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Different Rules For The Same Tool "the Lapband"

KristyT

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I have been banded for about 4 1/2 months now and I have read blogs, forums, internet searches and tons and tons of youtube videos and the different rules really baffle me? I hear all these rules of protien first, so many calories, low carbs, no drinking for 30 min, no drinking for 15 minutes, no drinkinhg for an hour. only 1/2 cup of food, only 3 meals a day and no snacks, so many ounces of protien, chew , chew, chew and chew some more and eat slowly and so on and so on, you get the picture. My surgeon had me do 1 week pre op and stated to me it was to shrink the liver, I was given no specific amount of calories, portion size or protien for after surgery, was just told to do liquids, then full liquids then mushies then solids, I went to my dr for my first fill and he gave me 3cc, i was steadily losing 1 lb a week after surgery, still no specific rules on calories but they do give me a paper every time I go that states, no liquids with meals, no liquids as meals, if you have to ask yourself is this a liquid then it is probably a liquid and dont eat it as a meal, take only 20 minutes to eat your food, if you are taking more than 20 minutes to eat your food then you are trying to out eat your band, weigh once a week and eat only 3 meals a day with 2 snacks if needed, wait 1 hour for drinking after meals. this is the only rules I have. so I go home after my first fill and still not much difference, continue to eat but make good choices but eating alot like 2 cups at a time of food, go back to the surgeon about 6 weeks later and still averaging about 1lb a week weight loss and at this time I am ready to get this thing tight so i can eat less and he looks at me and says well you are losing weight, a fill is probably not what you need right now. and I say well I am eating alot and he says well kristy, how much do you think you are suppose to be eating and I say a half a cup and he says NO, you are suppose to eat until you are full then stop. he says if a half of a cup fills you up then fine but if it takes a whole cup then eat a whole cup. and then he asks me what I had for dinner last night and I say chinese food, kung pao chicken and he says how much of that did you eat and I say all of the chicken and a few bites of the rice, and he says why did you not eat more of the rice and I say i heard to avoid rice, breads and past because they are bad for you and they can get stuck and he says NO that is not true, he says to me when you eat rice, bread and pasta it swells up and this will fill the pouch up so he tells me i need to be eating more bread, rice and pasta, so now I Iam really confused, and then he tells me I am losing 1lb a week without eating rice and bread so he gives me a very small fill and tells me to eat more bread, rice and pasta to fill the pouch up. so I leave the office and say okay. I notice no difference in my fill as I am able to eat everything I want and it goes down fine, so I attempt bread, rice and pasta and it goes down just fine so I eat it. I have to be back at surgeon in 8 weeks and this left me with no restriction over the holidays and him telling me to eat rice, bread and pasta. so, what do i do? I eat rice, bread and pasta over the holidays, i go back to the dr on jan. 10, 2012 and I had only lost 2 lbs and he was not pleased. he says what happened kristy? we are now going backwards. and I say well I did what you said and i ate bread, rice and pasta and he says well what did you eat for dinner last night and i say chicken and he says how much of that did you eat and i say all of it, and he says in a stearn voice, how did you eat it and im like ummmm i ate it, he goes you chewed chewed chewed and took 30 minutes to eat it didnt you and I was like NO i ate it, i chewed it normally and swallowed it then he says well what are you able to eat for breakfast and I said 2 scrambled eggs and a piece of toast and he throws his hands up and says "NO way in hell should you be able to eat 2 eggss and toast" and im like omg this dude is nutso because as you see earlier he told me to eat til i was full. so then he says Im going to give you a fill so you cant eat that much. and he gives me a fill of 1.5 cc for a total of 5.5cc in my 10 cc band and sends me on my way and he tells me to call him if i get heartburn at night. so now here in the present, I finally notice restriction and there is NO way in Hell i can eat 2 eggs right now as one egg barely goes down, i am having stuck episodes and I get full very fast. and i lost 4 lbs after this 3rd fill from last week. in essence though my dr says not to chew chew chew, he says when you do that it liquifies the food allowing you to eat more and that I should just eat normal and then swallow. he tells me i can eat whatever I want but smaller portions, he doesnt require a certain amount of protien or calories. but as I can tell, as long as you are losing weight with him he doesnt want to adjust you but then if you dont lose weight he gets on me for not losing. so I am still very confused. I am nervous about going to see him if i dont lose weight for fear of being "scolded" again and I am also fearful that when I need to be filled he will not fill me unless I am not making progress. anyone have thoughts on any of this? I would be greatlly appreciative for any insight with your rules and your experience with your surgeon.



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Oh Kristy! I am feeling the same way! I just had my first fill last week and I feel NO difference. I am able to eat, drink, slow or fast, chew alot or not chew very much.... ugh. I paid for this out of pocket and I am pretty upset, so I emailed my patient advocate with my concerns. Waiting for her response. I might argue to come back asap instead of waiting 4 weeks to have an adjustment. If I could lose weight on my own with watching my food and excercise, I WOULDN"T BE HERE! I will let you know what my patient advocate says.... Hang in there! Let's don't give up yet.... we have invested too much for that.... our journey has just begun and this is a minor speed bump.

