Karen Miller’s Lap Band Story

I can’t find the first installment of this series, but it’s about Karen Miller, a 26 year old woman, in Bridgeport, Connecticut who had a Lap Band procedure performed by Dr. Timothy Ehrlich. Like most future Bandees, she had lots of different health problems - frightening when you’re only 26. Those have gone away, and now she’s feeling (as a friend of mine put it) down right evangelical.

She said she’s actually had to stop herself from suggesting the procedure to others, for fear of seeming rude.`I don’t want to offend anybody,” said Miller, a law student at Western New England College in Springfield, Mass. “But I want to let them know that this is an option. Before I had the surgery, I didn’t even know it was out there. I wish I had known sooner.”

And her health problems are now better:

Her enthusiasm is understandable, given her response to the surgery. Before the procedure, she weighed 247 pounds. She also had Polycystic Ovarian Syndrome, which led to a number of health problems, including high blood pressure, irregular glucose levels and irregular periods.

The syndrome also made it difficult for her to lose weight, even though doctors urged her to do so.

On the advice of a friend, Miller, who works in the medical records department at St. Vincent’s, decided to explore bariatric surgery. However, she wasn’t interested in the more highly publicized gastric bypass surgery. That surgery, made famous by high-profile patients such as “Today” show weatherman Al Roker, involves rerouting part of the intestine.

Unlike gastric bypass surgery, lap-band is minimally invasive with few risks. Gastric bypass surgery, on the other hand, is a more complicated surgery that carries more risks, including possible death. Another benefit to lap-band surgery is that, unlike the bypass, it’s reversible.

Miller was deemed a good candidate for the lap-band, which is most effective for patients aged 18 to 65 and having a Body Mass Index of 40 or higher. Before surgery, Miller’s BMI - measurement based on weight related to height - was 42. Her health problems also made her a good candidate for the surgery, so she signed up.

One year later, she’s lost 72 pounds.

Since the procedure, Miller has gone from 247 pounds to 175 pounds. That’s obviously garnered a lot of reaction — most of it positive — from friends, family, strangers.

And she finds herself being cheered on.

Throughout the past year, Miller’s life has changed in many ways, but the thing that surprises her most is how supportive everyone has been.

“People are getting more and more cutthroat these days,” she said. “But when people see me doing this, they’re just so encouraging. I’m very happy.

It’s a good story - always gratifying to see someone decent have things go well. In the last installment, she’s about 20 pounds away from her goal weight - and wouldn’t we all like to be there.

Interesting Post on Fills

Hmmmm, here’s something I’ve never read before. Dr. Rachael Keilin is talking about how fills impact a bandee’s hunger, and how the impact of the fill isn’t necessarily immediate.

There is also a phenomenon we see fairly often, but really can’t explain well. Some people will have a delay in the “tightness” of a fill by as much as two weeks. This is why we won’t fill one day and then fill again three days later. Because there is sometimes a lag in the perception of hunger after a fill (and remember: it’s hunger control we’re aiming for, not bulimia!), we don’t want to end up over-filling patients, especially if they live out of town. Spitting into a cup is just not fun. You’re meant to have gradual weight loss with the Lap Band from eating less. You’re not meant to be on a liquid diet or pureed food diet. We want to eat more or less a regular diet, just eat a smaller amount of food so that you can lose weight.

Interesting. Now, that I’ve checked out Dr. Keilin’s site, I have to go find out what “Smart Lipo” is. Inquiring minds want to know.

Sorry I’ve been AWOL.

I’ve been working on a project with a friend’s daughter. She’s graduating from high school and chose to make a short film as her senior project. My husband edits motion pictures and we see a lot of student films - either he’s hired to put them back in order, or people ask me to take a look at them to tell me what I think. I have to say that most of them that I see are from college students who have some formal training as filmmaker and very few of them - even the ones from USC’s vaunted graduate filmmaking department - are as good as what my young friend has conjured up. Seriously. And that’s always a stunning thing to witness.

