A Visit to the Surgeon

I finally called, made the appointment and went in to have a little chat and possible fill with my surgeon.  I am going to bullet this because it is a bunch of random stuff.

• His nurse practitioner is out on maternity leave.  He only has office hours on Tuesday! WTF?  The rest of the week he is doing surgery.  My question is...how the heck can proper follow up happen with that sparse of a followup schedule?  Of course he had no one in the office when I went in so perhaps he is not doing much of anything or doing a lot of researchy kinds of stuff???
• we talked about my weight gain.  He discussed the fact that over time I might get smarter at eating around the band (duh I know).  He said that he didn't want me to develop an pouch in my esoph.  I asked him how I would know..he said that the biggest sign would be reflux that was not acidic.  Well thus far any reflux I experience is definitely acidy..so..I guess I am good there.  
• He gave me a 0.2cc fill.  I had all of my 7cc's in the band still so no leak.   It really had little effect when I drank my post fill water but I can feel a little difference this week.  
• Down 2 pounds so far.
• We talked about the sleeve.  He says research is finding that that band seems to work best for patients who learn to listen to another kind of satisfied (not the brain kind but the feel of their food in the pouch).  He said that the sleeve seems to work much like bypass surgery in that the food empties from the sleeve-like stomach faster than it would have with a big one.  The food then more quickly triggers nerve endings that send a message to the brain for satiety.  From what I gathered this means that thus far the sleeve shows promising results much like that of a bypass but without the nutritional issues.
• He definitely said that I am a successful band patient and that whether I carry these extra 20 pound or not I should work hard to keep my band and work hard at avoiding 'packing' food in.
• He said that if I feel the need for another fill he will first schedule an upper GI to make sure I do not have problems before doing another fill.
• The difference:  I have dropped back to tall coffees and also drinking tea at home.  No ice-cream cravings so far.  My meal sizes are similar but I stay satisfied much longer.
• Still a struggle:  Eating in the evening.  On evenings where I don't take the time for dinner (night classes or group nights)  I pay because I come upstairs at 9pm or later and forage for food.  It has not been ice cream but even a cracker or two, cheese etc.  sits in my stoma for a while and then I have to wait quite late before going to bed or pay with reflux.  

xxxooo