Jean McMillan

That's actually a 2-part question. There are foods that you shouldn't eat, because they're not healthy, contain empty calories, don't meet your nutritional goals, and/or don't provide satiety. Then there are foods that you may not be able to eat at various points (like bread, fibrous veggies, dry cooked meats, apple skins, etc.) because it's so hard to chew them enough to get them past the band. Carbonated beverages should be avoided because the carbonation supposedly can dilate the stomach (same goes for straws) and because the carbonation can be extremely uncomfortable for a bandster. Alcohol is empty calories that loosen your inhibitions, so that eating potato chips or Cookies or whatever seems like a great idea. Alcohol and caffeine can be gastric irritants. food tolerance is very individual and it changes often. Surgeons' and dietitians' nutritional instructions vary widely, and so do bandsters' willingness and/or ability to follow those instructions. None of us are perfect. So it's hard to come up with a single plan for "how to do it the right way". The best approach is to follow your surgeon's and dietitian's instructions. If they don't give you instructions, ask for them. If you don't understand their instructions, ask for clarification.

Jerky (beef, turkey) Protein Bars Granola bars Tuna salad "kits" Canned fruit (single serving) Single serving starchy goodies (cereal, crackers, cookies) Have fun!

There's nothing in a fill that will magically make you lose weight, unfortunately, and it often takes several fills to achieve optimal restriction. And yes, just 1 cc can make a big difference. Please try to avoid eating a big plateful of food. Doing that can overload your esophagus and stomach and eventually cause your band to slip. If you're physically hungry between meals, have a small healthy snack. The best foods to eat (with or without restriction) are SOLID foods because they provide the most satiety. Avoid soft or slider foods (milk, yogurt, cottage cheese, crispy crackers or chips, mashed potatoes, pudding, ice cream, milkshakes, Protein shakes, fruit juice or smoothies, scrambled eggs, anything pureed). Emphasize solid animal protein, fish/shellfish, soy/tofu, hard-cooked eggs, beans; non-starchy vegetables & fruits; and whole grains (brown rice, bulgur, barley, quinoa, thick crackers (like Wasa). You're actually doing fine. You're making good lifestyle changes with better food choices and exercise. I know it's frustrating to be stalled like this, but hang in there!

Well, you've had a little band vacation, and now it's time to get back to work! First of all, consider getting another fill. If you don't know how many cc's you had before the unfill, ask your surgeon or the person who does the fills. Then ask for a fill that's not quite as much as that. For example, if you had 8 cc's and they took out 1 cc, ask for a fill of .5 cc (that's just an example - there's no magic fill amount that will get you going again). Then, pick one thing to change about your behavior. If you've been drinking alcohol, that would be a good place to stop since alcohol is empty calories and loosens your inhibitions so that a bag of chips or Cookies looks like a dandy idea. When you've got that behavior under control, pick another one, like exercise. It might help if you found yourself a "jalkwing" buddy who'll expect you to show up to walk/run at a given time, and keep you company while you do it. Then pick another behavior, like eating sugary stuff. Go through your kitchen, pantry, fridge, freezer, car, desk, locker, or wherever else that stuff might be stashed. Throw out opened packages and donate the unopened ones to a food bank or neighbor or friend. You can do it!

You can click on my Bandwagon ads here on LBT (you may have to wait for them to cycle onto your screen because the ad spots are shared with other advertisers), or you can go to jean-onthebandwagon.blogspot.com and look at the purchase options on the left hand side of the screen. Thanks for your interest!

I'm sorry you had to go through that and are facing a few weeks without much restriction, but I think your doctor did the right thing by pulling plenty of fill out. With symptoms like you were having, leaving it alone could lead to a band slip. I've had unfills of all sizes (including complete unfills) and have to be honest: I gained weight while waiting to get more fill again. But once my restriction was back, I lost that regain. Good luck!

What part of your back is sore? If your legs ache, I would wonder if it's related to a blood clot, but that probably wouldn't be in both legs. I hope you've been able to contact your doctor by now. Good luck! Jean

You're very welcome!

