Sojourner

The lap band "journey" will vary if you are a self-pay patient, or having insurance cover the cost. There are also some differences between insurance companies. Some insurance companies require a 6 or 3 month medically supervised diet. Others make their decision on a case by case basis only. I got my band surgeon's name from my primary care doctor (internist), and attended the information seminar at the hospital where the surgeon's practice is located. My PCP supervised the 6 month diet, and submitted the letter of medical necessity, along with 5 years of documentation to address my history of being overweight to the insurance company for approval. There are a number of "hoops" to jump through, but all are part of the approval process and are screening tools also. I feel it is essential to have appointments with a dietitian so you can have some good education about your post op diet and supplements you will need. Many members of this forum have not had the nutrition education, and it is more difficult for them at least in the beginning to understand how much and what they should be eating and drinking. My surgeon also has an exercise physiologist who tracks the amount of "fat weight" vs "muscle weight" you are loosing, so there is a more precise measurement of your BMI. Fills are done usually every 6 weeks as needed, beginning 6-8 weeks post op. When you reach what is commonly referred to as your "green zone", you technically will not need any fills for some time, though this varies widely between patients. There were several medical reasons my surgery needed to be delayed, but I was able to finally get my medical clearance for the surgery, and had the pre op appointment and surgery scheduled within a month of my insurance company approval. I guess the bottom line is to research the success rate of the surgeon and the hospital program before getting involved with the surgeon's practice. My doctor is part of a bariatric "Center of Excellence", and I have benefited from having comprehensive pre op and post op treatment. Good luck with your decision process!

My insurance required a 6 month medically supervised diet, and only a physician is able to submit the letter of medical necessity for the surgery approval. Weight Watchers, while an excellent program, does not provide the medical oversight necessary for many insurance companies to approve the surgery. Using the accurate documentation from Weight Watchers should be a good source of information to augment the information submitted by your physician. Perhaps both sets of documentation can be submitted together...just a thought!

Seems like your system is irritated...perhaps it would be helpful to return to a liquid diet for a day or so to allow everything to calm down. BTW, I was advised by the dietitian that Protein bars, along with any type of granola bars are not good choices for the Band diet. Hope you will feel better fast!

No, salad greens and other raw veggies would not be good choices for this stage of post op eating. I was advised to wait until at least 6 weeks post op before trying any raw or steamed veggies. I missed salads so much...so much so that now every day lunch has raw baby spinach and a lean Protein or hard boiled egg.

I believe that the best reward that you can give yourself for dieting success is not related to food. A "food reward" for dieting success sends the wrong message to your subconscious thinking, and reinforces the flawed thinking we generally have towards food, which is a strong factor as to why many of us got to the point of band surgery. What do you enjoy, what do you usually not do for yourself? How about a massage or a spa day?? I'll take a massage any day...and I do miss an occasional cheeseburger! I hope that you are feeling better!

I was sorry to read of your situation; it can be so disheartening to feel that after all that time you are back at the beginning. So many of these issues happen because we loos touch with the reasons we initially had the band surgery...reflect back to those thoughts, and get your thinking centered again. Most importantly, set a few short term goals for yourself. Keep them simple and realistic to achieve. It has helped my hunger to drink free fluids when I feel hungry. It's a win-win. You get the fluids you need, and stay away from eating anything but the right foods and portion sizes to comply with your diet. Believe in yourself...and the rest will follow!

While I was limited to "mushies", I ate the Proteins I wanted to by pureeing everything in the blender. Even white meat chicken, with a little chicken broth added to increase the moisture level of the chicken. Actually, everything went into the blender...one of my all time favorites is pureed cantaloupe. Absolutely refreshing cold! I believe that there is a place on the forum for sharing recipes. I have preferred to keep everything basic and simple, I guess much easier for me as there are no children living at home now. Congratulations on your progress!

Your goal weight is usually discussed with your doctor. The BMI chart is important to consider also. Some doctors will also make adjustments to the "number" based on frame size and age. As was explained to me by the PAC, my doctor has a "target" weight for me (he uses a formula not disclosed to me), there is an "ideal" weight, which you will usually find online and is adjusted for height, and usually the patient will loose weight to a number between the target and the ideal. My ideal weight is listed at 134, but I believe that a good compromise of 140 is more realistic for me, which is well below my target weight. I think the doctor's usually give you a wide margin for your weight goal. You know your body best, so you also know at what weight you feel and look your best. I would let that be a guide...good luck! Any loss is progress!

