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Paul Simon’s, aptly names anthology of solo hits is called “Negotiations and Love Songs.” He does a great job of capturing the often bizarre and illogical discussions and negotiations we have with ourselves. I think he has done a better job than most in capturing the 5 Stages of the Mourning (Denial, Sadness, Anger, Bargaining, and Acceptance). Well…last night I found myself locked in a mortal battle of wills with Denial. Obviously, I have spent years denying that I had a real problem and that I could overcome it with “will power” or the other great line “…I’ll just stop eating…” I have a friend, that is a recovered alcoholic, and he always said giving up booze was easier than food. Because, you CAN just stop drinking, stopping food eventually kills you… he always said that recovery rate would be zero, if every AA member had to take three shots a day, but was still required to stop all other drinking. So how did Denial sink it’s claws into me? I have been doing much better than I thought I would with the liquid diet, and the Queen of Denial was whispering to me last night…If you have done this good so far, just keep it up, skip the surgery and save the money…maybe your will power will hold out this time…ARRRRGGHHH. Denial is one seductive bitch! So how do you combat Denial? I use the mirror test. I taped a picture of me from high school/college times (about 190LBS), and one of a friend of mine who has the look I want when I get to the other side, then I stand naked in front of the mirror and ask myself do I look like the picture? Obviously the answer is No. Denial, I abjure you, I reject you and I will overcome you. The sweet siren song of Denial will not lead me to the rocky shores to find myself, again wrecked and wondering how it all went wrong. I know the Lapband is only a tool, but, it is also a weapon in a lifelong battle that I will win this time.

