Jean McMillan

You might want to post this in the Maryland forum: http://www.lapbandtalk.com/forum/1119-maryland/

Kinda makes you wonder if that last fill even made it into your port. Or if the needle hit your tubing and you've got a leak now. My fills have almost always made a difference by the time 2 weeks has gone past. If it were me, I'd call your surgeon and ask to have the fluid level in your band checked (they stick the needle in as if doing a fill, but withdraw the fluid and measure it).

Before my weight loss surgery, I tried to anticipate who in my circle of friends and family might attempt to sabotage (with the most innocent and loving intentions) my weight loss effort. Since I share a home with an adult male who has a driver's license, a debit card, a hearty appetite, and easy access to all the junk food at Wal-Mart, fast-food restaurants and dozens of convenience stores, I warned him that I would need his help in keeping junk food out of our house. Although he's slipped up a few times, on the whole, my husband has been great in supporting my weight loss journey. Much to my dismay, I've discovered that JEAN is the worst saboteur in this household. I've always liked to think that I'm a detail-oriented, logical, analytical person. I just hadn't noticed before that I frequently apply my (occasionally) brilliant mind to rationalizing the absolutely worst self-defeating actions. For example: I work with a dozen or so college students who are always hungry and always short of the cash, time, and willingness to cook for themselves. Since I have no (human) children of my own, I take care of these kids by baking for them. Brownies, cookies, cupcakes, muffins...you get the idea. But let's be honest now. Somehow those baking binges happen only when JEAN is in the mood for a sweet treat. Somehow it's OK for me to bake a batch of cookies and eat six of them as long as I take the rest to work for my adopted kids. And it's extremely ironic that these kids never observe me eating sweets or junk food. I bring my own healthy food for lunch instead of running out to Taco Bell. I have the reputation of being a health nut, but little do they know about the spoonful of cookie dough that disappeared down my gullet before those cookies went into the oven. At a meeting the other day, I forgot myself. I picked a mini Milky Way candy out of a basket on the table and began to unwrap it. The youngster sitting beside me watched in alarm and exclaimed, "I think I'm going to faint!" Someone else said, "What's the matter, Sam, are you sick?" and she replied, "No! Don't y'all see? Miss Jean is eating candy! The world as we know it is ending!" WHY DO WE SABOTAGE OURSELVES? As I explained in Bandwagon, self-sabotage is the deliberate destruction of property or the hindrance of operations by an enemy. As you start your weight loss surgery journey, you might believe that your mother and her famous biscuits and gravy, or your husband and his Pizza Palace Frequent Customer card, or your children with their 9:00 p.m. demands of "Mom, I need some cookies for our class Christmas party tomorrow", will be your worst saboteurs. But beware! There is another saboteur who is with you 24 hours a day, 365 days a year. Who is it? Go look in the mirror. The saboteur is you. That earnest, innocent face hides a food demon who is determined to prove what you believed for so long...that you are destined to fail at weight loss...that you don't deserve to be slim and healthy....that without your protective layer of fat, you'll be too easily hurt or too easily noticed...that once you're up on the Pedestal of Success, you'll lose your balance and tumble back down into obesity anyway while all your friends and enemies point and laugh at you. Melissa McCreary wrote an excellent 2-part article about overeating and self-sabotage for the LBT WLS Magazine. Check it out here: http://www.lapbandtalk.com/topic/144909-overeating-and-self-sabotage-part-one/. It describes common erroneous (or dysfunctional) beliefs (“It’s not OK to be selfish”) and head-games (“I don’t have time to spend on activities that are healthy for me) that can trip you up. If you read Melissa’s article and even one of those beliefs or head-games sounds familiar, put that one up at the top of your to-do list. Unfortunately, self-sabotage is sometimes disguised beyond easy recognition. If you’re feeling frustrated and not losing weight but you’re not sure why, take a look in your mental mirror. Some signs of self-sabotaging thinking are: jealousy (comparing yourself to others), extreme anxiety, negativity, procrastination, giving up easily, ignoring feedback, feelings of worthlessness, living in the past, blaming others, and the all-time favorite: DENIAL. How can you overcome tough stuff like that? Professional counseling has helped me tremendously. Attending in-person support group meetings such as Overeaters Anonymous has also helped me. Checking in daily with my Accountability Partner helps me. What’s an accountability partner? I’m working on an article about accountability now, so watch for it!

