Melissannde

Mimi, I asked about liquid motrin (ibuprofen), but my doctor said it's not the "hanging out in the pouch" that's the problem, it's the systemic affect. If your doc ok's the 600mg.. go for it. But if you haven't checked with them, you might wanna.

Not counting my 2 c/sections, I've had 4 surgeries, including lapband, and have never woken up during them. I do know the feeling you are talking about as I had a spinal for one of my c/sections and had the sensation that it was difficult to breathe. I talked to the anesthetist about it at the time it was happening and he helped me. You should discuss your experience with your surgeon AND with the anesthesiologist so that they will be aware of your reaction to anesthesia. This will help both them and you.

Jess, for now, just stick with Tylenol and either Ice or heat, whichever makes it feel better. My surgeon will allow small doses of anti-inflammatories on a short-term basis (2 weeks), but we are also supposed to take a PPI (proton pump inhibitor) while taking the NSAID (non steroidal anti-inflammatory drug). Maybe yours will allow the same. Best of luck to you. I understand being reluctant to stop working out. I strained my elbow about 9 or 10 months ago and tried for 3 months to tough it out with just reducing my weights and using a support. I finally got better after using 200 mg ibuprofen twice a day and the PPI at night.

Denise is right. The reason to progress very slowly to solids is to allow for healing. Contact your doctor and talk to them about your issues. They may allow you to progress a little faster, or may have suggestions to help you through this time. Medication for nausea would be better than changing what you're supposed to eat on your own. Hang in there, it will get easier. The saltines didn't get stuck cause they are a processed food.. basically pre-digested. Yuck.

Usual time between banding and the first fill is about 6 weeks. That is what is advised by Allergan, the people who make the lapband. Not sure if it's the same amount of time for the Realize band. I received 1cc for my first fill. My doctor installed 3cc's at the time of surgery, so I had a tiny bit of appetite dimming from the get-go. I was taken up very slowly in the amount of fill, which could be frustrating for some, but it worked very well for me. I had time to adjust and learn to eat slowly, chew well and be mindful. When patients are taken up fast, sometimes they do well, and sometimes they have great trouble adjusting. Everyone is different on how they react. Be aware that sometimes fills can take up to 2 weeks to make their presence known. Last fill I had 10 days later I was suddenly tighter.

You'll have to make your own choice about whether or not to drink. I usually don't get any alcohol, but will sip from my husband's. YMMV. I thought I'd share this post from another band site discussing alcohol and it's effect on weight loss. Alcohol inhibits the hormones that make you feel full, promotes the hormones that make you hungry, and lowers your inhibitions. Yes, people tend to eat more when they drink. Plus alcohol is basically a toxin that your liver has to process and it doesn't process food in the same way while it's process alcohol. It takes about 3 days to get rid of the alcohol completely. So for every day you have a drink you'll generally go 3 days without losing weight. That doesn't seem like a good trade off. One can get by with a few sips of wine before dinner but a 5 ounce serving of red is about 130 calories. When one is trying to eat 1200 calories there's not a lot of room to spend a 10th of the daily allotment on alcohol.

You might look at Eggface's breakfast bites. They're basically a breakfast casserole in miniature form and don't use any bread/croutons.

Along with this site, and Obesityhelp.com, I also utilize yahoo groups. Smartbandsters is probably my favorite and one of the moderators is a RN who works in bariatrics and has been banded 11 years. If your bariatric surgeon doesn't provide support group, ask around in your area. My surgeon welcomes patients to support group who has been banded by other surgeons and for one reason or another can't attend support with their own surgeon. I know all doctors don't have that policy, but you won't know if you don't ask. There are lots of blogs out there about banding... one I've been looking at is bandedliving. Hope to see you at OH or Smartbandsters. I think they're both very informative (although OH does have surgery wars from time to time.. just 2 be forewarned).

Wow that is the best thing I've ever read about the band! I wish doctors would explain it like that. That is how I am working with my band, and always what I believed went on. You should make a post exclusively wit this article. Did that once a while back. It caused a lot of discussion, some agreeing, some disagreeing, some confused. Now I just post it in a thread when it seems appropriate. If you're on facebook, you can follow Dr. Simpson there. http://www.facebook.com/drterrysimpson

You can take all the ingredients and plug them into www.livestrong.com/thedailyplate and see how many calories/protein/carbs/fat etc. there is in your smoothie. I wouldn't count on a drink to keep me full for several hours. I've had Protein drinks satisfy me for 2 hours, but not 4 like dense protein will. Of course, everyone is going to be slightly different.

