Can somone go over the unwritten "rules" of the band

[aligirrl77 0]

i know there are a bunch of things we SHOULD and SHOULDN'T do now that we have our bands. Anyone out there think they can list them for us so we have them to look back on from time to time...

[princess_n_thep 2]

I think a lot of docs are different, but here is what I TRY (read as strive/hope) to do...

Eat hard solid Protein first (don't graze over the meal with altenating bites)... then veggies, then fruits, then carbs...

No drinking carbonation liquids at all, ever again.

No drinking liquids 30 minutes prior, during, and after meals.

Make healthy low fat, low carb choices for dinner.

Eat on a smaller plate, take more when you need it.

Don't ever swallow gum.

EXERCISE!! At least 3-5 times a week for cardio/health 30 minutes a session.

Don't force food down because you want it rather than you need it.

When you PB, DON'T drink and don't promote gagging and throwing up, if it happens let it. Try to walk and concentrate on breathing.

Do not lay down within 30 minutes of eating a full meal.

When needing a snack, choose healthier Snacks such as a yogurt rather than a snickers bar.

Stay away from empty calories and high sugar... (i.e. kool aid, etc)

Don't make yourself crazy with trying to be overfilled and starve yourself... remember that the band is a TOOL and it is meant to be a slower loss with a bit more self control to portion and choices.

When you have trouble staying on the weight loss wagon, come here and post because you will get amazing support.

[aligirrl77 0]

cool! thats a really good concise list. tell me... whats the deal with carbonated beverages? why cant we have them? and what if we break one of the rules every once in a while...is it something that will hurt us immediatly or are they bad for u if u keep doing them over and over again?

[PhotoNut 7]

Carbonated drinks cause very uncomfortable gas build up in the lower stomach area, which doesn't escape so easily through the banded area of the stomach. Some believe that carbonated drinks cause the stomach to be stretched out from bloating, although not all agree.

Also, carbonated drinks often fall into the category of liquid calories which is a big no no, and diet carbonated drinks have sugar substitutes which are thought to increase hunger. For that matter, so does beer. Where does everyone go after the bars close? To breakfast! I really put on weight in my drinking days!

[StrawartS 2]

There are conflicting views on whether or not carbonation is bad. Some say that it leads to pouch dilation, others say it has no effect. I personally drink diet sodas quite often, and the only problem I have had is gas (if it can't come back up by burping, it has to go out the other end!).

[donali 57]

The bandster "rules" as I remember them (many of these rules are variations on rules for RnY patients to maximize the benefits of their pouch). These are not necessarily in any particular order:

1. The Water rules:

I. Drink at least eight glasses of Water a day.<O:p</O:p

II. No drinking with meals - the liquid either washes the food through the pouch/stoma faster allowing you to eat more before feeling full, or it makes you "stuck" and you PB.<O:p</O:p

III. Waterload prior to mealtimes so that:<O:p

a) you're hydrated

your pouch gets that initial stretching so that the "full" sensation can kick in sooner. Even though the water should pretty much drain right through, the stretching effect can last 30 minutes or so, which helps you to feel less hungry.

To waterload - start drinking water an hour before you want to eat. About 15 minutes for you want to eat drink as much water as fast as you can until you feel full.<O:p</O:p

IV. Wait at least an hour after eating before drinking again. Again, this helps the pouch stay full longer, maximizing the stretching/full sensation.<O:p</O:p

4. CHEW CHEW CHEW. Worst case scenario, inadequate chewing can result in obstruction requiring doctor intervention to remove the offending piece. Less drastic ramifications of inadequate chewing can be severe pain and/or recurrent vomiting until the offending piece has been expelled.

5. SLOW DOWN when eating. Eating too fast, even if the food is well chewed, can result in your pouch filling faster than it empties, resulting in the “golfball” feeling (which is really, really painful/uncomfortable), and/or vomiting the overflow.

6. Eat solid foods. Solid foods pass more slowly through the stoma, allowing the pouch to fill and create the stretch that turns off hunger and creates a feeling of satiety.