The "Eight Golden Rules" for lap band patients By: Paul O'Brien, MD, We have formulated eight “Golden Rules” for getting the best result from the procedure. It is of vital importance that you follow these rules. The success of the procedure requires us to place the band correctly, but it equally requires that you follow these rules. I have been tempted to call them guidelines rather than rules. They are not absolute. A thunderbolt will not come from the heavens and strike you down if you break one of them. And, almost certainly, every patient has at one time or another broken each of the rules. However, they are more than guidelines. They do need to be followed to get the best results. If you do transgress one of them, I want you to feel guilty, admit to your sins and work out how you will avoid doing something so terrible ever again. But do remember that if the band is not correctly adjusted you will not be able to follow the rules. You must be in the green zone to follow them. So, before being consumed by self loathing at your weakness, do consider if correcting the adjustment is needed and come in to talk to us about it. We have already discussed these rules within the preceding chapters. Within these rules is a condensation of the advice in those chapters. We are repeating the key elements of the advice. We state the rules, briefly expand on what each rule intends and then restate them. If you are unsure about what they mean, reread the earlier chapters on eating, exercise and adjustment, and if still unclear, talk to us. THE EIGHT GOLDEN RULES for losing weight and keeping it off 1. Eat three or less small meals per day 2. Do not eat anything between meals 3. Eat slowly and stop when no longer hungry 4. Focus on nutritious foods 5. Avoid calorie-containing liquids 6. Exercise for at least 30 minutes every day 7. Be active throughout the day 8. Always keep in contact with us 1. Eat three or less small meals per day The Lap-Band works primarily by taking away your appetite. If it is adjusted correctly you should not feel hungry. You may eat up to three times a day. We don’t mind if you eat less than three times per day. Many people do not feel like Breakfast and some will miss a midday meal. If you don’t feel inclined to eat, don’t eat. If you find you are getting hungry between meals, tell us. We will probably consider adjusting the band a little tighter. There is not much room for food as there is a virtual stomach rather than a real space above the band. As you eat, the food seeks a space and you need to keep that space quite small. Therefore each meal should be about the amount of food you can get into half a glass. If you eat more than that you will not lose weight so easily and you will gradually stretch the stomach. This can lead to the need for a further surgery later on to reduce the enlarged stomach. The adjustability of the band is the key to allowing you to be happy with this small amount of food. If you find that you are tending to eat more than that, tell us and we will consider adding more Fluid to the band. Always use a small plate, put a small amount of food on the plate and always try to leave some. Remember the angels. They need their share. 2. Do not eat anything between meals No Snacks, no biscuits with your coffee, no fruit, nothing. All food must be restricted to meal times. One of the most frequent causes for failure is the taking of snacks between meals. If you are getting hungry between meals and are tempted to have a snack you must tell us. It is probably due to inadequate adjustment and you may need more fluid added to the band. Between meals you can only have zero calorie liquids – Water, mineral water, tea, coffee, low calorie sodas. 3. Eat slowly and stop when no longer hungry When you have eaten enough you will no longer be hungry and signals from your stomach to your brain tell you that you do not need any more. These signals take time to be generated. Give them that time. Each meal should be stretched out over 15 – 20 minutes. If you eat rapidly you will already have eaten too much before you realize that you have had enough. However, do not eat beyond 30 minutes. Throw away whatever you haven’t eaten at that time. That is the end of that meal and you must have nothing else until the next meal. Try to make each meal last for 15 - 20 minutes. Try to sense when you have had enough and stop before you feel at all uncomfortable. Use a small plate, put a small amount of food on the plate, and develop the habit of always leaving some of it uneaten. Once the meal is finished it is essential that you take no further food until the next meal time. This has to be avoided absolutely. The slow emptying of the stomach gives you a feeling of fullness which should make it easy for you to achieve this. You must ensure that this indeed does happen. 4. Focus on nutritious foods Foods that are high in Protein (meats, especially fish, eggs, dairy, lentils Beans and nuts) and foods that are high in complex carbohydrates (vegetables, some cereals) are best. Simple sugars are worst. Be careful with foods that are high in fats as they are dense form of calories. Be careful with fruits as they contain quite a lot of sugar. The good foods can come from all the main food groups and include vegetables, meats, eggs, cereals and dairy. There is no need to focus unduly on the particular foods in fine detail. It is not rocket science. It is simply selecting foods that are good (protein and complex carbohydrates), being careful with those that are not so good (fats, alcohol) and avoiding those that are bad (simple sugars). And take a well balanced Vitamin and mineral replacement each day. 5. Avoid calorie-containing liquids Any calorie containing liquids will tend to flow past the restriction of the band and not give you any feeling of satiety. You are then more likely to take too much. You are only allowed to drink: water mineral water tea or coffee (with low fat milk if you wish but no sugar) low calorie soft drinks (but be careful with the gas) An exception to the “no liquid calorie” rule is a glass of wine with meals which we have shown is good for your health and good for your weight loss when taken in a modest amount. 6. Exercise for at least 30 minutes each day This is at least as important as all of the other rules. Not only must you take in less calories but you must use up more calories. Exercise will improve your general health as well. Initially, while you are severely obese this can be difficult, but, as your weight decreases, it becomes easier. As you become fitter and healthier, you get greater enjoyment from exercise. We understand that not everybody is sports minded and exercise may be something quite new for you. Start slowly and seek to build up activity progressively. Aim to put together 30 minutes or more of moderate intensity physical activity on most and preferably all days. Walking is ideal to start off with. As your fitness improves, progress to more vigorous walking and even jogging, cycling, aerobics, swimming, and light resistance training. As your weight comes down your exercise capacity will increase and your general activities during the day will increase. This is to be encouraged and the more active you are the better the result will be. Your exercise program should be aerobic. You should be puffing and, if you check your pulse, generally it should be up around 120 – 140 beats per minute. There are a wide range of activities that will allow you to achieve this. If you can manage it, a personal trainer or fitness consultant can be an excellent assistant. They can provide an individual program according to your specific preferences and lifestyle that is realistic and achievable. Regular exercise requires commitment. The more effort you put in, the greater benefits you will see and feel. 7. Be active throughout each day Think of movement and activity as opportunities and not as inconvenience. Try to be active every day in as many ways as you can. Make it a habit to walk or cycle instead of using the car. Become active in the garden and do things yourself instead of using machines. Avoid sitting down at all cost. You should see sitting down as an opportunity for activity lost. Try to spend as much time outdoors as possible. We tend to be more active when outdoors. Use a pedometer as a stimulus to you to show how your activity level is increasing. If you are using a pedometer, aim to get beyond 10,000 steps per day – this represents a very good level of routine daily activity. 8. Always keep in contact with us We want to follow you permanently. There will never be a time when we say that the job of controlling your obesity is done and we do not need to see you anymore. There will always be a need to check your progress, monitor your health, check for nutritional deficiencies, make sure that you understand the rules, bring you up to date with new developments and adjust the volume of fluid in the band. There is always going to be a very small loss of fluid from the band over time. For example, if you had 3 ml of fluid present and we checked the volume after a 6 month gap, there would probably be about 2.7ml present. This occurs because the balloon of the band is not totally impermeable. If 3 ml was the correct volume, you would be starting to get hungry and eat more with a volume of 2.7ml. It is important you understand that this can happen and come back to see us for replacement of that small loss. This is the main reason that we want a maximum of 6 months between appointments. With this said, always follow your own doctor's protocol! There is a reason they give then to you! Also, my PA said she didn't quite agree with the "no snack" thing but if I could do with out and still be in the guidelines then wonderful. I am 3 years post op, and am in the green zone. (FINALLY) My recommendations may be different from newly banded receipants! Good luck and happy losing!!!! ~Jen~

