Jean McMillan

I haven't used Ultracet, but the doctor who prescribes my tramadol says that when you take the two meds together, it "boosts" the pain relieving effect.

How about tramadol (brand name Ultram)? It's an opiate, but less addictive than narcotics like VIcodin. I take it daily for chronic pain (fibro & myofascial pain syndrome). It doesn't make me high and I haven't had an side effects. I'm probably habituated to it and would have to be careful weaning off it, but it's been working well for over a year and I haven't needed to increase the dose.

You've gotten some good suggestions from other members. I don't think that one small sip of water is going to hurt. Although surgeons' instructions on this issue vary quite a bit, I have to assume that your surgeon told you not to drink after eating for a good reason - that she feels it's important to her patients' success based on her experience with her own patient population. Also, you are likely to find at some point in the future that drinking while or after you eat is an invitation to power puking. My own experience was that after several fills, my band would protest loudly if I added any liquid to the food that was already in my stomach. Since the food and liquid couldn't move downwards fast enough, it would all come back up. Not a pretty picture.

I agree with many points in your article, including the importance of an obese person taking responsibility for eating behavior rather than excusing it as a symptom of food addiction. But science is showing that certain food substances act on the brain the same was as some drugs do, and it's also showing that obesity is caused by a number of factors totally outside the person's conscious control. So I believe that food addiction exists. Maybe it needs a different label. What would you suggest?

Thanks for the plug, Stephanie! I hope that reading Bandwagon and Bandwagon Cookery help you as much as writing them helped me. Jean

CAN you smoke pot and drink alcohol after band surgery? Yes. SHOULD you? No. I think you're going to have to search far and wide to find a bariatric surgeon who would approve of a patient's drug & alcohol use, and if you're not honest with your surgeon, you're not going to get the help you need with anything - weight loss, drug use, depression, anxiety, etc. etc. The basic issue as I see it is this. I know for a fact that to succeed at weight loss after band surgery, and to avoid unpleasant side effects and serious complications, you're going to have to change your behavior. You say that this is a lifestyle change, but I can't see anything in your post that indicates you're willing to change your lifestyle. Your lifestyle now seems to revolve around dope, alcohol, and school. School's fine, but if it doesn't allow you enough time to exercise now, how is that going to change after surgery? If you can't or won't regulate your drug and alcohol intake, how are you going to regulate your food intake? There is nothing in the band that will magically make you lose weight. All it does is help reduce your hunger and appetite. You must still make good food choices, practice portion control, exercise, avoid emotional/boredom/stress eating, and so on. I don't think that a habitual user of weed or alchohol is able to see the problems associated with that habit. My husband used to smoke dope every day. When he thought he was acting fine, he was acting like an idiot. There is no way he could have maintained the self-awaress to regulate his eating behavior. Eating with the band requires a lot of attention and focus to avoid side effects. I don't know how you're going to do that when you're in a happy haze every day. And by the way, after my husband quite smoking weed, he lost 30 lbs. So in summary, I don't think you're ready to have weight loss surgery. In my opinion, your depression and anxiety, and your drug and alcohol use, all need attention more urgently than your weight issue. I know my post will come across as harsh and unsympathetic, but when you ask a question in a public forum, you're going to have to take what you get. I'm not unsympathetic. I know how hard it is to live with depression, anxiety, and obesity. So, please take this post as tough love.

