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Jean McMillan

LAP-BAND Patients
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Everything posted by Jean McMillan

  1. Jean McMillan

    Only Feel Restriction For 2-3Weeks After Fill

    I had a complete unfill to treat a band slip, and since my port flipped after that, I wasn't able to get fills for almost a year. Once I got more fill in my band, my experience of restriction was very different from the first time around. That was interesting, but it didn't signify anything pathological. I'm a living, breathing human being, not a statue cast in bronze, so my body is constantly changing. I had to deal with another learning curve, but that took maybe a month. Then I was off and running again.
  2. Jean McMillan

    Only Feel Restriction For 2-3Weeks After Fill

    Not a silly question at all. Some surgeons do fills under fluoroscopy - basically an x-ray done while the patient drinks a contrast medium (barium). If the barium is able to pass through the stoma, then theoretically the fill is not too tight. In my opinion, that's not a very useful method because the increased pressure of the band against the stomach can cause irritation and inflammation, and when all that calms down a day or so later, the fill you just had may not feel as "tight" as it did on the first day. And the opposite can happen - the fill can feel even tighter a day or two after the fill. The stomach is living tissue that expands, contracts, and is affected by many things other than the band (hydration, illness, medications, hormones, etc. etc.). So a fill under fluoroscopy is just a quick snapshot of the band and stomach when the fill is done, and a fill that looks OK on the x-ray may not feel OK to the patient. One advantage of fills under fluoroscopy, though, is that it's a good way to catch little problems before they become big problems. In addition to the flow of barium through the stoma, the x-ray will show any signs of esophageal or stomach dilation, for example.
  3. Jean McMillan

    Only Feel Restriction For 2-3Weeks After Fill

    Sometimes restriction appears to disappear after a few weeks because you've gradually adjusted your eating skills to suit the new fill level, so you have fewer eating problems. But if your definition of restriction is that your band lessens your physical hunger and provides early and prolonged satiety, I'd have to wonder if you have a slow leak. Since it's happened to you 4 times now, it's certainly worth mentioning to your surgeon. Does he/she, or the person who does your fills, withdraw all the fluid from your band to check how much there is in there each time you get a fill?
  4. Jean McMillan

    Gurgling & Burping

    First of all, congrats on the great weight loss! I believe that frequent burping can be a symptom of a helicobacter pylori infection, but it's hard to believe you'd still have it (or it recurred) if you were treated for it before your surgery. You may be swallowing air when you eat and drink (especially if you use a straw and/or drink carbonated beverages). Burps are caused by relaxation of the lower esophageal sphincter muscle, and since the band communicates a lot (especially pressure) to the esophagus, your band could be contributing to the burping. I had excessive burping when I had esophageal motility problems, so if you're still experiencing a lot of burping tomorrow, I'd give your surgeon's office a call, just to be safe.
  5. No, you will probably never feel "full" the way you did pre-op, and that's a wonderful thing. In the bad old days, I ate to the point of Thanksgiving dinner full at every single meal. I could out-eat my husband, who's 9" taller and does manual labor for a living. My early days as a bandster were a challenge because I had to give up that old definition of full and learn what my new definition would be. It also involved a lot of willpower because I knew that if I overate, I could cause my band to slip. So I weighed and measured my planned portions of food and stuck to that. I often felt that I could go on eating long after the small portion was gone, but I was too afraid of complications to do that, so I would tell myself I could have more food if i was still physically hungry (empty, growling tummy) in an hour. As I got more Fluid added to my band I discovered that the small portion of food was actually enough. I had to learn new "stop" signals to tell me when to stop eating - it might be a sigh, a cough, a burp, a hiccup, a runny nose, whatever. If I didn't notice or ignored those signals, I would end up in pain because eating too much caused a PB (productive burp), sliming (excess saliva), or getting food stuck. Eventually (maybe a year?) I didn't have to think much about all of that any more because I was in the habit of putting a small amount of food on a small plate, and would stop eating because suddenly I just didn't want any more. The band works by providing early and prolonged satiety. Satiety is the sense of having eaten enough food - no more, no less. To be satiated is not the same as being "full".
  6. Jean McMillan

    Terrified!

