Jean McMillan

I have a very strong hunch about why your weight loss has stalled. It's the poor quality of your food intake.I'm going to assume you ate the following quantities of the foods you mentioned in your post. Protein shake (8 oz) - 250mg sodium Turkey hotdog (1) - 300mg Turkey bologna (1 thin slice) - 302mg Potato chips (4 oz) - 674mg Fiber One bar (1) - 150mg That's a total of 1676mg of sodium, or 276mg over the daily recommended maximum intake for adult women. And if you also decided to munch a few more Chicken McNuggets, just 3 of them would give you 300mg, or 21% of the recommended maximum sodium intake. Aside from the irritating aspect of making you retain fluid (thereby slowing or stopping weight loss), excessive sodium intake does a number on your blood pressure. Keep it up, and you're on your way to a stroke. Now, before you conclude that I'm being mean to you, consider that I have high blood pressure, I struggle to keep my sodium intake down, and I'm terrified of having a stroke and TIA's like my mom did. So what I'm giving you isn't harrassment, it's a dose of genuine Jean Tuff Luv™. In my opinion, a mommy of 4 needs to do whatever she can to improve her health so she can watch those 4 kids grow up.

Be patient? Oh, no, that's not how it works. We're gonna make you drop and give us 100 push ups every time you ask a silly question. Just kidding! Everyone here was a newbie once, and we'll do our best to support you and answer your questions (even the silly ones).

You're not alone. Everybody in my family used to make loving fun of my great aunt Gladys, who was the slowest eater I've ever encountered. Thanksgiving dinner took her about 90 minutes to eat....she was still working on the turkey when the rest of us were groaning over the last bite of pie. When I was banded, I began to wish I was more like Aunt Gladys. It took just one stuck episode to teach me how important it is to eat carefully with the band. What helped me the most was putting my eating utensils down between every single bite. Other things you can try: cut your food into tiny (pencil eraser size) pieces, eat with baby utensils, use an egg timer between each bite. Stuck episodes feel different for different people. Mine usually caused severe chest pain and could last from a few minutes to a few hours.