If you can drink liquids without problems, you're OK for now. When you first get a fill, the increased pressure of the band against your stomach causes some irritation. As the irritation subsides and you get used to the new fill level, you'll find it a bit easier to eat. Remember, the whole idea of fills is to help reduce how much you're eating each day! Also, bananas can be iffy, though I don't know why since they're soft.

Congrats on the start of your WLS journey! You'll get more replies to your question about caring for your son if you edit the title of this thread to include the question, such as "child care during recovery" or something like that. I didn't have an infant to care for but bending over, reaching, turning, and lifting can all be uncomfortable when you're a new post-op, so you're wise to start thinking about this issue in advance. Also, I wouldn't want to be left alone to care for a baby when I'm taking narcotic pain relievers. good luck!

I think eating 1200 calories a day of healthy food would be fine, but strongly suggest that you break it up into 6 small meals or Snacks a day. Whatever you do, don't eat 3 meals at 400 calories each because that's likely to be far more volume than your still-healing stomach and band can safely handle. If you eat Saltines or another starchy food, try to combine it with a Protein. If you don't, the starchy food will temporarily spike your blood sugar, and when it crashes, you'll feel hungrier than ever. And...hang in there!

You're the first person I ever heard say that his band banished his sweet tooth! I know a lot of bandsters who still struggle with sweets years after being banded. When my band was at an optimal fill level, most foods just didn't taste so wonderful any more, but sweets still tasted pretty good!

Congratulations on taking positive action to improve your health and quality of life. The pre-op stuff varies tremendously depending on the patient's medical history and the surgeon's protocol, and how long it will take you to get to the operating room depends on how long it takes to do any pre-op tests & evaluations, and on how busy your surgeon's practice is. It took me about 4 months to get through all that, but I know people who've waited a lot longer and also know someone who was banded ony a week after her surgical consult. At the first appointment, your surgeon will probably do a physical exam, discuss your medical history, and explain the surgical procedure. You'll probably also have a nutritional consult with a dietitian and a psychological evaluation with a mental health professional (not to find out if you're crazy, but to establish that you understand what you're getting yourself into, can follow directions, and have a support system). If your insurance policy requires you to have an obesity-related health problems (co-morbidities), you'll need to have some blood tests, maybe a cardiac evaluation, maybe a pulmonary evaluation, maybe a sleep study. Also, the surgeon needs to make sure you're healthy enough to undergo surgery while anesthetized. I could go on and on, but those are the basics.

I know just how you feel. With my ex-PCP, I wanted to say, "Hey, I've done everything you told me to do. I improved my diet, lost weight, & started exercising, but how am I supposed toi erase my genetic predisposition to elevated cholesterol?"

Symptoms of a band slip usually include eating problems, possibly with pain or pressure in the center of your chest. Did you have a hiatal hernia repaired when your band was placed? Because I've heard that can cause discomfort in that area. I have an untreated hiatal hernia and when it's complaining, I get a painful pulling sensation at the top left side of my abdomen, right under my rib cage.

Don't forget to check out my cookbook too - Bandwagon Cookery.

Weight loss alone can stop diabetes in its tracks. In July 2007 (2 mos before my surgery) my A1C was 7.4. In December 2007 (2 mos after my surgery) it was 5.9.

It's a long story, but the short version is that I learned that I have a congenital condition of the esophagus called achalasia that my band was aggravating. In achalasia, the esophagus can't move food down into the stomach and the tissues at the juncture of the esophagus and stomach are thickened, causing a stricture. Left untreated, eventually the esophagus doesn't work at all and the patient can't eat at all. I'll be having some tests to evaluate how severe my achalasia is and hopefully get the stricture dilated (via upper endoscopy) enough that I can go ahead and do a sleeve revision later this year. I hate, hate, hate losing my band, but I'm trying to make the best of the circumstances. I don't want everybody freaking out that the same thing might happen to them. Esophageal problems were listed as a possible complication of band surgery when I signed the release for my surgery in 2007, but my surgeon insists that my band did not cause the achalasia. My brother also has esophageal problems so it seems to run in our family.