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It takes 4 or 5 fills usually to feel ANY restriction at all. I was banded in october 2010 and had to wait 6 weeks after surgery for the first fill. I couldn't come back for fills less than every 6 weeks. It took five fills to feel any restriction at all. I had 6cc's in a 10cc band. Not sure I have that "sweet spot" even now, but I've learned what works for me. I've lost slowly. Only lost 102 lbs in that amount of time. I only lost 15 lbs from pre-op to 6 weeks after surgery. Mine has been a steady lb or so a week until now. Now...I'm at a stand still and at a loss what to do. So...be patient :) we all go thru pretty much the same thing

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I don't think I would have signed on for this for 1-2 1bs weight loss a week! This cost me personally $12,000. I am just beyond frustrated. I have only 3cc's in my band right now.

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Cali. From what I have read about the band 1-2 lbs a week is average, unless you have something like plication along with it. Why are you expecting to lose more?

Kristy: I understand your fustration with the doctor's instructions because they are very confusing and counter to what most people are told. I would suggest trying to meet with a nutritionist to make sure you are on the correct diet but for the most part we are told that we should be eating proteins first, followed by veggies. I would say that you might be either at the right restriction or slightly too tight if you are having many stuck episodes (try going back to chewing everything very well and see if that lessens the stuck episodes). In fact I'm surprised that your doctor is telling you what to eat, I think that they generally leave that up to the nutritionists in the practice.

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HI Shellyac! I guess my surgeon set that expectation, plus the logic of eating 2500-3000 calories a day down to 800-1000. He told me I would be at my goal weight around the middle of the summer as long as I kept up with my adjustments, stuck with the diet plan and excercise. I have (had) 175 lbs to lose. In 5 weeks, I am down a total of 36 (24 post op). I expect to feel the restriction I guess and not feel like I am on my own again.

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I think that your surgeon set too high of an expectation, my doctor said that 1-2 lbs a week is what is normally seen in band patients. For bypass and sleeve patients that rate is about .5 to 1 lbs a day in the beginning From what I hear it can take 2-3 fills to feel any restriction, possibly even more. I think that mentally if you plan on 1-2 lbs a week you will be less fustrated when the weight isn't coming off faster than that, it is possible to lose more quickly than that and if that happens, just consider it a bonus.

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I agree that the weight loss should only be 1-2 lbs a week because with the band that is the average thus a slower weight loss but life time change of retraining your brain, what I dont get is all the different rules. first he says to eat til im full then he doesnt want to give me a fill, so i eat til im full, dont lose any weight and he scolds me and fills me, so I guess what Im getting at is what is right to eat? how much should I be eating for a meal. I suppose seeing the nutritionist is a good option and I just ordered a book about the lapband and weight loss for success, hopefully this will help. I also have the god awful diabetes and PCOS so this doesnt help any, I try to eat low carb with protien but hard to lose weight with both of these co morbidities. any suggestions on what to be eating daily?

Callie - I was at a stand still for a bit also before he finally adjusted me, some surgeons just seem to be stricter about adjustments. Im getting discouraged though because my surgeon seems to be so wishy washy. let us pray LOL

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Generally you should be getting in about 70-80 grams of protein a day. When you are at good restriction you should be eating about 1/2 to 1 cup of food at a time. Before you are at the green zone you may be able to eat more. You should concentrate on eating your protein first then veggies, ideally you shouldn't be hungry between meals but if you are, have high protein snacks like cheese or a protein shake.

Also check out the food and nutrition forum to get a sense of what other people are doing

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thank you shelly, I just got on myfitnesspal to start tracking my daily food intake, I am going to try the higher protien but I also have to have low carb because of diabetes, the fitnesspal said i should have 1200 calories a day, that is about what i have been having unless i have snacks which i usually do then i tend to have about 1300 calories a day. i usually get plenty of protien in but finding low carb things is difficulty due to diabetes. thanks for the input

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If you're looking for a good shake, I would recommend the premier shake from costco, it has 30g of protein and only 1g of sugar and is only 160 calories per shake and they taste pretty good. I'm also on myfitnesspal, my id is shellyac_1, feel free to add me

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I use Smoothie King - Gladiator. 45 grams of protein, 190 calories, 1 carb and no sugar. I actually only have half now and that gives me 23 g and only 95 calories. I drink it on the way to work! :)

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ok you are all are confusing me even more ....my dr has never told me to drink protein drinks and i do not drink 30 mins before or after i eat i am only on mushy foods i'm just 3 weeks out from banding but i am so confused i hear so m any people say you eat this you eat that ....use a straw dont use a straw and drink drink when not eating im so confused i wish all the drs would follow one diet and share it with all of us ....i'm so confused ...and really how much can you chew chew instant mashed potatoes or baby food??? .....im totally lost thanks for listening to me

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I agree that things are confusing, and I have yet to see a consistant post op diet plan. Protein drinks are just a good way to get your protein in because it is much easier to drink than to eat, especially once you start getting fills. Also protein drinks helps to curb your hunger. They aren't necessary if you are able to get all of your protein in through your usual food and drink intake, some people have mentioned that once they get restriction it is much easier to have a protein shake in the morning because their band is too tight to take down food.

