BetsyB

I didn't have an upper GI; bloodwork was scheduled once I got a surgery date. I think it's probably not realistic to expect surgery by the end of the year. I started the process in early July, and was banded mid-January. I was approved in November, but December surgeries were limited because teachers being banded on winter break had booked their surgeries months in advance. That, and the surgeon took time off for the holidays, as well. The surgeon's office will guide you, impeccably, through the steps--I really don't think you have to worry about important tests falling through the cracks. But you do need to be aware that the process can be slowed by things like holidays.

After the first few intense months, how much daily work is it for you to live happily with your band? How much time do you have to spend obsessing about, avoiding, or tallying up food? I do much, much less work than I did preoperatively. I do journal my food; it takes less than 3 minutes a day (truly). I use fitday.com, and it's just a handful of clicks. I wear a BodyBugg, and spend a couple of minutes a day inputting my fitday totals and downloading my calorie burn so I can compare what I took in with what I burned. Seriously, I spend no more than 5-7 minutes a day on these things. I don't obsess about food at all any more. Not even a little. I plan meals, the same as I always did---my family and I do have to eat, after all! But the "feed me" monster is gone. Just gone. Is it on your mind all the time, a whole new hobby, or can you live like a "normal person" who just eats only small amounts of lean protein and veggies? I guess at first, it felt like a new hobby. But now that it's become a way of life, I really do live a "normal" life. I have a much more "normal" relationship with food, I think, than I ever did. And yes, I really do eat just small amounts of lean protein and veggies. But I prepare them in ways that are delicious. My stomach capacity is smaller now--so it's important to me to make sure that the foods I eat give my body what it needs. But it's also still important to me---well, even more important than it was before--that what little I do eat is really good. Satisfying. Delicious. I can't mindlessly shovel large quantities of poor-quality food into my body--but I can choose really good foods that I love :smile2: (Not including exercise.) Gotta include the exercise--it's the most important piece of the puzzle, IMO! Every.single.day--every day. Do you find that, if you slack off, your band gives you a nice slap upside the head? I haven't slacked off--but my band does, in fact, let me know what it will and will not tolerate. I haven't pushed the limits, but even within the context of my food plan, there are things that don't work very well. I listen--and really, I don't miss anything I no longer choose to eat. (If I really missed something, I would have it.) Do you get physical feedback if you eat the wrong things or do something unhealthy? I do get physical feedback when something doesn't work well with the band. Is it less mental work than doing a strict diet? There's a learning curve; at first, it takes some work. But you achieve a level of mastery pretty quickly, after which, IMO, there is MUCH less mental involvement than with a strict diet. With a diet, you have the hunger factor, which feeds the feed-me demon. And the feed-me demon just saps so much mental energy. Remove the hunger, and the obsession recedes. You can focus on choosing the foods that work well with your band and give your body what it needs--and let go of much of the rest. Does it feel more like normal (but adjusted) life? It is far more "normal" than it ever was before. The relationship with food changes--but it doesn't stop being pleasurable. I am still able to eat in a restaurant with no problem (even though my doctor's recommended plan is about as stringent as they come, I have yet to encounter a restaurant menu I can't conquer without driving the server insane), I am able to attend parties, only the handful of people I have chosen to tell even know I'm banded. It was the best thing I have ever done for myself.

It is completely dependent on your insurance contract. Mine uses BEGINNING BMI as an indicator, and requires 3 months supervision, and a 6-pound (at least) loss. That loss pushed my BMI below the level required--but it didn't matter; they went with my starting BMI. Some policies have different stipulations. Read yours--it will spell out the requirements for you, and relieve a lot of anxiety!

Unfortunately, it's really common for doctors to be reluctant to care for patients they did not band themselves. Usually, with time, a great working relationship can be established, though. I'd encourage your fiancee to look for the doctor with the BEST aftercare program (support group, good dietary recommendations--and support---and so on) rather than simply someone who uses fluoroscopy. My doctor does use fluoroscopy with each fill--and it's nice to know that things are where they should be. But the fact of the matter is that most doctors do NOT---and that does not make their care sub-par. A good doctor will know when it's appropriate to order fluoroscopy, if he does not routinely use it. But really, there is no inherent need for it. Better to start by narrowing the physician field first by (a) doctors who are willing to provide aftercare to patients they did not band, and (:smile2: doctors whose groups provide the best aftercare. (It's too bad that these were not preoperative priorities. I wish the doctors who operated in Mexico networked better with doctors in the U.S. and Canada, so that there was more of a partnership, and aftercare were easier to establish.) As for the feeling of aloneness--this is really common postoperatively. Not just after banding, but after any procedure for which there is preop anticipation. The postop letdown is very real--and it is very common to feel ...well, abandoned. Part of this is physiological. Our bodies go through a lot, and the meds, Fluid shifts, hormone shifts (fat tissue is mildly estrogenic, and losing relatively rapidly increased serum estrogen levels, which can contribute to emotional upheaval), etc---well, they contribute to the problem. It's very difficult, but it is generally short-lived. Finding a good doctor will help relieve some of the anxiety.