Those a great strategies. I do something similar. I like Protein bars - they're like "legal" candy bars to me - so I don't keep them in the kitchen. To eat one, I have to walk all the way through the house, through a bedroom and a bathroom, to the storage room. By the time I get to the storage room, I've either forgotten what I made the trip for, or I've had enough time to consider whether I really need to eat that protein bar!

I plan a week's dinner menus in advance so I know what to buy at the supermarket and so I don't have to throw together a meal at the last minute. It's nearly impossible for me to make good food choices when I'm starving or rushed.

OK, watch your inbox!

Yumcious?! I love that word!

Some of the recipes are from Bandwagon Cookery. I just edited my original post to add the page numbers in the cookbook, and next time I do a post like this I will use as many recipes from the book as I can.

Being able to eat a wide variety of foods I like is one of the reasons I chose the band, though I'll admit that my tolerance of particular foods has varied over time, and food tolerance requires consistent use of good band eating skills. It also depends on cooking methods (moist is best).

Ah, another dog lover and rescuer! My husband and I run an informal animal shelter. People drop off unwanted kittens and puppies out here in the country all the time, so we have a steady supply of mutts. And I publish a free weekly e-newsletter about our critters (dogs & cats), Dog Days, if you're interested.

The liquid diet is no fun, but thank goodness it's temporary. Generally speaking, Protein shakes keep you going longer than other liquids (because of the protein), so you're less likely to feel light headed, but will probably still have to deal with hunger. I missed chewing so I ate a lot of SF popsicles. Other liquids you could try: bean or other veggy Soup pureed and thinned with enough broth to make it able to pass through a straw (even though you shouldn't use a straw) (add some FF dried milk to increase the protein content) reduced-sodium cream of chicken soup (or other "cream" of soups), made with FF milk, pureed unjury makes a great chicken soup flavor Protein powder. It's good on its own or mixed in with soup. You can only get it online (unjury.com). Their customer service is excellent. Fruit smoothies (add FF Greek yogurt to increase the protein content)

I know what you mean. When you're just starting out, you're dealing with an overwhelming amount of new information and new experiences. It's hard to keep it all straight at first.

Is that Buster in your avatar? A boxer? I love smushed-face dogs. I had a Buster boy who was a French bulldog, and we now have another Frenchie, a pug, and 8 mutts.

I did measure everything during my weight loss phase. In maintenance mode, I'm less strict about it, but I strongly recommend it because I'm terrible at "eyeballing" a portion. For example, I cut a piece of chicken that I think is 2 ounces, but when I weight it, it's 4 ounces, therefore twice the calories. How much you should eat per sitting depends on your surgeon's guidelines. Some surgeons say eat no more than 1/2 cup, others say 1 cup per meal. How much I can eat of a given food depends on its texture. So I could eat 1-1/2 cups of yogurt, but only 1/2 cup of chicken. Here's an example of portion sizes from the weight loss food plan my dietitian gave me way back when. Breakfast: 1 slice whole grain toast, 1 egg scrambled Snack: 1/2 cup fruit Lunch: 1/4 cup veg, 1/4 cup starch, 1/4 cup protein Snack: 1/2 cup fruit Dinner: same portions as lunch Snack: 1 cup protein shake or 1/2 cup SF pudding

One other thought - have you asked your surgeon or anyone on his/her staff for a written food plan? Doesn't hurt to ask, you know!

There's a thread pinned to the top of this forum entitled, Share Ideas, What Did You Eat Today? You can get some daily menu ideas from the posts on that thread. I'll start a separate thread here on the Food & Nutrition forum entitled, A Week's Worth of Dinner Menus, and will try to post a new thread with new menus once a week. For general purposes, my typical daily menu is: B: Click vanilla latte protein shake S: skinny latte S: protein bar, or Greek yogurt w/ fruit L: leftovers from the previous night's dinner S: trail mix D: a protein, a non-starchy veg, and a starch S: fruit, or SF pudding

Weekly menus for what? Breakfast, lunch & dinner? Or just dinner? Or what? Does your surgeon or dietitian give you any nutritional guidelines to follow? For example, low carb, no carb, 3 meals a day, with or without snacks, etc. etc. I've got hundreds of menus, but need to narrow down the scope of this or else you'll suffocate under the mountain of info I give you!

