Jean McMillan

What is your heart's desire - the thing you want so much that it takes up most of the room in your heart? A partner, child or friend? A job, home or vacation? Or is it weight loss - the thing that brought you to BariatricPal in the first place? YOUR HEART’S DESIRE What is your heart’s desire? Be honest now, with yourself if not with me. If your heart’s greatest desire today isn’t weight loss, that’s OK. There are lots of things in our lives that are just as important, or even more important, than weight loss. After a lifetime of dieting and weight problems, my mother’s dying wish had nothing to do with her weight. Her greatest wish was that her grown children (both in our 50’s) would stop fighting with each other. Maybe your heart’s desire is that your partner will love you more (or better). That’s OK too, as long as you understand that weight loss probably isn’t going to achieve that. Maybe your heart’s desire is to become a neurosurgeon, and you somehow believe that weight loss will make your studies easier or faster, or it will ensure your acceptance to medical school (but think twice about that last one). What if you don’t know your heart’s desire, but you hope that weight loss will help you find it? That’s entirely possible, but it may not be revealed to you in a sudden, blinding flash. You may have to go groping around in the dark for a while before you find it. JUST WANNA BE THIN? Is your heart’s desire simply to be thin? Are you sure of that? Before I ask you a question, I first try to answer it myself, and it’s not easy for me to answer this particular question. For much of my life, it’s been fairly easy to talk about what I don’t want. I don’t want to be fat, I don’t want to listen to another doctor lecture me about my high cholesterol, I don’t want freak-show breasts, and so on and so forth. When I decided to have WLS, I focused on the desire that burned most brightly in my dark life: weight loss. Intellectually I knew that things in my life other than my weight would change as a result of the surgery. My surgeon and nutritionist made it clear that I must change my eating and exercise behavior. I didn’t especially want to change those things – who doesn’t want to effortlessly lose 5 pounds a week while sitting on their butt eating potato chips and cookies? – but I nodded obediently and gave myself a stern self-improvement lecture for perhaps the 200th time in my life. I thought that weight loss was the most precious prize I could ever win. Everything else paled in comparison to it. Weight loss has indeed been a precious prize, but it has turned out to be the ruby instead of the diamond in my crown. We tend to believe that weight loss will cure all our problems. While it will indeed solve some problems (especially health-related), it also introduces us to some brand-new ones. Like my friend Joni, who after getting her heart’s desire (a baby), was astounded to realize that caring for that baby was going to be her 24-hour-a-day job at least until he turned 18, we discover that maintaining weight loss is a lifetime job. It may not require all 1440 minutes of our attention every day, but it’s still there and it’s still work. On the whole, I’m OK with that. I’ve come to realize what a precious gift my body is after decades of despising it, so I’m willing to give it the attention and nutrition, the relaxation and pleasure, the exercise and rest that it needs to in order to carry me onward. I discovered something else after achieving my heart’s desire. As soon as it was in my eager hands, I started looking around for another heart’s desire. Identifying that and figuring out how to get it has taken me longer than I expected, and I’ve changed my mind a few times along the way. I usually make decisions quickly, preferring to make a bad decision over no decision. What do I want now? Do I really need something else, or am I a compulsive seeker of experience and sensation? Am I still trying to fill the bottomless hole that I used to stuff with food? Or do I already possess my heart’s desire – such as a personal relationship with God – and just don’t recognize it? Sometimes I wonder if naming my heart’s desire is so hard because I wrongly persist in thinking of it as a thing – something as tangible and solid as a book or a chair or a car. Perhaps I should look instead for a place or even a state of being. OK, OK, don’t go to sleep quite yet. I’ll stop my philosophical meandering and tell you my secret heart’s desire. I want to live. After decades of self-punishment, frequent despair, and several attempts at total self-destruction, I want to live. And I want to live well, in a way that celebrates life. No more hanging back, no more wasting time. No more time spent counting the minutes until mealtime, or how many cookies are left in the Keebler package. I’ve got to stop fearfully dismissing new things because “I’ve never done that before,” or because “I don’t know how to do that.” SO HOW DO YOU RECOGNIZE IT? How do you recognize your heart’s desire? How do you envision and name it? Are you living your life like a shopper who doesn’t know what she/he is looking for, who says, “I’ll know it when I see it.” I know that feeling, but I wonder if a gut “that’s it” reaction always sends us in the right direction or helps us make the best decisions. No big deal when choosing a color of nail polish, but is it safe when choosing a career, a partner, or a medical treatment? While my analytical skills are overdeveloped, I also know that my built-in danger detector tends to sound the alarm when I’m facing something unfamiliar or unknown. With the alarm blaring in my ears, I back away or even beat a retreat from whatever adventure or challenge I’ve glimpsed. About 10 years ago I spent a long weekend in Honolulu when on my home from an overseas business trip. While there, I stood at the edge of a cliff and watched other visitors snorkeling in incredibly clear water, only inches from coral, shells, and undersea life so vivid I could see it easily from my distant perch. I was filled with envy. I knew that in a tourist town it would be easy to find a way to join a snorkeling expedition, but my inner alarm sounded, and it scared me off by blaring, “You can’t do that. You don’t have a bathing suit. You’re too fat to find a bathing suit to buy, never mind wear it in public. You’re afraid of the water. You’re a lousy swimmer.” So some of the questions I try to ask myself now when contemplating something new include: 1. Is this opportunity likely to arise again? 2. What’s the worst thing that could happen if I do it? 3. What’s the worst thing that could happen if I don’t do it? 4. Does the cost or risk outweigh the potential benefit? BITTERSWEET And that brings me to my final (for now, anyway) point. As I wrote in Bandwagon, saying goodbye to the excess pounds and problems can be bittersweet. We lose some beloved companions (such as our edible comforts) and discover new things about ourselves, not all of them lovable. For example, I discovered that I am a far more selfish person than I ever would have admitted when I was obese. When I was supporting my food addiction, I believed I was the only one affected by it, but I was wrong. It saddens me now that I gave my relationship with food more time and energy than my relationships with my friends and family. I can’t go back and change that, much as I might like to. All I can do is give those people (including me) the love and attention they deserve as I go forward.

