Okay, so Jarom had his phone interview with the Dept. of Fish and Game or is Fish and WIldlife?? Anyway, he had the phone interveiw this week and this afternoon he called to tell me that they wanted to do a face-to-face interview with him next week. We leave on Thursday to go to Prineville for Jenna's graduation. We will be there until Sunday morning when we will head to my parents' house in Troutdale. Jarom will have his interview Monday and then we will head straight home. We would stay longer if we could, but I have my surgery orientation on Tuesday in San Francisco at 7:30am.

I was going to work on my resume this afternoon and start submitting to companies for jobs, too, but I'm going to wait a couple weeks to see what happens. The same goes with unpacking this house. I'm not going to unpack another box. This has all happened so fast, which quite different from how the government usually works. It was just a couple weeks ago that he applied for the job and found out he was selected for an interview. This week was the phone interview and next week is the face-to-face interview. And, Jarom told them that if they offer him the job he would be ready to start in two weeks after giving his notice.

I'm trying not to get my hopes up because I don't want to end up in another dark pit struggling to climb my way out. It is really hard, though, to not think that we could be home soon and not get excited about it. I guess we all will have to wait and see what happens.

We are still working on trying ot get unpacked. I'm lacking motivation to do it. I think...no, I know it is because of this job in Portland that Jarom applied for. He had his phone interview on Wednesday and it sounds likely that they will set up an onsite interview too. My problem with unpacking is why should I bother if we may not be here very much longer. I'm trying not to get my hopes up about it, but at the same time I can't stand the thought of having to pack again in 6 months or less; but we won't know until they make thier selection.

On another note, I have to call and make my next appointment with the therapist next week for mid-June. I'm hoping I can get back to work. In fact, I have even been looking for jobs to apply for. I'm going to be a bit choosy-there are quite a few out there. I don't want to just settle this time. I want something I will enjoy and that I can use my creativity with. I want to be able to take my vacation whenever I want. I don't want to work Saturdays or have to travel really far. I want something fun and challenging and creative.

Since we have moved back here, to Elk Grove, I feel lighter and happier. I'm still struggling with the motivation a bit, but that is when it comes to the house and unpacking. However, in other areas, my motivation and happiness has improved. I have been smiling more and I feel better. Gus and Miss have adjusted quite well as have Hope and Minnie.

Please be patient with me as I add some of my elements back to my page. I lost my pictures, Meez and Friends when I updated my profile with a custom layout. I wanted to something other than what was offered by blogspot and in order to get it to take I lost everything except my posts. It will take a day or two to get everything back up and online.

Yeah, so I didn't get any pictures hung today. What a dissapointment. I did get my table at Target that I wanted and the floor lamp. The table is little scratched up and knicked, but I'm currently searching for a small lace tablecloth that will go over the top to cover that all up. I looked today, but couldn't find anything. There were only two of the floor lamps left, so we grabbed both of them.

Our guest bathroom upstairs is a complete guest bathroom. Of course there are towels, but today we picked up some of the essentials that guests may need but not pack because of airline restrictions or whatever reason. I filled the top drawer with disposable razor for him and her, shaving cream for him and her, tooth brushes, toothpaste (Crest and Auquafresh) and dental floss. I have a couple combs and hair brushes to put in there too, but I have to unpack them. The guest bathroom is decorated nicely too, with some mosaic glass candle holders with votives and some bathroom containers to hold cotton balls and Q-tips. The really pretty brown and blue trays Nicole got me last year for graduation is in there too and they look really good and match quite well. I just want to find a couple pieces of art to match and put on the walls. For now, it looks really good-even if I say so myself.

The remainder of the day, with the exception of a little nap in the middle, was spent finishing up the last of my Astronolgy homework. I had a final due and chapter questions. I learned a lot and I enjoyed the class, but I will not miss it. I may have enjoyed it a lot more had I had the actual text book. Instead, I had to wing it, using the online version, which is just tutorials and exercises, not chapter to actually read. It made it really hard. I ordered the book fut I never received it. I ordered it on Amazon because I could get it for half of what the school bookstore wanted for it. This was the first time I have ever had trouble with a seller on Amazon. I emailed the seller and told him I had not recieved the book and that I was wondering what happened. Two weeks later and there was no response. I put a claim into Amazon and told them what happened, and hopefully my refund will be back in our account by the end of the week. Needless, to say I had to wing it with the internet and the online version. That God for the World Wide Web.

Tomorrow, i start my last class a mythology class. Since I only needed two electives to finish I decided I wanted something fun and out of the realmof business. I really wanted a creative writing class, but they don't have any of those, just business writing. I was shocked to find out about the Astrology and Mythology classes and had my counselor book them right away. My mythology book was only $20, thank goodness; and I got it before we even moved. That is so much better than the $120 they wanted for my astrology book. I have a small 700 word essay to write tomorrow and about 20 pages to read. Actually the paper probably isn't due until later this week, but I thought I'd just get it done and out of the way, so I could focus on the house this week with exception to having to post to the class forum four days this week for participation credit.

It is late and I am catching up on my few shows from today. Plus, I need to make the chicken salad and get a lunch together for my hubby.

Now that I have completed my

Things still a little slow, getting everything situated, but we are getting there. Yesterday, we pretty much were about town, getting items at JoAnn's for one of the two quilts I need to get done for gifts. Once I have those done I have to get an afghan done, too. We picked up some new items for the house too:table lamps, knife set, bathroom accessories, small computer desk, and some soap from Bath and Body.