Julia is a seventeen year old girl who decided to make a movie. She’s an actress and was in our last film - she got about 4 days work out of it. And she’s been in a couple student films. In addition, we spent a day filming a one man stage show for a local actor and she was the boom operator for us. That is the sum total of her filmmaking experience. Anyway, I say all this, because this seventeen year old showed up with a script that was really, really good - by any objective standard. It concerns a teenage girl who involves herself in radical environmental activities and decides to desecrate a grave. I read the script and was pretty stunned at what she’d put together. A lot of it takes place at night time though and I told her she needed a real director of photograhy - this wasn’t something I had the equipment or the skills to light. She called up the DP we’d used on the film she’d been in, he read the script and told her he’d do it. Unbelievable. So this seventeen year old kid has a first rate script, a world class DP with a ten ton truck with all sorts of goodies, great locations and it’s turned into a wonderful project. My husband has been the camera operator and filled in a bit of the directing. But she did the writing, the casting and it is still her vision through and through. She’ll edit it for her final grade. Once that’s done though, I think she and my husband will sit down together for a polish.

It’s been an amazing thing to watch. She’s made interesting choices through and through. Anyway, tonight is the final night of shooting and I’ll have some posts for you tomorrow.

Deciding Between Gastric Bypass and Lap Bands

I want to put this last video from Dr. Simpson in a different post entirely. He talks a great deal about why he doesn’t do gastric bypasses anymore but instead prefers Lap Bands. Interestingly, he also talks briefly about why Lap Band patients are less likely to need plastic surgery after losing an equivalent amount of weight. As before, there is a silent animation during the first 40 seconds of the clip - nothing is wrong with your computer.

Live Longer With Weight Loss Surgery

I’ve written about this before, but I think it’s always good for a repeat. So many people hesitate to have weight loss surgery because they are concerned that there will be problems, and besides, surely they can lose the weight without such extremities.

To my mind, weight loss surgery is no more extreme than any other type of medical treatment. If I break my leg, I’m gonna get a cast on it, and I’m not going to engage in supersitious thinking that my broken leg is punishment for bad behavior and I therefore should heal without medical intervention. That’s just nonsense. It’s like the stigma against mental health treatment - schizophrenics can’t stop being schizophrenic. Depressed people can’t snap out of it. These are all medical conditions with medical treatments. Sometimes there are herbs that do the trick and sometimes accupuncture is the way to go. And most of us wind up with traditional western medicine of one kind or the other. The point is that if having a treatment will add years to your life - do it. Most of us have families who love us and want and need us around as long as they can have us. What’s wrong with giving your kids who love you an extra ten years? How many of us have grandparents or parents or even kids that we wish would have stayed among us longer?

So, obesity surgery extends your life.

From Dr. John Dixon’s paper Survival Advantage With Bariatric Surgery: report from the 10th
International Congress on Obesity.

A group from Monash University in Australia presented mortality data from two Melbourne cohorts [2]. A single surgical cohort of 1468 patients treated with laparoscopic adjustable gastric banding (LAGB) using the LapBand was compared with an established population-based cohort, the Melbourne Collaborative Cohort Study. Five deaths occurred in almost 6000 patient years in the surgical cohort, with vital status available for 98%. This group was compared with 2000 obese subjects in the Melbourne Collaborative Cohort Study. Five deaths occurred in almost 6000 patient years in the surgical cohort, with vital status available for 98%. This group was compared with 2000 obese subjects in the Melbourne Collaborative Cohort Study cohort in which 225 deaths occurred in 25,000 patient years. Adjusted Cox regression analysis revealed a 73% reduction in the mortality rate in the surgically treated cohort (hazard ratio 0.27, 95% confidence interval 0.09–0.81). The investigators concluded that LAGB surgery provided a significant survival advantage for this severely obese population.

Now, this study in Utah on gastric bypass found a 40% reduction in the risk of death, with a bizarre stipulation:

A collaborative research project conducted in Utah compared mortality in 8172 patients who had undergone gastric bypass surgery in a single practice with the same number of community controls matched for age, gender, and body mass index [3]. This latter cohort was matched with the surgical cohort using a community driving license data set. Vital status was assessed using the National Death Index. The gastric bypass cohort had a 40% reduction in mortality (P 0.001). Significant reductions in deaths related to coronary artery disease, diabetes, and cancer occurred, but deaths related to accidents, poisonings, and suicide were significantly greater in the surgically treated group. This long-term study, with 18 years of follow-up, represents the largest gastric bypass cohort followed for mortality.

I don’t even know what to say about that, but I’d love to hear what the doctors think.

Do You Regret Getting A Lap Band?

