and courageous interview, she shares her experience in the hope that it will help you to decide if LAP-BAND^® will be the proper tool to help you lose weight.

Before we get to the interview, let's quickly see if you might qualify for the procedure and describe the basics of the LAP-BAND^® system.

Do you qualify for LAP-BAND^® surgery?

According to the LAP-BAND^® Website (http://www.lapband.com/en/learn_about_lapband/safety_information/), "LAP-BAND^® surgery may be right for you if:

- You are an adult (at least 18 years old).

- Your BMI is 40 or greater, or you weigh at least twice your ideal weight, or you weigh at least 100 pounds (45 kilos) more than your ideal weight, or you have a BMI greater than 35 with at least one obesity-related health condition.

- You have been overweight for more than 5 years.

- Your serious attempts to lose weight have had only short-term success.

- You do not have any other disease that may have caused you to be overweight.

- You are prepared to make major changes in your eating habits and lifestyle.

- You are willing to continue working with the specialist who is treating you.

- You do not drink alcohol in excess."

Your BMI (body mass index) classifies you as overweight, obese, or morbidly obese. Your BMI is an important factor in the determination of whether you are eligible for LAP-BAND^® surgery. Click here to calculate your BMI.

How the LAP-BAND^® system works

The LAP-BAND^® system has an adjustable silicone ring that your surgeon places like a belt around the upper part of your stomach. The new upper part of your stomach holds only a small amount of food at a time, thus you'll feel full sooner and stay full longer even as you eat smaller amounts of food. The surgeon will also attach a tube from the LAP-BAND^® to an access port. By adding saline solution to or removing it from the LAP-BAND^® via the access port, your doctor can customize your weight loss experience.

Risks

The procedure is costly - up to $17,000 and most people pay out-of-pocket since many insurance plans do not cover the procedure. And as with any surgery, there are risks including "infection, leaks, respiratory arrest, blood clots and death, according to the American Society for Metabolic & Bariatric Surgery."¹

Of course, obesity carries its own risks including heart disease and stroke, high blood pressure, diabetes, cancer, gallbladder disease and gallstones, osteoarthritis, gout, and breathing problems that my friend developed; sleep apnea (when a person stops breathing for a short time during sleep) and asthma.²

Now that you know that you might qualify for LAP-BAND^® surgery and have a basic understanding of the LAP-BAND^® system, the potential cost, a let my friend tell you what you can expect if you decide to have the procedure - she's been there, done that.

The Interview

LAP-BAND^® surgery was not the first way you tried to lose weight. What weight-loss methods did you try before you opted for LAP-BAND^® surgery and why didn't they result in permanent weight loss?

In high school, I did a 10 pounds in two weeks diet. I lost the weight but couldn't maintain it for very long. I was fortunate to have a mother who made healthy food and to live in a town where fast food was not really an option.

In college, I went on the Medi-Fast liquid diet and the doctor put me on thyroid medicine even though I didn't have a thyroid problem. Soon after college, I was working at the mall and eating what I thought was healthy food in the food court; salad, veggies and rice, etc... But, guess what? I eventually ballooned to 240 pounds!

Several years later, with unmanaged stress and low self esteem, I hit 320 pounds. I then went to a doctor, started on appetite suppressants, and managed to lose 100 pounds.

With not managing stress and feeling desperate, I again ballooned, this time to 330 pounds, which is where I started when I had the LAP-BAND^® procedure.

Following almost any diet will work if you stick to it, the problem is what do you do when you aren't dieting. It's not the diet that doesn't work, it's the lack of knowledge about what is a "normal" portion and what is "good" food.

Did being overweight create health problems?

I'm a healthy person, so I haven't experienced most of the stereotypical problems. My cholesterol is great, I'm not diabetic, my heart is ticking just fine, but I do use a CPAP machine to treat sleep apnea. When they tested me at my highest weight, I stopped breathing over 100 times an hour. Not good! That can definitely lead to heart problems. I'm also asthmatic due to allergies. I don't use an inhaler all of the time, but when my allergies flare up, so does the asthma.