VICTIMHOOD Before we get into the meat of this article, I want to ask you a question: are you a victim? Don’t tell me the answer yet, but keep it in your mind while you read the rest of this article. Victimhood can be alluring. It garners attention, assistance and pity that you can milk for the rest of your life if you play the role well. You don’t have to be responsible for rebuilding your life or restoring what you lost. That doesn’t appeal to me, though. It sounds boring and tiresome, and it discourages laughter, which I find even more healing than tears, so why does victimhood continue and even proliferate? Let’s take a closer look at how obese people like us become victims. WHO ARE THE VILLAINS? Every victim needs at least one villain. Who or what are your villains? Me – I got a lousy genetic legacy. I inherited every strand of obesity DNA my mother’s gene pool had to offer (plus the ones for thin hair and crooked teeth). We won’t discuss the humor genes I also got from her, though. Humor doesn’t enhance my victimhood. But that’s okay, because I’m actually not a victim. While we’re blaming obesity on our ancestors, we need to look at the flip side of the nature versus nurture coin. I got a raw deal there, too. Neither of my parents encouraged exercise or sports. In fact, they ridiculed physical fitness programs and encourage scholarship and mental fitness instead, so I ended up being a very smart, very fat intellectual. And that’s fine, because I have a college degree and an impressive resume as a result. And anyway, I’m not a victim. Another popular villain nowadays is addiction. Addicts will do anything to support a drug or other destructive habit. We need ever-increasing amounts of our substance just to prevent withdrawal, never mind to get high. For my brother, the substance is methadone. For me, it’s food, especially sweet or salty or fatty or otherwise nutritionally evil food, and it’s even easier (and cheaper) for me to score a hit of my substance than it is for my brother to score some of his. Baskin Robbins, McDonald’s, Lays and Duncan Hines are just a few of the virtually inescapable pushers I know. It’s sad but true, but I can overcome it, because I am not a victim. Let’s not forget our celebrity-worshipping society and the flood of images of skinny women that wash over us every single day. The media and the likes of Victoria Beckham, Kate Moss and Angelina Jolie constitute a vast and powerful band of villains. The siren song of “Thin Is In” sounds all around me, but it doesn’t matter because I can shut my eyes, turn down my hearing aids, and remember something important: that I am not a victim. In addition to obesity, I suffer from another incurable, chronic, debilitating disease that’s scientifically been linked to obesity. The pain and fatigue of fibromyalgia and myofascial pain syndrome haunt me every day, with villainy that threatens to suck all the joy out of my life. But I’m not going to let pain get the better of me, because I am not a victim. IN CONCLUSION Now let’s go back to the beginning of this article, where I asked if you’re a victim. I want to hear your answer to that question now, after you’ve read the article. Think carefully before you speak. Okay, here goes. Are you a victim? Really, truly, a victim? No? That’s great! Neither am I. Like you, I’ve chosen to win the weight loss battle, conquer the villains, and emerge the victor. I’m not going to settle for anything less than that, and neither should you. So grab your swords, my friends, and fight back now!

As highland said: drink lots of water! Also, be careful of your sodium intake. I've been watching my sodium intake lately and that stuff seems to be in every danged packaged or processed food product in the grocery store. The old guideline for maximum sodium intake for adult women was 2300 mg/day. Now it's down to 1500 m g/day.

CarolinaGirl recently was banded with plication. I'll ask her to respond to this thread.

I'm sorry to hear that the band has been a mixed blessing for you. Some people just cannot tolerate the band or the experience of restriction, and despite many fills and unfills, never get to a happy place. It would be wonderful if we could predict that kind of outcome in advance of having surgery, but we can't. I guess you have 3 choices now. 1. live with it as it is 2. have all the fill removed from your band 3. have your band removed

I'm going to send you an e-mail about this.