Are you lactose intolerant? It honestly sounds like dumping to me. I had it just last night cuz I chose to have a crappy dinner instead of my planned dinner. Sucked. It sounds exactly like reactive hypoglycemia and some of the sugar alcohols cause this same reaction in bari-patients.

It is true it is hard. But it's going to be hard after the surgery too. And then you will have a band in place that can make you feel not too well if you eat too much. 1. After about 3 days of true compliance your cravings for sweets and carbs WILL go away. No lie. That crazy drug addict feeling does pass. 2. Those feelings of needing to eat the PB&J or pizza (that's mine) or whatever -- will pass also. They are just feelings and you need to say to yourself "Can I handle this for the next 2 minutes.", "Can I handle this for the next 5 minutes" and so on and so on. Sounds rediculous but I have a friend who is a recovering alcoholic and this is similar to what they have to do. Trust me some days you'll be able to say "Can I handle this for the whole day" and that seems 100% doable. There are other days where "3 minutes" seems way too long. Do NOT take this on as a week long or 9 day long or 6 month long or 100 pound losing long task. You need to break it up into teeny tiny pieces. 3. Keep in mind that it's just food, it's not going anywhere and it never tastes as good as we thing it does. I know we all have unhealthy relationships with food -- but you can make the choice. And you can do it. I know you can. 4. Find something to keep your mind busy. I bought a dumb mindless craft project at a store. I didn't even care what it was I just wanted something to do with my hands. I'm sure it's harder when you have 4 kids -- but maybe that's the perfect time to start a very messy project like finger paiting. 5. Make sure you are having shakes w/enough protein (based first on what your doc says). 6. Drink a lot of water or crystal light 7. Plan out your food/liquid consumption hour by hour. I found this was very helpful -- I mean I made myself little charts while on LD like "6am coffee" "7am protein shake" "8am crystal light" --- and then I checked it off. It was easier, made me feel in control and didn't feel like I was awash in a big abyss of liquids. Ok, those are my words of advice. I'm am a horrible dieter and I've managed to stay true to my pre-op LD (13 lbs down!) so if I can do it you can do it. Good luck and stay strong.

Sorry I also forgot to add that many people who are postop are on narcotics and drinking alcohol is a major contradiction.

HI KC, I am getting banded in about 34 hours from now 8-) I have been reading the blogs more this week. I wish I had found them earlier in the process. I feel like I have wasted my life being fat, and I don't have the energy to even think about trying weight watchers, or starting at the gym again, etc. My feeling right now is that the band will get me through the rough spots. .... I won't be hungry and decide to have a non-healthy, greasy, probably fried .... with gravy ... kind of meal and then end up giving up all together. At some point, I can have a taste of dessert, or something really yummy that would not be considered healthy, ........ but I will have only a little of it because I will be fuller sooner. ........ so the set back will not be as great, ....... and because it is not that big of a set-back, I will not get discouraged and give up, ...... it will be easy for me to get back to my standard (healthy) eating plan. Do I have the right perception of how this works? What is the thing that you would say is the most difficult for you? [i am not a big soda pop drinker, ... but I will miss my diet root beer] Is it hard to eat out because you only eat 1/3 of what they serve on one plate? What happens if we DO drink alcohol?

There's lots of hospitals who put their informational booklets online. Here's one that I found very helpful: https://www.hsc.missouri.edu/documents/bariatric/Bariatric%20Booklet%20VSG.pdf I know Kaiser put together a good one too, but I can't find it... maybe someone else has the link... As far as beer, I didn't drink it pre-op so I didn't ask or pay attention to the specifics on that. I know carbonated drinks can give you painful gas after surgery, but that eventually it's tolerable (after a few months). My surgeon said absolutely no alcohol for the first 6 months minimum. Most surgeons say no alcohol for a year... so you don't replace a food addiction with an alcohol addiction and also because it's empty calories/carbs. I do plan to enjoy a glass of wine again one day, but I've never been much of a drinker so these restrictions don't bother me at all. Good luck!

