GregNE

My fills typically only last a couple of weeks, then the band seems to loosen up again, even though no fluid loss occurs. Ah the wonderful mysteries of the band.

They normally ask you to stay on full liquids for 3 days after your first fill.

For a first fill, either fill doctor will do great. Both Dr. Romero and Dr. Acosta are very competent with routine fills. I have a preference for Dr. Romero when a person with a VG band needs a fill over 7cc. This is usually around a 3rd or 4th fill, so you will be fine with either doc doing your first.

I am pretty much in agreement about Dr. Acosta. During my negative experience with him, he implied that I must be eating lots of cream soups, ice cream, milk shakes, and sweets. I do have a clam chowder perhaps every 8 weeks or so, occasionally have a no sugar added 'Slim-a-Bear' item (I am diabetic), and my last milk shake was about 3 years ago. Sweets? My blood sugars are under better control in the last year than ever. And, his closing remarks were that I needed to take further steps to lose weight. The band would not do it for me. Now, I still have no regrets, as I am thinner and healthier than a year ago, I do eat less, and I do get some restriction. However, my original expectations have changed. I advised Dr. Romero that Dr. Acosta was too inexperienced to be doing VG band fills, to which he responded "I know." I do not question the medical qualifications of doctors in Mexico. I do think that OCC needs to give Dr. Acosta some more training with Dr. Romero. I hope they take notice of this. It is an issue for us.

Why would he not do the fill? Did they bring in a Dr. that would do the fill? I had that problem with Dr. Acosta a couple of fills ago. He said that my stoma would be occluded (closed off) if he put any more saline in. Well, I challenged him, we tested it by me eating a couple of pieces of toast, and then Dr. Romero took over. Not only did the toast not get stuck, it actually had passed through into the full stomach within 15 minutes. He then added some fill for me.

Laparoscopic placement of an adjustable gastric band (Lap-Band), (CPT 43770) which is a silicone implant in the shape of a ring, with an adjustable balloon. The band is placed just below the esophago-gastric junction, and the balloon is connected to a reservoir under the skin. The degree of gastric restriction can be adjusted by accessing the reservoir through the skin and adding or removing saline (CPT 90772 or HCPCS S2083). Just Yahoo! CPT codes lap band---many sources show up

No, it is not OK. Six NA beers in one sitting is wrong. Its like driving miles to get a coffee fix with decaf. He should be drinking real beers, like Sam Adams. Or 6 hard liquor drinks at a sitting would seem appropriate. LOL-- just kidding (even though I don't 'get' the NA beer thing) Carbonated beverages should be avoided for at least 6 months after band placement to cut slippage risk. I know many bandsters do ignore that rule though.

Just to let everyone following this series of articles that there are updates and here is the latest. Beachy Keen Just some observations about the man's ongoing success: Daily caloric intake is 800 calories Meals are one cup or less He is not allowed bread, pasta, and sugar beverages (keeps low-carb) He is in a formal exercise program at a gym with a personal trainer His fifth fill put him at 10cc in a VG Band

So they specifically exclude bariatric surgery, but are agreeing to reimburse? Odd, but congratulations! I have UHC Choice PPO. All obesity surgery excluded including for morbid obesity. Non-emergent care received outside of the US is also not covered. I see no upshot in filing. In fact, I am a bit worried that if they knew I had the surgery, they would exclude complications from WLS. But, again, congrats to all that have been able to get some reimbursement!

I actually have been doing medium paced 10-12 minute walks 6-8 times daily for the past 2 months or so. Perhaps I should up my times to 15 minutes.

I do not have loads of cash, nor do I keep cash around the house. However, I was able to pay for the surgery out of my available funds. I had to save for many months for the surgery and to restore my emergency fund (anyone else listen to Dave Ramsey?). Prior posts discussed cost per pound, and discussed whether one would recommend spending the money on banding to a friend. I was merely providing my 'two cents' regarding the financial issues. I did not mean to offend anybody. I rely on my paycheck every week just as most of us do. Why go to Mexico for the surgery? Because the doctor that did my surgery was one of the most experienced and competent surgeons in the world, and happens to practice in Tijuana. And, having surgery 'down the street' would have financially strained me. Why pay double or triple the price for an amateur, when a pro was available for a price I could manage. And thank you for the reminder- I do need to put more effort into allowing the band to assist me with my weight loss. I need to learn to use this tool to the best of my ability. It is not that easy-- it does take work. Your point is well taken.