Welcome, and congrats on being banded!

Cyndy, it never hurts to put yourself through a band refresher course!

I'm so glad my book and posts have been helpful to you. Writing and publishing all that is part of what keeps ME on the Bandwagon!

Go to my blog (jean-onthebandwagon.blogspot.com) and scroll down while looking at the left side of the page. If you want to pay by credit card, look for the picture of the book covers and click on it. If you want to use PayPal (with whatever form of payment you prefer), click on the yellow PayPal Add to Cart button to make your purchase. books ordered via the PayPal option can be autographed to you if you specify it when you order. If you have any problems ordering, send me a PM and we'll figure it out. Thanks for your interest! Jean Edited to Add: You can also order by clicking on one of the Bandwagon ads here on LBT.

LOL! And hey, hop right in!

Before my weight loss surgery, I tried to anticipate who in my circle of friends and family might attempt to sabotage (with the most innocent and loving intentions) my weight loss effort. Since I share a home with an adult male who has a driver's license, a debit card, a hearty appetite, and easy access to all the junk food at Wal-Mart, fast-food restaurants and dozens of convenience stores, I warned him that I would need his help in keeping junk food out of our house. Although he's slipped up a few times, on the whole, my husband has been great in supporting my weight loss journey. Much to my dismay, I've discovered that JEAN is the worst saboteur in this household. I've always liked to think that I'm a detail-oriented, logical, analytical person. I just hadn't noticed before that I frequently apply my (occasionally) brilliant mind to rationalizing the absolutely worst self-defeating actions. For example: I work with a dozen or so college students who are always hungry and always short of the cash, time, and willingness to cook for themselves. Since I have no (human) children of my own, I take care of these kids by baking for them. Brownies, cookies, cupcakes, muffins...you get the idea. But let's be honest now. Somehow those baking binges happen only when JEAN is in the mood for a sweet treat. Somehow it's OK for me to bake a batch of cookies and eat six of them as long as I take the rest to work for my adopted kids. And it's extremely ironic that these kids never observe me eating sweets or junk food. I bring my own healthy food for lunch instead of running out to Taco Bell. I have the reputation of being a health nut, but little do they know about the spoonful of cookie dough that disappeared down my gullet before those cookies went into the oven. At a meeting the other day, I forgot myself. I picked a mini Milky Way candy out of a basket on the table and began to unwrap it. The youngster sitting beside me watched in alarm and exclaimed, "I think I'm going to faint!" Someone else said, "What's the matter, Sam, are you sick?" and she replied, "No! Don't y'all see? Miss Jean is eating candy! The world as we know it is ending!" WHY DO WE SABOTAGE OURSELVES? As I explained in Bandwagon, self-sabotage is the deliberate destruction of property or the hindrance of operations by an enemy. As you start your weight loss surgery journey, you might believe that your mother and her famous biscuits and gravy, or your husband and his Pizza Palace Frequent Customer card, or your children with their 9:00 p.m. demands of "Mom, I need some cookies for our class Christmas party tomorrow", will be your worst saboteurs. But beware! There is another saboteur who is with you 24 hours a day, 365 days a year. Who is it? Go look in the mirror. The saboteur is you. That earnest, innocent face hides a food demon who is determined to prove what you believed for so long...that you are destined to fail at weight loss...that you don't deserve to be slim and healthy....that without your protective layer of fat, you'll be too easily hurt or too easily noticed...that once you're up on the Pedestal of Success, you'll lose your balance and tumble back down into obesity anyway while all your friends and enemies point and laugh at you. Melissa McCreary wrote an excellent 2-part article about overeating and self-sabotage for the LBT WLS Magazine. Check it out here: http://www.lapbandtalk.com/topic/144909-overeating-and-self-sabotage-part-one/. It describes common erroneous (or dysfunctional) beliefs (“It’s not OK to be selfish”) and head-games (“I don’t have time to spend on activities that are healthy for me) that can trip you up. If you read Melissa’s article and even one of those beliefs or head-games sounds familiar, put that one up at the top of your to-do list. Unfortunately, self-sabotage is sometimes disguised beyond easy recognition. If you’re feeling frustrated and not losing weight but you’re not sure why, take a look in your mental mirror. Some signs of self-sabotaging thinking are: jealousy (comparing yourself to others), extreme anxiety, negativity, procrastination, giving up easily, ignoring feedback, feelings of worthlessness, living in the past, blaming others, and the all-time favorite: DENIAL. How can you overcome tough stuff like that? Professional counseling has helped me tremendously. Attending in-person support group meetings such as Overeaters Anonymous has also helped me. Checking in daily with my Accountability Partner helps me. What’s an accountability partner? I’m working on an article about accountability now, so watch for it!