7. Protein first, veggies, and then if you have room, other stuff. Since your portions will become much smaller, you must make every bite count nutrition-wise. Get your nutritious foods in first before you indulge in empty calories, otherwise you will be too full to eat the stuff your body needs to be healthy.

8. Stop eating after 20 minutes. It is possible to eat so slowly that the pouch empties either at the rate of eating, or faster than the rate of eating, which means you can eat too much in one very long sitting. Limiting your eating to twenty minutes at a time helps keep your portions under control.

9. Avoid liquid calories. Liquids generally pass right through the stoma and don’t create a lasting feeling of fullness. You can really go overboard on calories by consuming caloric liquids. (Yes, ICE CREAM is considered a “liquid”… )

10. Keep up with your correct fill level - too loose and you will eat more than your body needs before you feel full. Too tight and you will resort to mushies/liquids and eat around the band (or vomit a lot, which is the number one cause of slippage).

11. No carbonation (CONTROVERSIAL - many do anyway) The number one reason cited for this is to avoid “stretching” the pouch, as carbonation expands. Personally I don’t buy that, since the pouch is not a closed system and gas can be belched up to relieve pressure. I would be more concerned about the high acid content and the possibility of that damaging the lining of the stomach. Regardless, some docs say “okay”, some say “never”, some say “as tolerated”. And regardless of what their docs say, some people indulge in carbonation. Some find they are unable to handle carbonation, as it is just too uncomfortable. Others have no problems with it, and still others will make some effort to eliminate at least some of the carbonation before drinking the beverage, either by letting it go flat naturally, or helping it along somewhat by stirring, shaking, etc.

12. NO NSAIDS!!!! These types of medications can cause ulcerations in non-banded patients, so are particularly dangerous for banded patients where the medication in pill form has a chance to be caught in the upper pouch or stoma and lay against the stomach wall, burning a hole in the lining of your stomach and possibly increasing your risk of erosion. Also, it's not just the physical presence of the pill in the stomach that is problematic. There's something about the way the drug works in our bodies that causes increased susceptibility to ulcers and bleeding. Liquid Tylenol is generally recommended as an aspirin substitute, but always check with your doc before taking any medications.

ALWAYS check with your band doctor before taking any kind of medication. Many band docs will closely monitor those patients that must take NSAIDs for whatever reasons.

http://lyberty.com/encyc/articles/nsaid.html

NSAIDs

: non-steroidal anti-inflammatory drugs

Aspirin

(Anacin, Ascriptin,

Bayer

, Bufferin, Ecotrin,

Excedrin

)

Choline and magnesium salicylates (CMT, Tricosal, Trilisate)

Choline salicylate (Arthropan)

Celecoxib (Celebrex)

Diclofenac potassium (Cataflam)

Diclofenac sodium (Voltaren, Voltaren XR)

Diclofenac sodium with misoprostol (Arthrotec)

Diflunisal (Dolobid)

Etodolac (Lodine, Lodine XL)

Fenoprofen Calcium (Nalfon)

Flurbiprofen (Ansaid)

Ibuprofen

(

Advil

,

Motrin

, Motrin IB, Nuprin)

Indomethacin (Indocin, Indocin SR)

Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)

Magnesium salicylate (Arthritab, Bayer Select, Doan's pills, Magan, Mobidin, Mobogesic)

Meclofenamate sodium (Meclomen)

Mefenamic acid (Ponstel)

Meloxicam (Mobic)

Nabumetone (Relafen)

Naproxen (Naprosyn, Naprelan*)

Naproxen sodium (

Aleve

, Anaprox)

Oxaprozin (Daypro)

Piroxicam (Feldene)

Rofecoxib (Vioxx)

Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)

Sodium salicylate (various generics)

Sulindac (Clinoril)

Tolmetin sodium (Tolectin)

Valdecoxib (Bextra)<O:p></O:p>

Note: Some products, such as Excedrin, are combination drugs (Excedrin is acetaminophen, aspirin, and caffeine).<O:p></O:p>

Note that

acetaminophen

(Paracetamol; Tylenol) is not on this list. Acetaminophen belongs to a class of drugs called analgesics (pain relievers) and antipyretics (fever reducers). The exact mechanism of action of acetaminophen is not known. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before it is felt by a person. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body's temperature when the temperature is elevated. Acetaminophen relieves pain in mild arthritis but has

no effect on the underlying inflammation, redness and swelling of the joint

.