Today, we are actually going back to Target to pick up a table on clearance that I didn't want yesterday, but want now, and to get a floor lamp that is on sale for $8.00, too. These will go into our guest bedroom. We decided that we are going to hang our pictures this afternoon. I think once we get those hung, things will start to come together better and quicker. Most of the large items are placed, but there are still a couple things in the garage furniture wise that we need to move inside, we just wanted to get other things set and cleared.

I, personally, have a few other things that I need to get done. I have a final exam due for my Astronomy class, plus chapter questions and a final weekly summary. I thought since I was up so early, I get caught up on a few things and then get all of that started and posted to my classroom.

The animals seem to be adjusting well. Hope and Minnie run up and down the stairs, down the hall around the rooms and all over again, chasing each other in the process. At one minute one is chasing the other and then the next is the opposite. Gus just goes with the flow, as he always does. He came to terms with no problem at all being stuck downstairs and only whines when we leave. Miss follows us all over. Up and down the stairs, room to room-she is there.

Jarom had a lot of help on Saturday from a friend bringing over some of the items that were left behind. The truck we had last week wasn't packed very well and many things were left behind. We have one more trip to make to get my craft room closet contents, which for the most part is in boxes and will be pretty easy to move; and the remaining contents of our garage.

I fixed Mike and Gina dinner for all their help. It was quite yummy. I picked up some steaks that Jarom bbq'd and I found a yummy looking fruit salad in the produce section, plus fresh corn on the cobs and salad. For dessert we had chocolate silk pie.

I'm, obviously, back on my feet, but I'm still having some trouble with my ankle. At the end of the day, it is really sore and I have had Jarom start wrapping it again for me for a while. For, now I need to get to m homework. I've been up two hours and I still haven't started it, yet.

We had so many people come to both houses to help us move on Saturday. We do still have to go back for some things, but that is okay. We figured we would. There were just some things we didn't get to pack, like my pantry, so our food is limited to the few things that were in the kitchen cabinets and the freezer and fridge.

We have been,or tather, Jarom has been unpacking. The reason he is doing most of it himself is because I sprained my ankle yesterday running up the stairs. I missed a stair, fell, twisted and fell on my left ankle. I feel quite dorky and dumb about it. :o) He did bring me a box to unpack my crystal to put in the wet bar cabinet, this afternoon, while we watched Transformers. Hopefully just a couple more days and I will be back on my feet unpacking and getting things where I want them-even if it means moving some of the things Jarom put away.

I did get the kitchen mostly unpacked with Gina's help on Satruday. I think I'm going to have to purge some of my cooking/baking dishes. This kitchen is quite small and doesn't have anywhere near the space I had at our old house. I just don't understand. This house is huge and the kitchen is tiny. The kitchen is one of the most important things in the house and most women's dreams are to have a big kitchen with plenty of storage. Oh well, i 'll adjust, there is plenty of room averywhere else.

So here is our game plan for the house. Our breakfast nook is a good size so we are going to use that as the dining room. Even with the leafe in our tabel there will be plenty of space to move around it. Since, I don't have formal dining room furniture, although I would like some with a hutch, I told Jarom that he could use the formal dining room for the pool table. We will use our tall little patio table and its two stools in there to sit and plac eour drinks and snacks on. Last Christmas, I bought him the collection of 5 pictures of the pool hall dogs and some frames for them and they will go on the hall. We are also going to replace the light with one of our ceiling fans. The living room will be our living room with the TV and home theatre. The family room will be the sitting room with my two oversized chairs and possibly Jarom desktop and our printer. You will learn why it *possibly* may be homed there soon.

Upstairs are the bedrooms and two full baths. Both baths have double sinks. Can you believe that!?! (there is a half bath downstairs). Anyway, there is our master suite with two closets, one is a walk-in, and so much room, even room for a bassinet should we get pregnant. The bathroom, oh my gosh, it is incredible with a garden tub, and a seperate shower that could actually fit four or five people in it. I can't wait to find all my stuff and decorate. Bedroom 2 will be my craft room and it has a small walk-in closet for my craft stuff and small filing cabinet. Bedroom 3 is going to be Jarom's computer room as it stand now, but it Jenna decides that she would like to go to school here, that will be here room. Bedroom 3 and 4 are teh same size and bedroom 1 is slightly smaller. Bedroom three is at the opposite end of the hall from our room, on the right side and therefore would give her more privacy. And having that as his computer room is easier to move than my craft stuff. Bedroom 4 is our guest bedroom at the end of the hall next to Bedroom 3 and would allow our guests a little privacy. I have my linen closet again in the hall upstairs. I'm very excited about that too. I've missed that. Our stairs are very cool with three landings between three and four sets of stars and kind of form a c shape with straight lines. I could see some great family/generation pictures going on here, or our daughter's prom or wedding-watching her descend those stairs. Oh my dreams! :o)

As far as the three car garage goes, I believe once we get things unpacked and cleared out we will park both cars on the one side. On the opposite side for a third car we will have Jarom's work table and tools and anything else that will be stored.