I think a lot of people experience at least some of the craziness you describe, not just in the context of WLS but a lot of other life changes. And some of those people (like me) apply our inborn analytic urges to every single thing we do, worsening and prolonging the craziness. But...I agree with Socrates, who said, "the unexamined life is not worth living." I want to live, to understand, to know myself and my world. Sometimes the learning process is very uncomfortable, but on the whole it's worthwhile (for me) and eventually it does get easier. And when I stop learning, I figure it's time for me to go home forever.

Dealing with intrusive food thoughts is a booger, isn't it? I spent so many years obsessing about food, I now think those thoughts built a superhighway between my brain and my mouth. Then I had WLS and went on obsessing about food in my eagerness to improve and control my food intake. For a few years post-op, my band did a wonderful job, making food far less interesting, and that's one of the things I sorely miss about it. So now I, like you, try to take it one day at a time.

I'll keep my fingers crossed for you on that lottery prize!

Being Superwoman isn't all it's knocked up to be, is it? About 10 years ago, I abandoned an interesting but stressful and time-consuming career. Having more free time felt strange for a while, but now it's precious to me.

I hope your mobility increases as you lose weight. I know several people who've had hip and/or knee replacement surgery after losing a chunk of weight as you have, and they're all doing very well now. Save your pennies for your UK/France trip. Europe is very expensive, but so wonderful to visit!

I just want to say thank you to the members who've posted such thoughtful responses to this article. I love your attitudes and after reading your responses, I understand and share some of your hearts' desires.

