From This Day Forward

READY TO BE WEDDED TO YOUR BAND?

On a humid May morning 37 years ago, after a four year courtship, I married my first husband. We exchanged our wedding vows in front of a Catholic priest, a Presbyterian minister, and 40 guests consisting of family and friends. We walked out of the church and into our married life with “until death do us part” in our young minds. Six years later, we divorced. Eventually each of us married again, this time to the right partner, and we’re all still happily married today. As the saying goes, practice makes perfect.

It’s practice that will make your “marriage” to your adjustable gastric band perfect, or as perfect as any human endeavor can be. It’s important to know that when you wake up in the recovery room after your surgery, you won’t be magically endowed with all the knowledge, experience, and habits you’ll need to succeed with your band. Even if you did tons of research, faithfully attended every pre-op educational class, and listened closely to and made detailed notes of everything your bariatric team told you, some things – important things – you’ll have to learn through the everyday experience of living and eating with your band.

When you leave the hospital or surgery center after your surgery, you probably won’t be headed for your honeymoon quite yet. That will come later, when you’ve had enough fills to achieve optimal restriction and you begin to feel that your band is really working. The excess weight will start coming off and you’ll walk around in a dreamy pink haze, delighted with your new life partner. You might even give your band a silly private pet name, the way my husband calls me “Love Bug” (which always makes me think of my first car, a chubby little Volkswagen Beetle).

Then one day, the reality of banded life will wake you up. You’ll think, “Who is this creature I’ve married?” And like Jenny, a former coworker of mine, you’ll realize that while the engagement, wedding and honeymoon were exciting and fun, the day-after-day business of marriage isn’t exciting or fun 24 hours a day. It’s hard work. It’s boring. It’s frustrating. It’s humdrum. Jenny divorced her new husband after only three months of marriage not because she didn’t love him, but because she didn’t love being married to him. For many of us, being a wife isn’t nearly as fun as being a bride. One day you’re a smiling princess dressed up in flowers and lace; the next day you’re a haus frau frowning at the skid marks in your prince’s underwear.

I suspect that Jenny just wasn’t old enough or mature enough to be a wife. Neither was I when I married the first time. One of the reasons most bariatric surgeons and insurance companies require a patient to have a pre-op psychological consult is to evaluate the patient’s understanding of what they’ll have to do to succeed after surgery. Are they ready for a lifetime commitment? Do they have reasonable expectations? Can they follow instructions? Are they capable of learning the new behaviors they’ll need for a productive, peaceful partnership with their band?

HABIT FORMING

New bandsters need dozens of new habits – something like 60-70% of my book Bandwagon is devoted to explaining those habits, so I’m not going to try to cram them all into a single article. I’ll pick one at random. Hmmm…how about EAT SLOWLY? How are you going to turn that behavior into a habit that will serve you well for the rest of your life?

So Dr. McMillan tells you, “Eat slowly,” and you nod your assent while thinking, “Get real! I’m too busy to do anything slowly. I have 3 kids and 2 dogs, I work 2 jobs, I take care of my elderly Aunt Bertha, I coach my daughter’s softball team, I have a house to run and a spouse who’s always on the road…” Well, you get the idea. Dr. McMillan has just told you to do something that’s very simple and yet impossibly difficult, you think Dr. McMillan needs to wake up and smell the coffee, and a door in your mind slams shut.

Actually, Dr. McMillan is already awake, has had a cup of coffee, has tended to all 10 of her dogs and all 3 of her cats, is about to leave for the fitness studio, and when she returns she will deal with a home renovation project while running her home-based publishing business off the kitchen table; tomorrow the fun will start all over again, including a 5-1/2 hour shift at her retail job and a trip to the supermarket. She’ll get someone to come look at the leaking French doors, do the laundry, pick another batch off ticks off the new dog, and cook several meals. Dr. McMillan’s friend Nina calls her the “Tennessee Tsunami”, and despite all that, Dr. M. still manages to eat slowly every time she sits down to a meal. As a pre-op, it took her maybe 5 minutes to hoover her way through a meal that would feed a farmhand, and now it takes her 5 minutes to chew her way through the first bite.

But that EAT SLOWLY habit (or any other habit) didn’t become a habit for me overnight. It takes many, many repetitions to turn a new behavior into a habit (a British study found that it takes anywhere from 18 to 254 days of daily repetition to make a new behavior “automatic”). I know it’s a big challenge, especially when you’re also trying to learn a few dozen other new behaviors and turn all of them into habits while somehow conquering the dozens of bad habits you already had, but I assure you, it’s worth the effort.

MIND OVER MATTER?

Sometimes the biggest stumbling block in changing my behavior isn’t the behavior itself – it’s me and my stubborn, willful mind. I rarely have a valid reason to refuse a new, healthier behavior, whether it’s a small thing like putting my fork down while I chew each bite, or a bigger thing like always wearing seat belts in the car. My brain stomps its feet and cries, “I don’t WANT to do it!” I have to ease into the new behavior gradually, so that I don’t become overwhelmed and end up crying, “See, I TOLD you it wouldn’t work!” So although part of me knows that this is a huge, lifetime deal, I dole out the changes in small pieces, one day at a time, one hour at a time, one minute at a time. If I live as long as my mom did, I have another 32 years of eating ahead of me. I eat 6 times a day, 7 days a week, so if my arithmetic is correct (no guarantees there), I have another 69,888 meals to chew my way through. That is a truly mind-boggling number, so I’m tackling this task one meal at a time, and I suggest you do the same.

I also suggest that you tackle one behavior at a time. Even simple things can become too complicated when you try to do them all at once. Last year, I bought a new cell phone. I hate the telephone and always have; as far as I’m concerned, cell phones are the work of the devil. I chose a phone with far more capabilities than my old one. It seemed like a dandy little gadget when the sales associate was demonstrating it, but when I’d had it a week, I had to return it because (as I told the puzzled 20 year-old who processed the return), I simply could not deal with a device that required me to hop on one foot while patting my head, rubbing my tummy, and singing the “Star Spangled Banner” in order to send an e-mail.

So sitting down to each post-op meal trying to remember whether you’re supposed to hop, pat, rub, or sing is a set-up for failure. Better to pick out one new behavior as this week’s challenge. Next week, add another new behavior to your repertoire. The week after that, another one. During that time you’ll be repeating all the new behaviors as you slowly add new ones, and gradually the behaviors that were new become old…in other words, they become habit, and you won’t have to think about them much if at all. When I was a little girl, my mom had to remind me to brush my teeth every day, but eventually the tooth-brushing became an automatic part of my routine.

If I were in a car accident (God forbid) and suffered a spine or brain injury that erased all my old habits (good and bad), I’d have to start it all over again. I’d probably festoon my house with reminder notes: BRUSH TEETH on the bathroom mirror; EAT SLOWLY on my placemat; FEED DOGS (well, maybe not – the dogs come complete with their own extremely reliable and audible meal reminder system). That’s a lot of work, I know, but the pay-off is enormous!