Persimmon

Your esophagus/stomach area is banded, not your windpipe...not the same part of the anatomy. If food gets stuck in your band, it doesn't affect your breathing. Anatomy 101... Metamucil is nasty regardless...Fiber from real food or Benefiber (which doesn't get thick and nasty) is better. Nancy -156

Doesn't matter...biotin doesn't address the causes of post-op hairloss regardless. It can't counteract the body's reaction to general anesthesia/shock of surgery and it can't counteract the excess hormones floating around due to shedding weight (we store extra estrogen in our fat). It's temporary. As long as you're getting enough Protein and eating a balanced diet, you can rule out nutritional causes...it's extremely rare for bandsters to lose hair due to malnutrition...takes a lot of work (and a big lack of common sense) to achieve that. Nancy -156

Any doctor telling you that you as a bandster should be eating 1/4-1/2 cup of food per meal has been improperly trained about banding. Period. That is from RNY protocols. Properly restricted bandsters eat between 1 to 1 1/2 cups per meal, get 50-60g protein from solid foods, 1200-1500 cal/day, sensible healthy balanced diet. Anyone feeling full on 1/4-1/2 cup meals is basically too tight which leads to banding complications. Banding is about sensible loss...attempting to starve it off with these instructions will put the body into starvation mode and make proper loss difficult if not impossible. The RNY confuses the body so that this is avoided during the initial honeymoon but that is not the case with bandsters. Gah...doctors...they get no education in nutrition in med school then are too big of control freaks to deligate that patient education to the people who DO have the education. Nancy -156

Well, first you have to eat like a bandster to get any accurate idea if you have proper restriction. You cannot test restriction on mushy or junky foods. A properly restricted bandster should be eating between 1 to 1 1/2 cups per meal, which means 3-4 oz solid Protein, 1 serving (1/2 cup) nonstarchy veggies and up to 1 serving (1/2 cup) starch if there's room...eaten in that order. Small bites, pause between bites (put the fork down if that helps), chew to almost liquid. If you're getting discomfort after just a couple of bites, you might be experiencing "first bite syndrome" aka esophagal spasms. To test (and fix) this, before you start eating, have some hot liquid...hot tea, broth, something light, but hot. If that allows you to eat your meal comfortably, then that's what's going on. If that doesn't help, and you know you're chewing and not rushing, you probably are too tight. Chef Boyardee Ravioli...not a good choice...it's a mushy. Fast food sandwiches...not a good choice. First adjust the eating habits then, if those are fine, adjust the band (either fill or unfill, as warranted). If you're unsure of how to eat a healthy balanced diet based around solid foods, get a good nutritionist to help you ASAP...a bandster's diet is really something any sensible weight loss diet will have already taught you...basic nutrition, based on healthy solid foods, treats/junk very sparingly. Nancy -156

"I can eat more than I think I can"... That's part of the problem...you're putting too much in front of you. It's really important, especially during this learning phase and while you're working toward proper restriction to make sure you're putting proper portions on your plate and not expecting the band to force you to stop midway through a too-large meal. This is one of the most common mistakes new bandsters make. If you're feeling like you're about to PB a lot, you're doing something wrong. Give up the crutch of washing the problem away with drinking during meals and address the problem. You're either not chewing enough or rushing your bites (put your fork down between bites to help slow you down), taking too-large bites or eating foods your band doesn't tolerate, or simply too tight. It also might mean you are ignoring your actual full signals. Full post-op means something different than pre-op. Pre-op, full meant stuffed/uncomfortable...post-op it means "not physically hungry anymore". We need to look for our "soft stop" which can be something like a burp, runny nose, sneeze, hiccup, a little sigh. Evaluate physical hunger levels after every bite (another reason not to rush) and see if you notice anything like that...that's the point where you need to stop eating. Ditch the Water at meals...you're sabotaging your band by continuing to drink with meals. Nancy -156

I never drink with meals...haven't for over 10 years. It's a bad habit and a major cause of heartburn and can allow you to cram more food down. As a bandster, I knew from the get-go that it was one of the things that was the most likely to prevent my band from doing its job...it washes food through the stoma faster thus allowing us to eat more...and if the pouch is already full, it can cause puking. Neither a good thing. So it's actually really important. Drink a glass of water/fluid right before your meal then remove the glass from the table. As the Nike ads say, Just Do It. You've got to go cold turkey on it. If you're properly hydrated, you won't be "thirsty". It's just a habit. Nancy -156

