Does this Sound like a Dilation problem?

[juliesam 0]

I'm posting this for a patient of mine-we're stumped..I was going to refer him for an Endocrine and GI evaluation but after reading the threads on dilation-this sounds similar. Any input appreciated-thanks!!

Adj. Gastric Banding Surgery done at the end of May 2006, about 6 months ago. To date I have had 6cc of Fluid placed into the band. My current weight is 444 lbs, down a total of 120 lbs from 2 years ago. The surgeon said that the band should be forming a pouch that would hold about 1 oz, and release the contents very slowly.

As of right now I can without having any sensation of being full, eat a 10 oz Top Sirloin Steak, a 6 oz Baked Potato, and a 4 oz dinner salad over a period of about 20 min. 30 minutes. I'm able to eat other foods that are normally restricted, such as celery, with no problem. In fact, the last time I had celery I ate the whole bunch, over a period of 30 minutes for lunch. Still no sensation of being full, nor any trouble as a result of the stringy nature of celery. Nor is any form of white non-toasted bread, or even Peanut Butter. The only item that has caused any sensation of fullness was eating one Blueberry Muffins that you can buy at the store. Also I have not had any problem that has caused me to bring stuff back up, as a result of eating too much.

My current average daily intake of calories, for the month of November is 1638 calories/day. Over the last 6 months my average daily intake of calories is down from a high of 2250 calories/day. But even at this months average of 1638 calories/day I am still gaining weight, and I am finding that the band is still allowing to large of volume of to be consumed, without feeling full.

I normally exercise by swimming 1 mile, in a little over an 75 - 80 minutes 3 times a week.

One other fact, which may or may not be important, is the fact that when the temperature is down in the low 30's, with little to no wind, I'm quite comfortable outside in a short sleeve shirt, with no coat.

Does any one have any idea about what is going on?

Or what it will take to get the band adjusted so that it is working?

Suggestion on what should be checked?

[CCBSTX 0]

First off, let me say how great you are doing! What you've done is no small feat. You are also doing terrific on your exercise.

I am assuming that you have a 10cc band. It doesn't sound like anything is wrong. It sounds like you are not restricted. This is very common. Sometimes it takes people a long while to find restriction (everyone is differnent). The band can also be very fickle (restricted in the AM, loose in the PM).

Keep adding saline to your band, you WILL eventually find restriction. Then an 10 oz sirloin will be unattainable (guaranteed).

Take care. Shawn

[Trace Curry 1]

I would agree this early in the game you're probably just not restricted enough yet. Significant pouch dilation usually takes more than 6 months.

Good luck,

Dr. C

Cincinnati, Ohio

www.TheBandDoctor.com 877.442.BAND

DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I'm posting this for a patient of mine-we're stumped..I was going to refer him for an Endocrine and GI evaluation but after reading the threads on dilation-this sounds similar. Any input appreciated-thanks!!

Adj. Gastric Banding Surgery done at the end of May 2006, about 6 months ago. To date I have had 6cc of Fluid placed into the band. My current weight is 444 lbs, down a total of 120 lbs from 2 years ago. The surgeon said that the band should be forming a pouch that would hold about 1 oz, and release the contents very slowly.

As of right now I can without having any sensation of being full, eat a 10 oz Top Sirloin Steak, a 6 oz Baked Potato, and a 4 oz dinner salad over a period of about 20 min. 30 minutes. I'm able to eat other foods that are normally restricted, such as celery, with no problem. In fact, the last time I had celery I ate the whole bunch, over a period of 30 minutes for lunch. Still no sensation of being full, nor any trouble as a result of the stringy nature of celery. Nor is any form of white non-toasted bread, or even Peanut Butter. The only item that has caused any sensation of fullness was eating one Blueberry Muffins that you can buy at the store. Also I have not had any problem that has caused me to bring stuff back up, as a result of eating too much.

My current average daily intake of calories, for the month of November is 1638 calories/day. Over the last 6 months my average daily intake of calories is down from a high of 2250 calories/day. But even at this months average of 1638 calories/day I am still gaining weight, and I am finding that the band is still allowing to large of volume of to be consumed, without feeling full.

I normally exercise by swimming 1 mile, in a little over an 75 - 80 minutes 3 times a week.

One other fact, which may or may not be important, is the fact that when the temperature is down in the low 30's, with little to no wind, I'm quite comfortable outside in a short sleeve shirt, with no coat.

Does any one have any idea about what is going on?

Or what it will take to get the band adjusted so that it is working?

Suggestion on what should be checked?

[ted12345 0]

Congratulations on your progress.

re: " I am finding that the band is still allowing to large of volume of to be consumed, without feeling full."

Personally, I believe it is a mistake to base our eating behavior on 'feeling full'. That is exactly what got ME to Morbidly Obese.

The notion of 'satiety' and eating toa 'NOT hungry' point is something new in my life. I think it is an important essential. My own efforts to retrain myself are slowly paying off.

I too average in the 1600 calorie range over the past 6 months...yet have lost only a few pounds.