As a new bandster, it's natural to wonder if every little (and big) thing that happens to you now is somehow connected to your band. Every hiccup, every twinge, makes you ask, “Is something wrong with my band?” How do you make sense of all these new experiences without making yourself crazy (or in my case, crazier)? ADJUSTING TO BANDED LIFE Having weight loss surgery is a huge project. You spent months, even years, in research, education, preparation, recovery and adjustment. No wonder you're obsessed with it. But it is not the only thing going on in your body and your life. It is not the cause of every adverse - or favorable - event. When I buy a new car, I go through phases similar to the ones I experienced as a new bandster. I look around, do research, study and compare before I buy. With all of that foremost in my limited-capacity brain, I cherish my new possession, and suddenly I see that same vehicle everywhere. Like magic, the same make, model, and even color is on every road, in every parking lot. It’s as if the 2011 Toyota Camry has become my world. Gradually the novelty wears off, things shift back into position, and the Camry becomes transportation again – at least until it suffers its first scratch or dent. Adjusting to life with a new band can be a lot like life with a new car, or even more so, because an adjustable gastric band isn’t something (I hope) you’re going to tire of and trade in one day. It’s a lifetime commitment, and even if your insurance pays for all or part of it, a band is a huge investment in terms of time and energy. It’s not surprising that everything that happens to you as a new post-op gets filtered through the AGB lens. We suddenly tune in to every little whisper of AGB stories, especially scary ones. As we move forward in the shiny new vehicle that we hope will take us far from the land of obesity, we listen carefully for any suspicious creaks, squeaks or whines, while cringing at every little bump in the road. After months of preparation and anticipation, we’re now in a hyper-vigilant mode that rings an alarm bell every time something even mildly unfamiliar happens in our bodies. We’re so alert that even a sore toe could be a sign of something insidious happening to our bands. We analyze every sneeze, every burp, asking, “Is this normal? Is something wrong with me or my band?” The answer to that is almost always, “Completely normal, and nothing wrong.” Although there's a tendency to interpret every post-op experience (especially physical ones) as band-related, chances are that the pain in your big toe has nothing to do with your band. It's easy to "awfulize" things when you have a pain, symptom or experience you didn't expect and can't explain. You're sure that's something's wrong. You haven't lost weight in three days, or you found hair clogging your shower drain, or you puked up your spaghetti dinner. You’ve probably had more practice at dealing with this kind of worry than you give yourself credit for, because it applies to many other aspects of your life. It's extremely difficult to make a good decision when you're in a panic. Your vomiting might be band-related, but it could also be the result of a garden-variety intestinal bug. Your teenaged daughter's failure to return your phone call could be because she was in a terrible accident, or it could be because her cell-phone battery died. WHEN SOMETHING GOES WRONG First, take a deep breath. Panic will not solve the problem, and it might make it worse. First, have a look at any discharge instructions or other written post-op information you were given before or after your surgery (if your surgeon or the hospital doesn’t give you anything like that, ask for it!). Then ask yourself: Is this an emergency? Is it life-threatening, disabling, or just inconvenient? What will happen if I don't do something about it right now? Can I deal with this myself, or do I need help? What kind of help (medical, emotional, spiritual, financial)? Who can help me (my surgeon, therapist, best friend, minister)? Be careful how you choose your helper(s). I know you love your sister, who might tell you that everyone in her family has been sick with a bug since you saw them (and their germs) on Sunday, but she cannot tell you whether or not your band slipped. So please don’t ask her, me, your hairdresser, neighbor, personal trainer, or a casual Internet acquaintance for medical advice. We may be well qualified to sympathize, but we’re not qualified to give you medical treatment, so call your surgeon instead. But first, make a list. I like list-making because it gives me the illusion of control and because it helps jog my memory when I finally get a doctor, nurse or dietitian on the line. If nothing serious (a temperature over 101°F, you can’t drink clear liquids, you can’t stop vomiting) or life-threatening (you can’t breathe, can’t move, can’t speak, are bleeding profusely, etc.) is on the list, consider waiting to call your surgeon for an hour or two, or until you have a list of at least three questions. Use that time to think of the answers to some basic questions your surgeon is sure to ask: how long the problem has been going on, whether it’s constant or intermittent, and whether it seems related to a particular behavior, time of day, or other event. If your list includes something life-threatening (see above), leave a brief message like “This is Jane Doe. I’m on my way to the ER at Hometown Hospital because I’m having severe chest pain” and don’t wait for your surgeon to call you back. Call 911 or have someone take you to the emergency room. But once you’re there, remember that you can’t expect the average ER doctor to know how to treat a problem related to bariatric surgery. The ER will rule out and treat things like cardiac arrest, infection, pneumonia, stroke, and the like, and will give you palliative care to make you more comfortable until your surgeon arrives or tells them what to do next. While it’s always okay to ask your surgeon or his/her staff about your worries, it’s important to remember that you are not the only patient under their care. If you don’t get a return call within a few hours of leaving a message, it may be because they’re overwhelmed with other patients’ problems and/or because they didn't understand the nature of your problem. Leave a clear, simple, but specific message. If you’re running a temperature and have a bad headache, say, “This is Jane Doe. I’ve had a temperature of 103°F and a bad headache for 5 hours. Please call me back as soon as possible at 123-456-7890.” NOT EVERYTHING IS RELATED TO YOUR BAND Now that you’re at least somewhat prepared to deal with medical emergencies that might arise, you need to hear this: not everything is related to your band. While it’s appropriate to be concerned and alert after any surgery and in adjusting to life with an implanted medical device like a band, don't let fear cloud your thinking. You will wear yourself to a frazzle if every event becomes a crisis, and you don’t want to neglect other important things in your life (like family, job, etc.) because your band has somehow taken over every waking thought.. I may sound unsympathetic, but I'm really not. I can whine with the best of 'em. I’m not saying that your confusion and struggles as a new bandster aren't important. They are. But it will be easier for you to handle them if you do it with a clear mind and a calm heart. I know from personal experience that worry and self-pity are deadly traps because they tend to paralyze you. So while it's good to keep your little buddy in the back of your mind when trying to figure out what's going on, remember that you are still vulnerable to the bacteria, viruses, accidents, exhaustion, bad habits, and dumb luck that ambushed you before your band surgery. Try not to let a three-inch ring of plastic hold you hostage. Your post-op life includes much, much more than just your band, eating, and weight loss efforts!

I had to see a dr on Saturday morning and actually managed to NOT mention my band because it was pretty obvious to even me that a head cold that had led to an ear infection was in no way related to my lapband. LOL!

Welcome, Bibi. Losing 15 lbs is fabulous - please don't torture yourself about losing more. If it happens, that's good, but if it doesn't, that's OK. The main point of the pre-op diet is to improve the size and texture of your liver so it's easier for your surgeon to handle (thus making surgery safer for you).

Mis73 gave you good advice. I just want to add this. If you feel that your surgeon is too conservative with fills, why not just talk with him/her about it? If he/she won't work with you on that, you could consider changing surgeons if you can find one to accept another surgeon's patient (you might have to pay a non-reimbursable program or patient transfer fee, though).

