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lovegrapes.. way to go! and have fun! AND everyone.. I found something and I wanted to share.. I have been trying different ways to get the water in and I am sick to death of crystal light.. I am not a good fake sugar person and after awhile it burns the back of my throat and taste nasty..plus the fact that its bad for you... and I dont want to drink things with extra calories I dont need.. so I found something that might be help if you are like me.. its a herbal tea that tastes sweet and has NO SUGAR.. it has nothing artificial in it and I got it at my grocery store.. it can be made hot or like ice tea and its very flavorful.. its sweet tasting and I have checked the box several times and there is no sweetner in it.. its by Good Earth and its the sweet and spicy herbal tea... here is a link if you want to get an idea of what it looks like.. I know the package has changed several times.. but it gives you an idea Good Earth Original Sweet & Spicy Tea & Herb Blend -- 18 Tea Bags - www.Vitacost.com anyways.. its a little spicy too.. its helping me get my liquids in. and it tastes really good. thought I would share.. still really discouraged at the moment.. dont really want to do anything.. i feel like if I have good restriction and its not helping.. what will.. I know I need to just keep going.. that weight gain is really messing with my head..:bored:

I am approaching the 1 year mark after surgery and I am in the maintenance stage. I don't obsess with my weight. I have an accurate scale, good for increments of 0.2 pounds. I weigh myself each morning when I get up and record my weight. I reached my bottom weight 7 months after RNY gastric bypass surgery. My weight generally falls within the 160.0 to 162.0 range. There were several times when my weight was below this figure and a few times above. Generally I look at the scale as an instantaneous feedback tool. I do a lot of experimentation. If I see a weight gain outside the range, I return to my basic meal plan and the weight falls back in line. So far some of the items that I have to stay away from by using this method are: bread, sweet corn, sweet cherries. On the other side, some of the things that appear to drive my weight below the limit is when I pick up a cold or when I eat out at restaurants.

I am going to assume week one is losing the water weight gained while in hospital and due to our bodies try to hold on to what it can. Hopefully week 2 will be much better. Gen :-)

So I was having issues with heartburn and acid reflux over the last month or so and I was really starting to get concerned. I called my doc and had to wait a week and a half for an appointment since he was on vacation, but I wanted an x-ray because I need to see if something was wrong with my band. When I got to my appointment, he didn't want to x-ray me because he said I had all the classic symptoms of being to full. He actually showed me a chart and sure enough, every symptom I had was on it under the category of "too full." I couldn't believe that I had never seen that chart before. If I had, I wouldn't have gotten so worked up and worried. Anyway, he took out the 1/2 cc I got back in March and I felt better by the end of the day and haven't had any symptoms since. He said I might gain a couple of pounds since he loosened it but it would level out and he'd see me again in a month to readjust if necessary. I thought I'd post this in case anyone else is having the same symptoms I was having. Your band may be too tight. Symptoms were: Heartburn on and off all day, night cough or occasionally choking on your spit at night, acid reflux, regurgitation of food, weight gain or no weight loss. It also modifies how you eat because you will automatically gravitate toward unhealthy choices because you start eating what doesn't hurt. So, please don't let your band get too tight and ignore the symptoms. Long term and they can be dangerous.

Good to hear you are well Kendra, sorry about the weight gain but you have been through an ordeal and getting your health back on track is more important than a few lbs. Hope you're not overdoing it with work and your moderator role. Sounds like fun though. I'm off to work so hopefully I'll see you around more often. Take care!

Well I went in Tuesday and got a really nice fill. It's working nicely! I did drop 2.2% of body fat but went up in water weight so the scale showed 2lb gain :biggrin: but Sue said not to worry about it cause its not real weight gain. Have anyone else met Sue.. She's the new NP and really very nice. Anyone have anything interesting happening this weekend??