    I'm having a hard time visualizing how the bowel could get nicked during band placement, since the bowel is down south and the stomach is up north. The surgeon would have to be massively inept to nick the bowel while placing the port, because the port is situated between the abdominal muscles and the subcutaneous fat beneath the skin. There would be no logical reason for the surgeon to make an opening into the abdominal cavity while placing the port. The organ that's most at risk for perforation during band surgery is the liver, not the bowel. Which is why most surgeons require patients to follow a pre-op liver shrink diet. As for the Crohn's disease, if your GI doc OK'd the band for you, I think you've got to stop obessessing about it. Bad things happen to good people all the time and every kind if surgery has some kind of risk.
  7. Jean McMillan

    A Rock And A Hard Place

    Getting another fill at this point will not increase your weight loss. In fact, it may slow it because when you can't eat solid food, you're too likely to eat slider foods that provide little or no satiety. That in fact may be why you've "only" lost 2 lbs since your last fill.
  8. Jean McMillan

    No Longer Pleasured By Food!

    That's an interesting question. For my first few years as a bandster, I felt like I was actually enjoying my food more because I wasn't shoveling it down - I was eating slowly, carefully, and really tasting it. But gradually I realized that a lot of food had lost its charm for me. It still tasted fine, but I wasn't bothered when I couldn't finish eating a meal. That actually turned out to be a blessing. When I started having problems and all the fluid was removed from my band, all that food suddenly started tasting marvelous again. I'm not sure if being a bandster so long had re-trained my brain's food pleasure center, or if the pressure of my band against my vagus nerves was interfering with the transmission of pleasure sensations, or what.
  9. Jean McMillan

    Finally, Got Stuck And So Happy!

    That's quite true, but I mentioned the other, harsher forum because if someone here is thinking of leaving town (so to speak), I want to wish them the best of luck in finding a friendlier neighborhood.
  10. Jean McMillan

    Finally, Got Stuck And So Happy!

    Well, we're in agreement about that, anyway. Unfortunately good communication skills are not required of LBT members.
  11. Jean McMillan

    Finally, Got Stuck And So Happy!

    I understand your point, but every word I've posted on this thread still stands, and I'm going to add a few more. If you think the response to this thread was harsh, you ain't seen nothin' yet. I can direct you to another online band forum frequented by people with the consideration and sensitivity of Attila the Hun. Also, when interpreting and reacting to posts on any online forum, keep in mind that these are people you may never meet in person. You can't hear their tone of voice or see their body language, so you have to decipher words that are, in a sense. out of context. My best friend, whose honesty I cherish, can say things to me that would make me smack another person for saying, because I know she loves me and wants the best for me. Finally, consider the possibility that "tough love" sometimes does us more good than coddling when we're headed down a bad road.
  12. I'm probably not being very objective about the sleeve right now. I think it could be an option for someone who wants to revise because their band was so problematic, but if you're thinking of revising because of disappointing weight loss, I'm not sure you'd be all that much better off.
  13. Jean McMillan