So, how many people have you personally met who've been banded for 8-10-12 years with or without complications? Five, ten, twenty, fifty? I'm not sure what the current numbers are and it's too late in the day for me to call my Allergan rep, but as of 2009, about 62,500 Lap-Bands were placed each year. So if you personally know 50 people who lost their band to complications, that works out to a failure rate of .08%. Of course, since the Realize band hit the market in US late 2007 (after having been used successfully outside the USA since the mid 1980's), we ought to factor in its failure rate as well, but perhaps the Realize band doesn't qualify for your personal study because it's been used in the USA for less than 8 years? I do personally know a woman who's been banded since December 2003 and still loves her band after almost 9 years. Since I personally know only one person who's been banded over 8 years, my own study yields a 100% satisfaction rate. But wait! I do know another person who's been banded over 8 years. His name is Alex Brecher, and he's the founder of LBT. He was banded in July of 2003 and guess what, he still loves his band, too! The consent papers I signed when I had band surgery way back in 2007 made it clear that band surgery (like any surgery) has a number of risks, and neither Allergan nor my surgeon offered me any guarantee of weight loss or of no complications or of the permanence of my band. My surgeon did tell me I should consider it a lifetime companion, and I don't see anything wrong with that. He just wanted me to understand that this was a major, long term undertaking, and he was absolutely right even though I ended up losing my band. It would be foolish of me to undergo surgery thinking, "Well, I'll give this a try, and if it doesn't work out the way I like in a year or two, I'll have it removed and try something else." According to the bariatric surgeons I interviewed when writing Bandwagon, bariatric surgery (whichever procedure you choose) is the ONLY long term treatment for obesity available today. If there were a permanent treatment for obesity, you could call it a cure, and that would be a wonderful thing,wouldn't it? But obesity is a chronic, incurable disease, and that fact is one of the reasons that bariatric surgery sometimes fails. Anyway, back to you...Have you personally had band surgery? Did your surgeon guarantee a permanent cure and no complications? If so, would you share his or her name and location, because that information would be useful to so many people on this forum and I personally would love to chat with him or her as part of my continuing education. Oh, one more thing. One reason you so rarely encounter a 8-10-12 year bandster, especially online, is that those people lost their weight and went on to other perfectly worthwhile things, like new jobs and new babies and new hobbies. Bariatric surgery faded into the background of their lives. Of course, some of them did have problems. I know a few bandsters who lost their bariatric focus because they were diagnosed with cancer (NOT, I hasten to add, caused by their band) or their spouse or child died in an accident or they lost their job and basic survival became more of an issue than actively promoting the band.

Here's my typical experience of a PB or productive burp (which is regurgitation, not vomiting). I'm eating something, anything, and suddenly I get the uneasy feeling that it's going to come back up. Sometimes there's an uncomfortable (not painful) fullness in that back of my throat, but sometimes the PB happens too fast for that. As soon as I have a suspicion that a PB is about to happen, I find a bathroom (or at least a sink) ASAP. And up comes the food I just ate, maybe with some slime (thick and sometimes foamy saliva). Then it's over. Except for times when my band was just too tight, or when my band slipped, most of my PB's were due to user error: eating too fast, taking bites that were too big, not chewing very well. Some of them happened when I was eating a food that wasn't cooked in a band friendly fashion, especially dry meat. So that's your answer to the how to avoid it question. PB's aren't an inevitable feature of a bandster's life. I know a very successful and happy bandster, 4 yrs post-op, who has never PB'd even once. On the other hand, if you do PB, it's not the end of the world...it's just a signal that you need to eat more carefully.

Everybody else gave you good advice. I just want to add two suggestions. 1. Never let yourself get so hungry that McDonald's seems like a good idea. The way I do that is by eating small, planned Snacks as well as small, planned meals. 2. Always carry a healthy snack food with you. You could post a thread asking for suggestions for snacks like that. I always carry a Protein bar in my purse. That way when you're leaving work and hungry (because you didn't eat that snack I suggested above), you'll be able to deal with the hunger without visiting McDonald's.

No. I haven't eaten baby/toddler food since I was a baby/toddler. Why would you eat that stuff when it's so easy to puree real grown-up food in a mini food processor?