YOUR HEART’S DESIRE What is your heart’s desire? Be honest now, with yourself if not with me. If your heart’s greatest desire today isn’t weight loss, that’s OK. There are lots of things in our lives that are just as important, or even more important, than weight loss. After a lifetime of dieting and weight problems, my mother’s dying wish had nothing to do with her weight. Her greatest wish was that her grown children (both in our 50’s) would stop fighting with each other. Maybe your heart’s desire is that your partner will love you more (or better). That’s OK too, as long as you understand that weight loss probably isn’t going to achieve that. Maybe your heart’s desire is to become a neurosurgeon, and you somehow believe that weight loss will make your studies easier or faster, or it will ensure your acceptance to medical school (but think twice about that last one). What if you don’t know your heart’s desire, but you hope that weight loss will help you find it? That’s entirely possible, but it may not be revealed to you in a sudden, blinding flash. You may have to go groping around in the dark for a while before you find it. JUST WANNA BE THIN? Is your heart’s desire simply to be thin? Are you sure of that? Before I ask you a question, I first try to answer it myself, and it’s not easy for me to answer this particular question. For much of my life, it’s been fairly easy to talk about what I don’t want. I don’t want to be fat, I don’t want to listen to another doctor lecture me about my high cholesterol, I don’t want freak-show breasts, and so on and so forth. When I decided to have WLS, I focused on the desire that burned most brightly in my dark life: weight loss. Intellectually I knew that things in my life other than my weight would change as a result of the surgery. My surgeon and nutritionist made it clear that I must change my eating and exercise behavior. I didn’t especially want to change those things – who doesn’t want to effortlessly lose 5 pounds a week while sitting on their butt eating potato chips and cookies? – but I nodded obediently and gave myself a stern self-improvement lecture for perhaps the 200th time in my life. I thought that weight loss was the most precious prize I could ever win. Everything else paled in comparison to it. Weight loss has indeed been a precious prize, but it has turned out to be the ruby instead of the diamond in my crown. We tend to believe that weight loss will cure all our problems. While it will indeed solve some problems (especially health-related), it also introduces us to some brand-new ones. Like my friend Joni, who after getting her heart’s desire (a baby), was astounded to realize that caring for that baby was going to be her 24-hour-a-day job at least until he turned 18, we discover that maintaining weight loss is a lifetime job. It may not require all 1440 minutes of our attention every day, but it’s still there and it’s still work. On the whole, I’m OK with that. I’ve come to realize what a precious gift my body is after decades of despising it, so I’m willing to give it the attention and nutrition, the relaxation and pleasure, the exercise and rest that it needs to in order to carry me onward. I discovered something else after achieving my heart’s desire. As soon as it was in my eager hands, I started looking around for another heart’s desire. Identifying that and figuring out how to get it has taken me longer than I expected, and I’ve changed my mind a few times along the way. I usually make decisions quickly, preferring to make a bad decision over no decision. What do I want now? Do I really need something else, or am I a compulsive seeker of experience and sensation? Am I still trying to fill the bottomless hole that I used to stuff with food? Or do I already possess my heart’s desire – such as a personal relationship with God – and just don’t recognize it? Sometimes I wonder if naming my heart’s desire is so hard because I wrongly persist in thinking of it as a thing – something as tangible and solid as a book or a chair or a car. Perhaps I should look instead for a place or even a state of being. OK, OK, don’t go to sleep quite yet. I’ll stop my philosophical meandering and tell you my secret heart’s desire. I want to live. After decades of self-punishment, frequent despair, and several attempts at total self-destruction, I want to live. And I want to live well, in a way that celebrates life. No more hanging back, no more wasting time. No more time spent counting the minutes until mealtime, or how many cookies are left in the Keebler package. I’ve got to stop fearfully dismissing new things because “I’ve never done that before,” or because “I don’t know how to do that.” SO HOW DO YOU RECOGNIZE IT? How do you recognize your heart’s desire? How do you envision and name it? Are you living your life like a shopper who doesn’t know what she/he is looking for, who says, “I’ll know it when I see it.” I know that feeling, but I wonder if a gut “that’s it” reaction always sends us in the right direction or helps us make the best decisions. No big deal when choosing a color of nail polish, but is it safe when choosing a career, a partner, or a medical treatment? While my analytical skills are overdeveloped, I also know that my built-in danger detector tends to sound the alarm when I’m facing something unfamiliar or unknown. With the alarm blaring in my ears, I back away or even beat a retreat from whatever adventure or challenge I’ve glimpsed. About 10 years ago I spent a long weekend in Honolulu when on my home from an overseas business trip. While there, I stood at the edge of a cliff and watched other visitors snorkeling in incredibly clear water, only inches from coral, shells, and undersea life so vivid I could see it easily from my distant perch. I was filled with envy. I knew that in a tourist town it would be easy to find a way to join a snorkeling expedition, but my inner alarm sounded, and it scared me off by blaring, “You can’t do that. You don’t have a bathing suit. You’re too fat to find a bathing suit to buy, never mind wear it in public. You’re afraid of the water. You’re a lousy swimmer.” So some of the questions I try to ask myself now when contemplating something new include: 1. Is this opportunity likely to arise again? 2. What’s the worst thing that could happen if I do it? 3. What’s the worst thing that could happen if I don’t do it? 4. Does the cost or risk outweigh the potential benefit? BITTERSWEET And that brings me to my final (for now, anyway) point. As I wrote in Bandwagon, saying goodbye to the excess pounds and problems can be bittersweet. We lose some beloved companions (such as our edible comforts) and discover new things about ourselves, not all of them lovable. For example, I discovered that I am a far more selfish person than I ever would have admitted when I was obese. When I was supporting my food addiction, I believed I was the only one affected by it, but I was wrong. It saddens me now that I gave my relationship with food more time and energy than my relationships with my friends and family. I can’t go back and change that, much as I might like to. All I can do is give those people (including me) the love and attention they deserve as I go forward.