Many people have difficulties with developing a positive and accurate self image, including those who have lost a considerable amount of weight. Working with a therapist to address these issues definitely would be helpful, but there are also other things to try as well. First, it important that the reassurances for positive self regard are initiated with you. The negative thoughts you wrote about are just like tapes you replay in your mind, over and over. Try to raise your awareness of the messages on those tapes, and change them to focus on positive and accurate thoughts. Identifying and modifying them will be a key issue to focus on with a therapist We all need some external validation from others, but ultimately, it is much healthier if we can develop our own positive self regard, and then we are able to reason our way through the negative thinking. You can begin to work on this today by challenging the accuracy of your automatic thoughts. If you "hear" something often enough, you tend to begin to believe it. Only you can change the messages on those tapes...it just takes some practice! Good luck!

My surgeon stressed the importance of taking both a multi Vitamin and calcium supplement. This is not because the food choices are questionable in quality, but that we limit the quantity of food, and the ability of the body to absorb all of the nutrients it needs is then also limited. The supplements I use are both chewable. I purchase the vitamins at his practice because they are less expensive there, and the calcium from CVS.

You bring up some valid points which should also be considered in this thread...and though others have missed the point I was attempting to make, I feel it was necessary to include the research one is using to write an article for a magazine. I rely on information to make informed choices, and I prefer to think for myself. If the article is addressing new approaches to diet and relies on research to make that determination, I would ask why did the doctor who rendered the decision not write the article instead of the dietitian, who did not cite any specific research. And no, I do not expect my doctor to prove everything he tells me. What I will say is that prior to seeking treatment from any physician who is new to me, I do research into their training, their board specialty certifications, and their history, if any, of any disciplinary actions taken by their governing medical board or court judgments which may be on record for the past 10 years. This practice has guided me away from a marginal physician on more than one occasion. I believe we owe it to ourselves to be informed consumers when it comes to our medical care. I ask questions, and do reading to better understand the issues. That practice is not wrong for me to do, and it has no impact on others. If this forum is a place where only 1 perspective is considered acceptable, then it is not at true community of supportive individuals... IMHO FWIW

This is a journey...and now is your time to focus on healing from your surgery. Remain compliant with your surgeon's instructions, and you will see progress! At the end of my post, if you "click" on my "ticker", it will take you to the site where you can design one to your preferences. Just follow the prompts... Good luck!

Please don't give up on your efforts to loose weight...this is a journey, and not an event! It takes time, and begins with baby steps... You did not mention if you had received any pre op nutrition education from a dietitian. If you have not yet met with a dietitian, it would be a helpful to do so. I was required to have 2 appointments with the dietitian and take a 3 hour nutrition class pre op and it has made a difference for me. The only other information I want to add is that I was advised to never count calories by my surgeon. I was given a comprehensive book which had food choice guidelines outlined for every stage of our diet. Each meal consists of 3 oz of lean protein, and 2 oz of a fiber carb. One of the carb choices every day can be a complex carb (IE. sweet potato). Also stressed to me was the need to measure my portions by volume after the food is cooked, take small bites, chew thoroughly, and a meal can last only 20 minutes. When you feel full, you must stop eating... I hope this information helps...and I would definitely consult with my surgeon about how you are feeling. You can do this, and we generally do better when we have some emotional support. Good luck!

Is that "Griding", or is it supposed to read "grinding"? If you are referring to teeth grinding (bruxism), generally this is not surgery related, but as a result of stress and anxiety. It might be possible that this is a delayed reaction to having your surgery. Keep monitoring how you feel. If you find your jaw becoming painful, you might want to consult with your dentist. TMJ can be a result of grinding, and that's very painful.

I have a friend who had the original gastric bypass surgery over 10 years ago. She told me while I was pre-op that she had known only 2 people who had opted for the band, and both of them had ended up having the band removed. She did not know the reasons why... I never had any second thoughts, because my surgery had to be delayed for so long. No regrets for my choice!

No, only sharing my opinion, just like you...and they are not the same opinion. So? If you could "hear" my message, then you were not reading it! Really, enough already. The "horse" is dead...