AND WHAT’S SO GREAT ABOUT ACCOUNTABILITY, ANYWAY? Accountabiity is a popular term in the WLS community. When I first saw it used in an online forum post, it reminded me unpleasantly of a company I worked for a decade or so ago. We were acquired by a much bigger company whose watchword was ACCOUNTABILITY. Seemingly overnight, our procedures changed so that every action had to be accounted for with a signature (or 2 or 5), a report, a committee vote, and/or an Act of Congress. This approach was intended to ensure ethical behavior in a group of employees who had never dreamed of committing unethical acts before, so it seemed to many of us that Big Brother was watching our every move, and that we had to ask him for permission for even the most trivial things, from a restroom visit to changing the toner cartridge in a copier. The initials, signatures and codes we were forced to append to every piece of work seemed designed to enable a complicated system of extravagant punishments and meager rewards. Needless to say, all that had tainted the word "accountability" for me, so that I reflexively cringed every time it appeared on my computer screen. Despite my unpleasant history with accountability, curiosity got the better of me. I began to read about accountability and accountability partners. I discovered a more positive and less punitive approach, in which reporting your eating, exercise, and other behaviors to a partner (or group) can help keep you honest about those things. For a long time, I had resisted any public declaration about my eating. When you're ashamed, you don't want to tell your secrets to friends, family, doctors, or the cop sitting in a speed-trap chase car. Even when I was active in OA (Overeaters Anonymous), I sometimes lied to my sponsor about whether I had followed my food plan for the day. I didn't like myself for that, so I attributed my own negativity to the whole accountability thing. It made me feel bad, therefore it was bad. But here were all these WLS patients seeking accountability partners online. Were they all masochists, or was I missing something? I must sheepishly (but happily) report (report? aargh! there's that word again!) that I had been missing something important and useful. Months after I'd reached my weight goal, when I was busy enacting the part of the Model Bandster, a friend and I joined up as accountability partners. She had lost over 100 pounds but found herself struggling with weight regain, and we thought a partnership might help her get back on the bandwagon. Little did I know how much it would help me! Almost 2 years later, my partner still tolerates me, and I actually look forward to our daily e-mail check-ins. We tell each other our food plan (or lack thereof) for the day and report (aargh!) how well we stuck to the previous day's plan. My partner hasn't caught the exercise bug like I have, but I also tell her my workout plans. We share anything else that's affecting our eating and weight management, be it travel, stress, holidays, work, illness, or apathy. We ask each other questions and offer suggestions and advice. I don't hesitate to point out the lack of protein in my partner's food plan; she sees when I'm slipping into maladaptive eating with a few days of soft and slider foods and asks, "Have you been satisfied with your meals this week?" We cheer each other on and prop each other up. We laugh and cry, complain about obstinate husbands, and brag about our dogs, children and grandchildren (human and canine). And sometimes all we do is listen. The bottom line? Accountability is not just about dotting your I's, crossing your t's, and signing "John Hancock" every time you take a pen out of the supply cabinet. It's about taking responsibility for your weight management while using the support of peers who know firsthand what that job is all about. HOW DO YOU FIND & CULTIVATE AN ACCOUNTABIITY PARTNER? A good place to find an accountability partner is in a WLS support community - at in-person support group meetings, in your surgeon's waiting room, or at online support communities like LBT. Go to a few meetings, eavesdrop on conversations and read forum postings until you identify someone "simpatico". By that, I mean someone you identify with for any reason, whether it's his/her age, profession, hobbies, geographic location, you name it. Try to avoid someone who would baby you when you need to be kicked in the butt. Initiate a conversation with that person. Introduce yourself, ask a question, give them a compliment, tell them a joke, express an opinion. If your interaction with this person goes well - they seem to "get" you and respond to you in a positive, caring and responsible fashion - ask if they'd be willing to try an accountability partnership with you. Tell them why. It might be, "I really admire your band success," or "Like you, I travel a lot for my job, and I'm wondering if you can share any eating tips with me." When you find a partner and agree on how you're going to run the partnership, begin communicating immediately, every day without fail. If you're not going to be able to check in daily for a period (be it one day or one week), tell your partner in advance or as soon as you know - don't just disappear. Be as honest as you possibly can be with your partner, and demand the same thing of her/him. Listen carefully to what your partner says or writes. You may not have the magic answers to all your partner's problems, but you'll be helping just by listening closely and respectfully. If you and your partner seem to fall into a rut, it might be time to shake things up. You can give each other a challenge, like exercising 5 minutes longer every day or giving up fast food meals for a month. You can decide to read a book together and discuss each section or chapter. A good book for this purpose (besides Bandwagon!) is The Emotional First Aid Kit by Cynthia Alexander (available on amazon). You can pledge to list three positive things that happened to you every single day. You can take a short vacation and give up talking about weight loss completely for a set period of time, but go on talking about other events and issues. When you return to the task of daily eating accountability, you might bring new energy or ideas along with you. If at some point the partnership doesn't seem to be working for you, tell your partner and ask him/her for ideas on how to improve the relationship. Your joint decision might be to end the relationship altogether, or to check in once a month instead of once a day, and that's OK. Finally, here's an example of the kind of message I send to my accountability partner each morning: Dear Partner (name withheld to protect the innocent), It's 15F this morning. FIFTEEN DEGREES!!! WTF?! I moved all the way to Tennessee to get away from 15F weather! I didn't eat according to plan yesterday, but I did OK. When I got done with my teeth cleaning and errands, I didn't have time to go home for lunch, so I got a chicken salad wrap at the coffee shop and ate most of half of it. It was pretty good, with grapes in the salad. This morning I have a Zumba class. I've taken Zumba before at a different place and liked it a lot, but so far I'm not liking the new class because the instructor doesn't explain the moves or call them out before they start. You just have to play follow the leader. I'll be at work from 11:00 am to 4:30 pm today. Food will be: B&S: the usual (protein shake before workout, a latte afterward) L: 2 oz catfish salad (like tuna salad), 2 Wasa thin & crispy sesame flatbreads S: 1/4 c. trail mix D: 3 oz crab cake, 1/4 c. barley & veggy salad S: granola bar I'm liking granola bars for an evening snack because they're so chewy. Gotta chew! Have a great day and STAY WARM! Jean