As tmf suggested, you may be able to eat a lot because you're zipping right past your new satiety (stop eating) signals. It's important to slow down and pay careful attention to how you feel as you eat, not just to avoid stuck episodes because that's the way you're going to have to eat for the rest of your life in order to lose weight, maintain that loss, and live happily ever after with your band. Satiety signals can change over time, and even over the course of one day. They include what I call soft stops (gentle reminders) and hard stops (running into a brick wall). Some soft stops are: mild queasiness, fullness or pressure in the back of the throat or the chest, difficulty swallowing, burping (or the urge to burp), the urge to take a deep breath, the urge to cough or clear the throat, a sigh, a sneeze, hiccups, watering eyes, runny nose, left shoulder pain, excess saliva, or a sudden distaste for the food you were jut enjoying. Some hard stops are: chest pain, esophageal pain (from esophageal spasms, which can also cause chest pain) - for me, that's like feeling I have a rock in the back of my throat - a stuck episode, PB's (productive burp or regurgitation), and sliming (so much excess saliva and mucus that's so profuse, you have to spit it out. It's best to stop eating as soon as you notice a stop signal. When the signal is past, you may feel perfectly normal, but the cause of the signal may also be causing inflammation in your upper GI tract, and if you go back to eating then, you're likely to increase and prolong the inflammation.

Sounds like you're experiencing the infamous, hated, but mostly unavoidable fickle band restriction. You really need to talk about it with your surgeon, but since you have to wait a few weeks to see her, I'll give you the benefit of my own experience (plus my medical degree from the University of Nowhere). First of all, the sushi. I love it (and sashimi) too, but sushi rice is even stickier than long grain rice, and sticky stuff is not band-friendly. The fact that you've been burping for an hour tells me that your esophagus, band, and stomach can't deal with it right now. Secondly, I've had fills take 2 weeks to kick in. It would be so nice to have your body respond to fills in a predictable fashion, but your body is subject to dozens of processes that can affect your experience of restriction. Like hydration, medication, illness, allergies, stress, time of day, time of month, etc. etc. etc. I have a suspicion that your body is giving you some hints about your last fill and you're just having some trouble interpreting them. That's not a criticism. I've been there, done that. So I suggest that you lay off the sushi and pay very close attention to how you feel before, during, and after you eat until your next appointment with your surgeon. If at any time you experience reflux, night cough, regurgitation, stuck episodes, sliming, foaming, or other symptoms and eating problems that disrupt your life, call your surgeon. If you experience severe chest pain and/or cannot swallow liquids, call your surgeon and then go to the nearest ER. I know what I just said must sound scary, so my next piece of advice will sound contradictory. Take a few deep breaths and remember that stress (including the stress you impose on yourself through worrying) almost always makes everything feel worse.

I love and admire everything about you, but most of all your tattoo, because I don't think I could ever withstand even one second of the tattoo procedure! Thanks for posting those pix. We all need inspiration... the more often, the better!