Here’s an interesting thread over at the Lap Band Talk Forum. Ramone asks:

How Do you feel about your choice to get banded ??? Please Vote !

Sorry i posted this by mistake in Intro section as well.

My Story

Hi, I’m new to the community and am scheduled to get banded on May the 13th !!! Soooo nervous and excited at the same time. Would really like to hear from some of you about your experiences. Does anyone here regret going through with the surgery ?

My biggest worries is that I may regret the surgery for the following reasons:

1) I may feel frustrated with having a foreign object telling me what I can and cannot eat (unable to eat foods like red meat, past and rice the rest of my life).

2) Feeling like an impostor in front of other people because I have something inside myself that I am hiding from other people. Like I will always be carrying around this embarrassing secret with me…

What do you think about my thoughts ?

BTW I am 23 years old and in college

And the answers are overwhelmingly positive. Well, I knew they would be. However, it’s an interesting read because everyone has their own reasons for being happy or regretful. As for the poll in question, 283 say it’s the best think they’ve ever done for themselves. 10 regret having been banded. And 51 haven’t made up their mind yet.

For Our Australian Readers: A Heads Up

GastricBandMan has this to say:

I had my fill appointment booked with my surgeon for next Thursday, so I went to my GP to get a referral to the Patient Assisted Transfer Scheme (PATS) so I could have my airfares booked.

(I’m sure I’ve talked about this in the past, but if you’re curious, PATS is a government scheme that subsidises travel and accommodation costs for remote patients who need to travel great distances in order to access specialist medical services.)

Before I sought the initial referral to even have the surgery, I checked with my doctor and made sure that the follow up visits would be covered by PATS, as dropping $600 every couple of months was just too much of a cost to bear. With his confirmation, I chose the surgeon and went ahead with the operation.

So, I submitted my application to go down next week for my fill, and then yesterday I had a message on my voicemail to contact the PATS office. No problem, I thought- I assumed they were just calling to confirm dates and details.

No such luck.

I returned the call today, and was told that my application had been declined. It seems that there is a surgeon that flies up to Karratha (the next town from us, about 240km away) once per month to both operate and conduct follow up appointments. Because of this, the scheme will only subsidise my fuel costs to drive to Karratha, rather than paying the airfare to Perth to see my surgeon.

Forewarned is forearmed. Make your surgeon decisions accordingly.

Clothing Tips For Women Losing Weight

One of the searches that I see repeatedly is women searching for advice on how to handle their wardrobe during weight loss. Lap Band patients lose, on average, about 8 to 10 pounds a month, which could mean a new wardrobe ever ten weeks or so. That would get pricey quickly.

One of my favorite plus-sized clothing sites is Janelle Lowe’s Love Your Peaches! Janelle is a plus size designer and I will let her intro page speak for her here:

Welcome to Love Your Peaches Clothing Co., where our motto is “no boundaries”. I started this company in 1996, because, frankly, I couldn’t find any clothes in the marketplace that spoke to me, the confident plus size woman. I hope you enjoy my fashions, all modeled by beautiful women of size. Some items are more daring, some are more conservative, but they’re ALL made with love. Seriously. I know it sounds corny, but Peaches is so much more than just a company to me. It’s my response to the world that told me that I was too fat, that I had to wear black, that I couldn’t go sleeveless, that I couldn’t wear a bikini, that I didn’t look good. Well, my friends, for me those barriers are coming down, and I hope they do for you, too, because it’s a wonderful thing to be free. I’m often asked what the name “Love Your Peaches” means. Those of you who are over 30 may remember this, it came from a line of an old Steve Miller song: “Really love your peaches, wanna shake your tree.” Great song. More than that, however, I chose the name because it speaks to self-esteem. As women, we really do need to “love our peaches”. We need to smile when we think of ourselves, to believe that we are as juicy and luscious and desirable as a perfectly ripe peach. We’ve wasted way too much time being unhappy with our bodies. Isn’t it about time we started living with joy? I hope you enjoy the site!

What I love about Love Your Peaches clothing is that the designs are simple and clean and made with high quality fabrics. What I love about the site is that Janelle shows her clothing modeled on genuinely plus sized models as opposed to lucious size twelves we normally see. And importantly, for plus sized women, she also includes line drawings so that you’re very clear as to what the shape of the garment is.