I still contend that via your published writing that informing people it's alright to modify the rules they live by with their band without first consulting with their physician is NOT sound judgement. If you are in a medical or allied profession there are considerations about publishing information which, in my professional opinion, goes beyond the scope of the author's professional practice. I also wrote that if she has the research, she should have cited the research studies if she wanted to publish what she did. That was my message; as you seem to have missed it. I think people should take the time to read things and interrupt them for what they are stating not for what they think they are stating...to quote you... I am all about self determination and being one's own best advocate...and I do read posts and have an opinion about them, as you do. I tend to want to "interpret" what I read, while according to your writing you seem to "interrupt" it instead. We all are going to have an opinion, and I, just as you are entitled to have an opinion. All participants on this forum have the same rights. The First Amendment...no argument intended, but a discussion. There was no scientific data cited or published with the article. I have been trained to accept nothing at face value scientifically unless and until I can read the journal it came from, and read the actual research data. Is there something the matter with that? You seem to believe there is...another difference of opinion... If you took the time to review my post content (not just this thread) you would read many posts which are both supportive and informative, which is the essence of a supportive community and wanting to help others as others have helped me. I hope that you are more calm now if you read this; and you did the correct thing to write about your feelings. That's very therapeutic, and it also helps with the accuracy of communication. Your mileage may vary...and best of luck to you!

Very interesting article, thanks for sharing! I will continue to follow my surgeons instructions, as none of them have posed any hardship for me, and the results have been positive ones.

If your exercising post op is relatively new in your life, it is possible that you are becoming more fit with your addition of muscle, which does weigh more than fat; so sometimes we do tend to loose inches instead of weight. Another consideration is that some of the medications you mentioned may be working against you in the weight loss aspect; psychotropic meds are notorious for this side effect. I would consult with your prescribing physician to identify the side effects of your current meds, and perhaps there are alternatives to the ones you are taking now. If you are meeting your daily Protein goals, are you also meeting your daily free Fluid goals? I have found that without drinking enough Water, my rate of weight loss will slow down. Though I have yet to have a first fill, I have read posts from others which seem to indicate that your feeling of restriction may take several fills to accomplish. This is a discussion to have with your surgeon. I seems that you are doing the right things to be successful...now maybe a bit of fine tuning with your meds might help. Stay on track; eventually all weight loss plateaus reach their end if you remain compliant with your diet!

They have actually done studies that validate that people who are up later into the evening tend to weigh more. I would think that it is important to try not to go to bed hungry, so you could avoid waking up in the middle of the night with the munchies. I know that it is impossible for me to fall asleep if I am hungry. I sometimes will have a small slice of Protein, such as turkey or chicken before going to bed; that makes for high protein and few carbs. I also am a chocoholic but cannot allow myself to give into this craving. The best alternative I have found to date is a 1/2 teaspoon of Peanut Butter (makes no sense, but it does satisfy the chocolate craving ) It would seem that finding a way to stay asleep the entire night is the solution for you. Good luck, I know how difficult this can be!

Though I have never seen any of the actual gels, I believe that "krill" oil is now being used as an alternative, and the gels are supposed to be smaller than the fish oil capsules. There are some contraindications to using krill oil, so I would definitely check with my doctor before using it as an Omega3 alternative.

If you are eating carbs such as rice and pasta on a regular basis, that alone could possibly derail your weight loss. Eating properly with the band means (at least as advised by my surgeon) that every meal consists of 3 oz of high quality protein, and 2 oz of a fiber carb (for me fresh fruit, vegetables, sometimes I steam the veggies). Our ideal diet should be very low in carbs, and they need to be healthy ones. Unless the pasta is whole wheat , it would not meet the nutritional requirements we are supposed to abide by. I have not had any pasta or bread since weeks prior to my surgery. Another important note is that we should avoid all the "white" foods (sugar, bread, rice, etc.) as these are over processed and have little nutritional value and the body converts them almost immediately to sugar after eaten.

Though every doctor seems to have a slightly different set of guidelines to follow. it was stressed to me the importance of measuring everything you eat...not by weight, but by volume, after it is cooked. Each meal is supposed to have 3 oz of Protein and 2 oz of carb. Carbs are also appetite stimulants, so they need to be chosen wisely. I was advised to stay away from processed foods as much as I could, and to avoid all foods which have any form of sugar added to them.

The other posts have covered this topic quite well. I have used the GNC Wheybolic Extreme powder for my Protein shakes; 1.5 scoops has 30 g of protein. I found this one to be the most palatable choice for me. You may have to try several before you find one you like. The only additional information I would add is that my surgeon advised us to use only 100% whey isolate protein powders. For bariatric patients, this is the most nutritious choice with the fewest carbs. Especially in pre and post op, I found it nearly impossible to drink as much as I was advised to, so every shake had to deliver high with the protein grams.