Contrary to our very tiny front yard is the our huge backyard. The picture does not do it justice in my last post. We have a lot of mature trees that rpovide plenty of shade. A couple of crab apple trees and Jarom found a cherry tree this morning. He has been watering our dirt since we got here, trying to moisten it up to work with and eventually we will put down some grass seed. The patio is quite large with only 1/3 of it covered with the lattice and I have some morning glory seeds that I can plant and once they start to grow and climb-that lattice will be stunning! The bushed out front will be getting a makeover, and not a trim by any means. I will have to give them a buzz cut. My planters will look great our front and in the back on the patio, too, with all their flowers and foliage. The driveway, will get its weeds wiped out too. I will be pulling them out and spraying to make sure they don't come back.

Finally, we have high valted ceilings. Lots of windows, with some close to the ceiling and it lets in a lot of light. This is very different from our house in Olivehurst. We tried to do everything we could to open up that house and bring in the light with the french doors in the front and back and lighter paints, etc. All the light is something I missed once we left the first Elk Grove house to move to the country. I'm loving all this light and the room in the house. I wish you all could see it in person.

Today we got the keys to the house and each of took a load to the house and left the truck there so we don't have to worry about how we are going to get it to the new house. Once we had thre keys we did a walk through to document things that we notice that are not up to par that the agent may have missed. Jarom and I aren't upset about all the stains on the carpet, but we are disturbed by the smell thorughout the house of baby pee, and the hole in the 4th bedroom in the subflooring under the carpet.
Just about everything is packed and ready to go. We will be coming back next weekend to get the remainer of rubbermaid boxes in the craft room closet. We have run out of boxes, so we have to free up some boxes from unpacking in order to get the rest, so the contents of the closet will remain until next week. Everything else is packed and ready to go, except the cats. I'll have to corner them in the morning to put them in their carriers.
I some things that won't go on the moving truck tomorrow and will carry with me in the car, like: china, crystal, laptops, clothes, candles, toilet paper, dogs, cats, kitchen TV and DVD player. That is probably all I can fit in my trunk sine the dogs will be in the back seat in their travel hammock and the cats in the front passenger seat. have a good size trunk but it isn't huge.
The only thing we really aren't looking forward to tomorrow is the 100+ heat, but we have a lot of help so it should go fast-both ways. Why do we always pick the hottest weekends to move?

And we are moving in this Saturday. We will be signing the papers and receiving the keys tomorrow.
It just seems like there is so much to do still to do, but there isn't. I guess it just looks like a lot because of the furniture.

...I'm so tired of it! However, there is only two rooms left--our bedroom and my craft room. We will be purging a lot of stuff once we get into a house. I told Jarom to just pack it all up and as we unpack we are creating two piles: "Donate" or "Dump". Anything we have not used in a year we are purging from our home.
It was nice to have a break tonight, I think Jarom would agree. I was asked to teach an enrichment in card making back in March for this month and that is what I did this evening. This afternoon, i made sure that I had everything together for the evening and created the kits and placed them in plastic ziploc bags for each person. I alos worked on some homework. The break was nice and a recharger. I really think Jarom enjoyed having the night off, to recharge and veg, too. It was quiet and he could have the television to himself without me telling him that I didn't want to watch what he chose.
I will be packing the craft room tomorrow...well, today, since it is already is Thursday. It should be fairly easy going, once I get some things back in their rubbermaid containers. I'll be shredding garbage and old bills too-that will be the most time consuming-the shredding and putting the boxes together.
As far as our bedroom goes, we really just have to pack up our clothes. We will not disassmbling our bed until Saturday morning. I also, need to put all our toiletries in a box and take it in the car with my china so that it stay accessible.
Miss and Gus aren't quite sure what is going on and they get a little spooked with the boxes, but for the most part they sit and watch us or try to sleep amongst us making all the noise. Hope and Minnie stayed hidden, if they can find a place. If they aren't hiding, they are sleeping on our bed. Minnie has been rather loving lately and she hasn't had any accidents lately--that is good. I wake up in the morning and she is cuddled up to me purring and Hope isn't far away. It has been kind of nice. She has not cuddled with me for quite some time. She even lets me pet her for a while without running away from me. I think this little kitty just might me relaxing some.
We still haven't found out about the house, yet. However, it looks very promising because we are not requesting new carpet or linoleum. The carpets, especially upstairs are stained, but our furniture should cover up the majority of those stains. I don't remember too much about the linoleum, except is being a little dated and some cuts. Like the outside landscaping, I can work with that. We should hear tomorrow a definite answer. They were just wainting to hear back from the owner.
On a fun note: we received an email from some friends in Tahoe that have bulldogs. Their two females are almost identical to Gus and Miss. Anyway, Snowball, Miss' twin will be featured in a 2009 calendar. She will be standing in front of a miniature Buckingham Palace in a guards uniform. They sent us pictures of her fitting of her costume. She is just so cute! I can't wait to buy a calendar with her in it--one more famous bully we know.

Can I just remind everyone how much this really SUCKS! You never really know just how much stuff you have accumulated until it is time to move. The sad thing is..we've moved seven times and it doesn't get any eaiser. Each time we have "donation" and "toss" piles, but even after that there is still so much stuff.

This afternoon, I started on the dining room hutch packing my china from mom and dad and my crystal very carefully with bath towels. (I will even be transporting them in my car when we actually move.) In the process, I lost my two Christmas Penguin salt and pepper chakers, but thankfully that was all I lost. I just didn't see the little guys hiding and knocked them right off the shelf.