Since Janelle designs her clothing, I wrote and asked her advice for bandees on how to select clothing that will be wearable through several months of weight loss and easily alterable as well. Here’s what she had to say:

#1. Find yourself a good tailor/alterations person. The dry cleaners is
a good place to start. If they don’t have someone on staff, they usually
have someone they can refer you to. Keep trying different ones until you
find one that you’re happy with. No matter what size you are, you will
look and feel better if your clothes fit you well.

#2. Knits are your friend as they can accommodate a changing body better
than a stiff, woven fabric.

Here’s a link to her new Calista dress - which I love. It’s a Cotton Lycra Jersey and it’s $65. It’s pretty, it’s feminine and affordable.

#3. For tops, one of the best looks around is an adjustable wrap top (or a
dress). Also, tops that have belts or ties at the waist. These are
great as they can be adjusted for changing sizes, getting more mileage out
of your clothing dollar. Luckily they’re also very fashionable right now!

Here’s a Wrap Dress and Wrap Top that shouldl do you well for several months.

#4. Skirts are probably the easiest thing to alter, embrace them if you’re
on a budget.

Janelle’s Every Day Skirt, goes with all of their knit tops. And let her know if you need a different length - important for us shorties. The Simple Skirt is indeed simple and easily altered as well.

#5 Pay attention to necklines. If the neckline gaps, or slides and
slouches from the get go, it’s will only get worse as your size changes.
You can get more mileage out of a garment longer if the neckline lays
correctly. Ditto for armholes.

#6. Avoid garments that have a lot of topstitching on the seams (jeans,
or denim garments). This makes them more difficult and costly to alter.

Pull on pants are perfect. They can be easily altered by taking in the seam on the side. Janelle’s got them in stretch denim, Cotton Lycra Jersey (to match the other pieces above) and linen.

#7. The fewer seams your garments have, the easier and therefore cheaper
they are to alter.

Here, here and here!

#8. If you have elastic waistband pants or skirts, have your seamstress
tunnel the elastic insead the seam, and leave a 2″ gap open on the inside.
(Tunneling is when the fabric is folded over and stitched down without the
elastic. The elastic is then fed through the waistband, leaving it free
inside the fabric). Then as needed, you can simply pull the elastic
tighter and stitch it , or even use a large safety pin if your not
comfortable with sewing.

#9. If you love woven fabrics, look for bias cut garments. When a woven
fabric is cut on the bias (on the diagonal), it has more give to it, almost
like a stretch fabric. The garment will grow, or fall in, as needed.

Here’s Janelle’s very pretty, and very simple Bias Cut dress.

#10. When you’re shopping, take pictures of yourself in new styles!
It’s difficult to analyze how you really look in a mirror, especially as
your body changes. Photo’s make it easier for you to be objective, and
recognize what really works for you.

Now this is something I had never thought to do. I’m an apple and have a terrible time picking clothing out for myself. So many times, the clothing I thought I couldn’t dream of wearing is exactly what looks best on me. So, this is something I’m going to try. Plus, it’ll make me remember to put my make up on before I go shopping.

She has a lot of career ware as well for those of us who pack up and go to an office or to see clients everday. And she has really fun stuff like her Edie Sundress and her Juno dress. The embroidered chiffon Bette shirt speaks to my inner Stevie Nicks!

Anyway, as you contemplate how you’ll get through the coming months or years of weight loss, Janelle’s advice gives you a solid way to think about clothing that can be worn through different weights with just a touch of altering. I hope you enjoy her site. As always, if you have any comments or questions, leave them here or email me.

What Can You Eat With A Lap Band II

I realized I’ve never done a post on what Lap Bandees are most comfortable eating. I have Lorraine Kay’s YouTube clip where she talks about what she can eat, but perhaps I should expand on this a bit more.

Let’s begin by addressing how one loses weight with a Lap Band. Lap Bands make your stomach much, much, much smaller. Typically, your stomach holds about one liter of food though it can be distended to hold up to four liters - close to a gallon! At the top of your stomach are stretch receptors and when they are stretched, they signal your brain that you’re full. With the Lap Band, you’ll be eating about six to eight ounces of food per meal. Because your stomach is so tiny now, those stretch receptors will be activated quickly, and you’ll feel satisfied with a far smaller amount of food than you would have before the Lap Band.