Hi Christy, I am not familiar with the med you have been taking so long. What exactly is it for? Have youseen a Neurosurgeon about your tumor, and if so, what does he/she say about whether or not surgery would be a definite plan for the future? Have you ever had any surgeries on it yet? Sorry, I don't recall alot of these things from your earlier post. I was starting the process for lap band surgery two years ago and then all came to a screeching halt because I first found out that my insurance has an exclusion through my employer for any kind of weight loss surgery, and second, my second tumor was found. I decided to get that surgery done and already knew that I would also be having the radiation treatment too later on. I am not sure if this surgery will help your weight gain, but for the most part, I believe it will because even though you are on meds that probably caused the weight gain by overeating or not processing fat like it should, the band should keep you in control over that. So, you are having surgery on Monday also? Cool! I will be thinking about you too hun. You take care and don't stress over the other. Concentrate on the surgery and how well it will help you in the long run. Take care, Judy

Hello, I am just wondering if anyone who has a pituitary tumor has had the surgery and if so, did it still work? I currently have an adenoma and the hormones are so bad. I think it has been a major cause of my massive weight gain. I'm scheduled for lapband on Monday!!!!!! Thanks!!!

Can someone tell me about the weigh in the day of surgery with Dr. Posner? I have so much anxiety. He said if there is any weight gain, surgery will be cancelled. My date is this wednesday the 16th. Does the nurse weigh you in? The doctor? Is there a weigh in at all???? Soooo nervous !!!

Hello all, hope you had a Merry Christmas! Mini, I am down 2. Amazing, can't remember another x-mas week ever in my life that did not involve a weight gain. I was at the store today and saw all the vitamins, powders, and various diet stuff for sale. Isn't it nice not to have to start the year with yet another resolution about losing weight? yeah bandsters!