I could not eat a baked potato by itself, let alone the 10oz steak etc you mention. In fact, a 10 oz steak would probably take 2 days for me. And preBand I routinely would consider that a small snack....

good luck

I agree we don't have to eat untill full, But i think if there are general food problems over a period of time that feeling of hunger can grind you down and leave you felling pretty grotty,

With reguard to the streak i take it you mean post band the band helps to restrict your ability to eat a steak now were as pre band you could manage one and some!

But what about the people who were not really volume eaters i mean i could never eat a 10oz steak pre or post op i was never a volume eater i am a comfort eater and eating is kind of done suncounciously like biting my nails. Agreed its a problem wont argue with you. But comfort eating is a responce to a emotion and emotions are far more complex to deal with than purly rectiticting the amount of food one can eat when they make and have made bad food choices for a very long time.

I think for some people the band can be as hard to work with as say a diet pre op we all failed at that and some have success with a band and some dont.

[ted12345 0]

How does putting you to sleep for a few hours and having a band fitted impact so much on your life,

For example do you still try and eat the steaks that pre band were a small snack for you? Have you tried and struggled learnt your mistake and not gone back. Or have you just never tried?

What i mean is there are foods i cannot eat like sausage and grapes and pinapple i like them but cant eat them the band really does not like them so you know what i never eat them now?

I just wish the band had the same impact on the crap i eat i know that band is restrictive and does not make food choices. But it's not 100% restrictive because it allows some food to be consumed easier than others. So say for exapmple i experienced the same thing i expereince when i eat a sausage when i ate crisps and other crap may be i wouldnt eat them???

But i dont so i still eat them and will power is not strong enough to stop me just like it wasn't enough before my band if you get my meaning.

There are loads of foods i no longer eat because i cant because the band kicks in. But then i find i am eating more of the crap my downfall.

Im being honest im admitting it i cant be any more hnst im honest with myself and every one. I am not a fool and i am not trying to fool any one or myself by making silly silly excuses. I know my band will work if i made the changes but for some me included the changes are harder to make because i didnt volume eat pre band never have i was and still am a comfort eater and i eat crap.

I mean can you see my point we all failed thats why we needed WLS but for some the band has more of a impact on the pre op diet of the patient like if my downfall was sausages and chips i would propabbly be a success because i cant eat them now. But my down fall isnt and my comfrt food is still band prrof and easily passable. If i had the will power and self controll to stick to diets and lifestyle changes i would never have needed the band!!! I just think this is a great exapmple of how people can fail with there bands and why its prob not always the best answer.

[dpingl 0]

Even though I am only 3 weeks out I feel like I can eat a bunch too!

TODAY for example

Breakfast

2 scrambled eggs, 2 pc turkey bacon

snack

High Protein slim fast shake

lunch

5 0z lemon pepper tuna, a little of very shredded lettuce. 1tbslp oil/vin dressing.

Snack

Soup@ Hand chicken & Stars

dinner

Spaghetti-1 cup whole grain noodes, 1 cup meat sauce.

Obivously I have not eaten some of this yet but its my plan for the day.

DOES'NT that sound like WAY TOO MUCH food?:hungry:

[ted12345 0]

Do you have the potine shake as a Meal Replacement or as a drink?

I think early post op you will be able to eat quite a lot the band is like a care its useless with out its fuel. Untill you have a fill and reach some restriction you may be able to eat quite a lot and some foods that you wouldnt expect to be able to eat.

Its like the car wont run untill you put fuel in, You band wont nessersarily work untill you have a fill.

Stick to the advice your surgeon gave you untill you have a fill and see how things go when you begin to get restriction. These early days can be very hard as you are needed to do most of the work diet wise.

[Carlene 12]

I just wish the band had the same impact on the crap i eat i know that band is restrictive and does not make food choices. But it's not 100% restrictive because it allows some food to be consumed easier than others. So say for exapmple i experienced the same thing i expereince when i eat a sausage when i ate crisps and other crap may be i wouldnt eat them???

But i dont so i still eat them and will power is not strong enough to stop me just like it wasn't enough before my band if you get my meaning.

Can you at least do this....force yourself to eat your hard Protein first, then allow yourself to eat the other stuff. I promise you will eat much less of it than pre-band, or what you eat of it on an empty pouch/stomach.

This does not require will power - just a minimal amount of discipline.

[ted12345 0]

Yeah and if you see my other thread in can't cope any more, You will see that i cant eat any solids foods at all so Protine first is a basic bot of bandster knowledge but how do you eat hard protine if you are texture sensative and cant eat sertain foods?

Its a visous circle so i cant eat solid food because im sick with it so what do i do i resort to eating food i can eat rather than should eat!!

Healthy food choices isnt always possable meat wont go down fiberus and stodgy fruit wont go down things like lettice and cabbage wont go down.

You know what im surviving on mash potatoes and basically anything that has a texcure of mashed potatoes. when i try and eat checken it gets stuck and i vomit no matter how much i chew and chew or how small a portion i eat.