Restriction seems to be the Holy Grail of bandsters, a sacred thing that we hunt for with a level of passion and persistence that we may never have experienced before in our lives. In our minds, restriction is endowed with the magical power to make us lose weight. But exactly what is it? THE MEANING OF RESTRICTION We bariatric patients use the word "restriction" in every other sentence we speak, write, or think, but do we truly understand what it means? In my 50+ pre-op years, the word restriction basically meant "no can do" or "you can do it, but within externally-imposed limits." To use extreme examples, that means "Thou shalt not kill" (no can do) or "Drive no faster than 55 mph on this stretch of road" (55 mph being the imposed limit). Keeping those examples of restriction in mind, it's reasonable to say that a restrictive WLS procedure is one that allows you to eat, but in quantities no greater than ½ cup at a time (or whatever your surgeon's food amount limit is). That's clear enough, isn't it? It's clear, but it's not specific enough to ensure safe and effective use of the "restrictive" WLS tool called the adjustable gastric band. For one thing, it implies that the band comes equipped with a monitoring feature, like the radar guns used by police to measure the speed of passing cars. It doesn't make it clear that the only monitoring feature that will work safely with the AGB is a conscientious, hard-working patient's conscious mind. Surgeons and patients who aren't aware of this aspect of the band are headed for accidents such as stuck episodes, PB's, sliming, esophageal or stomach dilation, band slips, or weight loss failure. IS RESTRICTION JUST A MARKETING TERM? The adjustable gastric band was first approved for use in the USA in 2001. Over a decade later, we are just now beginning to understand the true function of the band. A decade of struggle and learning has gone by. Eleven long years! How could that happen? When the adjustable gastric band was first marketed in the USA, it was positioned as a restrictive WLS procedure. In the world of marketing, a product's "position" determines how its features and benefits are communicated to customers and how they compare to similar products in the market. When introducing a new automotive vehicle to the market, an automobile manufacturer must present it in a way consumers will understand: Is it a sedan or an SUV? Is it a sub-compact or a full-size vehicle? A car or a truck? Manufacturers of medical devices like the adjustable gastric band must also educate their customers (surgeons) and end-users (patients) when they market a new product. They ask themselves: Is this a completely new concept? How can we make customers understand it and want to buy it? What other products on the market can we compare it to? In the case of the AGB, Allergan compared it to other bariatric surgical procedures: RNY (gastric bypass, which combines restriction and some malabsorption), DS and BPD (duodenal switch and bilio-pancreatic diversion, which combine restriction and a lot of malabsorption) and VSG (vertical sleeve gastrectomy, considered a restrictive procedure). The AGB doesn't cause nutrient malabsorption, therefore it fell into the restrictive category. As a result of this perfectly ordinary business approach, thousands of surgeons and their patients were not fully informed about the mechanism through which AGB patients lose weight. It's quite possible that even Allergan didn't fully understand at the start just how the band works. If the makers of medical devices and pharmaceutical products waited until every last detail is known about a new device or a drug, some life-saving products might never reach the people who most desperately need them. So for the last decade, we all believed that the band is supposed to restrict the amount of food we can eat and cause weight loss through reduced caloric intake, but that's changing now. In the past few years, Allergan has refined the band's market position and has been teaching surgeons that it should not be used as a restrictive device. Allergan, Endo Ethicon, and the bariatric medical community are realizing that a patient who eats until she or he "feels" restriction is far too likely to experience complications. They are coming to the understanding that the band's chief weight loss mechanism is reduced caloric intake through the reduction of hunger and appetite, with early and prolonged satiety after a small amount of food is eaten. IF IT'S NOT RESTRICTIVE, WHAT IS IT? So if the AGB is not a restrictive WLS procedure, what the heck is it? How can we explain it without using the word restriction? A better term for the true function of the AGB might be something like "optimization" - the process of modifying a system to make aspects of it work more efficiently, use fewer resources, and/or produce the most beneficial results. In a bandster, the system is made up of several important components: the band, the saline fill, the bandster's food choices and exercise level, with a few parts that are so top-secret, nobody knows what they are. Optimization is a clumsy-sounding word, though, and it makes the