No, it’s not great that you could only eat three McNuggets. And yes,cheating is a big deal, and I’m going to tell you why. You’re not going to get away with this one. Miss Jean has eyes in the back of her head. She sees the cookie crumbs on your face and the neon orange faux cheese film on your guilty fingers. SOME DEFINITIONS OF CHEATING The word “cheat” has two main connotations. One is cheating in the sense of lying and deceiving. It’s intentional dishonesty. You know what you’re doing is wrong, but you do it anyway. The other connotation of “cheat” is unfaithfulness. Unfaithful to a vow or promise you made to another person or to an organization. When someone cheats you, do you just shrug and say, “Oh well, he was having a bad day”? Let’s say you bought a car that you thought was brand new, and later discovered that the dealer had fiddled with the odometer and charged you full sticker price for a car with 1200 miles on it. Would that be okay with you? And what if your spouse, the person you trust with your life, cheated on you by sleeping with your best friend, would you be able to just shrug that off? If your child got a B+ grade by cheating on a test by copying answers from the student at the next desk, would you be proud of him or her? And what if you found out that a coworker betrayed you by using the great idea you confided to him or her and taking credit for it when it worked out splendidly? Would you still be eating lunch with that coworker? Or what if you donated money to a political candidate who you admired, and he or she spent it on a vacation in the Bahamas instead of on re-election expenses. Would that be okay with you? Would you vote for that candidate ever again? I’ll take a guess at your answers to these questions. In none of the situations I’ve described would you be happy or proud. In fact, you’d be disappointed and angry. So just how can you think it’s no big deal to cheat on your post-op diet? EXCUSES, EXCUSES I can hear grumbling in the room. I think I just heard someone saying, “I had to eat that mashed potato. I was so hungry and miserable and cranky from being on liquids for a week, I couldn’t stand it another minute.” I do understand very well how you felt, but in the big picture of world hunger, where babies die because their mothers eat so little that they don’t produce enough milk for nursing, your and my hungry misery is a big So What. And someone else is whispering, “My best friend’s surgeon let her eat mashed potatoes on her third day post-op, so it must be okay for me to do that too, even though my surgeon told me to wait until my 15th day post-op. It’s not my fault that every surgeon has a different post-op eating protocol.” While it’s true that surgeons’ eating instructions vary widely, you signed on with your surgeon, not your best friend’s. Presumably you chose your surgeon because you and/or your insurance company believe that he or she is well-qualified in laparascopic bariatric surgery. During your psych evaluation, you affirmed that you understand what the surgery involves and that you can and will follow instructions. You nodded when the shrink asked if you’re ready to make all the lifestyle changes needed for success. You nodded when the dietitian asked if you understood your pre- and post-op eating instructions. You scribbled your own name on a sheaf of release papers to indicate that you were informed about the risks involved and despite those risks, gave your surgeon permission to perform surgery on you. In addition to all of that, you spent weeks or months jumping through hoops to prove your need for bariatric surgery. Perhaps you suffered through a six-month pre-op diet. You had lots of medical tests and evaluations, most of them not much fun, because you were so eager to get your weight loss show on the road. You had surgery, suffered some degree of discomfort from your incisions and gas, and finally heaved a sigh of relief because all the struggles are over now. But then you discovered that there are still more struggles to survive because of that stupid post-op liquid diet. Yet despite jumping through all those hoops, in less than 60 seconds you blow it by popping a Cheez Doodle in your mouth, and justify that with the aforementioned misery excuse. And man oh man, that must have been some really serious misery, because evidently it drove out of your mind all the very good reasons for faithfully following that post-op diet progression. You forgot that one of the most common causes of band slips is the patient’s failure to follow the post-op diet. You forgot that food can get stuck in the stoma or esophagus and cause an obstruction or vomiting. You forgot that vomiting can disturb the position of the band, especially when you’re a new post-op and your stomach is still healing from surgery. You forgot that in order to move mashed potatoes or Cheez Doodles through your digestive system, your esophagus and stomach must expand and contract, which can disturb the position of your band and cause it to slip. You forgot all the promises you made to your bariatric team and to yourself about healthy eating and weight loss success, because you were so miserable and just a few little cheat bites are no big deal. I’ll try to give you the benefit of the doubt. Maybe you thought that being able to eat the Cheez Doodles without having any uncomfortable side effects or complications like a stuck episode, a PB, sliming, chest pain, esophageal dilation or spasms means that it’s okay to eat the Cheez Doodles. Well, I’m here to tell you that’s a wrong assumption. Cheating eating can cause problems without you ever knowing it until it’s too late. Cheating eating is just plain foolish. YOU’RE NOT ALONE Now here’s the good news. You’re not alone. Nobody enjoys the post-op diet progression. If any of us were good at following diets, we might not need bariatric surgery in the first place. And only infants enjoy a liquid diet. But in a sense, as a new post-op you’re a bariatric infant who must consume liquids because your body isn’t ready yet to handle anything else. Cheating on your post-op diet is cheating your health in a major way. If you already cheated once or twice or ten times, that’s not a good reason for continuing to cheat, so don’t do it again! I believe we should begin any project as we mean to go on. If you can’t follow your post-op diet, exactly when are you going to begin your healthy post-op lifestyle? Are you going to wait until after your first fill, or your second fill, or at some hazy time in the future? If so, don’t come running to me when your scale stays stuck on a number you hate. NOW is the time to begin your healthy lifestyle. NOW is the time to practice good band eating skills and making good food choices and controlling portion sizes. Doing that may not be easy, but it’s not impossible either. Losing a massive amount of weight is a big, tough project, but if you respect your band, it's going to be easier than any of your past weight loss attempts. Let me clarify that: it's going to be easier if you follow instructions. In addition to that healthy lifestyle, there’s another very good reason to stick to your diet. At some point you’re going to have to face up to your past and acknowledge that food and eating have been a major problem for you. The fact that you’re struggling with your post-op diet is a symptom of that. There’s no shame attached to that struggle. As mentioned above, if we didn’t struggle with eating, we wouldn’t need bariatric surgery at all. So I suggest that you look at the post-op diet (and your pre-op diet too, for that matter) as a rite of passage. During this rite, you’ll be painfully aware of just how many food devils you possess, because without food to shut them up, they’re going to be jumping up and down and screaming for your attention. But their wish is no longer your command. You’re going to send them a clear signal: that you’re not going to submit to their demands any more. From now on, you’re going to follow your surgeon’s and dietitian’s eating instructions no matter how much commotion those devils make. You’re in charge now. As the saying goes, today is the first day of the rest of your life. Do yourself a favor, and make it a day without Cheez Doodles!

No, I don't think having mashed potatoes now is a good idea. One of the #1 causes of band slips is the patient's failure to follow the post-op eating progression (liquids, purees, soft, solid).

