Jean McMillan

It's probably safer to say, "No more today" than "No more!" I often say that if you told me I could never, ever eat ice cream again, I'd be on my way to Dairy Queen faster than you can say "saturated fat."

If tortilla chips and hot sauce are your demon, you need to keep those bad boys out of your house, your car, your workplace... Ice cream used to be my demon. I would eat half a gallon at one sitting every single night. Ice cream happens to be entirely compatible with the band. The band can do nothing to stop that demon. Only I can. So I no longer buy ice cream and I do my best not to even walk down the freezer aisle at the grocery store.

My surgeon told me that the band was safe to leave inside the body (with or without fill) for a lifetime. It's made of biocompatible ingredients, like artificial joints and other medical devices. Yes, complications are possible, but that's true of every WLS procedure. Since the band was approved for use in the USA in 2001 (12 years ago), you're probably not going to find anyone here who can tell you what banded life is like after 15-20 years. You might be able to get feedback about that from bandsters located in Australia, Europe, and the UK. Maybe ask about it in one of the forums listed here: http://www.lapbandta...support-groups/ A bariatric surgeon is really the best person to tell you about the long-term safety and implications of band surgery, but depending on low long they've been in practice, they may not have anyone in their current practice who has been banded as long as 12 years. It's entirely possible that those patients lost their weight and moved on to new and wonderful things. Removing a band is possible if medically necessary but is not something you'd do (I hope) just because you felt you were done with it, because it's not as easy as band placement because of scar tissue from the original surgery. I loved my band, but If I were a self-pay patient like you, I probably wouldn't choose the band because I'd be afraid that I couldn't afford to pay for enough adjustments (adding and removing saline) to help me lose weight and to deal with any side effects or complications. I can't recommend the sleeve because I'm not getting along with mine very well, and I have no personal experience of other WLS procedures. You can get feedback on those procedures at LBT's affiliate sites (shown at the bottom of the forum page).

Look at it this way. Being reminded of how you felt before you were banded can give you a useful reminder of how far you've come since your surgery. I try not to dwell on stuff like that, but I don't want to become complacent either. And I don't ever want to take for granted something that turned my life around.

Guess what? Today is almost over, so your bad eating day will soon be history. And the best part is you can start fresh tomorrow.

Nate, People often ask me what I wish I had known before I had band surgery. My answer is invariably that I wish I had known how long it could take me and my band to achieve optimal restriction. My dietitian assured me that I wouldn't be hungry after surgery because of internal swelling, but I was starving hungry the day after surgery and felt that I could eat anything in any amount. Fortunately for me, I was too scared of complications to vary from my post-op diet progression. Should my dietitian or surgeon have told me anything different? Probably not, because individual patients react so differently to the band over the course of time. It might have been helpful if they had used more words like "might" and "probably". So where I got most of my encouragement and guidance in the first few months was from the in-person support group meetings where I was able to talk with other patients who had gone through bandster hell and come out the other side feeling great. I hope you're able to find that kind of support here on LBT. Right now, I just want to tell you one more thing: Don't give up on your band or yourself. This is just a little bump in the long road to weight loss.

Do you mean higher on the stomach? Because the band would be useless if placed anywhere on the esophagus.

You weren't asking me, but I'll answer anyway...Variable restriction is extremely common, and can be one of the most frustrating things about the band. It's not necessarily due to a complication like a band slip or esophageal or stomach dilation. Your stomach is living tissue that expands and contracts to help you digest food and is affected by a variety of ordinary things like the time of day, time of month, stress, hydration, medications, illness (for me, seasonal allergies always played havoc with my band). But...if the variations in your restriction are so extreme that it interferes with your daily living, I would suggest that you bring it up to your surgeon again.

Well, one good thing about an unfill (or the least bad thing) is that it makes you appreciate how much your band was doing for you before the unfill.

Try not to be too discouraged by negative posts. People tend to post more often when they're struggling than when they're doing fine. It's just the nature of a support site like this. I was banded on 9/19/07 (with the old 4mm Lap-Band) and lost 100% of my excess weight (90 lbs) in one year. I had some ups and downs, many of them due to user error, but I loved my band. I loved the adjustability of it, the early and prolonged satiety it gave me, and also its appetite reduction feature. I had a band slip at 21 months post-op that was resolved with a complete unfill and 6-week rest period. We don't know why it slipped because I hadn't been having any problems, so it could've been related to poor surgical technique by my original surgeon or plain old dumb luck. Then when I started getting gradual fills again, my port flipped (maybe due to a failed suture) and my new surgeon had so much trouble accessing it that we decided on surgery to reposition it. Unfortunately my work schedule delayed that surgery for several months and I regained about 20 lbs, but as soon as I got enough fill back in there. I was able to lose the 20 lbs. I lived happily with my band until December 2011, when I started having reflux. It got worse despite taking omeprazole, so I had another complete unfill, an upper GI study that showed esophageal dilation, and an EGD that showed esophageal damage from decades of "silent" reflux (long pre-dating my band). Since my band was probably aggravating it, my surgeon and gastro doc decided that we needed to remove my band. My band was removed in April 2012 and I had VSG surgery in August 2012. Since then I've lost the 30 lbs I had regained because of losing my band, but I'm having more problems adjusting to life with my sleeve than I ever did adjusting to my band. Weight regain is a possibility for every obese person, no matter what (if any) WLS procedure they have, because obesity is a chronic, incurable disease affected not just by our conscious eating behavior but other factors not within our individual control (like hormonal, neurological, inflammatory and other problems). Weight management is a lifetime project, but I promise you, all that work is soooo worth it! Jean

