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first bite syndrome "cures?"



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After my second fill (5 ccs in a 10 cc band), I started getting what my fill doc said is probably "first bite syndrome." I had read about that on the threads here, so I later searched for it and only found a few threads about it. Most people say to drink a warm liquid first (which my doc also suggetested), but I find that's not a guaranteed fix.

I also know that Jack the Super Moderator said (here: http://www.lapbandtalk.com/f13/does-any-one-have-problem-74494/) that he learned how to deal with and it eventually (after many months) went away. But I searched the forums and didn't find as many notes as I thought (hoped?) I might.

So, I was wondering, how many of you experience this? What are the various conditions under which you experience it? How long did it last (until an unfill, for X months, it still happens, etc)? And most importantly... what do you do to help not happen, or at least lessen the effects? Also, do you ever feel like if you have a lot of spasming one day that it can irritate your pouch?

For those who don't know what first bite syndrome is, I'll describe my experience with it below. It sounds like everyone is different, and I seem to be one of the "lucky" ones who can get it from liquid. =P

Thanks!

GBear

So, here's my story and what I have felt:

The first time it happened was actually a couple days after my second fill. I had successfully eaten liquids and mushies for 2 days and even a little bit of soft solid food. I had great restriction and I was happy! But then on day 3 (the fill being day 1), I thought I had my first "stuck" episode. I ate a bite of something (I forget what, but it might have been a small bite of bagel... before then I could handle breads fine) and it HURT like the dickens. I thought to myself, okay, no bagels/bread for me, now I know. And I slimed... but nothing came up. The pain eventually went away, but it took many minutes. I had similar problems most of the day, but even when eating mushy food. I began to wonder if I was too tight.

Over the weekend I kept a close eye on it and resorted to liquids and mushies. But here's what was the killer... One morning, I took my sip of liquid Vitamins and BAM, I felt massive pain at the based of my neck, in between my collar bones and I really started to slime. All I had had that morning was my liquid vitamins! I was really upset. The pain took several minutes to subside. But later on that day, I could eat food fairly normally.

On Monday I went to the doc thinking I needed an unfill. I explained how I could either get this massive pain OR eat normally. It was weird, because as long as I didn't get the cramping and the pain, I could eat normal bandster amounts of food. That's when he explained I probably have "first bite syndrome." He said that basically, stomach wall in the upper pouch is not used to having food in it, so it starts to spasm on constrict itself. Once it stops spasming, you're fine and can eat normally. As soon as he described it, I knew instantly that's what I was experiencing. The pain I feel definitely feels "muscular," so to speak. And the degree of pain I feel can go up and down within any given episode.

I decided to not get an unfill because I liked the restriction otherwise. Over the next three weeks, as my restriction loosened, the first bite syndrome occurred less often. But it's weird, because it can still happen with almost any kind of food or liquid. And drinking a warm liquid doesn't always work for me.

So, I got my third fill this past Thursday and I was fine on Thursday and Friday. Only very mild cramping/spasming. Very mild, especially since I was on liquids and then mushies. Saturday morning, I had a hard time eating some scrambled eggs because of the pain, but it wasn't too bad. Then later that morning, I took my liquid vitamins and BAM! Massive pain that lasted for minutes with sliming (again, no PBing). I had a hard time drinking any kind of liquid all day, and certainly couldn't eat mushies, so I wondered if I kind of irritated the stomach pouch with all of the spasming.

Sorry for the long story! Hopefully you only read it if you were bored. :biggrin:

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I think it seems to be something that goes away with time. Everyone who complains of it seems to have been banded less than a year.

I remember I got it a lot but never ever do now.

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You do know that only like 5% of people can stomach fresh bread and what not after surgery right?

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G-Bear, Thanks for the post. I have been on this site for several months and read a LOT of threads and posts but this is the first time I have heard of this. I was banded on july 31 and have had 1 fill and have had no restriction. I go for my second fill on Oct 10. I guess I am in for a rude awakening! I have been able to eat anything and everything and am trying very hard to maintain my weight loss from pre and post banding. I want to feel restriction very badly but hoipe not to have the symptoms you de3scribe. Good luck and hope this passes quickly for you. Jenhay

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Yeah, I know, but that's actually one of the few foods that has NOT given me the first bite syndrome since my third fill this past Thursday. It's really weird. Like I said, any food or liquid can cause the FBS, and I can get it at any time of day, as well.

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I believe the lower esophagus remains "on alert" and on the verge of spasm, following the initial incident, perhaps for weeks.

Your time frame is relatively short with this kind of incident.

I found that at my own worst time, that just the act of *thinking* I was going to eat something, could produce a spasm of moderate yet uncomfortable duration.