I prefer the experience of Dr. Romero. Having Dr. Acosta tell me I was totally occluded, only to have two pieces of toast quickly find the way through the band, left me a bit wary of his skills. You found Dr. Romero close-lipped, but he has always given me feedback, and he has taught me a lot about working with the band. Yes....I want to know if I need to do more to accomplish my weight loss as well. Dr. Acosta offered me no such information. He merely verbalized a list of untrue assumptions to me. I know what I need to do to accomplish my weight loss: eat less and exercise more. I have known that for 20 years, but never have been able to implement it. The band offers me a chance to eat less. It is nitpicky. Opinions and desires are not mutually exclusive. Is your objective to debate just for the sake of debate? I have a close friend that does the same thing, and I have been known to do it as well. It can be quite entertaining. Having an antagonist offers a refreshing twist on this forum. That is a safe assumption. I have a long history of not opting for efficient weight loss options. Now 'rah-rah sisters'- that is quite funny. Good to see you have humorous side. I have been in Orlando, Naples, Tampa, St. Petersburg, Talahassee, NYC, Hartford, Washington DC, Houston, Dallas, Austin, Salt Lake City, Las Vegas, Richmond, Greensboro, Charlotte, Omaha, Oklahoma City, Virginia Beach, and San Diego in the last 90 days. The world is a big place, and I visit many places in this country every year. And yes, San Diego/TJ is still a desirable destination for me. Just my opinion (or desire?) This statement is contrary to much of my life experience. I would say the longer an endeavor takes, the higher chance of success. Tenacity tends to bring results. Examples are building wealth, the fall of communism, the goal of putting a man on the moon, etc, etc. I guess I have not seen these 'thousands of studies', but I have seen hundreds of accounts of tenacious individuals reaching goals by not giving up. I agree that many people may lose interest. I am, however, obese. I will never lose interest in getting my band properly adjusted to work towards my goal. Getting fat was a long journey, so I fully expect losing substantial weight will not happen quickly either. We all desire a magic wand, but there is not one. The longer one works towards a goal, the higher the chance for success.

I do not disagree with NoWorry's position that he was not informed about the need for regular fills. He read Dr. Ortiz' book (I never have) prior to being banded. He also used information published on the OCC website. He is absolutely correct in his observation that the need for 4-5+ fills for a VG band is not discussed. And my understanding is that in the Ortiz book, it is stated 1/3 of people get restriction with no fill, 1/3 with 1 fill, and 1/3 after 2 fills. That may be the norm with the smaller bands, but not with the VG band. I can understand the source of his frustration.

Interesting seeing someone ask and discuss the more difficult questions. Some random ramblings: I am of the opinion, as several others, that the band should being doing most of the work. Yes, I am required to make certain changes to accomodate the band, but if I was able to diet properly, I would not have a need for the band. This really bothered me when Dr. Acosta did my last fill. Seeing my modest weight loss, he said, "Aren't you doing anything to lose more weight? (duh....I got banded to lose weight- you see the band on the flouro, right?) Do you eat lots of soup? (not lots, but I do like chicken noodle) Do you like rich creamy soup? (yes, as a matter of fact I have a cup of clam chowder about once a month or so) Are you eating lots of sweets and ice cream? (no, I am diabetic....is Spenda in my glass of iced tea a 'sweet'?) You can't just wait for the band to take your weight off. (hmm...should I try a cocaine or methamphetimine binge instead?) Needless to say, I don't yet have a high opinion of Dr. Acosta. And I have many frustrations with the band. But, bottom line, I began at 383 lbs one year ago, and I now am down about 50 lbs. Without being banded, I would weigh between 380 and 400 right now. I was eating too much. I can still eat too much, but it is rare, difficult, and time consuming. Is it worth the money? Well since I had a large amount of cash sitting around, thus far it has been worth it. I have more energy and I can be on my feet all day without hobbling around on sore feet. Would I have borrowed the money for the surgery? Probably not. I know many bandsters get loans for the surgery. I would be much more disappointed had I borrowed the money. Since the $10000 was rather inconsequential to me, I think my view is different. I know banding is a much larger financial strain for many. I do not have that extra stress factor. I knew before surgery that I would probably need 4 or 5 fills to get sustained restriction. I read enough experiences to have that expectation. I have made 3 fill trips, and need another. Another mini-vacation to San Diego is not such a bad thing. This is a two year or longer journey for me. No hurry.