    Great Expectations

    Recently an acquaintance told me about seeing an obese man on TV who claimed that bariatric surgery hadn’t worked for him. “How can it NOT work?!” Patsy exclaimed. There’s no simple answer to that question. In the past I’ve written about why weight loss surgery fails (read the article here: http://www.lapbandtalk.com/page/index.html/_/support/why-does-weight-loss-surgery-fail-r88). Today I’d like to revisit the topic and focus on how our expectations affect the perception of as well as the ultimate success or failure of WLS. BARIATRIC MYTHOLOGY Some powerful myths influence our beliefs about and expectations of WLS. An especially insidious one that affects both bariatric patients and the general public is that WLS is essentially magic, requiring little or no effort on the patient’s part to achieve the desired weight loss. Hence the infamous and heinous phrase: “Weight loss surgery is taking the easy way out.” This magic myth has a corollary one that purports that the weight lost as a result of bariatric surgery is weight lost forever, again without any effort on the part of the patient. Sorry, but that’s not true either. While the whole point of bariatric surgery is to make weight loss easier, it does not eliminate the need for hard work by the patient. No bariatric surgery can cure obesity, which is a chronic, recurring disease. That doesn’t mean that succeeding with WLS means you’re sentenced to a lifetime of hard labor, dragging heavy chains and digging ditches, but it does mean that in the long term a successful patient is one who takes responsibility for his or her eating behavior, weight management, and general health. Reading the paragraph above may serve to shatter some illusions that you held dear, but when would you rather face the truth: early in your journey, or later? Although I was once a bandster like you, I lost my beloved band and recently converted to vertical sleeve gastrectomy. I have to tell you that despite all my advance research and preparation, the reality of living with a sleeved stomach is giving me a bad case of buyer’s remorse, but there’s no going back now. Seventy-five percent of my stomach is gone forever, but living with what’s left and finding a way to eat and to manage my weight now is an ongoing challenge. And I’ve heard countless stories from all kinds of bariatric patients about the challenges they face after surgery. Anyone who promises you a completely sunny picture of the future is either mistaken or trying to avoid bursting your bubble. BAND MYTHS There are a number of myths related to the adjustable gastric band. One of them is that slower weight loss with the band will prevent sagging or excess skin, and that just ain’t so. A more dangerous myth, peculiar to bandsters, is that fills cause weight loss and unfills cause weight gain. While fluid adjustments are an important part of how the AGB works,the fluid is NOT what causes weight loss. In fact, there is absolutely nothing in any part of the band system (the band, the tubing, and the port) that causes weight loss. The band does not directly affect the way nutrients from food are ingested or metabolized. It releases no weight loss instructions into the patient’s bloodstream, nervous system, or endocrine system. It doesn’t directly affect the patient’s eating behavior or exercise habits. It doesn’t compel the patient to make good food choices, limit portion sizes, eat slowly, or resist the urge to graze or binge because of boredom, stress, cravings, etc. Weight loss results from eating fewer calories than you burn, and the band helps with that by reducing your appetite and causing early and prolonged satiety. Those features are related to the pressure of the band against the stomach and the consumption of solid food whose mechanical digestion triggers the vagus nerves in the upper stomach to send satiety signals to the brain. If the patient ignores those signals, the calories taken in may exceed the calories burned, slowing or preventing weight loss. And since weight is affected by many other factors entirely unrelated to the band (like medications, hormone imbalance, etc. etc.), all we can do is to concentrate on the ones that are within our control and understand that it’s a fallacy to attribute weight loss to the band or to fills. One harmful consequence of the fills=weight loss myth is that the patient seeks more and more fills in the quest for “perfect restriction” (also a myth) or the legendary (but also mythical) “sweet spot.” This patient tends to tolerate side effects and eating problems that can cause serious damage to them and their band because they’re so focused on finding that perfect but elusive fill level and believes (erroneously) that the more fluid in their band, the better. When you suggest to this person that they may actually need less, not more fluid in their band (so that they can eat healthy, solid food instead of not-so-healthy slider foods), they react with panic, so aren’t able to make a good decision and may not even be willing to tell their surgeon about the eating problems they experience. Please don’t read this article thinking that my purpose is to discourage you. I’m the eternal optimist who believes in self-fulfilling prophecies. If you’re determined to lose weight and work hard at it, you can indeed use your band to reach your weight goal. The key phrase in that sentence is “work hard at”. There’s just no getting around that, so if your expectation is that you’ll lose weight effortlessly, you’re probably going to be disappointed in your band, yourself, or both. Your band can assist your weight loss efforts by providing early and prolonged satiety, but it’s not going to make good food choices, control portion sizes, make you exercise, be vigilant with aftercare, win you cash and prizes, or turn you into America’s next top model. On the other hand, believing that you will succeed and working hard to learn and change what you need to in order to lose weight will greatly increase your chances of becoming a bariatric superstar. And when stardom comes from hard work, it is much, much sweeter and longer lasting than stardom that falls at random out of the sky!
  14. Be aware that former bandsters who convert to the sleeve may be delighted with their sleeve mainly because their band was so troublesome, not because the sleeve isn't troublesome. I lost my band in April and had sleeve surgery in August. The good news is that I've lost 12 lbs since then. The bad news is that my physical hunger (which supposedly disappears because of reduced grehlin production) is fierce. I can eat only a few bites of solid food at a time and get ravenously hungry an hour later. It's a pain when I'm at home, but a real problem when I'm at work and am not allowed to eat or drink except when I'm on my 15-minute break, during which time it's almost impossible to eat a sustaining amount of food. The other bad news is that I experience dumping if I overeat, eat too fast, or eat anything with more than 5 or so grams of sugar in it. You'd be astonished at how much sugar some "healthy" foods contain, like skim milk with 12.4 grams per 8 oz serving. I had been told that VSG patients don't dump because the pyloric valve is preserved (unlike RNY), but my surgeon says it can happen because my tiny new stomach can't store or churn food for very long, so it dumps the food into my intestines fast enough to make me hot, sweaty, dizzy, and very nauseated. I hope that none of that will happen to you, but beware of the rosy picture some ex-bandsters paint about the sleeve. Results not typical, you know....
  15. I had to go through a lot of the pre-op stuff again in honor of losing my band and gaining my sleeve. I have a friend who's having to go through ALL the pre-op stuff again in preparation for converting to RNY. If those are the rules of the game, those are the rules you've got to play by. It's frustrating but by no means lethal.
  16. Jean McMillan