You should have a followup appointment around 6 weeks out at which you can then discuss with your doctor if a fill is warranted. Most people need to go through 3-5 fills before getting properly restricted. Then, a new fill should be given a good 4 week try to see if it's working (restriction isn't really a "feeling", it's more a result...proper weight loss (1-2lbs/week on average) and your sensible bandster meals (3-4 oz solid Protein, 1 serving (1/2 cup) nonstarchy veggies and up to 1 serving (1/2 cup) starch if there's room) are making you full (full = not physically hungry anymore, not discomfort/tightness/about to puke/stuffed) and not get physically hungry again for 3-4 hours. No office person on the phone should be refusing to let you have an appointment. Even if you're still losing, if you're experiencing hunger and lack of satiety, you need a fill. Proper restriction results in both things. Nancy -156

Um...cuz somehow whoever gave you that card doesn't understand the difference between RNY patients and bandsters? Properly restricted bandsters eat between 1 and 1 1/2 cups of food and even that much can make it hard to get into the proper 1200-1500 cal/day range. 3 oz chicken = 1/2 cup. To even just get in the 50-60g Protein you'd need to eat 8-9oz chicken. That would put you under 400 cal/day and not allow for any sort of healthy diet. It's basic math. Bandsters put on RNY protocols do not do well...without the rearranging that confuses the body (so that it neglects to go into starvation mode because it's busy with other things), weight loss will be poor as will health. If you blocked off both ends of the pouch, it would be about 1/2 cup in size...but food is always trickling through as we eat. Part of the trick is learning to eat slower than we did pre-op but not so slowly that we allow too much trickling, thus meals should be no longer than 20-30 minutes. Once you're fully healed and back on solids you should be able to eat a proper bandster meal comfortably....discomfort and difficulty aren't the point. Nancy -156

Typically, bandsters start transitioning to solids around 4-5 weeks out and should be fully back on and tolerating solids for at least 1-2 weeks before deciding if a fill is needed. You cannot judge restriction on anything but solids and you cannot judge restriction on feel. New bandsters tend to obsess about "feeling" restriction and that's not the point. A properly restricted bandster will be losing 1-2lbs/week on average and have their sensible bandster meals (not teeny tiny micromeals...3-4 oz solid Protein, 1 serving (1/2 cup) nonstarchy veggies and up to 1 serving (1/2 cup) of starch if there's room) make them full (full = not physically hungry anymore, not tightness/stuffed/uncomfortable) and not get physically hungry again for 3-4 hours after a meal. So you can't see how things are going with solids until you've been on them for a little while first. Surgeons who fill prior to patients getting back onto solids haven't been trained properly and show a lack of understanding of how the band works. I can't tell you how many people I've seen end up too tight with problems because of surgeons who do this. Nancy -156

Well, to some degree your doc is right...many people experience some swelling from a fill and that goes away after a few days. However, if you cannot comfortably eat solids a week after a fill and get in 50-60g solid Protein and 1200-1500 cal/day, you are too tight and need a tweak out. Fills don't always loosen up, however...some people get kick-ins a week or two after a fill so end up even tighter. There are 3 ways it can go: what you have is what you get, swelling that loosens, or a kick-in/tightening a week or so later. As long as you can get all your fluids in, it's ok to wait it out for up to a week...but if you can't eat solids by then, call your surgeon and insist. Too many docs don't understand that being too tight does NOT help weight loss...soft food syndrome is usually the result and that is one of the most efficient ways to stall loss. Nancy -156

Muggle, I'm really sorry to read about all your difficulties. It's quite evident you are much too tight. It's impossible to eat like a bandster when you're too tight...you must be able to eat solid food comfortably. Your doctors have done you no favors in allowing you to stay this tight and I'm sure that's contributing to your emotional distress. All WLS requires drastic lifestyle changes...the RNY is stricter than the band, I'm sorry to tell you...but it's not easy for anyone...most of us fight old habits every day in some way or another. But what matters now is that you're fighting your band and it's causing complete disruption of your life to the extreme. You need to insist on a complete unfill. Restriction isn't a "loud" thing...it's surprisingly subtle, if it's right. Bandsters should not be puking regularly, unable to eat solid foods, etc. That doesn't result in weight loss...it only results in damage and stress. Being too tight doesn't result in any benefit whatsoever...not even in weight loss...it's nothing but misery. Hang in there and stand up to any doctor who doesn't listen...get that fill out. Nancy -156