LAP-BAND^® surgery may seem a drastic measure to some. What made you decide to have the procedure?

The reality to me is that it's not really drastic. It's a tool. It's like having an appetite suppressant without taking drugs. By the way, did that and the drugs made me very grumpy (makes a grouchy face, then grins).

So you choose LAP-BAND^® rather than gastric bypass surgery?

That's right. LAP-BAND^® is less invasive and doesn't present the health risks of other methods. If you're a female and want to get pregnant, the band can be adjusted by removing fluid and allowing more food to pass through. If you decide you don't want it, the band can be removed. With bypass, it's permanent. It's all or nothing. People have problems absorbing vitamins, have intestinal issues, etc... You drop weight very fast yet your body can't keep up. With LAP-BAND^®, it's up to you. You can lose at your own pace, exercise, and hopefully, not need to have an additional surgery to handle loose skin.

You did a lot of prep work before your procedure. How can someone get information about the LAP-BAND^® system in order to make an informed decision?

Go to one of the free seminars. Research LAP-BAND^® on the Internet. Talk to someone who's been through it. I had a friend that went through it a few months before me and I had a sister that was considering it at the same time. She went to a seminar and decided against it, while I went and decided to go through with it.

How did you physically prepare for LAP-BAND^® surgery?

A couple weeks before the surgery, I had to eliminate all sugars from of my diet.

Tell me about your LAP-BAND^® procedure and recovery period.

It's not a big deal. I took pain meds the first day and the second morning. Other than that, I just didn't want any food. When you get the surgery, your stomach is a little swollen, so you aren't really hungry and don't really want food. Having other people eat in front of me, even my favorite foods, didn't bother me. You stay on liquids for the first week, which sounds difficult, but you really don't have the desire to eat. I took a week off work because I could, not because I needed the time to recover.

It sounds like you didn't have any trouble sticking to the requirements of the three LAP-BAND^® eating phases (liquids only, transition, and solids).

At the end of each phase, I was ready for the next phase, but none of the phases were difficult. The phases are just that, phases, not forever.

What about LAP-BAND^® side effects - did you vomit, were you constipated, or did you feel bloated?

The only problem I've had is that I produce a lot of mucus from sinus issues. My friend that had surgery calls it frothing. The mucus can actually plug the stomach opening making it difficult to eat. For me, I have to spit it up or wait for it to go down. However, you can take sinus medications to resolve that issue. I'm looking for the combination that's right for me. Some people have problems with gas. I occasionally belch but let's face it; I did that before surgery (laughs).

You had the LAP-BAND^® surgery on March 25, 2010. How much weight have you lost, and are you satisfied with the results so far?

I've lost 40 lbs, which is a slower rate than for most patients, but as I've stated, I want my body and my weight to keep the same pace. That means I need to exercise and drink lots of water. The band holds 14 ounces of saline solution and right now, my band has only 5-6 ounces so it's almost to being halfway closed, so I have a long way to go.

I'm glad you brought up the band. Many people think they will have the LAP-BAND^® surgery and that's all there is to it. Describe the LAP-BAND^® access port and the follow up adjustments to the band.

My access port is located beneath the breast line in the middle of my stomach. If you choose to, a numbing medication can be given to you before the fill. However, for me, the shot for numbing can be felt more that the fill needle, but everyone is different. They also have a machine that will allow the tech to see the port. My port can be felt easily, so they don't actually have to use the machine for me. You can't eat or drink two hours before the adjustment and they will have you slowly sip water after the adjustment to make sure that there are no problems. The first 24 hours after the adjustment is a soft/liquid diet and the second 24 hours is "mushy" food. After that, everything returns to normal.

Let's talk some more about the band. There are three LAP-BAND^® zones based on the amount of saline solution place in the band: yellow zone (not enough fluid in the band), red zone (too much fluid in the band), and the optimal green zone. Which zone are you in and how do you feel?