I think it's way too early to give up on your band. And take my word for it: I had to revise from the band to the sleeve, and life with the sleeve is far more difficult than I ever expected it to be. And unlike the band, you can't adjust the sleeve. Once that big chunk of stomach is removed, it's gone forever, like it or not.

Do you ever look at your plate of tiny bandster food portions and think, "That's not enough to keep a bird alive"? That thought, or one like it, crossed my mind every time I sat down to eat in my early days as a bandster. Although I was eating tiny portions, losing weight, and feeling stronger and more energetic as each day passed, my brain kept whispering, "Something's wrong with this picture." Eventually I grew accustomed to those small portions, and now I rarely think about it unless someone else makes a comment about it - like my coworker who looks at my doll-sized lunch and exclaims, "I don't know why you even bother eating!" ONE MEAL AT A TIME Getting used to bandster food portions took me 6 or more months. At first I would look at my small plate with tiny portions of food on it and instantly feel deprived and sorry for myself. Never mind that the small portions were plenty of food for my banded stomach...they just weren't enough for my brain to accept. By paying very close attention to how I felt as I ate, I realized that small portions were indeed enough to quell my physical hunger and that I wasn't going to drop dead from malnutrition. Of course, the small meals didn't keep the hunger at bay for very long until I'd gotten enough fill in my band for a small portion of food to send long-lasting satiety messages to my brain. Since I was terrified that eating too much at one meal would hurt my band somehow, I stuck it out. My nutritionist's eating plan included 3 small meals and 3 planned, healthy snacks each day. I have to admit, I looked forward to each and every one of those meals or snacks. It wasn't until after I'd reached my goal weight that I began to forget to eat and stopped looking forward to each upcoming meal as if it were a happily-anticipated Thanksgiving Dinner. Yes, it would have been nicer and easier if the long-lasting satiety had kicked in earlier on my WLS journey, but really can’t complain because later is better than never at all. Maintaining my weight loss means eating like a bandster for the rest of my life. So I had to work my way through one challenging year in order to enjoy 35 or more years as a healthy, normal-weight person with a small appetite. Seems like a pretty good deal to me. But then you know me, Little Miss Sunshine! A MATTER OF PERSPECTIVE One day when I was about 9 months post-op, I found myself in a restaurant looking at the food on someone else's plate and thinking, "Oh my God, look at genormous plate of food!" That genormous plate of food contained the same huge serving sizes I ate as a pre-op, but because of the mental adjustment I'd made, it no longer triggered the "Oh, goodie!" button in my brain. In part, it's a matter of perspective. Perspective refers to the appearance of objects (or subjects) in relationship to each other. When my personal perspective was to view a Thanksgiving dinner plate as my "normal" food portion, the genormous plate of food looked right to me. After 300 or so bandster meals and snacks, my perspective had changed so that a tiny portion was my "normal", and the genormous plate of food looked ridiculous, even overwhelming. MASTERING THE FEAR OF FOOD DEPRIVATION The issue of food deprivation is a topic that deserves more attention. If we don't learn how to deal with it in a healthy way, achieving weight loss and a healthy lifestyle is going to be a lot harder. Fearing food deprivation is a basic instinct that drives every living organism. Every creature - human, animal, insect, you name it - survives by seeking food and shelter. So when I tell you that you need to master your fear of deprivation, I'm not telling you to deny this basic instinct by not eating when you're hungry. In fact, I'm telling you to respect it, that in fact you should eat when you're physically hungry. If trying to ignore physical hunger has been your strategy during years of dieting, it's time to try another strategy. You will never learn to recognize early satiety, or to experience and honor prolonged satiety, if you ignore your hunger. There's nothing intrinsically wrong with hunger. It's simply your body's request for more fuel. Food is fuel that you need, fuel that you deserve, fuel that you must have to stay alive and be healthy. While you're re-training your conscious mind to respond appropriately to physical hunger cues, you may go on experiencing uncomfortable emotions about eating less. There's no shame in that. Talk about it with your support group, friends, and/or counselor, or write about it in your journal. Generally speaking, keeping your emotions bottled up gives them more power to hurt or control you. On the other hand, talking about them to the exclusion of everything else isn't helpful either and borders on the obsessive. When I need to talk or journal about something upsetting or painful, I give myself a time limit. The time might be a 50-minute counseling session, or 10 minutes of journaling. When the time's up, I go on to something else. THE HALF-PORTION APPROACH I talk a lot about this approach because it's a good way to prevent overeating, and I’ll repeat it now because the half-portion approach is also what made it possible for me to survive my fear of deprivation while my mind and body adjusted to eating small food portions. Here's how it works. 1. Do not put serving dishes on the dining table. 2. In the kitchen (or wherever), measure out your planned bandster portion. Put half of it on a small plate (like a salad plate or the saucer for a tea cup), take it to the dining table, sit down, and slowly eat it, paying as much attention as possible to how you feel as you eat. (If you're eating in a restaurant, ask the server to bring a to-go box with your meal, put most of the food in the box, close it, and start eating what's left on your dinner plate.) 3. If your body gives you any "soft stop" signals, stop eating. You can throw the uneaten food on your plate away, or if that makes you anxious, put it and the other half of your portion (the one you left in the kitchen) in a storage container in the refrigerator, knowing that you can eat it later if and when you get physically hungry again. 4. If you finish the half-portion without getting any soft stop signals, go back into the kitchen, put the rest of your portion on your plate, take back to the dining table, and eat it, following the same instructions as in #3 (above). 5. If you get physically hungry again before your next planned meal or snack, go ahead and eat the reserved food portion. Eating it is not cheating, because you had planned to eat it, you measured it, and it's yours if you want it. This approach helped me get used to eating small portions while staying alert to satiety signals without the overhanging fear and anxiety of food deprivation. Give it a try, and let me know how it works for you!