When Jarom got home, I asked him to get some more paper towels to pack with so he went to fill up the truck and get paper towels. When he returned he helped with the packing of the kitchen, He brought down all my everyday china from the cabinets and put them on the buffet for me to wrap and box. When the buffet was full, he pulled other things from the cupboards-snacks, seasons, tupperware, pots and pans, etc. and packed those up. It was a great help to have him bring all the dishes down and help clear out the cabinets. The kitchen and dining room are done, with exception to my cookbooks. Now, we just need to pack up our room and the craft room.

Tomorrow, I will pack the cookbooks up so that they all stay together and the little trinkets in the living room, and bedrooms that are fragile, and some of my clothes, too. In the evening I have to finish up creating my "kits" for the card workshop for enrichment. Jarom can have an evening to do whatever while I finish up the kits.
Wedensday I will be workign on the craft room. the good thing about that room is once all the garbage is out of there, pretty much everything is already in various sized rubbermaid boxes that I've organized all my craft supplies into. Once we get everything of the floor and desk, it will be very easy to pack. So, I will be working on that on Waednesday afternoon before enrichment. Once that is done, we really just have to finish packing up our room and the bathrooms.

We have doen pretty good getting everything packed. We will create our "donate" and "toss" piles after we move and as we unpack everything. Right now, all I can say to keep me going is "Thank God for iPods and OnDemand. I can listen to movies and sing and dance to my music and that is a huge help in getting me motivated and keeps me on a roll, but if I get interrupted, it is very hard to find my groove again.

Tonight have such sore feet despite wearing my memory foam slippers. My right knee is bothersome and my lower back hurts from standing in one place so much for so long. I started a little jig in the kitchen this evening to keep my feet moving and relieve some pressure and Jarom and the pups looked at me like I was crazy.

This is the house we are trying ot get in Elk Grove. It's just under a mile from the old place a few years ago before we moved to the boonies. It is on the same side of Franklin as the old house. It is a bit bigger at 2100 square feet-four bedrooms, 2.5 baths, living and family rooms, formal dining room, breakfast nook and 3 car garage; and on a cul-de-sac. There is plenty of room for our family to grow here.

It needs a little TLC, but we can work with that. Some grass in the back yard to replace the weeds, trim back the bushes in the front, pull the weeds and clean up the driveway. The big palm is actually on the next property. We should here back Wednesday or Thursday.

I've read all of this before, but I thought that I would share it with all of you, since you may not know as much as I have learned abou the lap band. I have my orientation for the surgery o n June 13th in San Francisco. Once that is done they will do a number of medical tests to be sure that I have a good blood counts and such and that all my organs work like they should. Then, if all goes well, we will schedule a date for the surgery. I have never had diabetes or high cholesterol, so I don't have those against me, and I'm pretty sure all my organs work well. Withour further ado (retrieved from http://www.bariatricedge.com/dtcf/pages/3_Procedures.htm):

Defining Bariatric Surgery
Bariatric surgery is a treatment option for people living with morbid obesity—especially for those who have not experienced long-term weight loss success through other means. Often referred to as weight loss surgery, bariatric surgery has transformed the health and lives of more than 800,000 people in the past six years.26

How Does Bariatric Surgery Work?
Bariatric surgery is the clinical term for several different procedures. The procedures use one or both of two approaches to help patients lose weight and improve or resolve co-morbid conditions .

Restrictive Procedures
During these procedures, the surgeon creates a small stomach pouch, which limits the amount of food patients can eat. The smaller stomach pouch fills quickly, which helps patients feel satisfied with less food.
Examples of restrictive bariatric procedures:
- Gastric banding

- Sleeve gastrectomy


GASTRIC BANDING
Gastric banding is a restrictive surgical procedure. During this procedure, two medical devices are implanted in the patient: a silicone band and an injection port. The silicone band is placed around the upper part of the stomach and molds the stomach into two connected chambers. The injection port is attached to the abdominal wall, underneath the skin. The port is connected to the band with soft, thin tubing.
The band is adjustable. Adjustments are made by your healthcare professional using a needle to inject saline solution into your band through the port. Adding saline increases the amount of restriction provided by the band, helping patients feel fuller sooner and with less food.
Life After Gastric Banding
Excess Weight Loss
Gastric banding patients typically lost 47% of their excess weight.4

Health Benefits
Studies found that gastric banding:
- Resolved type 2 diabetes in 47.8 percent of patients4

- Resolved high blood pressure in 38.4% of patients4

- Improved high cholesterol in 78.3% of patients4

For more information about the effect of gastric banding on weight-related co-morbid conditions, visit Health Benefits.

Quality of Life
One meta-analysis stated that for bariatric surgery patients who experienced significant weight loss:1
- Overall quality of life improved greatly
- They experienced improved physical functioning and appearance
- They experienced improved social and economic opportunities

Recovery
Your healthcare team will advise you when to return to work and when you are able to resume normal activities.
Potential Concerns of Gastric Banding
- Gastric banding can help you feel satisfied sooner and with less food, but it won’t eliminate the desire to eat. You will need to follow your specific diet and exercise guidelines provided by your surgeon to achieve success.
- Gastric banding requires more intensive follow-up care than most other bariatric surgeries.This is mostly because the band is adjustable. Keep in mind that even after reaching and maintaining your success weight, you may still need to see your healthcare professional for further adjustments.