What makes Lap Bands so much more effective than diet and exercise is the capability to keep weight off once you lose it. Ninety eight percent of people who lose weight through diet and exercise put it right back on in under two years. That doesn’t usually happen with Lap Bands. Those stretch receptors being stretched after each meal tell your body that food is plentiful and because of that, your body doesn’t crank down your metabolism the way it does on a diet. And because your body doesn’t crank down your metabolism, you keep the weight off that you lose. Brilliant, eh? I should add that you’ll be consuming about 1100 to 1200 calories per day. Your body’s new set point will be established when the amount of energy you are burning at your new size equals the amount of calories you are consuming - same as for everyone else.

For the sake of a visual comparison, you’ll be eating the equivalent of McDonald’s Double Cheeseburger and a small order of French Fries per meal. Now, needless to say, your surgeon doesn’t want you eating those two things, but McDonalds’ food is internationally available and the same size everywhere.

Anyway, the first week, you just don’t feel any hunger by and large, and you only consume clear liquids. The point of this is to not stretch your stomach in anyway in the first days. Be of good cheer - I have yet to hear anyone complain about being hungry that week. After that, you begin a journey that will lead to your first fill and the adjustment process.

What so many Lap Bandees love about their Lap Band is that they can eat almost anything within reason - at holidays, you’ll eat what everyone else does, just less of it. Bread is the most consistently problematic because it mushes up into a gloopy little ball and doesn’t pass through the clip very well. Lots of bandees find that fish quickly becomes one of their favorite dishes - even the people who hated it before. Red meat needs to be cut into tiny pieces and chewed slowly. Crunchy stuff goes down well. As, Lorraine Kay says - tacos with crispy shells, good. Tacos with soft shells, not so good. Nachos, first rate. Some bandees do very well with rice and pasta, others less so. I think it may largely be a matter of being content with just a few bites and moving on. White meats tend to be easy though some people have to be very careful with chicken. You can have ice cream, of course, but it’s calorie dense and goes through the band quickly - thereby defeating the entire purpose.

That’s the short version of it all. I’ll be doing a couple more interviews this weekend, I think. I’ll be sure to talk to the bandees about it, and I’ll let you know what they have to say. In the meantime, if you haven’t watched Lorraine Kay’s interviews on this site, I’d encourage you to do so. She’s someone who thinks and speaks for succinctly. She covers a lot of territory in her interview and you’ll have a much better idea of the road ahead by listening to what she has to say.

I’ve covered caffeine a lot on this site. In fact, there is a whole category about it. The surgeons are split on the subject. Some don’t want you drinking any caffeine whatsoever, and some don’t mind. What I’ve noted in the past is that caffeine causes the blood sugar levels to spike in Type II Diabetics. Spiking blood sugar produces insulin and tells your body to store the energy you’re eating rather than to burn it. Atkins had long noted that people on his diet didn’t lose weight if they drank caffeine. Keep that in mind, and decide how much you value your morning Joe. Atkins now allows people to have one cup a day. If you’re a determined coffee or tea drinker, experiment to find out if there is a reasonable amount you can consume.

Some surgeons object to Lap Bandees having any alcohol at all - the feeling being that you are so restricted in the amount of calories than there are none available to waste on an alcoholic beverage. Dr. Paul O’Brien, of Monash University’s Centre for Obesity Research and Education, says that a glass of wine per day seems to do well by his patients. He’d encourage to check out Australia’s wines, as well.

As always, if there are any questions, pass them along. If you’re interested in reading more about why losing weight and keeping it off is so difficult, check these posts out.

Got Any Questions About Lap Bands Or Weight Loss?

I haven’t been blogging as much lately because I haven’t been sure of what to write about. I am new at this, y’know. Anyway, I thought I’d put it out to you - is there anything you’re specifically wondering about with Lap Bands, or even weight loss or weight loss maintenence, that you haven’t seen addressed anywhere? If so, leave the question here in comments or send it to me at love my lap band at live dot com.

I’m working on finding out about weight loss plateaus for Gwen of Gwen’s WLS Journey. She got stuck for eleven days without any weight loss but has finally dropped another pound and a quarter this morning. Congrats to her on that. BTW, she had to give up coffee to do so. As soon as I get some answers on plateaus, I’ll be posting those.

I’m also going to be doing a post on how to deal with the clothing crisis that develops when you’re burning through a new wardrobe every two to the three months, and discussing some sane ways to get through that without going broke. If you have any tips, thoughts or questions on that problem, be sure to drop them along as well.