I didn't read the comments because I have had enough of them to last a lifetime! But obesity is the last safe publicly permitted bigotry. Racism, sexism, homosexual disparagement are not politically correct anymore, but fat people are still allowed. Cause they're weak, and self indulgent. High functioning alcoholics or hot chicks with drug problems are OK because at least they're not FAT. Society sucks.

I had my first glass of wine about 3 months post op and it was delicious Check with your surgeon first and also some people handle alcohol way different after surgery. So you may want to take a test run at home before the party just to make sure you are OK with it. You don't want to cause a scene at your MIL's 50th b-day party LOL

Ok so lets start with stats Heighest 270 Surgery: 238.1 Current 223.2 * I actually gained 4 lbs in 3 days* Height 5'7" So let me start off my saying... BLAH!!!!!!!! OK so here goes.. I thought I was doing really well.. I was going to the gym 5 days a week, staying motivated, drinking all my fluids, and trying my best to stay on the program.. Don't get me wrong im not perfect and I did cheat.. normally I don't regret it because I really work my butt off at the gym, but recently I think because I've been justifying my cheat with a "well ill just work extra hard at the gym" im actually seriously sabatoging my progress. Let me say though funny part is im not cheating my eating foods im not supposed to eat.. but because i work in a bar im having a drink instead.. SO NOT A GOOD THING as im only 3 weeks out of surgery. Why am I telling you this... BECAUSE I AM GOING TO HOLD MYSELF ACCOUNTABLE! Now here is the kicker... TODAY I WENT TO THE HOSPITAL FOR SEVERE ABDOMINAL PAIN ON THE LEFT SIDE... I was in the ER for 11 hours, and they still have absolutely no idea why i have this pain .. i don't honestly think its because of the alcohol, but it scared me enough to realize that even a small cheat can be DETRIMENTAL to my health. As of now i am still in a considerable amount of pain, docs did an iodine test to see if i have any leaks and a CT Scan, all which came back normal.. SO why the pain? If anyone has the answer to that... PLEASE LET ME KNOW. From now on though.. im stickin to the plan cuz one thing i do know.. even though the alcohol may not be causing my ab pain... It sure as hell is contributing to my WEIGHT GAIN! And it is wayyyyyyyyyyyyy to early to be gaining weight! I mean ive heard of the the 3 weeks stall... but the 3 week weight gain.. GET REAL! So here is my pledge.... I will abide by the rules, i will still hit the gym, and i will hold myself accountable!

If you were a member of a family of alcoholics, would you drink to keep them company?

Post-op is worse in the variations that different doctors and NUTs have: 1. coffee 2. NSAIDs 3. Alcohol 4. Water before/during meals 5. Ability to stretch sleeve 6. Carbonation These are just a few of the various items that vary depending on who your medical team is. There are many more if you keep reading here.

I waited a month to drink alcohol again...I love my beer and wine but beer seems to make me bloated now and puts on the calories whereas a glass or two of wine each day doesn't seem to make much of a difference.

During my consult, the Doc said that it's fine to drink a glass of wine as it relaxes your stomach. I got the impression that it's all about the empty calories, as opposed to the alcohol itself.

Get back to basics. If you have to you can do the 5 day pouch test to help get you back to basics. Below you will find a brief list of the menu for each day. Please click the "Read more" links for further detail and hints and tips that will enable your success with the 5 Day Pouch Test. Days One & Two: liquid Protein low-carb Protein shakes, broth, clear or cream Soups, sugar-free Gelatin and pudding. Read more. Day 3: Soft Protein canned fish (tuna or salmon) eggs, fresh soft fish (tilapia, sole, orange roughy. Read more. Day 4: Firm Protein ground meat (turkey, beef, chicken, lamb), shellfish, scallops, lobster, fresh salmon or halibut. Read more. Day 5: Solid Protein white meat poultry, beef steak, pork, lamb, wild game Read more. You have to be dedicated to the process. Yes, I understand that it's difficult during the holidays, BUT, you are in control of what you choose to put in your mouth. I wasn't even released for alcohol consumption until after 3 months. Alcohol is just wasted/empty calories. It has zero nutritional value, and all you're doing is sabotaging yourself and your sleeve. It's okay to have a "treat" here and there, but overindulging is only going to stall your weight loss, and build your frustration.