I ran accross this today. I found it good information for those of us considering/waiting for WlS. Pouch Rules for Dummies INTRODUCTION: A common misunderstanding of gastric bypass surgery is that the pouch causes weight loss because it is so small, the patient eats less. Although that is true for the first six months, that is not how it works. Some doctors have assumed that poor weight loss in some patients is because they aren’t really trying to lose weight. The truth is it may be because they haven’t learned how to get the satisfied feeling of being full to last long enough. HYPOTHESIS OF POUCH FUNCTION: We have four educated guesses as to how the pouch works: 1. Weight loss occurs by actually slightly stretching the pouch with food at each meal or; 2. Weight loss occurs by keeping the pouch tiny through never ever overstuffing or; 3. Weight loss occurs until the pouch gets worn out and regular eating begins or; 4 Weight loss occurs with education on the use of the pouch. PUBLISHED DATA: How does the pouch make you feel full? The nerves tell the brain the pouch is distended and that cuts off hunger with a feeling of fullness. What is the fate of the pouch? Does it enlarge? If it does, is it because the operation was bad, or the patient is overstuffing themselves, or does the pouch actually re-grow in a healing attempt to get back to normal? For ten years, I had patients eat until full with cottage cheese every three months, and report the amount of cottage cheese they were able to eat before feeling full. This gave me an idea of the size of their pouch at three month intervals. I found there was a regular growth in the amount of intake of every single pouch. The average date the pouch stopped growing was two years. After the second year, all pouches stopped growing. Most pouches ended at 6 oz., with some as large at 9-10 ozs. We then compared the weight loss of people with the known pouch size of each person, to see if the pouch size made a difference. In comparing the large pouches to the small pouches, THERE WAS NO DIFFERENCE IN PERCENTAGE OF WEIGHT LOSS AMONG THE PATIENTS. This important fact essentially shows that it is NOT the size of the pouch but how it is used that makes weight loss maintenance possible. OBSERVATIONAL BASED MEDICINE: The information here is taken from surgeon’s “observations” as opposed to “blind” or “double blind” studies, but it IS based on 33 years of physician observation. Due to lack of insurance coverage for WLS, what originally seemed like a serious lack of patients to observe, turned into an advantage as I was able to follow my patients closely. The following are what I found to effect how the pouch works: 1. Getting a sense of fullness is the basis of successful WLS. 2. Success requires that a small pouch is created with a small outlet. 3. Regular meals larger than 1 ½ cups will result in eventual weight gain. 4. Using the thick, hard to stretch part of the stomach in making the pouch is important. 5. By lightly stretching the pouch with each meal, the pouch send signals to the brain that you need no more food. 6. Maintaining that feeling of fullness requires keeping the pouch stretched for awhile. 7. Almost all patients always feel full 24/7 for the first months, then that feeling disappears. 8. Incredible hunger will develop if there is no food or drink for eight hours. 9. After 1 year, heavier food makes the feeling of fullness last longer. 10. By drinking water as much as possible as fast as possible (“water loading”), the patient will get a feeling of fullness that lasts 15-25 minutes. 11. By eating “soft foods” patients will get hungry too soon and be hungry before their next meal, which can cause snacking, thus poor weight loss or weight gain. 12. The patients that follow “the rules of the pouch” lose their extra weight and keep it off. 13. The patients that lose too much weight can maintain their weight by doing the reverse of the “rules of the pouch.” HOW DO WE INTERPRET THESE OBSERVATIONS? POUCH SIZE: By following the “rules of the pouch”, it doesn’t matter what size the pouch ends up. The feeling of fullness with 1 ½ cups of food can be achieved. OUTLET SIZE: Regardless of the outlet size, liquidy foods empty faster than solid foods. High calorie liquids will create weight gain. EARLY PROFOUND SATIETY: Before six months, patients much sip water constantly to get in enough water each day, which causes them to always feel full. After six months, about 2/3 of the pouch has grown larger due to the natural healing process. At this time, the patient can drink 1 cup of water at a time. OPTIMUM MATURE POUCH: The pouch works best when the outlet is not too small or too large and the pouch itself holds about 1 ½ cups at a time. IDEAL MEAL PROCESS (rules of the pouch): 1. The patient must time meals five hours apart or the patient will get too hungry in between. 2. The patient needs to eat finely cut meat and raw or slightly cooked veggies with each meal. 3. The patient must eat the entire meal in 5-15 minutes. A 30-45 minute meal will cause failure. 4. No liquids for 1 ½ hours to 2 hours after each meal. 5. After 1 ½ to 2 hours, begin sipping water and over the next three hours slowly increase water intake. 6. 3 hours after last meal, begin drinking LOTS of water/fluids. 7. 