Are you struggling to get your fruits and veggies down? Here are some strategies to help you enjoy the good produce that yields good health. Believe it or not, I actually love the fruits and veggies my doctor tells me will keep me healthy. When I was growing up, no one had to tell me that, like Popeye, I needed to eat my spinach. I’d rather not eat greens out of a can, but decades later, they appear on our dinner table often. At home here in rural Tennessee, we enjoy many months of harvest from our big garden and small orchard. We are truly blessed in the produce department. The problem is that the harvest is too big for a big man and a small woman to eat. We give a lot to friends, coworkers, and the local food pantry, but my husband continues to overestimate how much I can eat nowadays, and I continue to work on strategies to make produce easier for my altered upper GI tract to handle. During my pre- and post-op nutrition classes, my dietitian warned us that fruits and vegetables are a challenge for most gastric band patients to eat, and repeated the “take tiny bites and chew each bite 100 times” mantra many, many times. It took several months and band fills for me to truly understand why Susan had repeated her warning so often, and what was true for me as a bandster is still true for me as a sleevester. If you’re in the same situation, I offer you a delicious mixed salad of produce prep ideas. But first, let me address the juicing of fruits and vegetables. It's true that juice is easy to get down. It’s true that you can get vitamins, minerals, and flavor from juiced fresh vegetables and fruits. It’s true that you can add protein powder to juice to amp up its nutritional benefits. But even the freshest juice won't give you the fiber and satiety of the solid versions. One of the things I like best about raw produce is its CRUNCH. Just the act of crunching a carrot makes eating it so satisfying to me. And no one can convince me that juicing is convenient. I used the fancy juicer my helpful husband gave me at the time of my surgery exactly twice. I love to cook and love kitchen toys, but assembling, cleaning, and reassembling a juicer takes far more time than I’m willing to give a glass of juice that takes me all of a minute to drink. I stuck to my pre- and post-op liquid diets like a good girl, but if I’d believed I could lose my excess weight and maintain a healthy weight by consuming liquids for the rest of my life, I wouldn’t have had bariatric surgery in the first place! Here are some suggestions that might make it easier to eat your fruits and veggies, both raw and cooked. Peel and seed everything within reason, except perhaps grapes (unless you can find yourself a cute slave boy to peel your grapes for you - and if you find one, ask him if he has a brother or sister who would like to move to Tennessee - MUST LOVE DOGS). It's easy enough to peel fruits like tomatoes, peaches and plums by dunking them in a boiling water bath for a minute. The skins of bell peppers can be a problem for me, but if you grill or broil the peppers until they're charred, the skins slip right off (you'll have to rinse off the stubborn bits) and the roasted flavor is wonderful. If eating fruits or vegetables "out of hand" (such as two of my favorites - carrot sticks dipped in hummus and apple slices smeared with with peanut butter) is a problem for you, cut them into small pieces and eat them with a fork. When I eat with utensils instead of my fingers, I automatically eat more slowly and carefully. Try shredding the food in a food processor. At times I haven't been able to eat broccoli, Brussels sprouts, cabbage, carrots, apples, spinach, kale and other things whole or even chopped, but they worked if I shredded them before I cooked or ate them. Try alternating bites of a challenging fruit or vegetable with a less challenging food. For example, instead of just eating a banana, cut it up and mix it with other cut fruits and berries in a salad. Then (slowly) eat a bite of banana, a bite of melon, a raspberry, and so on. Or eat a bite of strawberry, then a bite of cottage cheese. “Lubricate” fresh blueberries by mixing them into thick, yummy, protein-rich Greek yogurt (a sprinkle of chopped nuts in that makes it even better). Although I prefer fruits and most veggies raw, sometimes I have to do what my grandmother called "blanching". Bring a pot of water to boil. While it's heating, cut up the fruits or veggies into small pieces. When the water is boiling, throw the produce in, turn off the heat, and let it sit for one or two minutes. Then drain it and run cold water over it (or put it in an ice bath) to stop the cooking. The produce should still have its bright color and it hasn't lost a lot of nutrients, crunch, or flavor this way, but the parboiling takes some of the meanness out of the fibers. Just before serving, mix the raw or cooked produce with a sauce, yogurt, light sour cream, hummus, dip or low-fat dressing. Sometimes all any food (including meat) needs is a lubricant to help it go down. Just don't overdo the sauce so that it covers up the flavor of the food and sends a flood of saturated fat into your circulatory system. Corn kernels can be a challenge for us to eat (cooked or popped) because of the fibrous hulls. That doesn’t mean you can never eat corn again. It just means: eat it carefully, and in moderation. It’s mighty hard to eat corn-on-the-cob carefully, so I slice the kernels off the cob (which also reduces the annoyance of corn stuck in the teeth. I’ve also had good luck with fresh corn if I cut the kernels off the cob before cooking the kernels. Hold the corn cob so it stands with its stem end on a plate or bowl. Run a sharp knife from the tip of the ear straight down to the stem end, leaving 1/8 to ¼” of pulp behind on the cob. Then cook the cut corn with a little bit of water or broth, or proceed with your recipe. Use caution when eating generic brands of frozen and canned corn, which in my experience contain more tricky and/or indigestible stuff (like bits of cob) than the more expensive name brands. If you love fresh fruits and veggies too, y’all are welcome to pick all you can eat from our garden and orchard this year. To find us, get yourself to Memphis and drive north until you hear barking. I must warn you, though, that our dogs love produce too, so you may have to negotiate your share of the apple harvest with them. But they also love company, so come on down!