Multiple fills are indeed the norm for the VG band. The 4.0 cc bands generally require less fills. Of course there are always exceptions for both bands. Fortunately, I knew about the need for frequent fills prior to surgery. I am extremely reluctant to even consider a fill from anywhere other than the OCC. Although I have no personal experience, the 'lost fluid syndrome' worries me. Many fill reports from the USA talk about bands leaking. It has almost become a normal expectation to some bandsters. However it is not normal. According to Dr. Romero, the bands are very unlikely to leak, and the loss of fluid is due mostly to incorrect port needle insertion or withdrawl. And the stats correlate this. I have seen very few (if any) reports of fluid loss from OCC fills, but many from other fill providers. Dealing with fill frustration is something I can live with; worrying about incorrect fill technique is something I do not want to deal with. Not that all other fill providers are bad-- but many are. Just my opinion.

that makes sense......summer baseball camps, vacations, sea world

I had a lack of restriction as well, but what the band seemed to help me do was to not gain weight back. Holding steady was much better than gaining. Several of us have posted about the great difficulty in keeping the pre-op weight off with the VG band. I knew before my surgery that this difficult time would be coming. One male bandster even decided before surgery that he would stay on only liquids until his first fill, and he did. I had some 'last chance syndrome' pre-op, but believe me, with the VG you will have endless opportunities to eat your favorite meals. The first fill in a VG will offer a little restriction, but by dinner time, if you chew very well, you will be able to eat anything. You will most likely be able to enjoy your favorite foods for the forseeable future. And even with restriction, you can eat almost all your favorites....just much smaller amounts. Fill #1 is really going to be almost a non-event. Do not make the mistake of thinking your first fill will offer any restriction. With the VG band, look towards your third or fourth fill as your turning point. I wish you had read some of my old posts. There is more frustration coming your way before your band really gets jump started. Be patient....very patient.

For a Holiday Inn, that rate seems an appropriate value. I have learned SD, like many areas, is a pretty high rent area in the summer. Other warm weather locations experience a mini 'off-season' during the hotter months, but a few buck the trend.

I had some sensitivity problems too, but only while the light was on my mouth. It disappeared right after. But, if sensitivity causes you tooth pain, you are right to think twice about it. The minor discomfort I had was directly in the nerve of one tooth. I have the trays from my regular dentist, but I was not good at keeping a schedule to use them. They may become my once or twice a month booster though.

Do San Diego rooms go up that much in price during the summer? I get my room at Super8 for free (using points), but in January the rooms were going for $44 per night, and now are about $72. Travelodges normally are under $60, but if you paid about the same as the Lucerna at $85.....thats a pretty stiff rate for that brand. HoJo in National City had a rate of $129 listed, which is real high for that chain. I don't know the hotel market in San Diego, but it sure isn't the value it was during the winter.