AND WHAT’S SO GREAT ABOUT ACCOUNTABILITY, ANYWAY? Accountabiity is a popular term in the WLS community. When I first saw it used in an online forum post, it reminded me unpleasantly of a company I worked for a decade or so ago. We were acquired by a much bigger company whose watchword was ACCOUNTABILITY. Seemingly overnight, our procedures changed so that every action had to be accounted for with a signature (or 2 or 5), a report, a committee vote, and/or an Act of Congress. This approach was intended to ensure ethical behavior in a group of employees who had never dreamed of committing unethical acts before, so it seemed to many of us that Big Brother was watching our every move, and that we had to ask him for permission for even the most trivial things, from a restroom visit to changing the toner cartridge in a copier. The initials, signatures and codes we were forced to append to every piece of work seemed designed to enable a complicated system of extravagant punishments and meager rewards. Needless to say, all that had tainted the word "accountability" for me, so that I reflexively cringed every time it appeared on my computer screen. Despite my unpleasant history with accountability, curiosity got the better of me. I began to read about accountability and accountability partners. I discovered a more positive and less punitive approach, in which reporting your eating, exercise, and other behaviors to a partner (or group) can help keep you honest about those things. For a long time, I had resisted any public declaration about my eating. When you're ashamed, you don't want to tell your secrets to friends, family, doctors, or the cop sitting in a speed-trap chase car. Even when I was active in OA (Overeaters Anonymous), I sometimes lied to my sponsor about whether I had followed my food plan for the day. I didn't like myself for that, so I attributed my own negativity to the whole accountability thing. It made me feel bad, therefore it was bad. But here were all these WLS patients seeking accountability partners online. Were they all masochists, or was I missing something? I must sheepishly (but happily) report (report? aargh! there's that word again!) that I had been missing something important and useful. Months after I'd reached my weight goal, when I was busy enacting the part of the Model Bandster, a friend and I joined up as accountability partners. She had lost over 100 pounds but found herself struggling with weight regain, and we thought a partnership might help her get back on the bandwagon. Little did I know how much it would help me! Almost 2 years later, my partner still tolerates me, and I actually look forward to our daily e-mail check-ins. We tell each other our food plan (or lack thereof) for the day and report (aargh!) how well we stuck to the previous day's plan. My partner hasn't caught the exercise bug like I have, but I also tell her my workout plans. We share anything else that's affecting our eating and weight management, be it travel, stress, holidays, work, illness, or apathy. We ask each other questions and offer suggestions and advice. I don't hesitate to point out the lack of protein in my partner's food plan; she sees when I'm slipping into maladaptive eating with a few days of soft and slider foods and asks, "Have you been satisfied with your meals this week?" We cheer each other on and prop each other up. We laugh and cry, complain about obstinate husbands, and brag about our dogs, children and grandchildren (human and canine). And sometimes all we do is listen. The bottom line? Accountability is not just about dotting your I's, crossing your t's, and signing "John Hancock" every time you take a pen out of the supply cabinet. It's about taking responsibility for your weight management while using the support of peers who know firsthand what that job is all about. HOW DO YOU FIND & CULTIVATE AN