Finally, if you’re someone who already has a Lap Band or is having a procedure in the not too distant future and you live in Southern California, I’d love to interview you for this website. We’ll have a couple phone conversations. I’ll come out with a camera. We’ll set it up and talk for an hour or so. I know some people have professional concerns so to be sure, you can identify yourself however you’d like.

So, ask away! I love researching this stuff, and I’m happy to dig in to whatever it is you want to know.

Why You Eat What You Eat

Since it’s a holiday in much of the western world, I thought I’d link to this fantastic Word Press Blog post on why we eat what we eat and as much as we eat. This is one more in my series of why excess weight is so insidiously difficult to get off.

From SOMETHING TO READ WHEN YOU’RE BORED by Linsey Mallory - Do You Know Why You Eat?

This morning one of my coworkers (Rich) laughed at me when I told him I was covering up the stack of cookies he brought in because seeing them made me want to eat them. I defended my actions by informing him that there have been studies documenting the phenomenon of food visibility increasing consumption, but I still didn’t get the impression he believed me. So I of course decided to do some digging and prove to him that my snickerdoodle concealing behavior was not absurd.

So, this is what I learned in this post - that food that is convenient to us gets eaten - pretty much even if we don’t like it. I’ve done that - I’ve eaten an entire meal I didn’t like. I’ve snacked on snacks I didn’t enjoy. I don’t do a lot of it, but I have done it.

Mallory goes on to quote a CDC study on the subject:

People served larger portions simply eat more food, regardless of their body weight and regardless of the food item, meal setting, or timing of other meals; and the temptation to eat food at hand is so strong that human beings eat more even if the food tastes bad.

The amount of food consumed increases as the effort to eat it decreases, even if the differences in effort are tiny (the example they gave of this was a bowl of candy within reach, rather than a few feet away)

The mere sight of food can stimulate people to eat (Take that Rich!)

The longer the meal, the more people eat. The amount of food people eat is directly and strongly related to the number of people sharing the meal, with food consumption increasing by 28% when one other person is present and increasing steadily to 71% when the number of companions is six or more.

And this is what I find most germane to the essential topic of regaining weight after it’s been lost:

In general, human self-control over automatic behaviors is limited. Self-control tires like a muscle and taxes our ability to perform other tasks. And just as refusing food depletes a person’s mental reserves, tasks requiring mental effort can reduce the ability to resist the temptation of food. (this explains why I eat like crazy when I’m stressed out)

Because people are unaware of automatic behaviors, they are also unaware that the behaviors are not under control; people tend to fabricate reasons to explain their behaviors, typically choosing the most plausible, culturally acceptable theories.

Yes, I’ve experienced being too stressed to resist food that I didn’t want to eat. Eating didn’t require any mental gymnastics at all while refusing it seemed like the most ingracious ordeal imaginable.

Happy Easter to everyone. I’m editing my interviews with Lorraine finally today. I’m doing this post in the middle of a render. I’ll have them up later this evening for your viewing pleasure.

My Own Surgeon Didn’t Recognize Me!

From the News-Enterprise, this is one of the better told newspaper stories about lap band patients and their successes that I’ve read. Hardin Memorial Hospital in Elizabethtown, Kentucky has begun doing lap band procedures. They tell the story of Sandy Weaver, who has lost 82 pounds in the last 11 months and Mary Divinksy who has gone from 254 to 170 in the past year. Good before and after photos as well. Dr. Nandakishore Dukkipati and Dr. Srinivas Kaza of Advanced Surgical Associates of Kentucky performed their surgeries.

ELIZABETHTOWN — When Sandy Weaver sits down to dinner tonight, she won’t sit long. A couple ounces of meat, an ounce or two of vegetables and she’ll be full. It’s all her stomach can handle after bariatric surgery that Weaver says was the key to weight loss after decades of obesity.

Weaver underwent gastric band surgery 11 months ago. With a band blocking the lower majority of her stomach, she’d lost 82 pounds as of last week.

Sure, she’d like to have a cheeseburger — especially one with a bun — for dinner, but she won’t, she said.

“It’s hard to explain. I miss it, but then I look down and see my lap,” she said. “I have a lap now. It’s worth it.”

And Ms. Divinsky’s tale:

Mary Divinsky, a 59-year-old from Sonora, said she tried everything before she looked into the surgery.