Personally I find it easier to drink my shakes through a straw because I taste them less when I do, I've only been doing it the past two days and I do find that I burp alot while I'm drinking but they are tiny burps.

I had my stomach plicated in addition to getting the band and I find that although drinking a little right before eating or even a few sips while I'm eating doesn't cause any problems, if I have anything more than a few sips immediately after I become uncomfortable so I avoid that.

I think the fine chewiing of your food really applies to more solid foods, again this will be more of an issue once the band starts getting filled and you have a higher risk of getting stuck

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My surgeon trained with Dr. Paul O'Brien, so he provides his book (The Lapband Solution) as a guideline for how to eat and live with the band. I've been sticking to those guidelines depsite seeing so many variations of "the rules", and it's been working for me.

I stay away from protein shakes and my guidelines on protein are 30-40g per day- which I think is easily doable considering I'm eating 1,000 calories or less. I try to eat the most whole, natural food possible that I can find. The only thing I drink with food is alcohol, per the guidelines I was given. Using liquids to get in nutrients or calories is a slippery slope- if you aren't able to eat REAL food, then something is wrong. You can't do a liquid diet forever.

At the end of the day though, don't confuse yourself- if your doctor has given you guidelines, follow them- don't worry about what everyone else is doing! Reducing your calories will lead to weightloss and that is what the band will help you do! Hang in there!

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sunshine,

when they say chew chew chew that is for when you are tight and eating solid foods like chicken, beef jerky and other hard things to get down. the reason they say chew it good is because if you put a piece of chicken in your mouth and barely chew it then swallow it is going to get stuck and you will "slime" it up. my dr says dont drink protien shakes or any other liquid as a meal but I agree with shelly being that in the morning I am very tight and have a difficult time eating before about 2 pm so I tend to drink a shake in the morning to get some nutrients in my body. before I was adjusted I didnt drink the shakes i just ate and i dont drink them for lunch or dinner only in the morning now when it is difficult to get food down. i was on solid foods by week 2 and had a little restriction left from being swollen from the surgery but then that went away, i got 3cc fill at 6 weeks but it did nothing for me, i still could eat alot, another fill of 1cc at about 10 weeks and still nothing, my 3rd fill on jan 10th 1.5 cc now a total of 5.5 cc in my 10 cc band I have restriction, I am now eating smaller, chewing meats better and having the protien shake in the morning but only to get somethbing in me. this is very very confusing because there is so many different rules but i think we all need to do what is right for us and what works for us, you will learn as you go along as I am still learning and only been 41/2 months since banded. this is a great site with lots of information. hang in there and keep up the good work all

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Hi Kristy,

When I read your blog, I couldn't believe how much it sounded like my story!!!! I was thinking....she must have been a fly on the wall during my appointment today. I can tell you that your physician has told you exactly what mine had told me (as a matter of fact...he told me almost everything you have said at today's visit). I was banded in Sept. and I am your twin in our events and physicians. I had an adjustment today giving me a total of 5 cc's in my band. I can tell there is restriction this time. I've made a decision, as of today, to listen to my doctor and to disregard what most people say...not saying they aren't giving me good advice. But, all physicians are different...and I chose to go to him....So, I should respect his instructions. Don't loose your motivation, stay strong and hang in there. We'll make it. :)

BTW: 1-2 lbs. weight loss a week is considered GREAT. I haven't even lost 1 weekly yet.

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LOL!!!!!!!!! I just went to your profile and see that we have the SAME PHYSICIAN. Dr. O.!!!!!!! No wonder we've been told the SAME EXACT THINGS!!!!! I'm totally FREAKED right now!!!!

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Glenda,

I know right, I did the same thing, I checked your profile and i said ohhhhhhhhh she has same dr. Im glad to know that he is telling others the same thing, but oh how he confuses me so much.. lol I was wondering if you have talked to the nutritionist or thought about it to get some insight also? pls keep in touch and let me know how things go. good luck

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I asked him about talking to Jessica (nutritionist) yesterday and he told me there was no need for that right now. He told me that this is the learning phase right now and everything is going as he expected. But, later if he thinks I need to see her, he'll let me know. I am still considering a phone call to her, but hate to step over bounds with him. I guess we'll just have to keep chewing along. Have a great weight loss week my fellow bandster :)

BTW: Has ever said anything about exercising to you?

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well i seriously doubt he would know if you contacted her or not, I dont even think he remembers our names to be honest with you LoL, he is in such a huge hurry that he doesnt get to know you as a patient. always rushing. but if you do talk to her and she gives you any good insight, let me know so i can contact her too. good luck

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