[dpingl 0]

I usually try to eat my protien first... It does help. (I actually feel like all I eat is protien!) I am usually @ about 900-1500 calories a day. My protien shake is what the Dr says to do, so thats what I do....?? I am eating pretty healthy and most moist meats are not a problem. I am just afraid I am consuming too much. I get my first fill 12/20/06. ( I also have to watch eating TOO FAST! I am learning!)

[Wheetsin 714]

RE: your patient, I'd like to echo what Jack said. Full is the least relevant word here. S/he is still going to have to make the effort to change the behaviors, one of which is "eating until full" versus "eating until no longer hungry". There is a world of difference between those two states.

Perhaps in addition to whatever is done band-wise, some more trips to the psychologist would be helpful? Sounds like the patient is having a really hard time breaking their eating behaviors.

As for the types of food he can eat - so can I. bread, rice, Peanut Butter, Pasta - all the things I was told I wouldn't be able to tolerate. And I do have mild restriction, and do have to PB - but I have never PBed from eating too much, just from swallowing too much at once or not chewing well enough. My band has yet to restrict the quantity of food I can eat, so it's up to me to say when. That's my compromise for only having mild restriction... when I feel I can no longer own that part of the agreement, I will go for more fill.

What size band is it? 6 in a 4 is a much different scenario than 6 in a 10. At 6 in a 10, perhaps the patient just needs more fill?

[Carlene 12]

Yeah and if you see my other thread in can't cope any more, You will see that i cant eat any solids foods at all so Protine first is a basic bot of bandster knowledge but how do you eat hard protine if you are texture sensative and cant eat sertain foods?

Its a visous circle so i cant eat solid food because im sick with it so what do i do i resort to eating food i can eat rather than should eat!!

Healthy food choices isnt always possable meat wont go down fiberus and stodgy fruit wont go down things like lettice and cabbage wont go down.

You know what im surviving on mash potatoes and basically anything that has a texcure of mashed potatoes. when i try and eat checken it gets stuck and i vomit no matter how much i chew and chew or how small a portion i eat.

Are you too tight? Sounds like you need an unfill, but if that's not the case, you should still eat your "good" food (or as good as it gets for you) before you allow yourself carbs, sweets, etc.

How about chunky Soups (give them a go in the blender first if they are too chunky). Tomato or tomato bisque Soup. Chili. Eat 1 to 1 1/2 cups of any of those first and see if you don't have little room left for carbs. Eat 5 times a day if you are hungry, but always eat the Protein first.

If you are living on mashed potatoes, you are going to have nutritional issues after a while. Your hair is going to fall out. At least drink some skim milk with Protein powder added.

What does your doctor/nutritionist say about all this?

PS....I can't eat fruit, many veggies, salad, etc myself. chicken is a sometimes thing, too. But Cheetos go down just fine. So well in fact that I had to stop buying them. I am helpless in the presence of a bag of crunchy Cheetos.

[Bawilliams1 1]

I am freaking out myself! I had a band put in in April 05 and I lost a lot of weight. I had great restriction with a 4.0 cc band that was filled with 3.0 cc's. I puked too much and my band slipped. I am assuming that's why it slipped. I now have a new band. It is in the perfect position on my stomach according to my fill doctor and after a ton of frustration I got a fill two days ago up to 3.4 cc's. The flouro showed that the Fluid was going through the band slowly and I sat around the office and drank plenty of Water to make sure it was not too tight. Now, two days later I am going back to "regular" food and I STILL have no restriction! Why would this band be so different than my first band? When I get a fill it always appears that I am tight and I will have restriction, but by the time I start back on regular food it seems that the tightness is gone. I only have a 4.0 cc band. I am terrified that I am going to end up with 4.0 cc's of fluid in there and still no restriction. Is there anyone out there with a similar experience or any ideas or suggestions?

[ted12345 0]

I think some of us are just more sensative to restriction than others.

Charlene being banded now almost 2 years i really have tried everything. Eating chunky Soups that have been blended really is defeting the thory of the band!

Eating anything blended fedfetes the bands theory it is restrictive surgery.

Not a band so we survive on blended foods.

i do appreciate your advice but this has been going o from the day i was banded, its time it came out its a horrendus device i also am now begging to thing its too high up and thats why i am not able to eat anything without vomiting.

[Woodys 0]

Bawilliams1: I too had the same fear. I have a 9.5 cc in a 10 cc band. With every fill I had great restriction but as I continued to lose weight the restriction would go away and I'd get another fill. When I reached 9 cc I panicked and spoke with the fill nurse about this. She said that it is not uncommon to not find perfect restriction until the band is near full or full, she also mentioned that most bands are fillable beyond their capacity and sometimes that is what has to happen. She has "filled" literally thousands of banded patients and has not had one yet that has not reached maximum restriction that they could work with.

I felt much more relieved after this discussion......I have more than maximum restriction now, I can eat less than 1/2 cup of food right now but my last fill was only 4 days ago.....but I'm sure that once the stomach swelling is down and my body has adjusted that this will be the last fill for me and I will be where I should be.....only able to eat 3 meals / day of 1 cup of food.< /p>

Carol