I think already (13 days post op) I am eating pretty much "normal foods" I just make myself live by certain taboos: no caffeine, no fast food, no bread, no soda, no alcohol. I'm just eating much smaller amounts. Oh, and roasted chickpeas...they got stuck.

My birthday is 3 weeks after my surgery, and my surgeon said it is fine to have alcohol as it is liquid. problem with alcohol is the calorie intake...not the substance. Any liquid will pass right through into the stomach. It is best to stay away from ice cream, milk shakes, alcohol as it is easily ingested, but can cause you to not lose weight, as on any diet. Moderation and all is well.

My surgeon cleared me for the occasional drink, which I've enjoyed, for all that I rarely manage to finish a cocktail. Do be aware of the empty calories in alcohol, though. The other thing I was warned about was transfer addition; most of us were addicted to food to cope with things in the past and, being more or less denied that now, it's easy to switch to something else, whether it's alcohol or exercise or shopping or some other such thing. Just discuss it with your surgeon and keep your eye on your intake and you should be fine.

I recently attended a LB support group. I listened as I heard stories of how many still have just a shake for breakfast/lunch. I got out of that habit some time ago. I then questioned those that did this if they were the cooks or the caretakers in their households. Well the ones that were shakes only with one meal per day were all single. Those of us that tired of the shakes eventually had mouths to feed, groceries to buy, sandwiches to cut.... etc. Frankly, IT IS MORE difficult no matter what anyone sez. I'm not using it as an excuse, but I would love some kind of support group or help. I mean if an alcoholic had to touch, handle liquor all day long... would he be able to stay sober? In my dream world, I would wake up, have a shake, do my day, have a proti-Protein Soup for lunch. Throw in a healthy snack or two, go to the gym, and make a healthy dinner, and go to bed. My friend, a father of 5, leaves all of the above to his lovely wife. He agrees that if he had to touch, shop for, cook, taste, etc, ... food all day he'd not have gone quite so far. NOT an EXCUSE... but @%#! :wink:... man I'd love a break from all this food handling. LOVE my dh and kids and wouldn't change my life for all the pounds in the world, but really would like a clue... any ideas ? Gotta go make the lunches. <sigh> Anyone else go through this?

by 8wks out, i was cleared for alcohol & i have had wine regularly since. no bad experiences - all in moderation.

Praying for you.. I grew up w/ an alcoholic father... you know the rest!!.. Be strong and positive...

well, I agree with all the above.. I was married to an alcoholic and I enabled him to continue to be for 10 years. Finally broke free of that! Yours sounds a lot like mine... giving orders and such. If he wants a divorce, let him file it. Why should you take on all the stress of that, meeting with lawyers, paying for it and so on while he sits back and just signs his name when you are done doing ALL the work. Screw that. Let him do it and you sit back and sign when you agree to everything. Thats what I say... Dont let him keep ordering you around... you dont owe him sh*t.

I had a mixed drink about 2 weeks post-op. It was a friends b-day and I just sipped it over the course of about 3 hours. Now I will have a drink here and there, but I too feel it quickly. For super bowl I had a pomegranate martini and even though I took it slow and had food with it, I was too tipsy to drive home. Even 2 hours later, I ended up getting a ride with my mom and going back for my car the next day. If you are going to have a drink, make sure you have a ride or someone else to drive you home. Also make sure you are not taking pain meds with the alcohol. (I know that most people know this, but it never hurts to say it) Other wise, Cheers. ~Mandy

I wouldn't recommend it! Not because I'm "old", OR because I'm a mother, OR because you're underage...but because you will have a new lap-band that hasn't settled into place yet. You will still be healing, and most likely not be eating solid foods yet. When prom night rolls around, you will not have had much to eat for the past 6-8 weeks. You won't be eating much that day/night, then you'll add alcohol on top of that. It will take a lot less alcohol to do way more damage than ever before. If you drink to the point where you throw up, then you risk damaging your band and having major problems. You made the decision to have the surgery so that you can be healthy. Don't take a chance on losing all that for a night of drinking. It's just not worth it. And, there will be plenty of opportunities for you to drink later, when you are completely healed. Have a happy and safe prom night!

First thing I do is make sure I have enough restriction. In my case I am going back in after Christmas for a fill. I am going to recommit myself and eat healthy and limit alcohol. Keep your eye on the prize and look at some "fat" pictures. You can do it!