bandster sound like a machine instead of a human being. For the time being, we don't have a better term than restriction, so we'll go on using it until something better presents itself. HOW CAN I FIND IT IF I DON'T KNOW WHAT IT LOOKS LIKE? How will you recognize restriction? If you were hunting for the Holy Grail, you could equip yourself with a picture of a chalice to guide you, but there's no picture of restriction. Don't kid yourself into thinking that a fill under fluoroscopy (x-ray) is going to yield a picture of your very own restriction. That x-ray image is just a snapshot of part of a living, breathing, changing human body, and while it might illustrate a theoretically good fit on the band on the stomach, it cannot illustrate what's happening in your nervous system. It can't track the production of hormones that triggers hunger or satiety messages between your brain and your body. To recognize, utilize, and safeguard your restriction, you're going to have to start paying attention to dozens of things that you took for granted or didn't even know existed before. I don't go on and on about eating slowly just because it helps prevent unpleasant side effects, but because it's mighty hard to pay attention to your body's signals when you're gobbling your meal. I didn't realize this until perhaps 6 months post-op. Until then, I was eating carefully only to prevent stuck episodes, PB's, and sliming. Very gradually, over the next 6-12 months, I learned to listen to my body, not just when I was eating but between meals. It wasn't until after my 15th fill, at almost 3 years post-op, that I had mastered mindful eating enough to actually enjoy my experience of restriction. Three years is a long time, but don't let that scare you. I lost 100% of my excess weight with far less "restriction" than I had at 3 years post-op. And when you remember that I spent over 50 years eating carelessly and excessively, changing my eating in only 3 years is pretty good! So, what signs of restriction you should be looking for? 1. Early satiety after eating a small portion of food. You lose interest in eating, feel that another bite would just be too much, and/or feel a sudden distaste for the food. 2. Prolonged satiety after eating a small portion of food. You are not physically hungry, and have no appetite (desire to eat) for several hours after you eat. How many hours? It's going to vary by person, and will be affected by many factors, such as food choices (solid versus liquid, for example). For me, 3-4 hours is a very long time to experience satiety and I'm delighted by that. Another person might not care to eat again for 5-6 hours after a meal. 3. Reduced appetite. You're just not as interested in food as you used to be. You think about it less and you might even forget to eat. The food may not even taste as wonderful as you remember it. 4. Reduced physical hunger. You're just not as hungry, and not hungry as often, as before. All that sounds marvelous, doesn't it? A dream come true! It is indeed, but it's also very complicated because the human body and human behavior are very complicated. We're constantly changing, in changing circumstances. While our unconscious brain and body are trying to communicate hunger and satiety, our conscious brains and our lifetime habits are also at work. So even though you weren't especially hungry for that chicken dinner at 6 pm, it's quite possible that a phone call from a troublesome family member will trigger some comfort eating at 6:15 pm, or that boredom will send you looking for snacks at 8:00 pm, or that craving will send you looking for chocolate at 9:00 pm. OBEY THE STOP SIGNALS! Stop signals aren't there just to make you late for work. They're there for your protection. Some of the worst car accidents in my town happen at a major intersection on a busy road where some drivers seem to be ignoring the stop signals. As those drivers are sped away from the scene in the back of an ambulance, I wonder how badly they're hurt or whether they'll survive. I think it's good that our town has installed cameras at that intersection. Stop signals are equally important to bandsters. How? In addition to the 4 signs of restriction explained above, you will also get hints to stop eating that I call "stop signals". As newly-filled or newbie bandsters, we expect our bands to give us good, loud, clear stop signals with clanging bells and flashing lights, but eventually learn (if we work on it) to recognize the quiet stop signals such as mild queasiness, fullness or pressure in the back of the throat, difficulty swallowing, burping (or the urge to burp), sneezing, sighing, hiccups, watering eyes, runny nose, and so on. If we heed those signals, we stop eating before something more drastic and uncomfortable happens. You may not experience any soft stop signals, but don't stop looking for them just because you aren't noticing any; they could sneak past you at any time. And if you experience no hard stop signals (like stuck episodes, PB's, sliming), don't go looking for trouble! The absence of hard stops does not mean that your band isn't working. It means you’re doing a good job!