I think you will find things fall into place a bit for you, when you achieve better restriction. (My suspicion is that you don't have restriction, if you're able to eat a turkey sandwich.) In the meantime, I would focus a LOT more on lean, good-quality Protein (Lean Cuisines just don't have enough), and less on processed, prepared foods. A meal of 3 or so ounces of lean protein (meat, fish, poultry, soy substitute, whatever) plus nonstarchy veggies is much more satisfying, MUCH lower in sodium, and more nourishing than a Lean Cuisine. It is also much less expensive, and no harder to prepare. I would also give serious thought to adopting an exercise regimen that helps you feel better about your body---regardless of its size--and takes you outside your house. Walking is a great choice. It doesn't require a membership, special equipment, or anything else. And it gets you moving, and out of the "cabin" you're trapped in. Aside from promoting weight loss and good physical health, regular exercise is so, so beneficial emotionally. It releases chemicals that improve mood. And even more importantly, every bit of progress helps increase confidence and build strong self-worth/esteem. I really think it's the most critical piece of the proverbial pie, in conquering body image issues. The part of your post that concerns me the most is that you are postponing life until you achieve a certain loss. And I wonder: is there something about resuming school that might be causing anxiety sufficient to cause you to self-sabotage on the weight loss somewhat? As you embark on this completely new way of living, I would really, really encourage you to get some professional help to deal with body image. It's so important to love yourself--no matter what your body weight. When you do, it becomes possible to achieve what you want to achieve--both in terms of weight loss and in terms of achieving other goals. Stumbling blocks to progress are removed. You're worth it.

Most doctors don't just use rate of loss as the indicator for the need for a fill. They assess whether you are being compliant with their eating regimen, then assess your satiety. All of us lose if we're compliant---but most of that loss is due to sheer white-knuckling through real discomfort. A good doctor will work with you to reach a level where you are able to be compliant without struggling and starving. If you're pretty confident your doctor is a good doctor (which I bet you are--after all, you trusted him enough to operate on you!), then you can probably put your concerns about being denied a fill to rest. If he does seem reluctant, gently remind him that your loss is due to dieting rather than assistance from the band. That you realize your role will continue to be compliant, to make the right food choices, to exercise, and so on--but that you also need help from the band, and therefore would like a fill.

I agree that it's important to have a doctor assess the abdominal distension. Usually, it's completely benign--related to Fluid retention unrelated to anything harmful, or to gas. But there are a handful of things a doctor would want to rule out.

It's very difficult, especially at the beginning, when you're genuinely hungry and others are eating "real food" that you have to prepare! It gets so much better. I know that doesn't make it better now--and you need relief. But it really, truly gets better. If you are really having a difficult time, I'd call your doctor or nurse coordinator and discuss it with him/her. I was very compliant, and losing well---but really having a hard time with genuine hunger (which not everyone does experience soon out of the starting gate). I emailed my doctor's coordinator and described what I was experiencing (amounts I was taking in, amount of time that elapsed before starvation set in, etc.) For me, the result was an appointment for a MUCH earlier fill. For you, it might be permission to advance diet to the next stage. (I didn't need that permission, because my doctor starts pureed Proteins on Day Three.) Worth a try. No matter what the outcome, hang in there---it is SO worth it. Even when the outlook is bleak and your stomach is roaring.