Well, it has been almost a week (filled June 11), so thought I would give a report on my latest fill at OCC. I needed a fill for a couple of months, so was anxious to get it done. I drove from Omaha, made a business stop in Salt Lake City, and then went on to Las Vegas. Harrah's gave me a comp coupon for 4 free nights at Ballys, and another coupon to get $100 cash from the casino, so I took them up on the offer. I needed a few days to myself after a nine week stint working on the East Coast. I ended up losing $90 of the $100 by the fourth day, so, I was able to leave Vegas in good spirits. I have been staying in National City at the Super 8 for all my fills, parking at the border, and doing the walk across then a taxi. Well, this time I was daydreaming, and missed the parking exit. It is truly the last US exit, and to my knowledge if you miss that exit, there is no proper way to turn around and avoid crossing the border (I might be wrong about that). So, I figured, I can drive into TJ, and did. I did not know the way to the clinic, because I never really paid it much mind, so I spent about 20 minutes looking for the building. Finally, I saw the Lucerna, and stopped to ask directions. They were very helpful, and gave me a map of TJ and circled the location. Once I had the map, I realized I had driven past it 3 times, but, now I know where it is. I found a parking spot just a few hundred feet from the clinic, locked up, and went in. I had a 10am appt, but was told Dr. Romero was on his way. I talked with several patients waiting to be called back for their surgery, offered my encouragement, and socialized. Well, Dr. Acosta came out and said he would be doing my fill. I mildly expressed my concern, as I felt Dr. Romero's experience was invaluable, but I was okay with Acosta. He was very cautious, verified I had 6.6 cc, and filled me to 7.0. He told me my band was totally occluded (closed) at 7.0, and backed me down to 6.8. I told him I wanted a more aggressive fill, and he went into a discussion about complications of being closed off and facing a risk of frequent PBing and possible slippage. I expressed to him my concern that I just traveled about 2000 miles, and wanted to make sure I had good restriction. We agreed to do the 'toast' test, with a barium study right after I tried to eat the toast. He filled me back to 7.2cc, and went to get my snack. Well, 4 pieces went down with no problem. To my surprise, Dr. Romero came out, and said "are you ready to take a look?" I was very relieved. He had me drink the barium, and we found out not only did I eat the toast easily, but it also had already made it past the band. Dr. Romero asked if I could stay in TJ for a few hours, and have lunch. I agreed, and he filled me to 7.9cc. Well, I saw the Zoom teeth whitening special, and asked if the dentist was busy today. She wasn't, and I got right in. Well, I have white teeth now, actually 8 shades whiter than before. I am blessed with very good perfectly straight teeth, so it's great to have that Hollywood smile now. The price was $299, and I got a free cleaning too since Zoom recommends getting the procedure done after a cleaning. The going price in my city is $700-$800, so I got a bargain, and they did a great job! It took about 2 hours, and was a little uncomfortable, but instant results sure make it worth it. I then went to lunch around the corner from the clinic. I decided to try the tuna salad served on lettuce, as I could not have any tomato sauce or other foods that can stain teeth for 48 hours. The whitening process makes the enamel susceptible to staining for a couple of days, and I was clearly warned. I was able to eat about 1/2 cup, then pb'd part of the meal. I returned to the clinic as asked, and got my third needle poke of the day. Dr. Romero decided to take my level down to 7.6cc, and that is about perfect right now. I have good restriction, and actually have dropped 10 lbs in the last 6 days. I drove to Austin, TX for a business stop, then to Dallas, then to Oklahoma City, and finally home. I told Dr. Romero that Dr. Acosta needs a little more practice with fills, and he replied "I know". Now, Acosta is doing fine in my opinion. He already has done more fills than many US doctors, and he is cautious, has the right technique so he doesn't lose the saline like most US doctors do. But in my case, a third fill with a VG band is a bit tricky. I needed the experience of Romero, and perhaps Dr. Acosta also needed that experience. I would have no concern getting a first fill from him, or a fill in a 4cc band. And, to repeat myself, he already has more fill experience than most US docs. I know this is a very long post, but I have gotten quite a few private messages from people telling me they like reading the details I provide, and that they learn a lot from what I write about. So, for those that enjoy lots of detail, here it is. If you don't like detail, at least I don't post topics very often. Best wishes to all.

OCC gives you 4 sublingual Toradols. They do not give narcotics, as narcs tend to induce vomiting, which increases the risk of a slip, especially immediately after surgery. I was not given any script for liquid pain killer. When they refer to liquid pain killer, they usually are talking about liquid Tylenol. After only getting 4 Toradols, I promptly went to the aforementioned pharmacy, and purchased 16 more. I discovered, however, that the 4 tablets were sufficient for me. I had little to no post-op pain.

Tylenol (acetaminophen) is allowed.

I knew I was most likely going to get the VG Band prior to going to TJ for surgery. The most convincing testimonials are those you get when you are in the OCC office, and see and talk to patients that have lost their weight. I have seen women with great bodies (yes, I look a lot) that are very happy with Dr. Ortiz work. They are often there for a slight unfill. I would estimate only 5% of OCC's patients post here, and yes, we are almost all 'in process' of losing our weight. I have been to lapbandtalk, and yes, there are many positive testimonials there, as well as many negative ones. Just by sheer strength of numbers, there seem to be many posters there with both bands that have reached their goal, but continue to hang around. Finally, the band is an effective tool for weight loss. It is how you use this tool, and your ability to use it properly, that determines the outcome of your experience.

Across from the Lucerna is a pharmacy called 'Farmacia Especiales' or similar. Dr. Martinez vouched for the reputation of this business to me. Their prices are good, a discount given for cash, and the meds are authentic and real. Be warned, purchasing controlled substances (addictive meds) in Mexico is illegal without a script. However, Toradol, which is a totally acceptible and effective non-narcotic pain reliever is available. I also like to purchase antibiotics (Bactrim, Cipro, Amox, Azithromycin, etc.) in Mexico. I have crossed the border many times with these meds. I have heard also that crossing with 50 or less doses of a controlled substance is allowed by Customs. Some states have laws against this, but Border Agents are Federal officers, and do not enforce state law. I have read that some pharmacies have an 'affiliated' doc on the premises that will give you a script for controlled drugs for a small fee. I have no idea which pharmacies may have this arrangement. Hope this helps.