Aha! I knew that title would get your attention! Are you thinking that Jean, a very vocal, longtime band fan, has finally lost her mind (on which she never did have a very firm grip)? No, I haven’t lost my mind. I still think the band is grand and I still wish I still had mine, but because I want everybody to succeed at weight loss, I feel duty-bound to tell you some reasons not to have adjustable gastric band surgery. So here goes, in no particular order. Don’t have band surgery if… You’re phobic about needles. Right now, a needle is the only way to get fluid into the band. The fill needle is not a big, scary one, and you don’t have to look at it at all if you prefer, but it’s still a needle. You believe that band surgery cures obesity. Obesity is an incurable, chronic disease with the very real potential for recurrence. Weight regain can happen to anyone. You think that once you get to your goal weight, your weight loss journey stops. Nope. It’s only just begun. Next you’ll have to maintain that weight loss for the rest of your life, and that takes vigilance and hard work. You’re a self-pay planning on having surgery in Mexico or elsewhere out of country. What are you going to do if you have a problem or complication or just need another fill or unfill? Travel back to the Mexican clinic? Try to get help locally? Finding a US-based bariatric clinic that will accept patients who had surgery overseas is not easy, and once you do find one, you’re probably going to have to pay a non-refundable program fee, from $200 to $2000. You can’t afford the time and expense for frequent follow up visits for fills, unfills, and other medical care. Even if your insurance covers those visits, you’ll have to take time off work, arrange for child care or pet care, fill your car’s gas tank, and shell out a co-pay. You're a self-pay and don't have money or plans for dealing with fills, unfills, and possible complications. See above. You hope to lose weight without getting any fills. Sorry, but it probably won’t work that way. See above. You expect to lose a pound+ a day. Average weight loss with the band is 1-2 pounds/week. That average includes people who lost weight faster as well as people who lost no weight at all. Rapid initial weight loss is usually related to fluid retention, not fat loss. You believe that slow weight loss with the band will prevent sagging skin. According to several plastic surgeons I’ve asked about this, your age and genetics have the most influence on how your skin will respond to massive weight loss. The rate of weight loss has little or anything to do with it. You expect to experience restriction and lose weight steadily from the moment you wake up after surgery. Most band patients need several fills to achieve optimal restriction, plus more fills and unfills (or adjustments) to maintain that restriction, and virtually no one loses weight at a steady rate. My weight loss was extremely uneven – down 1#, down .5#, up .75#, down 1.75#, down 0/up 0, down .25#, and so on. You believe in the sweet spot or perfect restriction. Restriction is constantly changing, just like our bodies, because of dozens of quite ordinary factors (food choices, eating and drinking habits, weight loss, time of day or month, illness, medications, stress, etc.). If you think you’ll lose weight only at the mythical sweet spot, you’re going to spend energy on frustration that could be better applied to changing your eating behavior. You’re not willing to follow pre- and post-op liquid and puree diets. No, liquid and puree diets are not fun, but they’re short-term. When I was banded, I had 36 years ahead of me, assuming that I live as long as my mother did. That’s 12,672 days. My pre- and post-op liquid diets used up a whopping 17 days. Do the math. Even if you add in post-fill liquids and purees, those liquid and puree days represent a teeny, tiny fraction of my life. You believe you’ll never be hungry again. Maybe, maybe not. The fact that you feel hungry 5 hours after a meal doesn’t mean your band isn’t working. It just means that your body needs fuel. And part of your ongoing work as a bandster is going to be figuring out whether you’re feeling physical hunger or “head” hunger. You think the band is going to do all the work for you. The band has no magic ingredient that triggers weight loss once it’s wrapped around your stomach. All it does is affect your hunger and appetite. The band is not going to make good food choices, practice portion control or banish the demons who make you eat when you’re stressed or bored. Nor is it going to exercise for you. Success with the band is the result of a joint effort between you, your band, your surgeon and dietitian. Have a don't-have-band-surgery reason to add to this list? Post it in the comment section!

It's way, way too soon to be calling yourself a failure. Your band isn't fully functioning yet, and it may take more than one fill for it to start doing its job. Until it starts giving you the early and prolonged satiety that will help you eat less, it's important that you monitor and control your portions, because overeating does more than make you gain weight - it can cause esophageal or stomach dilation, and even a band slip. Get out the measuring cups, spoons, and scale. Unless your surgeon or dietitian tells you otherwise, eat no more than 1 cup total at a time. Edited to add: I hate to tell you this, but your band is not going to cure your food addiction. You're going to have to work on the emotional/mental/behavioral aspects of eating while your band works on the physical aspects.

My weight loss was very uneven, but as long as the overall trend was downward, I was happy. My weight loss slowed down considerably towards the end and I've seen that happen to lots of people. You don't do yourself any favors by comparing your weight loss to theirs. A loss of 37kg in 7 months is fabulous. At an average of 1.3kg (2.9 lbs) a week, it's actually well above the typical rate of loss (average 1-2 lbs/week) with the band.