Most erosions are generally asymptomatic...usually the patient experiences a loss of restriction...it's a very slow thing. If you have any concerns, of course, you should be calling your surgeon and getting it checked. Pain is more likely to be something like an ulcer. Nancy -156

I don't have any "forbidden" foods...everything in moderation, as tolerated, as long as most of the time I'm eating like a bandster (in the proper order). I have brown rice all the time...has nutrients and Fiber and doesn't get stuck. I also have sushi/maki rolls regularly and that has white rice. Nancy 394/265/180

A shotglass worth of food isn't normal unless you had a micropouch RNY. A bandster meal consists of: 3-4 oz of solid protein, 1 serving of veggies (1/2 cup) and up to 1 serving of starch (1/2 cup) if there's room. How "much" volume you can eat is not one of the criteria of whether or not you need a fill. First you need to make sure you're actually eating like a bandster. If you're doing so 70-80% of the time, then it's based on weight loss and hunger/satiety: 1. You're losing 1-2 lbs/week on average; and 2. your sensible bandster meals are making you full (full = not hungry anymore, not stuffed/uncomfortable/golfball, PBing/tightness) and you're not getting physically hungry again for 3-4 hours. Now, the "meals" you listed...well, to be quite frank, not at all good bandster choices. The band can't choose your foods for you...you have to do that and McDonalds breakfast sandwiches are poor choices (very high calorie due to all the grease in them and poor source of protein). Bagel...high calorie, high in simple carbs, low in nutrition...probably not much protein there either. Try eating like a bandster, and judge your hunger/satiety based on that, and what the scale does over a few weeks. That's the only way to know if you need a fill. Nancy 394/265/180

Please bear in mind that surgeons are really only concerned about 1 thing: the numbers on the scale. If someone chronically undereats, their metabolisms will slow down in response to perceived famine. Also, unless that person is doing real weight training (not toning level, but building level weights), 25-30% of their weight loss will be lean tissue, which also contributes to a reduction in basal metabolism. I managed to do something my surgeon didn't think was possible. She does RMR (resting metabolic rate) tests at her practic. Shortly after my surgery, my RMR was 1850 cal/day. That's just to be breathing, no activity whatsoever, and my starting weight was 394. She retested me when I was about 90 lbs down...now, mathematically, that RMR should have gone down...it goes down for the vast majority of people. However, I had adhered to a pretty strenuous weight-training regime. My RMR INCREASED to 2100 despite losing almost 100 lbs. At no point have I undereaten, and throughout I've been lifting weights. I went into banding determined not to end up a 5'10" 180lb woman struggling to maintain on 1000 cal/day...not healthy for long term living. Nancy 394/265/180

There are no "feelers" at the top of the stomach. Satiety is triggered by the vagus nerve which runs next to the stomach. Many morbidly obese people have physiological or psychological satiety disorders (physiological would be that the signals aren't being triggered properly at the physical level, psychological would be that the person has trained themselves over time to ignore real hunger/satiety signals and responds more to head hunger, etc.). The band, when the pouch fills, "kicks" that vagus nerve which sends a full signal to the brain and when well-kicked, that's what keeps hunger at bay for a few hours...the pouch doesnt' stay full of food for 3-4 hours (which is why it's ok to drink 45-60 min after a meal), but if the signal is good and strong, hunger doesn't come back for 3-4 hours. Nancy Dr. Kurian 394/265/180