Malabsorptive Procedures
During these procedures, the surgeon reroutes the small intestine so that food skips a portion of it. The small intestine absorbs calories and nutrients from food, and avoiding part of it means that some calories and nutrients are not absorbed.
Surgeons rarely perform strictly malabsorptive procedures. Most procedures that use malabsorption also use restriction.
Combination Procedures
Certain procedures such as Roux-en-Y gastric bypass surgery uses a combination of restriction and malabsorption. During this procedure, the surgeon creates a small pouch. The surgeon then attaches a Y-shaped section of the small intestine directly to the stomach pouch. This allows food to bypass a large portion of the small intestine, which absorbs calories and nutrients. The smaller stomach pouch causes patients to feel fuller sooner and eat less food; bypassing a portion of the small intestine means the patient’s body absorbs fewer calories.
Examples of combination bariatric procedures:
- Gastric bypass

- Biliopancreatic diversion with duodenal switch

These different methods work to help patients lose excess weight, lower their BMI , and transform their health by resolving or improving co-morbid conditions . Bariatric surgery has many benefits that can lead to a healthier, higher quality of life. It also has certain risks.

It’s obvious to many people who have lived with morbid obesity for years that the disease has a severe negative impact on quality of life. Because of morbid obesity, you may choose not to participate in certain activities. You may feel that you have limited career choices.
What you may not know is that morbid obesity has been found to affect the quality of your health and the length of your life. 4
Morbid obesity has been linked to several serious and life-threatening diseases. These co-morbid conditions include type 2 diabetes , heart disease and high blood pressure, acid reflux/GERD, and cancer. Most of these conditions do not develop for years. So many people living with morbid obesity may have one or more of these health issues without even realizing it.
Bariatric surgery may offer you a whole new outlook on health…
- One study found that gastric bypass surgery reduced the total number of co-morbid conditions of participating patients by 96%. 5

- Many surgeons recommended bariatric surgery as a treatment option for type 2 diabetes.12 In some cases, resolution of type 2 diabetes occurred within days of the surgery. 4

- A meta-analysis stated that several studies found that bariatric surgery patients felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities, and had more self-confidence than they did prior to surgery. 4

BARIATRIC SURGERY RISKS
Bariatric Surgery Indications
Bariatric surgery is intended for people who are 100 pounds or more overweight (with a Body Mass Index (BMI) of 40 or greater) and who have not had success with other, less risky weight loss therapies such as diet, exercise, and medications.In some cases, a person with a BMI of 35 or greater and one or more co-morbid condition may be considered for bariatric surgery.

Important Considerations
Bariatric surgery should not be considered until you and your doctor have explored all other options. The best approach to bariatric surgery calls for a discussion of the following:
- Bariatric surgery is not cosmetic surgery.
- Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.

- Together, you and your doctor should discuss the benefits and risks.
- You must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery.
- Complications after surgery may require further operations.
- Patients who underwent bariatric surgery have significantly reduced rates of developing cancer, cardiovascular diseases, endocrinological disorders, infectious diseases, musculoskeletal disorders, psychiatric disorders, and pulmonary disorders. 6


Risks Associated with Abdominal Surgery
- Bleeding
- Pain
- Shoulder pain
- Pneumonia
- Complications due to anesthesia and medications
- Deep vein thrombosis
- Injury to stomach, esophagus, or surrounding organs
- Infection
- Pulmonary embolism
- Stroke or Heart Attack
- Death
Note: Risks are associated with any type of surgery, including abdominal surgery. These risks are greater for individuals who suffer from obesity.
Risks Associated with Bariatric Surgery
- Abdominal hernia
- Chest pain
- Collapsed lung
- Constipation or diarrhea
- Dehydration
- Enlarged heart
- Gallstones, pain from passing a gallstone, inflammation of the gallbladder, or surgery to remove the gallbladder
- Gastrointestinal inflammation or swelling
- Stoma obstruction
- Stretching of the stomach
- Surgical procedure repeated
- Vomiting and nausea
Note: Your weight, age and medical history play a significant role in determining your specific risks. Your surgeon can inform you about your specific risks for bariatric surgery.
Risks Associated with Gastric Banding- Migration of implant (band erosion, band slippage, port displacement)
- Tubing-related complications (port disconnection, tubing kinking)
- Band leak
- Esophageal spasm
- Gastroesophageal reflux disease (GERD)
- Inflammation of the esophagus or stomach
- Port-site infection
Note: Complications may result in reoperations. Refer to the Realize™ Band Patient Guide for a full description of risks and side effects. To order a patient guide click here.

Risks Associated with Gastric Bypass- Dehiscence (separation of tissue that was stitched or stapled together)
- Leaks from staple lines
- Ulcers
- Dumping syndrome, an unpleasant side effect that may include vomiting, nausea, weakness, sweating, faintness, and diarrhea
- Required supplementation of diet with a daily multivitamin, calcium, and sometimes vitamin B12 and/or iron
- Inability to detect the stomach, duodenum, and parts of the small intestine using X-ray or endoscopy, should problems arise after surgery such as ulcers, bleeding, or malignancy
- Increased gas

Compare Mortality Rates
Procedure Mortality Rate Occurs In…
Gastric banding 0.1% 1 out of every 1,000 people
Gastric bypass 0.5% 1 out of every 200 people
Hip fracture repair 3.3 to 8.2%10, 11
6 out of every 200 people10, 11