    "stuck Episode" Best Thing To Do Is....

    I find it hard to believe that drinking a hot liquid could convey enough heat through the stomach walls and into the band enough to change the rigidity of the band. I wonder if what your surgeon meant is that a hot liquid can lubricate and relax the stomach (and esophagus) to make it possible for stuck food to pass through the stoma and into the lower stomach. The hot liquid tip reminds me of yet another tip, to prevent stuck episodes and other eating problems that I've heard from a number of bandsters: that drinking a hot beverage before you begin to eat can lubricate and "soften" the esophagus and stomach. Might be worth trying.
  17. Jean McMillan

    "stuck Episode" Best Thing To Do Is....

    Who told you that? Your surgeon? First I ever heard of it.
  18. Jean McMillan

    How Do I Admit?

    Amen to what Missy said.
  19. Jean McMillan

    "stuck Episode" Best Thing To Do Is....

    Not necessarily. While there some trial and error involved in adjusting to a fill, careful eating can prevent a lot of problems.
  20. Jean McMillan

    "stuck Episode" Best Thing To Do Is....

    Strategies for stuck episodes: 1. Prevention - take tiny bites, chew very well, eat slowly, don't drink while eating, be extra cautious with foods you haven't yet eaten since your fill 2. During the episode - the only thing that ever worked for me was patience. 3. After the episode - DO NOT GO BACK TO EATING YOUR MEAL, and follow a liquid diet for 24 hours to let your esophagus and stomach calm down.
  21. Jean McMillan

    Seminar Tomorrow

    I don't mean to rain on your parade, but the most common co-morbidities recognized by insurance companies are hypertension, hypercholesteremia, type 2 diabetes and sleep apnea. If the surgeon who did your back surgeries can fully document that your obesity caused your back problems, then that would probably count as a co-morbidity, but depending on your insurance policy, it could be a harder sell. So after saying those discouraging words, I also want to welcome you to LBT and congratulate you on starting your weight loss surgery journey. Jean
  22. Jean McMillan

    Question

    From the point of view of someone who was banded for almost 5 years and wrote 2 books about the band which were vetted and blessed by a bariatric surgeon and a bariatric dietition... The general purpose answer to your question is: EVERY BANDSTER IS AT RISK FOR A BAND SLIP AT ANY TIME AFTER THEIR SURGERY. Overeating can cause a band slip, and so can vomiting, coughing, a failed suture, and poor surgical technique. We need to concentrate on the factors we have some control over, so we need to keep an eye on portion control and get prompt treatment for vomiting or coughing.
  23. Jean McMillan