I'm forced to post this here because my elderly brain has not been able to retrieve a recent post (yesterday or today) in which someone asked me if my band book, Bandwagon, is available for the Nook. I'm not trying to advertise the book (though I've payed LBT plenty for that privilege in the past), just trying to answer another member's question. So, here is the answer. Yes, a Bandwagon Kindle version is available on amazon, but I warn you in advance that it's got some formatting issues. Nothing horrible, it's still readable, but it's kind of weird. That's because I know virtually nothing about e-books and did a botched (but free) job of converting the manuscript to Kindle format. If you do buy the Kindle version and would like to tell me where I went wrong, I'd be glad to hear it! Thanks, Jean

I'm even more techno challenged than you are. The e-book is formatted (not very neatly) for Amazon Kindle products and I don't know if that's compatible with an iPad. You might find more info about it on Amazon. There's a Kindle help forum (see below) where Kindle users might be able to help you. Or ask about it wherever you got your iPad? http://www.amazon.com/gp/help/customer/forums/kindleqna/ref=hp_ss_comp_kindle_forum_C

Missy and CG gave you good advice about calling your surgeon for post-fill protocol instructions. It's possible that eating a meal of solid food added to your discomfort, but I don't see how holding your 20-lb child could affect your band or stomach. If by saying your stomach hurts you mean that your abdomen hurts, it's probably just irritation from the needle and that will go away soon enough. If picking up or holding your daughter causes you pain or discomfort right now, you might want to ask a family member to help out for a few days.

Yes, there is a risk in not following your post-op diet. That's a common cause of band slips. Here's a link to an article on why it's not a good idea to cheat on your post-op diet: http://www.lapbandtalk.com/topic/163124-help-guys-band-or-sleeve-im-scheduled-for-band-feb1/

It sounds like you've got a case of Soft Calorie Syndrome. A small unfill could help you eat the solid food that provides the early and prolonged satiety that the band is supposed to give you. Part of your problem could be not that your band isn't working but that you're very sensitive to it and can't tolerate the same amount of fill as others can. If I were you, I'd want to try a different fill protocol before giving up on the band altogether. I'm not qualified to say whether your surgeon is acting in your best interest, but performing another surgery on you can be seen as a way for him to increase his income. Please don't let yourself believe that weight loss with the sleeve is easier than weight loss with the band. It's not. Success with every WLS procedure requires good nutrition, exercise, and other lifestyle changes, and no WLS fixes the eating demons in your head. I loved my band and am having a hard time getting along with my sleeve. You can read about my experience in this thread: http://www.lapbandtalk.com/topic/163124-help-guys-band-or-sleeve-im-scheduled-for-band-feb1/

Your surgeon and/or nutritionist are the best people to advise you about your diet progression at this point. Until you get clarification from them, I would follow whatever your post-fill protocol is, such as 24 hours of liquids, 24 hours of purees, 24 hours of soft foods (foods you can cut with the side of a fork), then carefully transition back to solid foods.