According to the American Society for Metabolic and Bariatric Surgery 2004 Consensus Statement, the operative morbidity (complications) associated with Roux-en-Y gastric bypass in the hands of a skilled surgeon is roughly 5%, and the operative mortality (death) is roughly 0.5%. 9
For gastric banding, the same consensus statement reported that, in the hands of a skilled surgeon, the operative morbidity is approximately 5% and operative mortality is approximately 0.1%. 9

Why Would I Have an Open Procedure?
In some patients, the laparoscopic or minimally invasive approach to surgery cannot be used.
Here are reasons why you may have an open procedure, or that may lead your surgeon to switch during the procedure from laparoscopic to open:
- Prior abdominal surgery that has caused dense scar tissue
- Inability to see organs
- Bleeding problems during the operation

Based on patient safety, the decision to perform the open procedure is a judgment made by your surgeon either before or during the actual operation.
DAY OF BARIATRIC SURGERY
For many bariatric surgery patients, the day of surgery is a major milestone. Postsurgical patients often referred to this day as their “birthday” because it signifies a life-changing transformation.
Preparing for the Day of Surgery
It’s critical that you follow your surgeon’s specific instructions the day of surgery.
These instructions generally include:
- Do not drink or eat anything prior to surgery—most often this fasting period begins the night before surgery.
- Most medicines can be taken the day of surgery, just with small sips of water. Your doctor will have instructions regarding specific medications.
- Bring all of your medications with you.
- If you have a CPAP (Continuous Positive Airway Pressure) machine, bring it with you for use in the hospital.
- Arrive early; some hospitals and surgery centers require patients to arrive two hours early.
What to Expect the Day of Surgery
- When you arrive, you will undergo several preoperative steps.
- You will speak with your nurses, and often, your surgeon and anesthesiologist.
- An IV line will be started to keep you hydrated and to administer medications such as antibiotics.
- The preoperative experience is often a short one, after which you will be taken to the operating room.
- Your anesthesiologist or anesthetician will provide you with anesthesia medications to put you under.
- Bariatric procedures, whether they are minimally invasive or open, generally take 75 to 90 minutes.

- After surgery, your healthcare team will continue monitoring you and arrange for you to be taken to recovery.

RECOVERING FROM BARIATRIC SURGERYRecovery takes time and patience. The diet is strict; you may experience discomfort and pain as your body heals, and the length of time to return to normal activities can vary from patient to patient. Some patients are able to return to work within a few weeks and see weight loss fairly soon after surgery. For others, a couple of months go by before they experience noticeable weight loss.
One study found that ,on average, gastric bypass patients:
- Started an oral diet in 1.58 days2

- Left the hospital on the second day2

- Returned to work at 21 days2

Many bariatric patients who experienced transformations of their health were able to do so because they began exercising and eating healthfully prior to surgery. Losing a few pounds before surgery can help to reduce the possibility of surgical complications.
Call Your Bariatric Surgeon
If you experience any of the following:
- Pain and/or swelling in your feet, calves, or legs
- Abdominal pain
- Bleeding
- Blood in stool
- Pain, burning, urgency, frequency of urination, or blood in urine
- Signs of infection such as fever or chills
- Vomiting or severe nausea
- Redness, swelling, pain, bleeding, or discharge at the incision sites
- Coughing, shortness of breath, or chest pain

POST-OP BARIATRIC SURGERY RECOVERY DIET
Your bariatric program will provide you with specific information about what to eat after surgery, but here are some generally accepted guidelines to give you an idea of what to expect.
One to Two Days Post-op
At this time, your bariatric surgeon will be monitoring your progress by seeing how well you tolerate low-sugar, non-carbonated liquids such as water, tea, broth, or Gatorade®.3 Sugar-free gelatin is another option.
Use a cup to drink. Avoid sipping from a bottle or straw—you could swallow too much air and get gas.
A Note on Sugar-Free Foods
Artificial sweeteners such as Splenda®, Equal®, and Sweet’N Low® are calorie-free alternatives to sugar.3 Most bariatric surgery patients are able to tolerate artificial sweeteners in moderation. It’s important to keep in mind that these artificial sweeteners are used in many no- and low-calorie foods. An excessive amount of artificial sweeteners can lead to dumping syndrome in gastric bypass patients.
Three Days to One Month Post-op
If you tolerate liquids well, your surgeon will likely recommend that you move on to a pureed diet and begin eating three meals per day. However, if you are not hungry, you do not have to eat.
Remember, your stomach will be very small, and so will your portions. You should only eat a few tablespoons at a time.
Many patients are able to consume about 16 to 24 ounces, roughly two to three glasses, of protein shake each day.
Hydrating Is Critical
You must remain hydrated. Hydration is critical, but can be difficult because your stomach will be roughly the size of an egg. Here are a few tips:
- Drink 48 to 64 ounces of water each day.
- Sip calorie-free liquids frequently—when not eating.
Keep the following in mind:
- Do not drink while eating.
- Wait at least one hour after eating to begin drinking again.

Protein and Nutrients
Bariatric programs generally recommend including quite a bit of protein in your diet, because your body will need it while you are healing. The recommended daily requirement for adults is 60 to 65 grams of protein.
Healthy protein sources include:
- Lean meats
- Beans
- Eggs, especially the whites
- Dairy products
Getting enough nutrients is often a challenge for bariatric surgery patients. You have the same nutritional requirements as people who have not had bariatric surgery, but a far smaller stomach and, for gastric bypass patients, a limited ability to absorb nutrients and calories.
Bariatric programs generally recommend taking chewable multivitamins and chewable calcium supplements every day.
Tips- Eat slowly. Plan on spending about 30 minutes eating a meal.
- Chew thoroughly so that your food is the consistency of peanut butter.
- Cut up meat to the size of a pencil eraser when eating.
- Stop eating before you feel full.