“All the diets invented, I tried them,” she said, rattling off a list of diets and weight- loss programs from Weight Watchers and the Atkins Diet to fasting.

She struggled with her weight since childhood. Friends and relatives can hardly find her in her third-grade class picture because she was so tiny. In the fourth-grade photo, however, she was heavy enough to look like an entirely different person.

She boarded a dieting roller coaster in the early 1980s. She would lose 50 pounds, stabilize, get discouraged and regain the weight.

“I did the yo-yo thing for years and years. Lose it, gain it back, lose it, gain it back. I just thought (gastric band surgery) was the right thing to do,” she said.

Divinsky is the unit secretary at HMH’s intensive care unit, so she knew about the program early. Plus, her brother has had a band for three years.

Poor health drove her decision.

She was taking the highest dose of oral diabetes medication and knew she was a step away from needing insulin shots because of her weight. She also had high blood-pressure.

She started a pre-surgery diet in January 2007. At that time, the 5-foot, 4-inch woman’s weight had peaked at 272 pounds. She weighed 254 when she underwent surgery April 23 — Divinsky, Weaver and one other patient had the surgery on the same day.

Divinsky weighs 170 pounds now. Her goal is 153.

And the really happy part of the story for her family:

She no longer takes medication for high blood-pressure or diabetes.

Patients usually decrease or drop their obesity-spurred medications within a few days, Dukkipati said

And the same for Sandy:

Since the surgery, she stopped taking acid reflux medication, hormones and water pills for swelling. She no longer suffers sleep apnea and her insomnia has improved.

And that part of the story brings us back to Dr. Paul O’Brien’s study at Monash University study which found a 72% decrease in the risk of dying that lap band patients experience over people who use diet and exercise. 72% is a very big deal, and would, no doubt, make a lot of people who love you very happy to know.

There is a lot of good basic information in the story, so if you’re beginning to consider having a lap band procedure, it’s a good article. It covers all the basics.

And while Advanced Surgical Associates of Kentucky does not have a website, their patients have a MySpace page where they provide support for each other.

How much do Lap Band surgeries cost in the US? Part 2.

I was going to do one big blog post and includes lots of numbers from lots of different doctors. That doesn’t seem to be happening. But I am talking to the offices one at a time, and thought I’d update you.

I spoke with Meghan, in the office of Dr. Steve Webb in Jacksonville, Florida. If you’re self-paying, the entire cost is $14,500 and that includes the hospital, the anesthesiologist, pre- and post-op testing, and psychological support (meaning those support groups that help you lose more weight after surgery). They also have a Clothes Closet, and their weight loss surgery patients can come in and exchange clothes - what a great idea! Their phone number is 904-367-4443. Meghan was smart, cheerful and a real delight to talk to.

Lap Bands, Weight Loss and Exercise

I’m reading the Mankato Free Press in southern Minnesota right now, and they have an article about Dr. William Lee, a local surgeon, who has just recently begun doing lap band surgeries. It’s a good article with all of the basic information you’d expect. This, however, jumped out at me, and I thought you’d want to know this:

Lee said his patients can be divided into two groups, those who shed 6 to 8 pounds a month and patients who lose 10 to 15 pounds a month. “The difference between these two groups,” he said, “is exercise.”

Up to 9 pounds more a month because of exercise. Wow. Now, I know you probably hate exercising as much as I do. There’s nothin’ I’d rather do than hunker down in my little bedroom on my lap top, with my little foster dog snoring adorably at my feet and cruise the internet. But that really doesn’t cut it, does it? Nope. Not for me. Not for you. And that’s part of the way I, at least, got into this mess.

Anyway, if you’re contemplating surgery, you do need to prepare to start walking afterwards. Being a great walker, myself, I have a few tips to pass along.