15 minutes before the next meal, drink as much as possible as fast as possible. This is called “water loading.” IF YOU HAVEN’T BEEN DRINKING OVER THE LAST FEW HOURS, THIS ‘WATER LOADING’ WILL NOT WORK. 8. You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness. THE MANAGEMENT OF PATIENT TEACHING AND TRAINING: You must provide information to the patient pre-operatively regarding the fact that the pouch is only a tool: a tool is something that is used to perform a task but is useless if left on a shelf unused. Practice working with a tool makes the tool more effective. NECESSITY FOR LONG TERM FOLLOW-UP: Trying to practice the “rules of the pouch” before six to 12 months is a waste. Learning how to delay hunger if the patient is never hungry just doesn’t work. The real work of learning the “rules of the pouch” begins after healing has caused hunger to return. PREVENTION OF VOMITING: Vomiting should be prevented as much as possible. Right after surgery, the patient should sip out of 1 oz cups and only 1/3 of that cup at a time until the patient learns the size of his/her pouch to avoid being sick. It is extremely difficult to learn to deal with a small pouch. For the first 6 months, the patient’s mouth will literally be bigger than his/her stomach, which does not exist in any living animal on earth. In the first six weeks the patient should slowly transfer from a liquid diet to a blenderized or soft food diet only, to reduce the chance of vomiting. Vomiting will occur only after eating of solid foods begins. Rice, pasta, granola, etc. will swell in time and overload the pouch, which will cause vomiting. If the patient is having trouble with vomiting, he/she needs to get 1 oz cups and literally eat 1 oz of food at a time and wait a few minutes before eating another 1 oz of food. Stop when “comfortably satisfied,” until the patient learns the size of his/her pouch. SIX WEEKS After six weeks, the patient can move from soft foods to heavy solids. At this time, they should use three or more different types of foods at each sitting. Each bite should be no larger than the size of a pinkie fingernail bed. The patient should choose a different food with each bite to prevent the same solids from lumping together. No liquids 15 minutes before or 1 ½ hours after meals. REASSURANCE OF ADEQUATE NUTRITION By taking vitamins everyday, the patient has no reason to worry about getting enough nutrition. Focus should be on proteins and vegetables at each meal. MEAL SKIPPING Regardless of lack of hunger, patient should eat three meals a day. In the beginning, one half or more of each meal should be protein, until the patient can eat at least two oz of protein at each meal. ARTIFICIAL SWEETENERS In our study, we noticed some patients had intense hunger cravings which stopped when they eliminated artificial sweeteners from their diets. AVOIDING ABSOLUTES Rules are made to be broken. No biggie if the patient drinks with one meal – as long as the patient knows he/she is breaking a rule and will get hungry early. Also if the patient pigs out at a party – that’s OK because before surgery, the patient would have pigged on 3000 to 5000 calories and with the pouch, the patient can only pig on 600-1000 calories max. The patient needs to just get back to the rules and not beat him/herself up. THREE MONTHS At three months, the patient needs to become aware of the calories per gram of different foods to be aware of “the cost” of each gram. (cheddar cheese is 16 cal/gram; peanut butter is 24 cals/gram). As soon as hunger returns between three to six months, begin water loading procedures. THREE PRINCIPLES FOR GAINING AND MAINTAINING SATIETY 1. Fill pouch full quickly at each meal. 2. Stay full by slowing the emptying of the pouch. (Eat solids. No liquids 15 minutes before and none until 1 ½ hours after the meal). A scientific test showed that a meal of egg/toast/milk had almost all emptied out of the pouch after 45 minutes. Without milk, just egg and toast, more than ½ of the meal still remained in the pouch after 1 ½ hours. 3. Protein, protein, protein. Three meals a day. No high calorie liquids. FLUID LOADING Fluid loading is drinking water/liquids as quickly as possible to fill the pouch which provides the feeling of fullness for about 15 to 25 minutes. The patient needs to gulp about 80% of his/her maximum amount of liquid in 15 to 30 SECONDS. Then just take swallows until fullness is reached. The patient will quickly learn his/her maximum tolerance, which is usually between 8-12 oz. Fluid loading works because the roux limb of the intestine swells up, contracting and backing up any future food to come into the pouch. The pouch is very sensitive to this and the feeling of fullness will last much longer than the reality of how long the pouch was actually full. Fluid load before each meal to prevent thirst after the meal as well as to create that feeling of fullness whenever suddenly hungry before meal time. POST PRANDIAL THIRST It is important that the patient be filled with water before his/her next meal as the meal will come with salt and will cause thirst afterwards. Being too thirsty, just like being too hungry will make a patient nauseous. While the pouch is still real small, it won’t make sense to the patient to do this because salt intake will be low, but it is a good habit to get into because it will make all the difference once the pouch begins to regrow. URGENCY The first six months is the fastest, easiest time to lose weight. By the end of the six months, 2/3 of the regrowth of the pouch will have been done. That means that each present day, after surgery you will be satisfied with less calories than you will the very next day. Another way to put it is that every day that you are healing, you will be able to eat more. So exercise as much as you can during that first six months as you will never be able to lose weight as fast as you can during this time. SIX MONTHS Around this time, our patients begin to get hungry between meals. THEY NEED TO BATTLE THE EXTRA SALT INTAKE WITH DRINKING LOTS OF FLUIDS IN THE TWO TO THREE HOURS BEFORE THEIR NEXT MEAL. Their pouch needs to be well watered before they do the last gulping of water as fast as possible to fill the pouch 15 minutes before they eat. INTAKE INFORMATION SHEET AS A TEACHING TOOL I have found that having the patients fill out a quiz every time they visit reminds them of the rules of the pouch and helps to get them “back on track.” Most patients have no problems with the rules, some patients really struggle to follow them and need a lot of support to “get it”, and a small percentage never quite understand these rules, even though they are quite intelligent people. HONEYMOON SYNDROME The lack of hunger and quick weight loss patients have in the