Welcome to the brave new world of bandsterhood! I'm going to add my responses in blue text below. Had my first fill yesterday and now I am back on liquids. The liquid diet doesn’t really bother me because I know that it will help me achieve my goal. The Dr. put me on a 3 day liquid diet, then soft, then regular. I have read people going on a 1 day and even 2 day liquid diet, but not a 3 day after a fill. Is my Dr. exaggerating this diet by extending it another day or two? Or is this the regular post fill diet? A regular post fill diet is whatever your doctor says it is. They all have their own protocol and it's useless trying to figure out why. Also, at this time, I am not hungry and have been satisfied with my liquids. My concern is…. Will I be hungry on liquids for 3 days? I don't know. Maybe, maybe not. Time will tell. Although I am not hungry, I don’t feel full. Is that normal? I think it's normal. My pre-op idea of "full" was Thanksgiving Dinner full. As a post-op it took me a while to figure out that full should be "just enough food, nothing more, nothing less." My last question is…. How can I tell if I am over filled or under filled? Underfilled = frequent physical hunger (say, less than 3 hours after a meal). Overfilled = unable to eat or drink without discomfort or regurgitation. It's actually more complicated than that, but you don't need complication right now. Right now you need things simple. Right now, everything feels a bit “normal”, but I have to assume that it is because I am only drinking liquids, but I can still drink at least a 16oz cup of water within 45 mins. Am I able to drink too much? It's extremely unlikely that you would ever drink too much water, and you should always be able to drink plenty of water, though maybe not guzzle it. One sign of a fill that's too tight is being unable to drink water. The last, last, last question: Am I over thinking this too much? Yes you are, but it's better than not thinking about it at all! UGH… I feel so confused

Well, it may not work this way for you, but when my band was adjusted to provide optimal restriction, it did change and even diminish my enjoyment of food, same as the Sensa is supposed to do, only it worked 24 hours a day and I didn't have to buy anything or put anything on my food. Food was just not as appealing to me, even my old pre-op favorites. So you may be pleasantly surprised by what an adjustable gastric band can do for you. The band presses on the vagus nerves at the top of the stomach. The vagus nerves are responsible for (among many other things) sending satiety messages to the brain. So I think my band was continually telling my brain that it was already satisfied, thank you very much, and as a result, food became no big deal for the first time in my life. Now that my band is gone, I have been shocked to discover how fabulous food tastes again.

The main reason for not drinking during or within 30-60 minutes after a meal is that (in theory), the liquid will wash the food through your upper stomach pouch too quickly, thereby reducing or preventing the early and prolonged satiety that the band is supposed to give you. I'm not sure how true that is. There's some debate about it in the bariatric community. In Australia, where they've been doing band surgery much longer than in the USA, they're saying that taking small sips while eating is OK. But at a bariatric conference I attended last summer, several surgeons said that one of the most common reasons for disappointing weight loss is drinking with or after meals. For me, it only took one episode of regurgitating the beverage I'd just had and the food I'd just eaten to persuade me that I'm better off following the rules.

I would wait another week, depending on how quickly you can get fill appointments. I've had fills that took 2 weeks to kick in.

I haven't tried Sensa. I have tried a zillion fad diets, diet drugs, and bariatric surgery. The only thing that has worked for me, not just for weight loss but for maintaining weight loss, is bariatric surgery. I looked up Sensa at the pubmed site (a site created by a US government health and medicine agency, the NCBI). There are absolutely no studies or clinical trials indexed there that prove that Sensa works and is safe. On the other hand, many studies have shown that bariatric surgery works, and if the various procedures weren't safe, no insurance company would pay for them. Right now, bariatric surgery is the ONLY obesity treatment with longterm success. I have to agree with readytogoforit: a weight loss product that sounds too good to be true, is too good to be true. But if you want to try it, now or after surgery, go for it. I would hope that you wouldn't even need it after surgery. If you did need it after surgery, why even have surgery?

You really need to ask a doctor about that. I've heard that stress as well as hormonal problems can cause increased cortisol production. Since cortisol helps to regulate your blood pressure, insulin and glucose levels, being diagnosed with some sort of endocrine disorder could actually give your doctors more ammunition in treating your obesity.

Another downside of losing weight very quickly is that it's associated with gallbladder disease.

Bandwagon is a printed book. It's no longer available on Amazon because their discount left no profit for me. You can order it by clicking on one of my ads here on LBT, or by going to my website and clicking on one of the purchase options shown on the left hand side of the page. The address is: http://jean-ontheban...on.blogspot.com You can also sign up to receive my free weekly e-newsletter, Bandwagon on the Road. Scroll down the page beyond the book purchase options and look for the brown sign-up block.