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Saturday, July 11, 2009

Band Thoughts

Today I was surprised and pleased to see MSNBC.com post an article about The End of Overeating, the book I just finished reading by Dr. David Kessler. Looks like he is getting some good press.

This weekend I am taking a class for my program called Law and Medicine. It is 3 days, 8 hours each day. This year because of scheduling conflicts, our last day of class is tomorrow, which is Sunday. We're pretty unhappy about that. The class is useful, but long and not terribly dynamic. Our instructor was the first CRNA in the country to earn her JD, and is very knowledgable about the subject. Amazingly, my program is the only one in the country that includes a class on law and medicine in the curriculum. Our final class will focus on how to read and negotiate an employment contract.

We get a make-up day off on Thursday, but that's not the same. Today I did a little reading, went to the gym, and spent the evening at Riverside State Park, hiking and cautiously playing in the river, which is notoriously dangerous. I stuck to parts that seemed still, avoided the current, and stayed by the bank. The park is huge and I drove out much further into it than I have before. It's such a beautiful park, I hope to have time this summer to play in it some more. My legs are tired, in a good way, from my run and from several miles of trekking.

I finally made an appointment with my new band surgeon for later this month. I will probably have to reschedule it but at least I'm on the books. Interestingly, this summer we start going on "field trips" to small CRNA-only practices in the area, and one of the places we go is the surgery center where my band surgeon operates. So once I find out when I am scheduled to go there, I'm going to see if I can schedule my appointment for the same day, for the sake of convenience. I didn't have surgery there; I had surgery in Portland, at a hospital that only has anesthesiologists (like most in Portland). But it's cool that this surgeon works exclusively with CRNAs. Anyway, I need to see the surgeon and probably need a fill. I just can't decide. I haven't been seen for my band in a long time, over a year, so I should go in anyway. I weigh about 2 pounds less than I did a year ago. I want to lose about 20 more.

At just under 2.5 years post-op, I'm a little frustrated, either with the band or with myself. I do believe that getting control of the psychological issues of weight loss are key to getting to goal for me, and would be no matter what surgery I had had. Perhaps if I had done something really major, like duodenal switch, I would have gotten to goal pretty definitively, but then I think maintenance might have been an issue, not to mention the issues associated with long-term malabsorption. But if I had it to do over again, I would probably have the sleeve gastrectomy. I have already decided that if I ever needed a revision or re-op due to a problem with the band, I would have the VSG. Why? It works like the band, but nothing needs adjusting, and there's nothing to slip. No wringing of hands trying to figure out if you need a fill or not, no convincing a provider that you really do need one. Yes, the initial attractiveness of the band was that it can be removed if necessary, and there was no permanent rearrangement of my anatomy. But, I dunno, there's just a lot to be said for having that angst taken out of the picture. I guess you have staple lines that could potentially leak, but I've seen this surgery done, and the staple lines created by the tools they use today are pretty solid, 3 rows of tiny staples. With a good surgeon, leaks are extremely rare. Any other post-op lap banders have this thought ever?

That's not to say that I haven't been happy with my band. It has served me well as the tool it was intended to be. At the time I had surgery, I wouldn't have considered amputating my stomach. Now I think it isn't as big a deal. But at the same time, since hunger isn't really the issue with me, it might not make a bit of difference, except that I wouldn't have to worry about fills or whether I have insurance to pay for them. I'd just have a smaller stomach with no moving parts. I could still eat ice cream and milkshakes and other things that would go right through. It wouldn't be any guarantee that I would be at goal now, or that I wouldn't regain.

I don't know. I wouldn't call it buyer's remorse. I'm not sorry I was banded, and I'm glad I've lost 60 lbs. (65 on a good day.) I have work to do on my eating, and thankfully, my band has helped me stay around the same weight for a year--but I am frustrated that I'm not getting any more headway in the direction I want to go. It's still a lot of work. Getting rid of hunger is only the first step, the thing that allows you to do the rest of the (much harder) work of controlling weight for life. It's still a work in progress.

1 comment:

Inspiration said...

Gwen, Have you tapped into my mind?! I too have thought about "I should just have done gastric bypass" or something else that would have definitely gotten me to my goal weight. I even said this to my PCP Dr today and he said that lapband is the most effective long term for not gaining the weight back. He might not know about the sleeve though. I don't know much about the sleeve, but I have a friend who only lost 20 lbs with the lapband and she tells me that she wishes she got the sleeve.
I am tired of not ever getting back to restriction, my weight loss has stalled and the only way I am losing weight is that I am really trying (might as not well have the band, its not helping). Also, the aftercare is horrible. They won't do a fill, they say I'm not eating right if I eat more than 4 oz. Its a joke. Sorry to vent, but I hear your frustration. HUA!