first six months sometimes leads them to think they don’t need to exercise as much and can eat treats and extra calories as they still lose weight anyway. We call this the “honeymoon syndrome” and they need to be counseled that this is the only time they will lose this much weight this fast and this easy and not to waste it by losing less than they actually could. If the patient’s weight loss slows in the first six months, remind them of the rules of water intake and encourage them to increase their exercise and drink more water. You can compare their weight loss to a graph showing the average drop of weight if it will help them to get back on track. EXERCISE In addition to exercise helping to increase the weight loss, it is important for the patient to understand that exercise is a natural antidepressant and will help them from falling into a depression cycle. In addition, exercise jacks up their metabolic rate during a time when their metabolism after the shock of surgery tends to want to slow down. THE IDEAL MEAL FOR WEIGHT LOSS The ideal meal is one that is made up of the following: ½ of your meal to be low fat protein, ¼ of your meal low starch vegetables and ¼ of your meal solid fruits. This type of meal will stay in your pouch a long time and is good for your health. VOLUME VS. CALORIES The gastric bypass patient needs to be aware of the length of time it takes to digest different foods and to focus on those that take up the most space and take time to digest so as to stay in the pouch the longest, don’t worry about calories. This is the easiest way to “count your calories.” For example, a regular stomach person could gag down two whole sticks of butter at one sitting and be starved all day long, although they more than have enough calories for the day. But you take the same amount of calories in vegetables, and that same person simply would not be able to eat that much food at three sittings – it would stuff them way too much. ISSUES FOR LONG TERM WEIGHT MAINTENANCE Although everything stated in this report deals with the first year after surgery, it should be a lifestyle that will benefit the gastric bypass patient for years to come, and help keep the extra weight off. COUNTER-INTUITIVENESS OF FLUID MANAGEMENT I admit that avoiding fluids at meal time and then pushing hard to drink fluids between meals is against everything normal in nature and not a natural thing to be doing. Regardless of that fact, it is the best way to stay full the longest between meals and not accidentally create a “soup” in the stomach that is easily digested. SUPPORT GROUPS It is natural for quite a few people to use the rules of the pouch and then to tire of it and stop going by the rules. Others “get it” and adhere to the rules as a way of life to avoid ever regaining extra weight. Having a support group makes all the difference to help those that go astray to be reminded of the importance of the rules of the pouch and to get back on track and keep that extra weight off. Support groups create a “peer pressure” to stick to the rules that the staff at the physician’s office simply can’t create. TEETER TOTTER EFFECT Think of a teeter totter suspended in mid air in front of you. Now on the left end is exercise that you do and the right end is the foods that you eat. The more exercise you do on the left, the less you need to worry about the amount of foods you eat on the right. In exact reverse, the more you worry about the foods you eat and keep it healthy on the right, the less exercise you need on the left. Now if you don’t concern yourself with either side, the higher the teeter totter goes, which is your weight. The more you focus on one side or the other, or even both sides of the teeter totter, the lower it goes, and the less you weigh. TOO MUCH WEIGHT LOSS I have found that about 15% of the patients which exercise well and had between 100 to 150 lbs to lose, begin to lose way too much weight. I encourage them to keep up the exercise (which is great for their health) and to essentially “break the rules” of the pouch. Drink with meals so they can eat snacks between without feeling full and increase their fat content as well take a longer time to eat at meals, thus taking in more calories. A small but significant amount of gastric bypass patients actually go underweight because they have experienced (as all of our patients have experienced) the ravenous hunger after being on a diet with an out of control appetite once the diet is broken. They are afraid of eating again. They don’t “get” that this situation is literally, physically different and that they can control their appetite this time by using the rules of the pouch to eliminate hunger. BARIATRIC MEDICINE A much more common problem is patients who after a year or two plateau at a level above their goal weight and don’t lose as much weight as they want. Be careful that they are not given the “regular” advice given to any average overweight individual. Several small meals or skipping a meal with a liquid protein substitute is not the way to go for gastric bypass patients. They must follow the rules, fill themselves quickly with hard to digest foods, water load between, increase their exercise and the weight should come off much easier than with regular people diets. SUMMARY 1. The patient needs to understand how the new pouch physically works. 2. The patient needs to be able to evaluate their use of the tool, compare it to the ideal and see where they need to make changes. 3. Instruct your patient in all ways (through their eyes with visual aids, ears with lectures and emotions with stories and feelings) not only on how but why they need to learn to use their pouch. The goal is for the patient to become an expert on how to use the pouch. EVALUATION FOR WEIGHT LOSS FAILURE The first thing that needs to be ruled out in patients who regain their weight is how the pouch is set up. 1. the staple line needs to be intact; 2. same with the outlet and; 3. the pouch is reasonably small. 