That's why my surgeon, her nutritionist (and all the research I've done) say buggers to that idea. Most bandsters should be getting in 1200-1500 cal/day. Larger patients might even start higher. The goal is to lose 1-2 lbs a week on average. I started at at 394 lbs. For me to lose at the proper rate, I started around 1800-2000 cal/day. There is no point dropping lower before you have to...you have to have room to drop. If you start in the 1000-1200 range (or lower) right off the bat, where are ya gonna drop to when loss stops? (and it will stop as the metabolism adjusts) Banding is about sensible weight loss. Ultra-low-cal is not sensible. Rapid loss isn't sensible. Both will nuke your metabolism and make it harder to maintain long-term. When you're eating sensibly, you don't need to be as tight to feel full on those sensible amounts. To feel full on 1/2 cup meals (which is cr*p, sorry but it is...poll done on the huge Bandsters list on yahoogroups a year or so ago showed that veteran bandsters doing well were averaging 1 to 1 1/2 cups per meal, plus planned snacks), you have to have a LOT MORE restriction...that in turn puts you at higher risk for reflux, slippage and/or erosion. My observation over the past 3-4 years on the boards is that US surgeons are being, in general, much more aggressive (because they're trying to hurry up loss), and thus we're seeing a higher slippage and erosion rate than worldwide stats indicate. So, find the highest daily calories that allows you to lose 1-2 lbs/week on average over time, maintain the LEAST amount of fill that allows you to do it comfortably, get over the idea that the band is there to stop you from eating, but embrace the idea that it's there to HELP you stop eating by giving you clearer hunger/satiety signals, and use common sense when it comes to healthy eating for a lifetime. Nancy Dr. Kurian 394/265/180

No. Fills should be decided by both patient and surgeon after a discussion. They should not be "on demand" by the patient because that's an excellent way to get too tight. The discussion should include what and how much you're eating, hunger levels, exercise, etc. Office staff cannot tell you if you'll be getting a fill or not...they are neither the doctor nor the patient. So just go to your appointment and talk about it. Nancy 394/270/180

Never ever compare yourself to a bypass patient. They are losing at a very rapid rate (and that's not really very healthy/safe). In terms of your loss, you're doing fine. If you want to fine tune things, let us know what a normal day of eating entails. Nancy 394/270/180

It's not irrelevant for self-knowledge...it's only irrelevant in comparison to anyone else. At some point in our lives, someone else might need to access our ports...what if there's a tubing kink and they think they've unfilled everything but they haven't and the band really needs to be totally unfilled? If you don't know there was 2.2cc in there, you wont' know that .6cc coming out doesn't match. My surgeon would never dream of thinking it was inappropriate for me to have information that directly applies to my medical care. Nancy

But you're not ON a plateau. You're settling into a more appropriate rate of loss, as you should. A plateau is when you've lost neither pounds nor inches for at least 4 weeks straight. And having a little stall right now is due to really that you've lost a bit too fast initially and your body needs to balance things out. You're only looking for 1-2 lbs/week if you're eating properly. Surgery also doesn't change biology...we will never lose consistently. Nancy

Because most plastic surgery isn't also involving an expensive medical implant (the band itself costs $3000-$4000). It's still less expensive than the RNY... Nancy 394/270/180

Worrying about when food is going through the band is focusing on the wrong thing. First and foremost: Are you losing, on average, 1-2 lbs a week? Second (and almost as important): Hunger...are your sensible meals making you full (full = not hungry anymore, not stuffed/uncomfortable/golfball/puking) and not getting physically hungry again for 3-4 hours? The VG band is much more "forgiving" than the 4cc capacity bands in terms of things getting stuck...it's more flexible. This is a 2-edge sword. It's the primary reason it's often used in band replacements due to erosions because it's lower-pressure on the stomach...however, you'll get less negative feedback from not chewing well enough. Are you generally eating the bandster way? (3 oz solid Protein, 1/2 cup serving of produce, up to 1/2 cup serving of a starchier complex carb) Are you at any point getting a "soft stop" (which might be something like a runny nose, sneeze, hiccup, burp, a little sigh, etc.)? This is your signal to stop eating. Are your meals taking no longer than 20-30 minutes? The longer you eat the more you will be able to eat. Are you waiting for the band to force you to stop? Or to have it help you stop? There's a big difference. The former is a crutch, the latter is a tool. Waiting for golfball etc. is the hard stop which means you've overeaten. When it comes to too-big portions...as Jessie Ahroni says all the time: "Just because you can, doesn't mean you should". Put a sensible portion in front of you. If your'e at a restaurant, ask for the take-home box in the beginning so you can divide your meal into more sensible portions before you take 1 bite. Nancy 394/270/180

Soft food syndrome...in other words, you're too tight. You need to be able to eat solids comfortably. No one should be PBing/puking regularly. Nancy 394/270/180

That's one of the possible "soft stops"...has to do with your vagus nerve. Other possible soft stops are sneezing, hiccup, burp, a little sigh...that's the signal to stop eating. You might notice your nose gets just a little runny earlier than the point where you're very full. Try stopping then. Nancy 394/270/180