Here's more than you probably wanted to know: The Latest on Nutrition and hair Loss in the Bariatric Patient by Jacqueline Jacques, ND Nutrition and Hair Loss A common fear and complaint of bariatric surgery patients is postoperative hair loss. While for most of us as people, our hair is important as part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like the brain and heart and away from hair. Hair loss has many causes. The most common type of hair loss after weight loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states: anagen, a growth phase, and telogen, a dormant or resting stage. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase,which lasts for approximately 100 to 120 days. Following this, the hair will fall out. Typically, about 90 percent of hairs are anagen and 10 percent are telogen at any give time—meaning that we are usually losing a lot less hair than we are growing, so the hair loss is not noticeable. But sometimes this can change. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include the following: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end-stage liver disease), hormonal disruption (such as pregnancy, childbirth, or discontinuation of estrogen therapy), acute weight loss, crash dieting, anorexia, low Protein intake, Iron or zinc deficiency, heavy metal toxicity, and some medications (such as beta-blockers, anticoagulants, retinoids, and immunizations). Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss will rarely last for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One should be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if any of the following occurred: 1. Hair loss continued more than one year after surgery 2. Hair loss started more than six months after surgery 3. Patient has had difficulty eating and/or has not complied with supplementation 4. Patient has demonstrated low values of ferritin, zinc, or protein 5. Patient has had more rapid than expected weight loss 6. Other symptoms of deficiency are present. Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40mg/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemic, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after biliopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high-dose zinc supplementation as a therapeutic agent for related hair loss2 in patients who had undergone vertical banded gastroplasty. The study administered 200mg of zinc sulfate (45mg elemental zinc) three times daily to postoperative patients with hair loss. This was in addition to the Multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus, we cannot definitively say that zinc would prevent hair loss after weight loss surgery, and further study would definitely be needed to make this connection. A further note: The tolerable upper intake level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60mg/day. Information related to this study has made its way to many a support group and chat room—even to doctor’s offices—with the message that “high-dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high-dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen, or prealbumen.3 Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk.4 With surgical reduction of the stomach, hydrochloric acid,5 pepsinogen, and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion rather than malabsorption is responsible for many cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2g of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Biotin Many individuals believe that supplementing with, or topically applying, the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include Vitamin A, inositol, folate, B6, and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS), and is influenced by genetics. Conclusions Hair loss can be distressing to bariatric surgery patients, and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. References 1. Rushton DH. Clin Exp Dermatol. 2002;27(5):396–404. 2. Neve H, Bhatti W, Soulsby C, et al. Reversal of hair loss following vertical gastroplasty when treated with zinc sulphate. Obes Surg. 199;6(1):63–65. 3. Updegraff TA, Neufeld NJ. Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc. 1981;78(2):135–140. 4. Segal A, Kinoshita Kussunoki D, Larino MA. Postsurgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg. 2004;14(3):353–360. 5. Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity.Dig Dis Sci. 1994;39(2):315–20. 6. Moize V, Geliebter A, Gluck ME, et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):23–28. 7. Mock DM. Biotin. In: Shils M, Olson JA, Shike M, Ross AC, eds. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:459–466.

If a revision has to be done, you might look into the VSG or Sleeve as well as the RNY or bypass. Best of luck.

I had no pre-op diet other than Clear liquids the day before surgery and while that was a little aggravating, it wasn't all that hard cause there was no limitations on the amount. Post-op I don't recall being unduly hungry. There was some hunger, but for me it was normal hunger, not overwhelming. My surgeon installs the band with a "starter" fill so I think that makes a huge difference. I didn't go through extreme "bandster hell" before my fills started working. Ask the surgeon that you're considering using his philosophy of working with the band. Best of luck to you.

The band isn't about restriction, it's about appetite control. http://drsimpson.net/fills/Lap-band-eating/lap-band-not-restriction/lap-band-and-restriction.html My appetite was somewhat dimmed from the day of surgery, but then again, I had Fluid installed during surgery.. THANK YOU Dr. B... which got me off to a head start.

I take a supplement called 5-HTP. It's a precursor to serotonnin and is thought to help with mood and is a very mild appetite suppressant. I think it helps a little. I take it three times a day.

To the OP, you might benefit from reading Dr. Simpson's article "It's not about restriction". http://drsimpson.net/fills/Lap-band-eating/lap-band-not-restriction/lap-band-and-restriction.html And yes, 1cc is a big unfill. I had to have .2cc's removed last spring because I got too tight and it made a difference. Call and see when you can go back for more and ask for only .5cc (or less). In the meantime, do the best you can to eat dense Protein and low carb/low calorie veggies. My doc says I can always have more veggies if I'm still hungry 20 minutes after my meal. That's providing that the veggies aren't drowning in butter or some high calorie sauce. You might also push through some (maybe not all) of the hunger by upping your water/ very low calorie Fluid intake. Try to eliminate white bread, Pasta, rice, white potatoes. Those are high glycemic items and tend to make us hungrier sooner. Hang in there!!