Restriction seems to be the Holy Grail of bandsters, a sacred thing that we hunt for with a level of passion and persistence that we may never have experienced before in our lives. In our minds, restriction is endowed with the magical power to make us lose weight. But exactly what is it? THE MEANING OF RESTRICTION We bariatric patients use the word "restriction" in every other sentence we speak, write, or think, but do we truly understand what it means? In my 50+ pre-op years, the word restriction basically meant "no can do" or "you can do it, but within externally-imposed limits." To use extreme examples, that means "Thou shalt not kill" (no can do) or "Drive no faster than 55 mph on this stretch of road" (55 mph being the imposed limit). Keeping those examples of restriction in mind, it's reasonable to say that a restrictive WLS procedure is one that allows you to eat, but in quantities no greater than ½ cup at a time (or whatever your surgeon's food amount limit is). That's clear enough, isn't it? It's clear, but it's not specific enough to ensure safe and effective use of the "restrictive" WLS tool called the adjustable gastric band. For one thing, it implies that the band comes equipped with a monitoring feature, like the radar guns used by police to measure the speed of passing cars. It doesn't make it clear that the only monitoring feature that will work safely with the AGB is a conscientious, hard-working patient's conscious mind. Surgeons and patients who aren't aware of this aspect of the band are headed for accidents such as stuck episodes, PB's, sliming, esophageal or stomach dilation, band slips, or weight loss failure. IS RESTRICTION JUST A MARKETING TERM? The adjustable gastric band was first approved for use in the USA in 2001. Over a decade later, we are just now beginning to understand the true function of the band. A decade of struggle and learning has gone by. Eleven long years! How could that happen? When the adjustable gastric band was first marketed in the USA, it was positioned as a restrictive WLS procedure. In the world of marketing, a product's "position" determines how its features and benefits are communicated to customers and how they compare to similar products in the market. When introducing a new automotive vehicle to the market, an automobile manufacturer must present it in a way consumers will understand: Is it a sedan or an SUV? Is it a sub-compact or a full-size vehicle? A car or a truck? Manufacturers of medical devices like the adjustable gastric band must also educate their customers (surgeons) and end-users (patients) when they market a new product. They ask themselves: Is this a completely new concept? How can we make customers understand it and want to buy it? What other products on the market can we compare it to? In the case of the AGB, Allergan compared it to other bariatric surgical procedures: RNY (gastric bypass, which combines restriction and some malabsorption), DS and BPD (duodenal switch and bilio-pancreatic diversion, which combine restriction and a lot of malabsorption) and VSG (vertical sleeve gastrectomy, considered a restrictive procedure). The AGB doesn't cause nutrient malabsorption, therefore it fell into the restrictive category. As a result of this perfectly ordinary business approach, thousands of surgeons and their patients were not fully informed about the mechanism through which AGB patients lose weight. It's quite possible that even Allergan didn't fully understand at the start just how the band works. If the makers of medical devices and pharmaceutical products waited until every last detail is known about a new device or a drug, some life-saving products might never reach the people who most desperately need them. So for the last decade, we all believed that the band is supposed to restrict the amount of food we can eat and cause weight loss through reduced caloric intake, but that's changing now. In the past few years, Allergan has refined the band's market position and has been teaching surgeons that it should not be used as a restrictive device. Allergan, Endo Ethicon, and the bariatric medical community are realizing that a patient who eats until she or he "feels" restriction is far too likely to experience complications. They are coming to the understanding that the band's chief weight loss mechanism is reduced caloric intake through the reduction of hunger and appetite, with early and prolonged satiety after a small amount of food is eaten. IF IT'S NOT RESTRICTIVE, WHAT IS IT? So if the AGB is not a restrictive WLS procedure, what the heck is it? How can we explain it without using the word restriction? A better term for the true function of the AGB might be something like "optimization" - the process of modifying a system to make aspects of it work more efficiently, use fewer resources, and/or produce the most beneficial results. In a bandster, the system is made up of several important components: the band, the saline fill, the bandster's food choices and exercise level, with a few parts that are so top-secret, nobody knows what they are. Optimization is a clumsy-sounding word, though, and it makes the