Hilary, Sounds like your bariatric surgeon & staff haven't been doing their job, which unfortunately happens quite often. I wrote a book about how the band works and how to get the most out of it, but I can't figure out how ti distill everything you need to know into something that would fit in a forum post. So right now I'll just mention 3 things. 1. If you are having eating problems (stuck episodes, regurgitation, etc.) a few times a week, your band may be too tight and/or you may need to work on your eating skills (take tiny bites, chew very well, eat slowly, don't drink while you eat, etc.) and on making yourself stop eating when you've had about 1 cup of food. You may want to go on eating at that point, but if you do, you'll risk another eating problem, and those things tend to snowball, and you'll end up with an esophagus and stomach that are so irritated that eventually you could have problems even drinking liquids. 2. The consistency of the food you eat counts for a lot. While it may be easy to eat 2 cups of something like oatmeal, yogurt, mashed potatoes, or thin crunchy stuff like chips and crackers, you'll get the most and the most long-lasting satiety (the sense of having eaten enough food) by eating mostly solid food like animal Protein, non-starchy veggies, and fruits. When eating food like that, you may find that only 1 cup feels like enough. 3. After eating like every meal was Thanksgiving dinner for several decades, it took me a long time to learn how to recognize satiety and how to make myself stop eating. It's important to pay very close attention to how you feel as you eat now. If you wait until you get a Thanksgiving-stuffed feeling, you've overeaten. Everybody's different, but some "soft" stop eating signals include: hiccups, burping (or the urge to burp), sneezing, a fullness at the back of the throat, an urge to clear your throat, pressure (but not pain) in the chest, and right shoulder pain. You may not notice those signals every time you eat, but over time you'll be able to notice and heed them better. Jean

You might want to consider finding another surgeon to do your aftercare. Sounds like you didn't get off to a good start with the original one.

Dude, Please keep your pecker to yourself. Or talk about it in the men's forum.

Not to worry. I know for a scientically proven fact (courtesy of Reader's Digest) that laughter is the best medicine.

When I decided to have bariatric surgery (back in the olden days), I went into it open-minded. A friend was having great success with RNY (gastric bypass), but when my surgeon explained the 3 procedures he did then (Lap-Band, RNY, and VSG), I just had a gut feeling that the band was right for me. It didn't involve altering my anatomy (other than clamping a removable silicone band around my stomach) and the adjustability of it appealed to me. At the time, I also bought into the idea that the band is the least invasive surgery, an idea whose time has passed because all surgery is invasive. So I had band surgery on 9/19/07, a red-letter day in my life. I loved my band. I lost 100% of my excess weight (90 lbs) in a year. I put my heart and soul into my band and my online community of bandsters, wrote 2 books for bandsters, started work on a 3rd book, met a lot of my online friends in person, published an e-newsletter for bandsters, attended WLS conferences, sat on ask-the-expert panels, spoke at support group meetings...and life was wonderful, until December 2011, when I began having symptoms of esophageal damage from 20+ years of "silent" reflux. My gastro doc and my surgeon agreed that my band could be aggravating my condition and had to come out, so in April 2012 my band was removed and in August 2012 I revised to the sleeve. I have had more medical problems in the 5 months since then than I'd had 15 years, all of them related to my sleeve. If you can hold back your tears of pity for me for a few more minutes, you can read about my life with the sleeve in my response to this recent thread: http://www.lapbandtalk.com/topic/163124-help-guys-band-or-sleeve-im-scheduled-for-band-feb1/ And if you have any questions after reading that, let me know. If I can't answer your questions, I can probably point you in the right direction. The take-home message here is that there is no such thing as a perfect, effective, risk-free weight loss surgery, but bariatric surgery of any type is still the most effective treatment for obesity available at this time. One day, medical science may come up with a cure, and even some kind of innoculation against obesity. In the meantime, obesity is a chronic disease without a cure, and no matter what kind of WLS we choose, we'll have to fight the obesity devil for the rest of our lives.

That's the first time I heard of the sleeve reducing sweet cravings. Or any cravings. When my band was adjusted properly, I had very few cravings, very few intrustive food thoughts, and even the flavor of food wasn't thrilling any more. But in the time between my band removal and my sleeve revision, all that changed. Lots of cravings, lots of food thoughts, and every bite of food tasted fabulous again. I have now been sleeved for 5 months, and none of that has changed. Everything tastes wonderful, I think about food a lot, I crave certain things (including sweets, which I can't eat because they make me dump), and every meal or snack requires Iron will to survive it without overeating. And unlike my band, there's no way to adjust this sleeve of mine. It is what it is. 75% of my stomach is gone forever, so there's no going back now.

And who do you call? Trollbusters! (let's pretend I pasted a photo of Dan Ackroyd and Bill Murray into this post)