1) Use thick barium to confirm the staple line is intact. If it isn’t, then the food will go into the large stomach, from there into the intestines and the patient will be hungry all the time. Check for a little ulcer at the staple line. A tiny ulcer may occur with no real opening at the line, which can be dealt with as you would any ulcer. Sometimes, though, the ulcer is there because of a break in the staple line. This will cause pain for the patient after the patient has eaten because the food rubs the little opening of the ulcer. If there is a tiny opening at the staple line, then a reoperation must be done to actually separate the pouch and the stomach completely and seal each shut. 2) If the outlet is smaller than 7-8 mill, the patient will have problems eating solid foods and will little by little begin eating only easy-to-digest foods, which we call “soft calorie syndrome.” This causes frequent hunger and grazing, which leads to weight regain. 3) To assess pouch volume, an upper GI doesn’t work as it is a liquid. The cottage cheese test is useful – eating as much cottage cheese as possible in five to 15 minutes to find out how much food the pouch will hold. It shouldn’t be able to hold more than 1 ½ cups in 5 – 15 minutes of quick eating. If everything is intact then there are four problems that it may be: 1) The patient has never been taught the rules; 2) The patient is depressed; 3) The patient has a loss of peer support and eventual forgetting of rules, or 4) The patient simply refuses to follow the rules. LACK OF TEACHING An excellent example is a female patient who is 62 years old. She had the operation when she was 47 years old. She had a total regain of her weight. She stated that she had not seen her surgeon after the six week follow up 15 years ago. She never knew of the rules of the pouch. She had initially lost 50 lbs and then with a commercial weight program lost another 40 lbs. After that, she yo-yoed up and down, each time gaining a little more back. She then developed a disease (with no connection to bariatric surgery) which weakened her muscles, at which time she gained all of her weight back. At the time she came to me, she was treated for her disease, which helped her to begin walking one mile per day. I checked her pouch with barium and the cottage cheese test which showed the pouch to be a small size and that there was no leakage. She was then given the rules of the pouch. She has begun an impressive and continuing weight loss, and is not focused on food as she was, and feeling the best she has felt since the first months after her operation 15 years ago. DEPRESSION Depression is a strong force for stopping weight loss or causing weight gain. A small number of patients, who do well at the beginning, disappear for awhile only to return having gained a lot of weight. It seems that they almost on purpose do exactly opposite of everything they have learned about their pouch: they graze during the day, drink high calorie beverages, drink with meals and stop exercising, even though they know exercise helps stop depression. A 46 year-old woman, one year out of her surgery had been doing fine when her life was turned upside down with divorce and severe teenager behavior problems. Her weight skyrocketed. Once she got her depression under control and began refocusing on the rules of the pouch, added a little exercise, the weight came off quickly. If your patient begins weight gain due to depression, get him/her into counseling quickly. Encourage your patient to refocus on the pouch rules and try to add a little exercise every day. Reassure your patient that he/she did not ruin the pouch, that it is still there, waiting to be used to help with weight control. When they are ready the pouch can be used once again to lose weight without being hungry. EROSION OF THE USE OF PRINCIPLES: Some patients who are compliant, who are not depressed and have intact pouches, will begin to gain weight. These patients are struggling with their weight, have usually stopped connecting with their support groups, and have begun living their “new” life surrounded by those who have not had bariatric surgery. Everything around them encourages them to live life “normal” like their new peers: they begin taking little sips with their meals, and eating quick and easy-to-eat foods. The patient will not usually call their physician’s office because they KNOW what they are doing is wrong and KNOW that they just need to get back on track. Even if you offer “refresher courses” for your patients on a yearly basis, they may not attend because they KNOW what the course is going to say, they know the rules and how they are breaking them. You need to identify these patients and somehow get them back into your office or back to interacting with their support group again. Once these patients return to their support group, and keep in contact with their WLS peers, it makes it much easier to return to the rules of the pouch and get their weight under control once again. TRUE NON-COMPLIANCE: The most difficult problem is a patient who is truly non-compliant. This patient usually leaves your care, complains that there is no ‘connection’ between your staff and themselves and that they were not given the time and attention they needed. Most of the time, it is depression underlying the non-compliance that causes this attitude. A truly non-compliant patient will usually end up with revisions and/or reversal of the surgery due to weight gain or complications. This patient is usually quite resistant to counseling. There is not a whole lot that can be done for these patients as they will find a reason to be unhappy with their situation. It is easier to identify these patients BEFORE surgery than to help them afterwards, although I really haven’t figured out how to do that yet… Besides having a psychological exam done before surgery, there is no real way to find them before surgery and I usually tend toward the side of offering patients the surgery with education in hopes they can live a good and healthy life.