    Question

    Um, let me hazard a guess. She was trying to be - wait for it! - helpful. Nothing Maddysgram said was presented as medical advice (which to my knowledge no one on thie forum is qualified to give). "Stick to your doctors orders" is hard for me to misunderstand, anyway.
  24. Are mirrors and scales telling you lies? Don’t let them sabotage your weight loss and peace of mind. THE MIRROR LIES I don't know about you, but I have trick mirrors in my house. In fact, trick mirrors lurk everywhere, in public restrooms, department stores, hotel lobbies and on several walls of my health club. These mirrors never tell the truth. Like a funhouse mirror, they tell me I'm fat, thin, old, young, ugly or beautiful. Rarely do those messages match up with reality. If you have trick mirrors in your world, do not believe their lies! You know I'm kidding, right? The trick isn't in the mirror, it's in my brain. Because of decades of denial, self-hatred, weight fluctuation, aging, envy, societal messages (the fast food server asks me, "You want that super-sized?" while I study the skeletal body of an actress on a magazine cover), and random electrical impulses skipping crazily around my brain, I cannot accurately process data from my reflection in the mirror. This isn't unique to obese and formerly-obese people, but it's a special burden for us because as we work so hard to lose weight, we are even hungrier for positive feedback than we are hungry for food. For this reason, I suggest that you save your Before photos and one Fat Outfit (no matter how much you hate them), keep records of your body measurements (because sometimes you'll see progress there when none shows on the scale) and document your weight loss surgery journey with monthly photos. Last Monday I looked at myself in my bathroom mirror and thought, "Damn, girl! You look good!" On Tuesday, after a weigh-in that showed no increase or decrease, I looked in that same mirror and thought, "Damn, girl! You are porking up!" At moments like that, it is a great comfort to try on my fat clothes and feel them slide off my body because they're so big, or to set a Before photo alongside a Now photo and be reminded of how far I've come. THE SCALE TELLS THE TRUTH But not the whole truth. The scale weighs your clothes, shoes, fat, muscle, bone and water weight. This data will vary throughout the day as you eat, drink, exercise, urinate and defecate. You can buy fancy scales that will give you readings for total body weight, fat and water weight, and all those values will fluctuate every day. You can't let those fluctuations make you crazy. Recently I tracked my weight every day over the course of a week. It went like this: up, down, down, down, up, up, with a net gain or loss of zero. When I'm trying to maintain rather than lose weight, I'm happy about that. When I’m trying to lose weight, seeing my weight creep up and up as the day goes on does absolutely nothing positive for my weight loss effort. On the day when my early-morning weigh in showed a 3.6 pound increase, I could have let that information spoil my day, but instead I copied my British friend, Kate. I shrugged and said, "Silly cow." My body weight is just one piece of information about me. It does not tell the whole truth of my worth as a human being and a WLS patient. The scale doesn't remind me that I had lost 1.75" from my bust, waist, legs and arms when I measured myself that week. It doesn't remind me that I exceeded my weekly exercise goal by 75 minutes. It doesn't remind me that I met all of my nutritional goals, wrote 20 pages of my book manuscript, had a job interview, gave medication to my dogs, listened to my husband rant after a bad day at work, took one of my dogs to visit the nursing home residents, or any of the other things that are important to me. I realize that the scale is our primary tool for measuring our progress as we lose or maintain our weight, but you can't let it run your life. When an inanimate object starts to dictate your thoughts and feelings, it's time to lock it in the trunk of your car or have someone hide it from you. As Kate says, keep the scale where it belongs: beneath your feet, not in your head.
  25. Jean McMillan

    Too Tight? Or Stomach Irritated?

    It sounds like your esophagus and stomach pouch are inflamed after the vomiting-eating-vomiting thing. Call your surgeon and follow a liquid diet until you get to the bottom of this.

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