Paracetamol, unlike other common analgesics such as aspirin and ibuprofen, has no anti-inflammatory properties, and so it is not a member of the class of drugs known as non-steroidal anti-inflammatory drugs or NSAIDs. <O:p

* Naproxen Sodium

" Naprelan contains naproxen sodium, a member of the arylacetic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs)"

"The chemical name for naproxen sodium is 2-naphthaleneacetic acid, 6-methoxy-a-methyl-sodium salt, (S)."

13. Be extremely careful of food/products that expand with water. Rice, Pasta, potatoes and bread are the most common food items that people have problems with. These food items either swell in liquids and/or tend to combine in the pouch into large, globby, sticky balls that are too large to pass through the stoma, which results in the “stuck”/“golfball” feeling, and/or vomiting until the offending piece is expelled. Eating these foods in combination with other, less sticky foods can often help reduce the incidence of problems. Fiber products, such as Metamucil and psyllium husks SWELL in water to many times their dry volume. VERY, VERY dangerous if this swelling takes place in the pouch. If you need to add Fiber to your diet, try a non-bulking agent such as Benefibre. If you do taking a bulking agent such as Metamucil/psyllium husks, be sure to wash it through with lots and lots of water so that it will bulk in your lower stomach, not your pouch.

14. Avoid Vomiting/PBing (productive burping) at ALL Costs. Vomiting/PBing is the NUMBER ONE CAUSE of slippage. In addition to being the number one cause of slippage, vomiting/PBing usually results in (and/or from) an irritated stoma/pouch, which causes swelling. Continuing to eat after a vomiting/PBing episode is likely to increase your chances of repeating the episode, and people can be caught in a vicious cycle where they eventually will have to get an unfill to allow the stoma/pouch/esophagus to heal.

The best ways to avoid vomiting/PBing:

a)

CHEW CHEW CHEW

SLOW DOWN your eating

c)

Avoid overly dry foods. Help lubricate dry foods with gravy/sauces.

d)

Avoid/be extremely careful with foods that swell/recombine in the pouch, such as rice, Pasta, potatoes and bread. Take extra care to consume these items slowly, and chew them very well.

e)

Avoid/be extremely careful with foods that do not breakdown well even with chewing, such as hardboiled eggs and rubbery foods like calamari.

The “After the Vomiting/PBing” Rules:

a)

Stop eating immediately

Do liquids only until the next meal.

c)

If you still have problems at the next meal, do 24 hours of liquids before trying solids again.

d)

If after 24 hours of only liquids you still have problems, you should probably make an appointment with your band doctor, and stay on liquids until you can be seen by them.

e)

If you are unable to tolerate even liquids after 24 hours you MUST see your doctor right away. Dehydration is a very serious risk.

15. Don’t Cut/Crush pills without Doctor Approval. You shouldn’t have to break/cut/crush your medications as a general rule, but people on the tight side, or those who must take very large pills oftentimes will have problems. NEVER break/cut/crush a medication without checking with the prescribing doctor first. Some medications are meant only to be taken in whole form, and it can be dangerous to take them cut or crushed. Time-released formulas are a good example – cutting/crushing a time-released pill means you would get too much of the medication too quickly.