ACCOUNTABIITY PARTNER? A good place to find an accountability partner is in a WLS support community - at in-person support group meetings, in your surgeon's waiting room, or at online support communities like LBT. Go to a few meetings, eavesdrop on conversations and read forum postings until you identify someone "simpatico". By that, I mean someone you identify with for any reason, whether it's his/her age, profession, hobbies, geographic location, you name it. Try to avoid someone who would baby you when you need to be kicked in the butt. Initiate a conversation with that person. Introduce yourself, ask a question, give them a compliment, tell them a joke, express an opinion. If your interaction with this person goes well - they seem to "get" you and respond to you in a positive, caring and responsible fashion - ask if they'd be willing to try an accountability partnership with you. Tell them why. It might be, "I really admire your band success," or "Like you, I travel a lot for my job, and I'm wondering if you can share any eating tips with me." When you find a partner and agree on how you're going to run the partnership, begin communicating immediately, every day without fail. If you're not going to be able to check in daily for a period (be it one day or one week), tell your partner in advance or as soon as you know - don't just disappear. Be as honest as you possibly can be with your partner, and demand the same thing of her/him. Listen carefully to what your partner says or writes. You may not have the magic answers to all your partner's problems, but you'll be helping just by listening closely and respectfully. If you and your partner seem to fall into a rut, it might be time to shake things up. You can give each other a challenge, like exercising 5 minutes longer every day or giving up fast food meals for a month. You can decide to read a book together and discuss each section or chapter. A good book for this purpose (besides Bandwagon!) is The Emotional First Aid Kit by Cynthia Alexander (available on amazon). You can pledge to list three positive things that happened to you every single day. You can take a short vacation and give up talking about weight loss completely for a set period of time, but go on talking about other events and issues. When you return to the task of daily eating accountability, you might bring new energy or ideas along with you. If at some point the partnership doesn't seem to be working for you, tell your partner and ask him/her for ideas on how to improve the relationship. Your joint decision might be to end the relationship altogether, or to check in once a month instead of once a day, and that's OK. Finally, here's an example of the kind of message I send to my accountability partner each morning: Dear Partner (name withheld to protect the innocent), It's 15F this morning. FIFTEEN DEGREES!!! WTF?! I moved all the way to Tennessee to get away from 15F weather! I didn't eat according to plan yesterday, but I did OK. When I got done with my teeth cleaning and errands, I didn't have time to go home for lunch, so I got a chicken salad wrap at the coffee shop and ate most of half of it. It was pretty good, with grapes in the salad. This morning I have a Zumba class. I've taken Zumba before at a different place and liked it a lot, but so far I'm not liking the new class because the instructor doesn't explain the moves or call them out before they start. You just have to play follow the leader. I'll be at work from 11:00 am to 4:30 pm today. Food will be: B&S: the usual (protein shake before workout, a latte afterward) L: 2 oz catfish salad (like tuna salad), 2 Wasa thin & crispy sesame flatbreads S: 1/4 c. trail mix D: 3 oz crab cake, 1/4 c. barley & veggy salad S: granola bar I'm liking granola bars for an evening snack because they're so chewy. Gotta chew! Have a great day and STAY WARM! Jean