Believe it or not, I actually love the fruits and veggies my doctor tells me will keep me healthy. When I was growing up, no one had to tell me that, like Popeye, I needed to eat my spinach. I’d rather not eat greens out of a can, but decades later, they appear on our dinner table often. At home here in rural Tennessee, we enjoy many months of harvest from our big garden and small orchard. We are truly blessed in the produce department. The problem is that the harvest is too big for a big man and a small woman to eat. We give a lot to friends, coworkers, and the local food pantry, but my husband continues to overestimate how much I can eat nowadays, and I continue to work on strategies to make produce easier for my altered upper GI tract to handle. During my pre- and post-op nutrition classes, my dietitian warned us that fruits and vegetables are a challenge for most gastric band patients to eat, and repeated the “take tiny bites and chew each bite 100 times” mantra many, many times. It took several months and band fills for me to truly understand why Susan had repeated her warning so often, and what was true for me as a bandster is still true for me as a sleevester. If you’re in the same situation, I offer you a delicious mixed salad of produce prep ideas. But first, let me address the juicing of fruits and vegetables. It's true that juice is easy to get down. It’s true that you can get vitamins, minerals, and flavor from juiced fresh vegetables and fruits. It’s true that you can add protein powder to juice to amp up its nutritional benefits. But even the freshest juice won't give you the fiber and satiety of the solid versions. One of the things I like best about raw produce is its CRUNCH. Just the act of crunching a carrot makes eating it so satisfying to me. And no one can convince me that juicing is convenient. I used the fancy juicer my helpful husband gave me at the time of my surgery exactly twice. I love to cook and love kitchen toys, but assembling, cleaning, and reassembling a juicer takes far more time than I’m willing to give a glass of juice that takes me all of a minute to drink. I stuck to my pre- and post-op liquid diets like a good girl, but if I’d believed I could lose my excess weight and maintain a healthy weight by consuming liquids for the rest of my life, I wouldn’t have had bariatric surgery in the first place! Here are some suggestions that might make it easier to eat your fruits and veggies, both raw and cooked. Peel and seed everything within reason, except perhaps grapes (unless you can find yourself a cute slave boy to peel your grapes for you - and if you find one, ask him if he has a brother or sister who would like to move to Tennessee - MUST LOVE DOGS). It's easy enough to peel fruits like tomatoes, peaches and plums by dunking them in a boiling water bath for a minute. The skins of bell peppers can be a problem for me, but if you grill or broil the peppers until they're charred, the skins slip right off (you'll have to rinse off the stubborn bits) and the roasted flavor is wonderful. If eating fruits or vegetables "out of hand" (such as two of my favorites - carrot sticks dipped in hummus and apple slices smeared with with peanut butter) is a problem for you, cut them into small pieces and eat them with a fork. When I eat with utensils instead of my fingers, I automatically eat more slowly and carefully. Try shredding the food in a food processor. At times I haven't been able to eat broccoli, Brussels sprouts, cabbage, carrots, apples, spinach, kale and other things whole or even chopped, but they worked if I shredded them before I cooked or ate them. Try alternating bites of a challenging fruit or vegetable with a less challenging food. For example, instead of just eating a banana, cut it up and mix it with other cut fruits and berries in a salad. Then (slowly) eat a bite of banana, a bite of melon, a raspberry, and so on. Or eat a bite of strawberry, then a bite of cottage cheese. “Lubricate” fresh blueberries by mixing them into thick, yummy, protein-rich Greek yogurt (a sprinkle of chopped nuts in that makes it even better). Although I prefer fruits and most veggies raw, sometimes I have to do what my grandmother called "blanching". Bring a pot of water to boil. While it's heating, cut up the fruits or veggies into small pieces. When the water is boiling, throw the produce in, turn off the heat, and let it sit for one or two minutes. Then drain it and run cold water over it (or put it in an ice bath) to stop the cooking. The produce should still have its bright color and it hasn't lost a lot of nutrients, crunch, or flavor this way, but the parboiling takes some of the meanness out of the fibers. Just before serving, mix the raw or cooked produce with a sauce, yogurt, light sour cream, hummus, dip or low-fat dressing. Sometimes all any food (including meat) needs is a lubricant to help it go down. Just don't overdo the sauce so that it covers up the flavor of the food and sends a flood of saturated fat into your circulatory system. Corn kernels can be a challenge for us to eat (cooked or popped) because of the fibrous hulls. That doesn’t mean you can never eat corn again. It just means: eat it carefully, and in moderation. It’s mighty hard to eat corn-on-the-cob carefully, so I slice the kernels off the cob (which also reduces the annoyance of corn stuck in the teeth. I’ve also had good luck with fresh corn if I cut the kernels off the cob before cooking the kernels. Hold the corn cob so it stands with its stem end on a plate or bowl. Run a sharp knife from the tip of the ear straight down to the stem end, leaving 1/8 to ¼” of pulp behind on the cob. Then cook the cut corn with a little bit of water or broth, or proceed with your recipe. Use caution when eating generic brands of frozen and canned corn, which in my experience contain more tricky and/or indigestible stuff (like bits of cob) than the more expensive name brands. If you love fresh fruits and veggies too, y’all are welcome to pick all you can eat from our garden and orchard this year. To find us, get yourself to Memphis and drive north until you hear barking. I must warn you, though, that our dogs love produce too, so you may have to negotiate your share of the apple harvest with them. But they also love company, so come on down!