Examples of Pureed Foods
- Protein shakes or supplements
- Plain chicken broth: no noodles or bits of chicken
- Lean meats or poultry pureed in a blender
- Scrambled or soft-boiled eggs
- Low-fat or skim milk
- Low-fat yogurt
- Low-fat frozen yogurt
- Beans: split pea soup or fat-free refried beans
- Unsweetened applesauce
- Mashed ripe bananas
- Diet frozen juice bars

One Month to Lifetime Post-op Diet
If you tolerate the pureed diet well, your surgeon will likely recommend that you begin to incorporate solid foods.
You should slowly incorporate small amounts of new foods—a few tablespoons rather than a half-cup. Everyone encounters problems with some foods; it’s perfectly normal. If you do have a poor reaction to a certain food, you always can try it again in a week or so.
Hydration Is Still Important
Hydration will continue to be important. Hydrate with more than 64 ounces of water, calorie-free or very-low-calorie drinks, and diet frozen juice bars. Beverages such as fruit juices contain calories, which will slow down your weight loss or cause you to lose less weight than you could.
Proteins and Nutrients
You still need 60 to 65 grams of protein each day. This translates to about 4 ounces of lean meat, three times each day.
At this point, you can switch from chewable multivitamins to those in pill form.
When it comes to calcium, calcium citrate is the best-absorbed calcium. Some calcium supplements contain vitamin D and magnesium to aid in absorption.
Your surgeon may prescribe iron supplements as well.
Tips
- Incorporate new foods in small amounts.
- Avoid foods and beverages high in fat and/or sugar.
- Chew your food thoroughly.
- Eat slowly.
- If your stomach feels irritated, let it recover by consuming liquids in place of the next meal or two.

Examples of Healthy Lifetime Foods
- Lean ground beef, chicken, turkey, or pork
- Fish
- Tofu
- Cottage cheese
- Cheese
- Soft pasta
- Cooked or canned fruits and vegetables (avoid starchy vegetables such as corn)
- Whole-grain cereals and breads
- Protein shakes or supplements

POST-OP PHYSICAL ACTIVITY
Several bariatric surgery patients featured on BariatricEdge.com, such as Carlos and CJ, point to exercise as an important key to their success. Years after surgery, they continue to rely on exercise to help them stay within their selected healthy weight range and stay energized.
Regular exercise, next to following your bariatric program’s dietary guidelines, is an important factor when it comes to optimizing your health outcomes and quality of life after bariatric surgery. Check out the following for what to expect and helpful tips.
One to Two Days Post-op
Your surgical team will likely have you up and walking or doing other leg exercises as soon after surgery as possible. Walking and leg exercises after surgery help patients avoid deep vein thrombosis, a blood clot that can form in veins.
First Few Weeks Post-op
Bariatric programs generally recommend that patients phase in exercise as soon after surgery as possible. You will need to discuss specific details with your surgeon, but most patients are able to walk for at least a few minutes each day. It’s a low-impact activity and a great introduction to exercising.
Patients with a very high Body Mass Index (BMI) (70 or higher) frequently cannot walk for more than a minute or two at a time. However, the average bariatric surgery patient has a much lower BMI and is able to tolerate walking for a bit longer. Regardless of your BMI, be patient and work as hard as you can.
Tips for the First Few Weeks
- Consult your bariatric program about your exercise plans.
- If you’re unsure how to start exercising, begin by walking for five minutes, five times each week.
- Gradually increase the amount of time you spend exercising by adding a few minutes each week.
- Do not accept fatigue as an excuse to not be physically active.*
* If you experience significant fatigue, you may want to discuss it with your surgeon.
FAMILY, FRIENDS, AND FOOD
Celebrations, spending time with the family watching a favorite show, cookouts on warm evenings… eating and events are social activities that have long been tied together, and you shouldn’t have to give them up. But, after bariatric surgery and with new healthy habits, you won’t want to eat as much as you used to and, most likely, you won’t be able to.
These situations can present challenges. Sometimes even the most well-meaning family and friends may try to push food on you.
Here are some coping strategies for dealing with family and friends who don’t “get it,” and for eating in restaurants and at special occasions.
Pressure from Family and Friends
Some of your family or friends may have difficulty supporting you. They may be unaware that certain comments they make or things they do are unsupportive.
Maybe you are frustrated because a family member continues to bring home high-calorie foods, even though you are trying to avoid them. Or, maybe you are upset because a friend who only knows the myths of bariatric surgery thinks it is the easy way out.
Tips
- It may be as simple as talking with your family members or friends. Be honest and calmly let them know what your goals are, what you need in the way of support, and, specifically, what comments or behaviors are not helpful.
- You may want to offer to bring them to a support group or information session at your bariatric program.
- Provide them with the information you used while making your decision.
- Politely change the subject if eating or bariatric surgery comes up.
- If they’re unable to change their behavior, you may consider limiting the amount of time you spend with them.
Eating in Restaurants
Eating in restaurants after bariatric surgery can be challenging, especially with the size of restaurant portions. Often restaurant portions are two to four times larger than the recommended portion and are high in fat. This can lead to a slower rate of weight loss for bariatric surgery patients. For gastric bypass patients, this presents an opportunity for an unpleasant episode of dumping syndrome.
Tips
- Avoid baskets of bread or chips.
- Order salads with dressing on the side and dip your fork in the dressing instead of pouring it on.
- In many restaurants, appetizers are closer to an appropriate portion size than the entrées.
- Split an entrée with someone, or divide it and take home half.
Eating at Special Occasions
Special occasions can be challenging: There might be pressure to “try some of this,” and the food can be tempting. The festive nature might make you feel like letting go of healthy habits.
It’s important to plan ahead. Having a plan can help you avoid overeating or eating unhealthy foods.
A common mistake is to plan on eating nothing. Even with the best intentions, it’s hard to resist the atmosphere and the food.
Tips
- Eat something small before you go or drink a glass of milk, so you don’t arrive hungry.
- Enjoy conversation while you eat—you’ll eat more slowly.
- Try small amounts of new foods instead of your old favorites.