bandster sound like a machine instead of a human being. For the time being, we don't have a better term than restriction, so we'll go on using it until something better presents itself. HOW CAN I FIND IT IF I DON'T KNOW WHAT IT LOOKS LIKE? How will you recognize restriction? If you were hunting for the Holy Grail, you could equip yourself with a picture of a chalice to guide you, but there's no picture of restriction. Don't kid yourself into thinking that a fill under fluoroscopy (x-ray) is going to yield a picture of your very own restriction. That x-ray image is just a snapshot of part of a living, breathing, changing human body, and while it might illustrate a theoretically good fit on the band on the stomach, it cannot illustrate what's happening in your nervous system. It can't track the production of hormones that triggers hunger or satiety messages between your brain and your body. To recognize, utilize, and safeguard your restriction, you're going to have to start paying attention to dozens of things that you took for granted or didn't even know existed before. I don't go on and on about eating slowly just because it helps prevent unpleasant side effects, but because it's mighty hard to pay attention to your body's signals when you're gobbling your meal. I didn't realize this until perhaps 6 months post-op. Until then, I was eating carefully only to prevent stuck episodes, PB's, and sliming. Very gradually, over the next 6-12 months, I learned to listen to my body, not just when I was eating but between meals. It wasn't until after my 15th fill, at almost 3 years post-op, that I had mastered mindful eating enough to actually enjoy my experience of restriction. Three years is a long time, but don't let that scare you. I lost 100% of my excess weight with far less "restriction" than I had at 3 years post-op. And when you remember that I spent over 50 years eating carelessly and excessively, changing my eating in only 3 years is pretty good! So, what signs of restriction you should be looking for? 1. Early satiety after eating a small portion of food. You lose interest in eating, feel that another bite would just be too much, and/or feel a sudden distaste for the food. 2. Prolonged satiety after eating a small portion of food. You are not physically hungry, and have no appetite (desire to eat) for several hours after you eat. How many hours? It's going to vary by person, and will be affected by many factors, such as food choices (solid versus liquid, for example). For me, 3-4 hours is a very long time to experience satiety and I'm delighted by that. Another person might not care to eat again for 5-6 hours after a meal. 3. Reduced appetite. You're just not as interested in food as you used to be. You think about it less and you might even forget to eat. The food may not even taste as wonderful as you remember it. 4. Reduced physical hunger. You're just not as hungry, and not hungry as often, as before. All that sounds marvelous, doesn't it? A dream come true! It is indeed, but it's also very complicated because the human body and human behavior are very complicated. We're constantly changing, in changing circumstances. While our unconscious brain and body are trying to communicate hunger and satiety, our conscious brains and our lifetime habits are also at work. So even though you weren't especially hungry for that chicken dinner at 6 pm, it's quite possible that a phone call from a troublesome family member will trigger some comfort eating at 6:15 pm, or that boredom will send you looking for snacks at 8:00 pm, or that craving will send you looking for chocolate at 9:00 pm. OBEY THE STOP SIGNALS! Stop signals aren't there just to make you late for work. They're there for your protection. Some of the worst car accidents in my town happen at a major intersection on a busy road where some drivers seem to be ignoring the stop signals. As those drivers are sped away from the scene in the back of an ambulance, I wonder how badly they're hurt or whether they'll survive. I think it's good that our town has installed cameras at that intersection. Stop signals are equally important to bandsters. How? In addition to the 4 signs of restriction explained above, you will also get hints to stop eating that I call "stop signals". As newly-filled or newbie bandsters, we expect our bands to give us good, loud, clear stop signals with clanging bells and flashing lights, but eventually learn (if we work on it) to recognize the quiet stop signals such as mild queasiness, fullness or pressure in the back of the throat, difficulty swallowing, burping (or the urge to burp), sneezing, sighing, hiccups, watering eyes, runny nose, and so on. If we heed those signals, we stop eating before something more drastic and uncomfortable happens. You may not experience any soft stop signals, but don't stop looking for them just because you aren't noticing any; they could sneak past you at any time. And if you experience no hard stop signals (like stuck episodes, PB's, sliming), don't go looking for trouble! The absence of hard stops does not mean that your band isn't working. It means you’re doing a good job!