To clarify: No, the band doesn't stretch, but as you lose weight, the fat surrounding your internal organs, including your stomach, shrinks, so the band feels looser, as if it had stretched, and you need more fill. But usually as you get more fills, it takes smaller and smaller fills (not bigger ones) to "fine tune" the fit of your band. My fill history went something like this: +1 cc, +1 cc, + .5 cc, + .3 cc, + .2 cc, + .15 cc.

You can also order by clicking on one of my Bandwagon ads here on LBT. The 2 books are Bandwagon (which I call the giant encyclopedia of adjustable gastric band advice) and Bandwagon Cookery (a cookbook - recipes w/ nutritional data, and a lot of info about meal planning & preparation to suit bandsters' needs).

Your story just goes to show that patients need to be their own advocates regarding medical info and care. When I was in the hospital a few weeks ago, waiting to be taken to surgery prep, I started feeling dizzy and sick and called a nurse to ask her to check my blood sugar (since I'd been on a clear liquid diet the day before and had nothing to eat or drink since midnight). The nurse who answered said, "Your blood sugar? Are you diabetic?" Well, yes, isn't it in my patient file? Isn't that kind of important for y'all to know?! I've never heard of someone's surgery getting moved up because of a diabetes diagnosis. Not impossible, but unless you have uncontrolled diabetes with serious complications like neuropathy, vision loss, kidney failure, etc., I don't think anyone's gonna get excited about it. Which is kind of sad when you think about it, but diabetes is getting to be such an epidemic in the US, it seems to be losing its power to frighten people.

I could write a book in response to your post. Wait a minute, I did write a book! But to give you a few quick answers... The best foods to eat: solid food. Liquids, soft foods, and "sliders" (like thin crackers, chips, etc.) give virtually no satiety, plus they can be very high in calories, fat, and sodium. The best protein: SOLID Protein cooked with a moist method (easier to eat without problems). The best veggies to eat that won't get stuck: impossible to list, because it varies so drastically depending on your restriction and on how you prepare them. According to Allergan, common problem foods include very fibrous veggies (like asparagus, celery, cabbage, corn, popcorn) and fruits (avoid citrus membranes, fruit skins & peels). I think there's a list of them on lapband.com. The best exercise: anything you enjoy and will do on a consistent basis. hair loss is unpredictable. I've always had thin hair but didn't lose any and actually it seems thicker and healthier than ever before (better nutrition and Water intake. Hair loss can be related to anesthesia and to inadequate protein intake.

A new member asked for ideas for daily menus, and that reminded me that I used to post a week's worth of dinner menus once a week on another online forum. I'm going to start doing the same thing here (though I can't promise it'll be every single week, due to my work schedule), and I invite everyone else to post their menus on the thread. I eat the same things for Breakfast most days, and lunch is almost always leftovers from the previous day's dinner. Occasionally I have to work nights, so I don't cook dinner on those days (it's "every man for himself" then). Here's a week's worth of dinner menus from my vast archives (saved because I'm writing a cookbook called Menus Made Easy). Some of these are from recipes in my cookbook, Bandwagon Cookery. I noted the page # beside those dishes. SUNDAY Roast chicken w/ lemon & rosemary Baked onions & cranberries p.136 Cooked greens (spinach, kale, turnip) MONDAY Crab cakes w/ lemon sour cream sauce on the side (light sour cream, grated lemon rind, onion powder) p. 278 & p.145 Green Beans - roasted - p.314 Mashed sweet potato TUESDAY Tex-Mex chicken casserole (using leftover roast chicken) Grapefruit & avocado salad w/ cilantro p.188 WEDNESDAY Baked cod w/ a "crust" of crushed pretzels (with more of the lemon sour cream sauce on the side) Asparagus Brown rice THURSDAY Steak - herb marinated - p.259 Grilled potato wedges, summer squash & zucchini (basted with Italian salad dressing) Tomato salad w/ reduced-fat feta cheese - with lemon salad dressing on p.184 FRIDAY Baked tofu w/ spicy peanut sauce p.293 Korean-style cooked spinach p. 313 Barley cooked w/ chicken broth SATURDAY Parmesan polenta topped with spaghetti sauce (with cooked ground turkey or beef in it) Green salad with lots of veggies - with roasted red pepper salad dressing p.187