First of all, you need to buy a good pair of walking shoes, and that involves going to a store where they really know how to fit you for shoes. A good store will have a clerk that watches you walk, takes a look at your bare feet, checks for flexibility, and they’ll have a good idea what shoes are likely to be best for you. The right shoe can change instantly how far and how fast you walk and how much fun you have doing it. People who have high arches are miserable in shoes designed for people with flat feet and vice versa. The right pair of shoes will let your feet just roll forward - easy as pie - and stay steady. And when you experience it for the first time, it’s going to change your mind about walking. Seriously. Walking, in a good pair of walking shoes, is a premium physical delight. Now, good walking shoes aren’t necessarily expensive. You should budget somewhere between $60 and $150 and it can fall anywhere in between. There are some that are more expensive, but unless they are particularly perfect for you, you can probably find something as delicious for quite a bit less. In LA, my favorite place to buy shoes is Phidipiddes in Tarzana - great stock and wonderful sales people who know their business. It’s worth the trip from all over the city. They also have this little note about how many calories you burn walking:

We are often asked about calories burned while running or walking. The number of calories is directly proportional to your weight. In round numbers, a person weighing 100 pounds will burn 67 calories per mile. If you weigh 190 you will burn 128 calories per mile. These numbers are for walking, and running tends to be slightly higher. As with any transportation system (and our bodies ARE, in fact, a transportation system) the issue is moving weight over distance, so the more you weigh, the more you will burn in moving that weight.

The best site I’ve found for walking is www.thewalkingsite.com. They outline an excellent walking program for beginners. They have a wonderful forum as well where you can check in to ask any questions that you have.

Lastly, I haven’t tried Nordic Walking yet. But I understand from people who have that it makes walking easier particularly for people who are heavy. The poles engage your entire body so you burn more calories, and they help move the impact of weight away from hips, knees and ankles - in other words, less pain. Good deal. Here’s what the Nordic Walking Online Site has to say about weight loss using Nordic Walking Poles:

Nordic walking is also great for weight loss. By using the Nordic walking poles, you increase your heart rate on average 10-15% more than normal walking. This means you can burn up to 450 calories per hour, much more than normal walking, which only burns approximately 280.

Now, the numbers there are less optimistic than the numbers from The Walking Site. But I do know that with the Nordic Walking Poles, so much more of your body is engaged - arms, back and abs - that it will inevitably burn more calories while protecting your joints from trauma. Here’s what Tom Rutlin, who more or less invented it as an exercise form has to say about the benefits:

* Strengthen abdominal, back, arm, shoulder, chest, leg and all “core” muscles (without separate weight or resistance training!)
* Burn 25-50% (and up to 70%!) more calories with each step
* Improve both “cardio” and vascular fitness
* Increase overall stamina and muscle endurance
* Improve lymph system function and boost your immune system
* Reduce pain and injury-causing stress on hips, knees and feet Help maintain overall bone density
* Maintain joint health and range of motion Improve both your posture and balance
* Enhance both your energy and mood Experience a truly fun and convenient “good use” total body exercise

When you first start walking, don’t fret. If you get out of breath after ten feet, that’s okay - just stop. Catch your breath. Walk another ten feet. And then another ten. If that’s all you can do, turn around and go home. Just make sure you do it the next day as well. The point is that you don’t have to be a marathon walker the first day out. Once you get to the point where you can walk a couple blocks and back again comfortably, you’re going to feel a lot different about starting your walking program. And maybe, if you’re too self-conscious, you don’t think of it as a program until you’re that far along. That’s okay too. Whatever you do, don’t let “shoulds” intimidate you. The only thing you should do is get out and walk and get a little fresh air.

Here are a couple more Nordic Walking Links:
http://walking.about.com/cs/poles/a/nordicwalking.htm
http://www.skiwalking.com/index.asp
http://www.fittrek.com/weightloss.htm

I know you didn’t come here to hear about exercising. But I figure that if I can lose eight to ten more pounds per month, that’s something I want to know about and I’m betting you do too. At least, I want you to have the option.

UPDATE Claire Walter, a Colorado based writer, provides a link to her website with a really fantastic story about two obese women who are using Nordic Walking to lose weight and are seeing their blood pressure and other vitals returning to healthier norms.

Elizabeth Foote, one of the two Nordic Walkers, told KSL, “The first time I did this I went out three times. My blood sugar dropped 20 points. So that got my attention. The fact my knees didn’t hurt got my attention. I could breathe and talk while I did this and that got my attention.”

If you’re interested in reading more about Nordic Walking, check this out!

And the link to the home page ofClaire Walter’s Nordic Walking site as well.

Thanks, Claire!

Dental Insurrection.

I have a tooth that feels its not getting enough attention and has moved to assert it’s nerve-based primacy in my life. Blogging has been, and will be, slow for another few days. My apologies.