Give it a little while, and try again. I had difficulty with salad, too---even when I had far less fill than I do now. But now I do fine with it--thank goodness! (When I was on my pre- and post-op diets, I fantasized about and craved salad; I would really be unhappy giving it up!) Be sure to chew VERY well (and consider starting with more tender greens, torn into very small pieces), because there's something about leaves; they can lie across the stoma and create quite an obstruction without actually being stuck. My doctor's advice, and my personal experience, is to give foods that cause trouble another try after letting things calm down for a while. Avoid these things for a little while, then gradually reintroduce them, one at a time. Broccoli is a problem for me, in terms of getting stuck. I have switched to broccoli slaw, which I adore (raw, with an Asian dressing, or very quickly cooked), and causes no problem. If your problem is gas, chances are your body would have decided, band or no, that it was going to give you that problem (yes, even after years of tolerating it)----but you can take care of that with something like Beano. It really works :smile2:

I think you have to separate a couple of things in your mind in order to make the right decision. Are you reluctant to get a fill because you're terrified of vomiting? Or are you reluctant to get a fill because the amount of food you are able to eat keeps you satisfied for a few hours, until it's time to eat again? The decision to band is based not only on rate of loss, but also on satiety level. If you're genuinely satisfied, there's no need for a fill. But if you're telling yourself you're satisfied because you are afraid you'll vomit after being filled, you probably can put that fear to rest. Eating slowly, chewing well, stopping when satisfied, etc. will lower the likelihood of vomiting. Plus, it must be said that post-band vomiting is nothing like pre-band vomiting. It's just very, very different. The sensation that precedes it is more uncomfortable (real pressure), but the nature of the emesis is completely different (no bile, no gastric juices, just regurgitated food and mucus), and the RELIEF is instantaneous. So, while getting stuck is something you do want to avoid if possible (as is taking that one bite too many), it's not something that results in something so terrible that you should avoid getting a fill if your satiety level is unsatisfactory.

It's very normal for swelling to persist for a while after a fill, giving you a too-tight sensation. It sounds like you may have had a couple of stuck incidents, which can cause swelling to recur. Once the swelling recedes, it's VERY common, after the first few fills, to feel totally unrestricted again. This will diminish with each fill, until you get to the right level of adjustment. However, the swelling-after-fill and swelling-after-stuck phenomena will persist. So even after the fill that gets you to the sweet spot, you may feel too tight for a short while---then find that when the swelling recedes, VOILA! You're there :smile2:

I started feeling some restriction around 8-8.5 cc in an 11 cc band; I don't really know where I am now (with good restriction), because I've forgotten to ask for my last 3 fills. But I'm just about 8 months out, and for the last 3 or so months (and fills), I've been toeing the line of restriction---just sort of fine-tuning.

I have postponed, but only when I've felt my level of restriction was good. I don't like white-knuckling it. If you're satisfied, it sounds like you're where you need to be! Your rate of loss is excellent.

I think you will find it more helpful to think of food restrictions not in terms of "I can't," but rather in terms of, "I choose not to." For the latter, you are in control. I could probably tolerate most of the foods you've listed. I don't really know--I haven't had them. I choose not to, and I enjoy the weight loss. I don't miss them; if I did, I would occasionally enjoy a serving. Simple as that. It's all about choices. You may truly enjoy many foods--but none of them really is part of your identity. It's just food. And you will still enjoy food.

You have to be careful about heating, because heat denatures the protein, and can cause terrible clumping. So, just like when you make custards or other smooth things involving protein, you have to temper the protein gradually. I use a protein powder--Inspire (flavored) or PURE (unflavored) from Bariatric Eating. I put the powder into a clean, dry (this part is important) mug, then add a slosh of the liquid I'll be using (cold) and give it a stir. I set the protein aside, and heat the remainder of the liquid (almond milk if I'm using flavored protein, broth or Soup or whatever if I'm using unflavored protein) in the microwave. I heat for just about a minute--until it's warm, but not hot. Stirring constantly, I add about a quarter of the liquid to the protein in my mug. The idea is to gradually warm the protein so it doesn't denature (clump up or "scramble"). Then I heat the rest of the liquid for about a minute longer--until it's hot. Again, stirring constantly, I slowly add it to the protein mixture. The gradual addition of heat keeps the protein smooth. (If it does clump, it still has the same nutritional benefit, but it's not very appealing, and since we don't eat all that much these days, I think it's pretty important that the things we do eat are appealing!) You really have to do this on a serving-by-serving basis---you can't add protein to, say, a pot of soup, then reheat it as leftovers, or you'll end up with clumps of protein separated from the soup.

Yep, those days are gone--but you will find that you appreciate the foods you do eat so much more. The flavors, the aromas, the sensation of being satisfied without being stuffed. Big changes--but all good :rolleyes2:

If you're able to last 4 hours between eating, you're doing really well! I know I need a fill when I am starving after 1.5 hours or so. I've got good restriction now, and my stomach is asking for something well within four hours. So, yes--you're normal! It's okay to have small, healthy Snacks between meals. (Shhh. My doctor is a three-meals-a-day guy; it's one of his recommendations I respectfully and very cautiously bend to meet my own body's needs. He would agree that I'm one of his more successful patients--and that those who do best tailor his recommendations to work for themselves, so I feel comfortable with this.)