wait a minute ... hold everything including the burger patty?? that's different.... btw - mayo bread is what started my weight gain ... when i was 6 or 7 my mom used to feed me 3-4 sandwiches a day of just a thick glob of mayo on it... then 5 years later wondered why i was fat ??? gee - wonder why i dont talk to her anymore... ??? :thumbup:

Just a little words of wisedom. Your weight gain didn't happen over night and it's not going to all come off over night. Things take time and your body is adjusting to all of the changes it's going through. Eat right and move as much as possible and give yourself time. If you do all of the things you are suppose to do the weight will come off soonier or later. I know soonier is what you want to see but time is the only true judge!

Ok, need some suggestions. I went to the doctor today and they put me on another antibiotic, breathing treatments every 4 hours, and steriods. Any suggestions on keeping the steriod weight gain down?

Eyespy I was just going to say that I do a lot of volunteering and I love it! We have a local women's group here and we do community projects, fundraising, and lots of social stuff. There is always something to do, which I often find to be a pain in the butt, but at the end of the day I'm happy I volunteer. I'm a firm believer that if everyone did a little bit for their community, then we would make a big difference. Hokey, I know, but it's how I feel. I've made some great friendships though, and have had the chance to do some fun things with my "volunteer" friends. Go for it! As far as recovery, I needed two weeks. I had soooo much shoulder pain after surgery I really was in agony. That, and I think I ate less than 300 calories a day for the first 7 days so I was very weak and didn't feel well. The second week I felt better, but I did get tired easily. Some people bounce right back though, so it's hard to tell how you'll do. Denise - congrats on the fill working! I hit a point after this last fill where I said "ah ha, THIS is how it's supposed to work". lol. JC hang in there! I know the weight gain is devastating, even with all that exercising, but you're doing great. Look at all the positive changes you have made in your life since you've had the band. I can bet a 4 mile walk and kyaking was not a part of your regular routine in your past. You should be pround of that accomplishment!

Do NOT let yourself get upset over this weight gain. You have been in the hospital for several days now and no doubt with IV fluids being pumped in 24/7, right? I gained 6 pounds in one day being in the hospital! It came off very quickly once off the fluids. Any new updates from the docs on your condition? Did you surgeon ever come by to see you and if so, what was his excuse for not coming over the weekend? I am thinking about you daily.

Musicalmomma- Thanks for the explanation of weight gain! I was a bit freaked out.

Well, its sure all quiet here... Had our 2nd Xmas last night in T.O. with DD and DsiL + all his family. It was great fun, DSIL's mother brought her photo album with the only baby phot0s of Bryan that survived her exodus from S.Vietnam after the war. Oh they were just precious... I am getting along with her well. She brought me a HUGE bottle of perfume and I was embarrased cause all I brought her was a box of chocolates (I'm mrs. Gump) We all played Rock BAND and it was really funny. DInner was rare Prime RIB( my fav.) and I brought my SWISS potatoes, Bry made stir fryed veggies, I made the gravy, and for appetizers Bryan(DSIL) made Vietnamese FRESH Rolls with shrimp in them with a peanut dipping sauce.. TO DIE FOR!!! Today, we drove back into the city to attend the Visitation for my GF hubby that passed away last week. Ah it was so sad... he looked gastly in the coffin... I hate that part about funerals.... But Dar was really glad we made the effort to be there, so I am really glad we went.. ... there but for the Grace of God, I know I take my sweetie for granted at times, but he gets extra hugs and lovin today! Karla; I am glad you had a good visit with your girls... have a relaxng couple of days before school starts anew. Phyl: Hope your feeling better about DSon today... try not to let it get you down. I had forgotten that he was adopted, how old was he when you got him? Janet: Good for you throwing out the fudge!!! I have to make a donation to the local FOOD BANK tomorrow... I'm taking all the unused packages of baking things... you know the tiny brown things that are so sweet? I am sure someone else will appreciate the goodies that I no longer want to wear on my ass!!! I have been so tight, and I know its because of the weight gain, more importantly the amount around my stomach... this is causing my band to be tight... So a few days of PROTIEN only and lots of shakes should get me back on track. Today I've eaten 2 eggs, 1 ww toast, tea/milk, insides of a pulled pork sandwich(threw away the bun) and now I'm on TEA again....I only have to hang in for 4 more hours....:biggrin: Oh yeah, forgot to mention that MY KNEE went out on me last night... perhaps too much at the gym with the weights....argh Limping everywhere today, we'll wait a couple of days to see if it settles down.. If not then Ill have to go visit the doctor agian...