I'm still in the early stages of the LAP-BAND^® process so I'm still in the yellow zone. The yellow zone is what I call figuring it out. It's the time you take to learn how to eat, what to eat, and what works for you. You get to know what actual hunger is, not just what you think it is because you want to eat. You monitor how much you eat and how long it takes until you are hungry again. If you are hungry in a couple of hours, you may need another adjustment. If you aren't hungry for several hours, you may be in your green zone. It's a combination of eating the right portion size and knowing when you are truly hungry.

Do you ever feel frustrated - do you want to eat more than you are allowed to eat or do you crave foods that you should not be eating?

With the LAP-BAND^®, certain foods are restricted due to known complications. For instance, white pasta can get stuck in the opening if the opening is not very big. I've been a whole-wheat pasta eater for years, so I'm not giving up anything. Things like pasta, rice, and potatoes, are the "white" foods that everyone is told to steer clear of, LAP-BAND^® just gives you a bigger reason to follow that good advice. Other "watch out" foods on my favorites list are shrimp, celery, and asparagus. These foods are fibrous and may clog the stomach opening. If food has celery added, I avoid it in chunks, but may eat it if it is small enough. Shrimp, I just take a bite, move to something else, and take another bite. I'm just cautious so I don't eat too much.

No more bubbly, beer, soda, champagne. I don't really drink sodas so no big deal, but I used to enjoy beer. You can still have the drink as long as you get rid of the bubbles. The problem with carbonation is that it is gas and it can stretch the stomach pouch. After going to the expense and spending the time on this option, why would you want to stretch the pouch? My vice is chocolate. However, dark chocolate is the only thing I'll eat and only before my monthly cycle. Yes it's sugar, yes it's a no no for weight lose, but I've got to live. This isn't a "diet" that you start and finish, it's a way of life, and you have to live your life within reason. Just don't abuse the freedoms.

You seem satisfied with the recommended half a cup of food for each meal.

For me, that's like talking in a foreign language. The half cup is based on compressed food, not an actual cup. So I describe my intake in terms of familiar foods. I figure that the medical professionals can tell me if it's too much or not enough. The half cup of compressed food is what you want to achieve for the green zone and it's a process of trial and error to get to that "sweet spot." Just like before LAP-BAND^®, there are times when you're hungry and times when you aren't.

What other changes have you made to your eating habits since having LAP-BAND^® surgery?

There isn't anything that I've found so far that I can't eat; however, I do have problems with some meat. It's just a matter of taking it slow, chewing well, and letting your body tell you if it's okay. As far as changing my habits, the biggest thing is I make sure I always have some type of protein on hand. I used to base my meals on brown rice or wheat pasta, and then I would add a vegetable or a sauce. Pasta without meat. Rice and veggies. Now I plan my protein and add the veggies. If I want, I may sprinkle some brown rice or wheat pasta on top. The carbohydrates are an extra bonus, not the meal.

What about exercise? Is that a part of your weight loss plan?

Exercise is a must for everyone, not just people trying to lose weight and definitely not just LAP-BAND^® patients. The larger you are, the less work it takes to work off the weight. Men with greater muscle mass also have an easier go of it. However, at some point, diet alone won't take the weight off. So exercise because it's good for you not just because you need to lose weight. I used to work out at least 4 days a week, but I got out of the habit two years ago when I moved. I started the habit when I previously lost the 100 pounds. The rule of thumb is three days a week to maintain and more days to lose. Exercise and lots of water help with the elasticity of the skin. That coupled with slow weight loss help the body recover its natural state. Some people may still need additional help, but I'm working with nature to help me.

Based on your experience, what would you tell someone who is considering LAP-BAND^® surgery?

Please remember that LAP-BAND^® is an aid to get you to where you need to be rather than the end all. Your stomach stretches if you overeat, so you still have to be responsible for what you do and what you eat. LAP-BAND^® just makes it a lot easier to eat less. As long as you can be honest with yourself and take responsibility for your behavior, you will succeed.

Sources:

1 - http://news.yahoo.com/s/hsn/20100920/hl_hsn/gastricbandsurgeryrisingamongobeseteens
2 - http://www.webmd.com/cholesterol-management/obesity-health-risks