I found that my anticipation was also accompanied by an actual physical sensation in my lower glottus, that behaved *just as if* I had taken that bite.

I had to train myself to first relax and sip a little hot coffee, slowly consider my next move, and take only a SMALL taste (nibble size), hold it and rather gum it about, chew to very liquified stage, then swallow. In a few minutes, follow with a small sip of coffee. NOT my preOp SWIG.

There would eventually be a sensation of something relaxing in my esophageal-glottal region, and then I could eat normally...Bandster normally.

Make sure you are not just slamming your liquid vits down, as the muscular coordination required for a slug of liquid is very similar to solid food. Too much too fast probably is the culprit.

Let us know how it goes.

Thanks, Jack. Having you describe what you do in more detail helps. I will try this very specific technique, but maybe I'll wait a couple days and stick to liquids for a couple days to let my body heal a little. You say this is a relatively short time frame, and as I read that, I realize you're probably right. Bummer, eh?

Also, you're right, I was slamming the liquid Vitamins because they're kind of funny tasting. I was thinking all day yesterday that maybe that was a problem and I was considering diluting them with some warm Water so they're not so cold and so I could hopefully sip it a little. So you're reaffirming my hunch.

As long as I can get Protein drinks down tomorrow, I think I'll wait this out and see about letting my body heal and then trying your approach. Hey, at least I can enjoy the extra weight loss in the meantime, eh? :biggrin:

Thanks!

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G-Bear, Thanks for the post. I have been on this site for several months and read a LOT of threads and posts but this is the first time I have heard of this. I was banded on july 31 and have had 1 fill and have had no restriction. I go for my second fill on Oct 10. I guess I am in for a rude awakening! I have been able to eat anything and everything and am trying very hard to maintain my weight loss from pre and post banding. I want to feel restriction very badly but hoipe not to have the symptoms you de3scribe. Good luck and hope this passes quickly for you. Jenhay

Hi Jenhay,

Well, hopefully you won't get this. =) Like you said, there are very few posts about it, so hopefully that means that most bandsters don't get it. Although, I suppose it's possible that some people get it, but don't realize it and instead think they are "just too tight." I know I'm not too tight because when the spasming doesn't happen, I can eat normal bandster amounts of food.

Good luck with your next fill! Be optimistic! :biggrin:

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I have that problem if I eat too soon after I get up. It seems if I move around for half an hour or so first things "loosen up" for lack of a better term and I don't have any trouble.

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I have the same problem, but mine is all morning. My doc says it is because I am dehydrated in the morning. I recently had twins and have to stop drinking at 7 pm or I'm awake all night going. So I have to get some warm liquids in me in the morning and a Protein shake then about 10:30 - 11 I can eat food.

Patti

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Actually, two years out I do still occasionally have problems with "first bite syndrome". Whenever I eat, I am always especially careful with my first bite just to make sure things are going to go down well. After I take that bite, I wait a few minutes to make sure everything is OK before I continue eating. If I find it isn't, then I will drink something hot and that usually resolves my problem and I can continue eating. I have learned that I tend to have more problems with this during TOM, or if I have been particularly stressed. During those times, I usually start off my meal with a cup of something hot, just to help avoid any problems.

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Thank you guys all so much. I got my second fill at the beginning of this month (Sept) and my docs patients do two days clears and then two days full liquids before moving back to food. Well, that night I went into spasm and it lasted all night long. I truly thought my band had slipped. Now I'm about three weeks out from that fill and I still have to have a bite and then wait to see if it will go down.

I thought I was all alone in this. My doc didn't exactly say so, but was somewhat belittling about it - said he had pts. that would "kill" to have the fill I had.

Jack is right, sometimes you have to have a bit of warm liquids before you eat - and go super, super slowly. No matter what - nothing very cold before you plan on eating.

These episodes have lasted for hours when they've happened to me. They are horrible and I'll do anything to avoid them.

Best of luck everybody!

Barbara

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Thank you everyone who has commented so far! I hope more people continue to comment. =)

I've been nursing my Protein drink for a few hours today so far. I get the suspicion the inner wall near my band is sensitive from the spasming over the weekend or something, so I can feel every sip that goes down. I'm going to stick to liquids (and maybe a liquidy soup) today and hopefully tomorrow and see how it goes.

And now I know to be even MORE patient than I already was! Boy, there's patience and then there's slooow patience. =) I need to exercise slow patience. =)

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this is it ... i now realise that my problem is first bite syndrome and not restriction ... the only good things as far as i cna see is that this has helped me loose weight without a fill as the discomfort made me eat less ... not that i want ot keep on having it

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