Good Afternoon Peeps Had boot camp this morning then funeral - then did a little shopping got this great bbq sauce from World Mart - Stockyard BBQ - OMG to die for - I know there is a Stockyard Restaurant in Dallas that's really famous I assume it's from there - going back tomorrow to buy a whole bunch - cuz it's hard to find good bbq sauce and when I find one I love - they quit making it.. So gotta stock up Candice - I don't think I have had rubbard.. Bannana nut bread - omg - that can't be a N American thing - how werid Linda - How' Mindy doing are you home yet Phyl - Wine really doesnt help your bp - I think it makes it worse really This is from the Mayo Clinic - I just wanted to make sure that Dr Janet was giving correct info Question Alcohol: Does it affect blood pressure? Does drinking alcohol affect your blood pressure? Answer from Sheldon G. Sheps, M.D. Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks in one sitting temporarily increases your blood pressure, but repeated binge drinking can lead to long-term increases. Heavy drinkers who cut back to moderate drinking can lower their systolic blood pressure (the top number in a blood pressure reading) by 2 to 4 millimeters of mercury (mm Hg) and their diastolic blood pressure (the bottom number in a blood pressure reading) by 1 to 2 mm Hg. If you have high blood pressure, avoid alcohol or drink alcohol only in moderation. Moderate drinking is generally considered to be: Two drinks a day for men younger than age 65 One drink a day for men age 65 and older One drink a day for women of any age A drink is 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof distilled spirits. Keep in mind that alcohol contains calories and may contribute to unwanted weight gain — a risk factor for high blood pressure. Also, alcohol can interfere with the effectiveness and increase the side effects of some blood pressure medications. So gf sorry to say gf - you need to only have 1 period - they can give you meds for the bp - are they talking about changing it.. Exercise and getting some more weight off will help.. Hugs on that proceedure - you are in my prayer - but ya gotta limit salt too i think Well I am off to the couch for a while - cbl

Is anybody using birth control? I'm thinking about going back on the pill, but I'm worried about hormonal changes and weight gain. A friend of mine had better luck with the nuva ring. Any advice? HW 296 - SW 266.3 (4/1/13) - CW 219

I see your on ativan I took that for a while klonipin works much better for me also latuda works amazing for depression and anxiety and doesn't cause weight gain. Trileptal is amazing for mood I'm on all 3 it keeps me sane Sent from my SM-T380 using BariatricPal mobile app

Sounds like everyone had a good productive day! Just got back from the fill doc. Everytime I go, I just love him a little more. He actually is pretty funny and REAL. He and his wife recently got married and between them they have 11 kids, so he is still hungry for money. He did have a hard time angling the port. He pulled out what was in there. Rohre SAID he put in 2.3 cc's, there was only about 1.5 cc's. Hummm...do I feel a 'setup'. Anyway he added 0.5 cc. Then we talked about my intestinal issues. He feels pretty sure it is celiacs. DD#1 has horrid celiacs, she was so bad that her body started breaking down, teeth, etc. So I was tested about 5 years ago because it is inherited, and I test positive, but I never really thought I had it because I was fat. Well come to find out you can have celiacs and be fat. Doc says that less sever celiac can actually increase weight gain, because your intestines can't absorb complex nutrients, but it will grab onto the simple sugars. So i need to start thinking about avoiding gluten. Anyway, gave myself a B shot. I had to tell Chris, the doc, to turn around cause I couldn't do it with him watching. It was easier that I thought. I use to give my neighbor shots every week, so I have given them before, but not to myself. He also wants me to replace one meal with a super protein drink. He says the B complex with help with my focusing issues and I should think about antioxidents. So I have a lot to think about.

I am down 1 pound this morning, and TOM has visited today. Usually, that means weight gain!! I am also back in moderate ketosis. Are you a nurse, Mamato?? Before i started staying home with all these kiddos I was a nurse. Well, still am just not working right now!! Way to go everyone!! Here's to another great day!!

I started my program over 300 lbs. Highest weight ever: 335 Start weight: 312 Weight on the day of the surgery: 294 Sleeved on 5/5/14 Current weight: 226 I'm dealing with the monthly 3 to 5 lb weight gain from my period right now. Bloating can suck it. But I hope to be below 200 by the end of the year.

Oh and the weight gain is always possible! That's why this was step 1 leading to step 2 bypass! This surgery isn't malabsorptive, the biliary pancreatic diversion offers best weight loss over all surgeries, but more risk by far. If you get 2 + years out and need to lose more weight they can adapt the BPD to your sleeve, or do the total bypass.