The scale does fluctuate from day to day--it's just one of those things. Female bodies, in particular, bounce around a bit. As long as you're seeing a downward trend, that's what matters. A lot of people will tell you that the postop period, before you achieve restriction, isn't the time to worry about weight loss. I disagree. I think it's exactly the time to build new habits--ones that will serve you well when you do have restriction. If you're not measuring or weighing your portions, it's not a bad idea--at least for a while, so you get a realistic idea of amounts. I journal what I eat on Fitday.com. I know that some people find journaling to be an onerous task; for me, it's not--it's just part of my routine, takes a couple of minutes a day, and helps me make sure I get enough Protein (which I would not, if I didn't keep track). That said, it sounds as though you're losing at quite a nice pace. You can expect that to pick up as you add exercise. Be sure your doctor is okay with Tae Bo at your stage postop; I got clearance for walking immediately, but was asked not to do other exercises until after my 4-week check (after which I was cleared to exercise with no restriction). I think that exercise is every bit as critical as changing the way you eat---maybe even more so. I can't emphasize enough how important it is, for me, to exercise daily (at least once; I prefer twice). It's important for loss, it's important for health, it's important for stress reduction---it's just essential. You don't have to choose something punishing--pick something you like well enough to stick with, then try new things every now and then. You may be surprised to find new things you love--or you may find that it's just something you tolerate. Either way, DO IT! What kind of eating plan does your doctor recommend? Mine was pretty liberal about reintroducing solids (pureed protein at 3 days postop, for example), but very, very conservative when it comes to what his patients eat. The plan I follow is restrictive, but is very effective; I'm down 80 since mid-January, and am just now in my first real plateau (I've had a couple of one-week spans without loss, but am now coming up on 2...so I think my body is finally saying, "hey! you're not feeding me as much!" My entire relationship with food has changed, but I still enjoy every bite I take, and make sure that the foods I choose are ones I love, and prepare well.) If you're interested, my eating plan is in my visitor messages in my profile.

Sweet car!

Adding in heart-healthy fats will make a HUGE difference, esp. with all that exercise.

It's probably pretty unrealistic, Erin. Continue to do what you need to do to lose---and know that you'll be closer to your goal than you are now. That's really the best any of us can do----we do the work to lose, and accept the losses we get. Don't set yourself up for failure and disappointment. Keep things realistic.

He wants me to get 65 g protein/day, and prefers that I use only 1 shake toward that goal. I've found that I lose and feel better when I get 80-100 g/day. I have two Protein shakes a day. (I have them warm, and they are critical for me---the warm liquid dissolves my supplement capsules so they don't get stuck.) I am one of his most successful band patients. His stance is that those who do the best learn how to tailor the rules to their needs.

I focus on Protein and nonstarchy veggies---for my family, I add a potato (or rice or Pasta or whatever starchy side dish) to basic fare of meat/poultry/fish and veggies and/or salad. When I make them something like pasta as a main dish, I pull out some of the meat and sauce and skip the pasta, or I have something else entirely; I do try, though, to have pretty much what they're having (unless I've had a recent fill, in which case, all bets are off, when it comes to solids, for a few days). I do make Soups and chilis a lot--we all enjoy those. I add bread and/or salad--and skip the bread.

I weigh myself daily. I don't intend to change. Over time, the number becomes less important---observing my change in response to the scale has been really helpful to me. It has shown me that the emphasis on weight as a measure of worth is changing. What jumps out at me about your post is not that you weigh yourself a lot, but rather that you have not had a fill because your loss is steady. Why is that? Why is loss the only measure your doctor uses? Are you feeling restriction? Or are you white-knuckling it? I lost steadily from the very beginning, but because I was dieting. The goal was to reach a point where I was losing steadily, but (while still mindful of amounts and quality of food) not feeling as though I was starving myself. I bring this up, because my obsession with scale and numbers pretty much vanished when I reached that point. I would talk with your doctor. If you have not had a fill, and are still stuck in the diet mentality---then you will have behaviors like the scale obsession that are part of that diet mentality. Perhaps between the two of you you can reach a decision about how best to use your band so that you can let go of behaviors that are not working for you.