16. Get a prescription for an anti-nausea medication and keep it on hand. Phenergren is one of the common medicines for this, and comes in oral and suppository forms. If you have a tendency towards motion-sickness, make sure you take Dramamine or the equivalent BEFORE the motion-sickness activity – I believe 30 minutes is the suggested timeframe. Read the instructions and plan ahead.<O:p

17. Don’t Skip Meals. Eating regularly helps keep your blood sugar stable, and helps keep you from being too hungry at the next meal and then eating too fast or too much.<O:p

18. Exercise. Exercise is always an important part of a healthy lifestyle, and will help keep your metabolism revved and your goals on track. Exercise also increases muscle mass, which takes up less room than fat mass of the same weight. So even if the scale isn’t moving downwards, you’re losing inches – plus, muscle is what burns fat, so the more muscle you have, the higher your metabolism. This is why men generally tend to drop weight more quickly than women – they generally have more muscle mass, so their metabolisms are faster.

<O:p

19. AFTERCARE. FOLLOW-UP, FOLLOW-UP, FOLLOW-UP. Regular follow-up with a band doctor will help ensure your success and band health, and keep problems to a minimum or nip them in the bud. If your banding doctor is far away, make sure you line up an aftercare doc BEFORE you get banded. This cannot be stressed enough.<O:p

20. Be your own best advocate. Learn everything you can about being banded, and the common warning signs of trouble. TRUST YOUR GUT. If something doesn’t feel right, CONTACT YOUR DOCTOR. Sometimes relatively minor problems can escalate into major problems because of delay in diagnosis/care.<O:p

21. Find and participate in some sort of support group. Most people are more successful when they have a support group. Plus it's lots of fun, and you learn a lot about being banded, and life in general.

22. Do not lay down sooner than 2-3 hours after eating. Laying down with a full pouch can cause reflux.

23. Do not leave reflux untreated. Reflux is a symptom that something is wrong – you are either too tight, are eating too close to bedtime, or are suffering from an esophageal problem.

Unfortunately, reflux is the bain of many long time bandsters. If you are already following the guidelines for reducing reflux then you need to see your doc for prescription antacid medication. It is critical that you do NOT leave this untreated, as stomach acid in the wrong places can cause severe damage, and create pre-cancerous conditions.<O:p</O:p

"ACID REFLUX CAN KILL YOU. YOU CAN ASPIRATE STOMACH ACID, GET REALLY BAD PNEUMONIA AND DIE." - GeezerSue<O:p</O:p

The only solutions I know of are modification of diet/habits, medication, reduction/removal of fills, band removal (worst case scenario).<O:p</O:p

You may find that something specific you are eating/drinking is contributing to this problem. If you're not interested in having a little fill removed, you may try eliminating these things from your diet for a while, and see if that makes a difference:

1. acidic juices/fruits, like citrus

2. caffeine - coffee, tea, chocolate

3. spicy foods

Guidelines for reducing/avoiding reflux (in order of least to most aggressive):<O:p</O:p

1. Do not over eat.

2. Avoid acid producing foods/drinks, like caffeine (coffee, tea, chocolate), peppermint, citrus fruits/juice, spicy food.

3. Do not lie down sooner than three hours after eating.<O:p</O:p

4. Do not eat or drink 3 hours before bedtime.<O:p</O:p

5. Switch evening medications to morning if okay with your doctor.<O:p

6. Take an OTC med to control

reflux

.<O:p

7. Elevate the head of the bed (helps keep the esophagus above the stomach so there's no backflow).

8. Have your doc prescribe anti-reflux medication.<O:p

9. Get a slight or complete unfill.<O:p

If these things do not help you, you must seek the care of your physician for additional help.

24. After the fill protocol. Most docs recommend doing only liquids for a day or two after a fill to allow the stomach to adjust to the new restriction and allow any residual swelling to go down. Also is a cautious way for you to test out your new fill level.

[JanetC 2]

Wow, I love that list!! Thanks! Learn something new every day!

[princess_n_thep 2]

There is no debate about the fact that sodas are bad but there is some on the carbonation issue. My opinion was that if the doctor said no, even if ONE doctor said no, I wasn't going to do it. Why do it and not lose the full weight or hurt my band or pouch in the end. I self paid, so I am taking care of it and trying to be nice to it.