Be sure to drink LOTS of Water when you're eating high-fiber foods and/or supplements. If you don't, the constipation is like to get worse instead of better. Water helps the body assimilate the fiber. Infrequent bowel movements are not considered a medical problem, but when that goes on and on, it can be very uncomfortable (for me, anyway). A colonic would probably help (I had one before my last colonoscopy), but having to do that on a regular basis for the rest of your life could get expensive and a colonic is not risk-free because there's an area in the neighborhood of the anus that can cause heart problems if it's stimulated the wrong way (if that's confusing, remember that I'm not a doctor!). Another approach would be to swallow an 8-ounce bottle of magnesium citrate (immediately followed by an 8-ounce glass of water when the situation gets to the very uncomfortable stage. It makes me gag but it does work (I think that other forms, like liquid gel pills, don't have the laxative effect). But...using it (or any other laxative for that matter) on a regular basis can make your bowels too lazy to function properly, which is a worse problem than constipation. Another thing I've used in the past is Laci Le Beau Super Dieter's Tea. I get it in the tea & coffee section at Walmart. It comes in a few flavor choices; I prefer the cinnamon. You make the tea with one teabag and 12 oz of water; that has 1.9 g of senna in it. You can also find senna in tablet form. But...it's not a good idea to use senna on a regular basis (see above). Do you have a gastroenterologist whose advice you could seek?

Oh, I forgot - you can find a wide variety of foods like breads and cereals that have extra fiber along with their natural fiber content. And some grains and Beans already have a high fiber content, and certainly taste better than magnesium citrate. There's a list of high-fiber foods here: http://www.mayoclinic.org/high-fiber-foods/art-20050948

Infrequent bowel movements are not considered a medical problem, but when that goes on and on, it can be very uncomfortable (for me, anyway). A colonic would probably help (I had one before my last colonoscopy), but having to do that on a regular basis for the rest of your life could get expensive and a colonic is not risk-free because there's an area in the neighborhood of the anus that can cause heart problems if it's stimulated the wrong way (if that's confusing, remember that I'm not a doctor!). Another approach would be to swallow an 8-ounce bottle of magnesium citrate (immediately followed by an 8-ounce glass of Water when the situation gets to the very uncomfortable stage. It makes me gag but it does work (I think that other forms, like liquid gel pills, don't have the laxative effect). But...using it (or any other laxative for that matter) on a regular basis can make your bowels too lazy to function properly, which is a worse problem than constipation. Another thing I've used in the past is Laci Le Beau Super Dieter's Tea. I get it in the tea & coffee section at Walmart. It comes in a few flavor choices; I prefer the cinnamon. You make the tea with one teabag and 12 oz of water; that has 1.9 g of senna in it. You can also find senna in tablet form. But...it's not a good idea to use senna on a regular basis (see above). Do you have a gastroenterologist whose advice you could seek?