And remember…
If you do overeat, keep it in perspective. Overeating at a single event does not lead directly to regaining weight. It is unhealthy daily habits that do. So don’t let one slip-up lead to overeating or eating unhealthy foods at several meals. Stick with your healthy eating habits, and you will notice the difference it makes.
EMOTIONAL EATING AND CRAVINGS
Having bariatric surgery does not necessarily mean that you’ll be free from cravings or bouts of emotional eating. Succumbing to food cravings and emotional eating can lead to weight regain and, for gastric bypass patients, dumping syndrome.
Successfully overcoming cravings and emotional eating takes patience and knowledge of a few coping techniques.
Coping with Cravings
Cravings can be difficult to deal with. A lot of people fight the craving for a period of time and then try eating the desired food to get rid of the craving. This often results in eating too much of the food and then feeling guilty. Giving in to the urge often makes the craving stronger and more frequent with time.
It is actually more effective to avoid the desired food. With time, the craving will pass and will be less likely to return.
If you experience difficulty in coping with cravings, you don’t have to go it alone. Contact your bariatric program or attend a support group meeting.
Tips
- Distract yourself when you have a food craving: Take a quick walk, read a book, or call a friend.
- If a food craving is associated with a specific room or activity, break it by changing your habits. Go to a room that you don’t eat in or avoid the activity for a period of time.
- Keep high-fat, high-sugar, high-calorie food out of the house. Encourage your family to eat healthfully and to reserve these empty calories for rare occasions.
Coping with Emotional Eating
For some people, eating is a way to cope with emotions. After bariatric surgery, this can be a painful and unhealthy coping mechanism. You should know that breaking the pattern of eating in response to stress, frustration, or sadness is possible.
Identifying the Emotion
When you experience a strong emotion that leads you to food, stop and identify the emotion you are experiencing. You may open the refrigerator and realize that you feel sad or angry rather than hungry.
Ask for Help When You Need It
Breaking the connection between emotions and food can be difficult. If you feel overwhelmed or out of control, attend a support group meeting or contact your bariatric program’s mental health professional. These two resources can help you identify what’s causing the emotion and provide you with strategies and alternatives to eating.
HEALTH TRANSFORMATION
One of the most rewarding aspects of bariatric surgery is the transformation of health and increase in quality of life that many patients experience.
Studies have shown that gastric bypass patients:
- Lost an average of 61.6% of excess weight4

- Experienced significant health improvement with resolution or improvement of 96% of co-morbidities, specifically type 2 diabetes, high blood pressure, sleep apnea, depression, and back pain5

- Had significantly reduced rates of developing cancer, cardiovascular diseases, infectious diseases, and psychiatric disorders6

- Experienced 89% lower mortality rates when compared to a control group of people who did not have gastric bypass surgery and were still living with morbid obesity6

Studies also have shown that gastric bypass patients:
- Had dramatically lower hospitalization rates for cancer, heart conditions, and high blood pressure than a control group of people who did not have gastric bypass surgery and were still living with morbid obesity6

- Experienced a 77.3% drop in total cost of diabetic and blood pressure medications compared to a control group of people who did not have gastric bypass surgery and were still living with morbid obesity and these co-morbid conditions6

I have struggled with my weight pretty much since I got married, maybe a little earlier. As I gain more weight, I have more back problems. I've started to have knee problems and foot problems. My feet not only hurt more but they swell. I'm not comfortable in my own skin, and ultimately this has suppressed my personality, I think. I have tried Weight Watchers, SparkPeople and others, but I still ahve trouble losing weight. I do well for awhile and I hit a plateau or revert back to old habits. Some of those old habits are: overeating, eating lots of sweets and fats, not eating enough produce, drinking lots of soda and less water, etc.

I need help with losing the wieght and helping me to feel fuller sooner, so that I don't overeat and stop sooner. I emailed my doctor today, and told her about these problems as well as the health issues. I asked her about the lap-band system which is pretty new, but not as invasive as gastric bypass. Gastric bypass is just not for me, I think, but I have friends that have had awesome results and I have been so supportive. It just isn't for me. I love the results of gastric bypass, but I didn't want to go that extreme. The lap-band is an outpatient procedure and I will have to go in periodically to have it adjusted. She is putting in the referral for me and I should know more soon and get all my questions answered soon.