The diaphragm? What diaphragm? The one you were born with, in your abdomen? Or are you referring to the band? Or what? When the band is filled with Fluid, changes in air pressure aren't going to affect it.

Sorry, but my advice for this kind of situation is along the lines of suck it up, etc. I feel kind of like the sorority & fraternity members who used to enjoy razing new pledges because after enduring their own razing, it felt only fair to inflict it on others. So my bratty inner bandster is saying, "Heck, if I survived Bandster Hell, so can NettaRue." Regarding the discomfort under your left rib cage - did you by any chance have a hiatal hernia repaired when your band was placed? Because I have an untreated hiatal hernia, and when it bothers me, I feel the discomfort right under my left rib cage.

Too much fun, and too funny. Just what I need at the end of a long day!

I've taken quite a few long and short flights since being banded and it never affected my restriction. I think what causes it to happen to some people is a combination of factors: a disrupted routine, dehydration, stress, etc. The air in an airplane cabin is quite dry, so on your flight home I'd try to drink as much water as possible.

Man, oh man. I'd be dancing in the aisles if I ever lost 5 pounds in only 6 days. You're doing fine. You can't see it, but deep inside you, your pre-op diet and weight loss are shrinking the size of your liver and improving its texture so that it'll be more easily maneuvered by your surgeon, making your surgery safer. That's a good thing! Now I have to dish out some tough love. It's highly unlikely that you will go on losing almost 1 lb a day, before or after surgery. I think you need to take a few deep breaths and remind yourself that this is going to be a long journey requiring a lot of work on your part, but that it's totally worth it.

LOL! I thought you meant Perth in the state of Washington (WA)!

What are you going to do? Tough it out. It's temporary! And if you don't stick with this liquid diet, you risk damage that you'd have to live with forever!

I don't want to add to your panic, but yes, you could have done serious damage. One of the #1 causes of band slips is failure to follow the post-op eating progression (liquids, purees, soft food, solid food, in that order). It's irresponsible of your surgeon to put a band in you without giving you (or having a dietitian or nurse give you) detailed eating instructions. If my surgeon had left that part out, I would've been asking about it before we got into the operating room. It's too late now in your case, but I'm posting this for the benefit of pre-ops who might be reading the thread. Finally, I have to mention that you may not have been able to get through to your surgeon because we're celebrating Independence Day this week here in the US. It's surprising that your surgeon doesn't have an emergency message service; you could try calling the hospital or surgery center where the surgery was done.

Ain't that the truth! And if you don't want to hear uncomfortable answers to your questions, keep your questions to yourself!

When things go wrong during your weight loss journey, who are you going to blame? I’m a control freak, so this is hard for me to say, but say it I must. Life is full of unexpected events. Events that are good or bad, that you can or can’t explain, with effects that you may or may not be able to control. As much as I wish you (and myself) continued success on your weight loss journey, chances are that at some point, something’s going to go wrong. The fickle finger of fate is going to zap you with a surprise, a disappointment, a side effect, or a complication. It’s going to confuse, upset, frustrate, or infuriate you. What are you going to do when that happens? Who are you going to blame? Your surgeon, your spouse, your sister, or the girl who won the spelling bee in 6th grade when you were the far better speller? And when the blame is firmly placed (preferably at a considerable distance from you), then what are you going to do? Wait for your fairy bandmother (that would be me, Jean) to wave her magic wand over you and make it all better again? You might not want to wait for me and my magic wand, because we’re fully booked until March of 2044. That means that you may have to find your way out of the problem all by yourself, because even if you can get someone else to accept the blame for your stuck episode or band slip or weight regain, you are the one who’s going to have to either live with it or fix it. Oh, sure, you can take your surgeon to court over his purportedly inept placement of your band or port, once you convince an attorney that the case is worth at least (say) $100,000 in medical expenses, lifetime nursing care, lost wages, pain, suffering, and hangnails. And some ten or eleven years later, after dozens of postponements and motions and hearings, as well as thousands of $$ in court costs (all at your expense), you may or may not be granted an award or settlement that you may or may not be able to collect before March of 2044. And meanwhile, you’ll still be obese, confused, upset, frustrated and infuriated. You’ll be divorced because your husband’s pizza habit ruined your diet. You’ll be lonely because your sister lied about how easy WLS is. You’ll be doctorless because your surgeon flagged your name with the infamous Difficult Patient tag. And did I mention you’ll still be obese? Wow, this story doesn’t have a very happy ending, does it? I think we’d better start over. So take a deep breath and click here to find out how taking personal responsibility for your weight loss will give your WLS story a happy ending.