Good suggestions from previous posters. You can also try drinking a cup of hot tea right before your meal and see if that will help. Sometimes warmth will relax the band just enough.

Not drinking during eating is a good habit to develop. Yes, the thinking is that not drinking will slow the progression of food through the smaller upper stomach into the larger lower stomach. Right now, you may still be swollen from surgery and that is why you are not having much hunger. Once the swelling goes down, you are likely to get the hunger back. When I was first banded, I did the "no drinking 30 min before, during and 30 min. after a meal" as instructed. Now that I am 2 years out and have experience and know my body and how it will react, I can bend the rules a bit. But I strongly urge you to stay as close to what your doctor recommends during your early time as a bandster.

Are you making sweet or dill pickles? I've never had a nutritionist tell me I couldn't eat anything.. they make suggestions about better choices, but I've never had any food item forbidden.

Cubbies, Way to go on your weight loss!! You've done spectacularly well. I see your starting BMI is even higher than mine was.. and mine was pretty high. You're on your way to beating my rate.. and I thought I lost pretty fast at getting 100lbs off in 7 months. Goes to prove what the fact that larger people lose faster. But still, you deserve the credit.. YOU are the one doing the work. Just a couple of things you might want to consider. Right now, you have plenty of energy in the form of fat stored in your body, so for the short term, 600 calories/day is probably not going to be a problem. But as you lose, the fat will become less available for use and your body will start using some of your muscle for energy. You don't want to lose muscle because muscle is a fat burning engine. There are two main ways to combat this.. one is to up your calorie intake slightly.. you can do it 50 to 100/day until you are used to eating around 900 - 1000 and it won't feel like "eating just to be eating". Another thing you should be considering doing is some sort of exercise to maintain and/or build muscle. I didn't do muscle building exercises from the beginning, but wish I had. I wasn't knowledgeable about what I was doing by not using some weights.. even little ones. I average around 1100 to 1200 calories a day, but I also work out quite a bit. Working out makes me hungrier, so I probably consume more than 1200.. but I work off at the very least 250 a day, and that's a very low energy day. Most days my exercise burns 500 or more ( I use a polar HRM.. not using charts or machine totals). Again, congratulations on your FANTASTIC loss. As to your question if there's anyone else who has lost so much w/o a fill.. I know of a few who've lost some, but not as much as you have. Just out of curiosity, does your doctor put in a fill during surgery? Not that it matters at all, I'm just curious.

Elfie, If you don't have issues with Stevia, look for the new Crystal Lite "Pure". They're a few more calories per serving (15 I think), but don't use aspertame or sucralose. And Walmart (and probably Target) have generic versions of the Pure too. Another thought is the "Pure Lemon" and "Pure Lime" and "Pure Orange" flavorings. I don't think they have any sweetner in them at all. Good luck on finding something you can use.

We are told to take Calcium citrate. Viactive and caltrate are calcium carbonate and not well absorbed by folks with reduced stomach acid. I use Bariatric Advantage chewable calcium citrate. It's the best price-wise I've been able to find. We're also told that children's Vitamins are NOT sufficient for us.. even if you're taking more than one. An adult chewable is ok for bandsters as we don't malabsorb. Centrum makes a decent one. Also if you're supposed to take 1500 or 2000 of calcium, make sure to be taking it in divided doses throughout the day, not all at once. The human body doesn't absorb calcium very well, so taking it in spaced out doses increases the chance that we'll absorb at least a little. If your multi-Vitamin contains Iron, don't take it within 2 hours of calcium. They will interfere with each other.

I'm doing the c25k program now, but I didn't start it till I was under 200. Not to say that YOU couldn't start it at a heavier weight, but for me, it was too hard on my knees at a heavy weight. I walked, did zumba, bootcamps, body pump, rpm and lots of other things that are less stressful on the knees before I started the c25k program.

All I used post-op was blended canned soup. Bought one cannister of Protein powder and ended up giving it away. I might have used it one time. BA is ok .. I've tasted it at support group.. tastes like cake batter, the one I sampled. If I'm going to do protein, I prefer Syntrax nectar. www.si03.com

Powerade Zero Sassy Water: 8. 5 CUPS Water 1 TSP/ GRATED GINGER 1 MED. CUCUMBER, sliced 1 MEDIUM LEMON, sliced 12 SPEARMINT LEAVES combine all of the above and let sit overnight. Strain to drink. Just something a bit different than plain ol' water.