I like cucumbers too. I prep them by skinning them with a vegetable peeler, cutting them in half lengthwise, and removing the seeds by running a melon baller down the middle (you can use a small spoon if you don't have a melon baller). Then you can slice/cut them however you like. Or you can fill the channel left by the melon baller with goodies like tuna/chicken/seafood/egg salad.

I think that counseling is a good way to deal with emotional baggage, but is it wonderful? Not so much, for me anyway!

No, I don't mean that a "healthy" obese person can solve their weight problem in other ways than having WLS. As you point out, it's been well-proven that even healthy obese people have the potential for future health problems, some of them serious. In my opinion, at this time there is no single safe and effective way to solve a weight problem for the life of the patient. Obesity is a chronic and incurable disease. It's complicated and its causes are both behavioral and physiological. Unfortunately, we're a long way away from a cure for it. WLS doesn't cure it, and neither does any kind of diet or other non-surgical scheme. WLS is still the most effective treatment for obesity, but that doesn't make it the best choice for every obese person.

I don't mind at all. At about 4 years post-op, I began having reflux that didn't respond to any meds or other measures. An upper GI study showed that my esophagus was dilated, so my surgeon removed all the Fluid from my band and told me my band would have to go. Esophageal dilation can be caused by poor eating behaviors (overeating, frequent PB's, etc.) and/or by esophageal dysfunction - that is, the esophagus isn't doing its job of moving food down into the stomach. The dysfunction is often caused by untreated reflux. After my band was removed and I had had a lot of tests, the various doctors I'd seen concurred that my esophagus had been damaged by decades of "silent" reflux whose only symptom was a chronic dry cough. When I consulted an ear-nose-throat specialist in the mid 1980's, he told me my problem was reflux and I didn't believe him (since of course I know far more than any graduate of any medical school), so my reflux was never treated. Apparently the pressure created by my band was aggravating this. My choice of the sleeve for my revision was pretty foolish (a choice made in panic and haste) because reflux is very common in sleeve patients, even in those who never had reflux pre-op. Fortunately, omeprazole is managing that for me now.

Thanks for posting this, maestrita. Your thread has provoked an interesting discussion, and I'm glad no one has resorted to mud-slinging (yet). Since I revised (not very happily) to the sleeve, I've often been asked if I regret my initial choice of the band. I admit that my affection for my band colors my response to a question like that. No, I don't regret my band surgery. It's harder for me to answer 3 other common questions. One: Would I recommend the band to pre-ops as eagerly today as I did 6-7 years ago? I'm not sure. The answer depends as much on the person who's asking as it does on me, and there's no such thing as a perfect or one-size-fits-all WLS procedure. Two: Would I choose to revise again (if needed) today? No. Since most of my stomach is gone forever, there's only one other WLS option available to me now: duodenal switch. I'm having enough trouble with micro and macro-nutrient malabsorption with my sleeve. I can't imagine how I'd manage with the DS. Three: Would I recommend bariatric surgery (as a whole, not related to a particular procedure) to an obese person today? I'm just not sure. I guess I would if the person's co-morbidities were so severe that some kind of WLS could be life-saving.

Has anybody reading this thread delved into the reasons (if any) given by that study's author for the higher re-operation rate in band patients? It would be interesting to look at that information. Based on my personal experience and the experience of some band patients I've known for a long time and know IRL (in real life), there are a number of reasons for re-operation, not all of them due to complications. Some revise to other procedures because of disappointing weight loss (and the disappointment can be related to concurrent medical issues that affect weight as well as unrealistic weight loss expectations). Some revise because of side effects. Some revise because of complications. Some revise because a band that worked very well for the 1st few years didn't respond to fills after pregnancy and birth of a child.

The fact that the band procedure is re-operable, whereas other WLS procedures are not, may factor in to the higher rate. RNY and the band can be reversed (not necessarily with ease, but it can be done). The sleeve, and the sleeve portion of DS (duodenal switch) cannot be reversed because 75-80% of the stomach is removed and discarded.

I'm about 18 months post-op. Yesterday I felt lousy and very nauseated, like I was coming down with some kind of stomach bug. My years as a bandster have made me very nervous about vomiting (which can cause band slips). Other than the general nastiness of vomiting, is it bad for my sleeve?

That's good news. Even better news would be the departure of the stomach bug. Thanks!