Jean McMillan

Unfortunately, weight loss surgery happens in your stomach, not in your brain. And yes, even though WLS should make weight loss easier, it's still hard. Making your band tighter and tighter is not going to speed up weight loss or banish those demons who tell you a glass of wine and handful of potato chips and 2 Cookies are OK, just this once. There is no such thing as just this once. That was true for me before WLS and it's still true now, 6 years and 100 lbs. later. Also, you sure don't need a tighter band if you're having eating problems at your current restriction level. I think right now you need to stop worrying about weight loss and start concentrating on good food choices and good eating skills (take tiny bites, chew very well, eat slowly, etc.). Making good food choices means choosing foods that are good nutritionally and are good for satiety. In other words, emphasize solid foods and avoid slider foods (soft and liquid calories, plus crispy carby stuff like crackers, chips, etc.). You'll have to experiment with food preparation to make things like chicken, fish, or whatever more band-friendly. I can't eat chicken or turkey breast, but I can eat dark meat if it's prepared in a way that doesn't dry it out. Broiled, grilled, or microwaved meat/fish/poultry can be a problem for me, but baking or braising with some liquid (like broth) or sauce can make all the difference. A little bit of sauce, gravy, salad dressing, salsa, etc. can add flavor and make the food easier to get down. Just don't drown the food in it! One more piece of advice - something you already know, but I want to reinforce it. Drinking wine every night is the first thing you need to address. Alcohol is not only liquid calories with no nutritional benefits; it also makes foolish food choices and hours of grazing seem like splendid ideas. Hang in there!

That young lady may be suffering Last Meal Syndrome or I'll Start My Diet on Monday Syndrome - she's planning to eat and drink anything she wants right up until she gets wheeled into the OR. Then wake up and make dozens of lifestyle changes overnight. Also, it does seem like some folks believe that liquid calories don't "count".

My husband has a coworker who's addicted to Baskin Robbins Cappuccino Blasts. This guy confessed that last weekend, he made a 30-mile round trip drive to get the jumbo size...FOUR TIMES!

Yeah, tighter isn't always better (did you read my recent article about that? http://www.lapbandtalk.com/page/index.html/_/support/post-op-support/tighter-isnt-always-better-r118 Ice cream is a problem for me, too. Tastes wonderful, goes down all too easily!

My brother is a highly intelligent man. This was proven decades ago, when IQ tests (performed while his teachers and parents tried to figure out why he was a miserable little bugger) showed a genius level IQ. I know that sentence sounds unsympathetic to my brother, but we were all miserable - our parents, his teachers, me, and my brother. The decades that have passed since then haven't given him any more common sense or made him any less miserable. A good example of that is his reaction when I first talked with him about my weight loss surgery. This highly intelligent and (by then) well-read man said, "Wow! So, you have the surgery, and then you eat anything you want and you still lose weight!" Well, no, I told him. Not really. In fact, nothing like that. During the 6 years of my weight loss surgery journey, I have (over and over and over again) witnessed bariatric patients who came out of the operating room after surgically successful procedures still wondering why they couldn't eat anything want and still lose weight. Their disappointing weight loss was and is a perpetual puzzle to them because somehow they had not grasped that behavioral change is required for weight loss success. It's easy to label those patients as stupid or ignorant or deluded, or to blame their bariatric team for failure to properly educate those patients about what would be required of them both pre- and post-op. All of those things could be a factor. In March 2012 I attended 2 sessions of a required pre-op nutrition and education class. My BMI then made me obese, but not morbidly so. I had gained weight after a complete unfill and was preparing to say goodbye to my beloved band due to medical problems aggravated by my band, planning to revise to vertical sleeve gastrectomy in the same procedure. The dietitian leading the class was a perky, pretty 20-something girl, adorably pregnant, who had clearly never struggled with her weight before. Her slightly condescending attitude was hard to take, but about halfway through the class I thought I could understand her attitude. She had just named a long list of foods we should not eat after surgery (including fried foods, candy, baked goodies, soda, alcohol, salty snacks, etc.) when I heard a woman nearby say bitterly, "I don't know. That seems like an awful lot to give up." Since I had known the before and after of WLS, I was strongly tempted to respond to her, but I held my tongue (wisely, for once). I don't know just why so many people think that WLS is magic, that you can eat anything you want and still lose weight; that you don't have to give up a single food or behavior or attitude in order to succeed. Maybe we can blame that kind of thinking on the media, or maybe we can blame it on the deeply-entrenched denial that tends to go along with obesity. But the fact is, you can't eat anything and still lose weight unless you're dying of cancer or AIDs or some other fatal disease, and probably don't want to eat a single bite of anything anyway. And I'd trade dying of cancer for WLS sacrifices and success any old day, wouldn't you?

As a kid I had to clean my plate, and I would've cleaned anyone else's plate if they didn't want to. But my mom would watch me eat, starting with my least favorite food, and say, "You'd better not save the best for last, because you never know when your plate will be snatched away from you." I know she meant well, I know she loved me, but that was a crazy thing to say to a little girl. No wonder I felt I had to gobble up every last morsel of food.

Give your dad a big hug for me!

I have a (normal weight) coworker whose obese daughter is taunted and bullied at school every single day. According to the daughter, kids do that in front of teachers and the teachers do nothing to intervene.

When I was in 4th or 5th grade, my gym teacher weighed and measured the height of every kid (boys & girls) in my class. When she was done, she announced to the class that Jean was the shortest and heaviest student in the class.

I think some of that has to be blamed on the absence of or inadequacy of pre-op psych evaluations.

I belonged to the CPC (Clean Plate Club) for over 50 years, so I consider myself something of an expert on it (and I am, after all, The World’s Greatest Living Expert on Everything). I thought it was a lifetime membership, but my bariatric surgeon rescued me from the CPC Cult – oh, excuse me, Club - and deprogrammed me so that I’m able to function more or less like a normal person now. Here’s my story. I was inducted to the CPC as a child, when I was too young to realize that the promise of going to heaven if I always cleaned my plate was a bit more complicated than it sounded at the time. All I wanted to do at the time was to please the cult leaders: my mother and my grandmother. I have reason to believe that my grandmother, whom I called Dranny, was the original founder of the CPC. Orphaned as a small child, she was passed around the family like a piece of unwanted furniture, and she raised her own children during the Great Depression. Through the combination of those circumstances and her own peculiar (and wonderful) character, Dranny was a pack rat. She didn’t live in filth and disorder (just the opposite, actually), but she couldn’t bear to throw anything away, especially not food. If three green peas were leftover from a meal and she hadn’t been able to persuade someone to eat them, she would lovingly place them in a custard cup covered with a shower-cap style cover (this was in the days before Glad Wrap), and store them in the fridge, where they would remain until someone ate them (or my mother threw them out while Dranny was in another room). I’m a lot like my grandmother in various ways, and also something of a pack rat. So after eating my way through hundreds of childhood meals with Dranny and my mom (who was not a pack rat, but who was offended by the idea of wasting food that she’d worked so hard to procure and prepare), I emerged into adolescence with warring impulses – part of me still wanted to clean my plate, and part of me wanted to starve so that I could lose weight and be as skinny as the British supermodel, Twiggy. 101 WAYS TO CLEAN YOUR PLATE One of my problems with meal planning and storage is that it's hard for me to predict how much food I'll be able to eat at a future meal. Often I don't know that until I've eaten several bites. My basic strategy for dealing with this unpredictability is to keep my plate clean from the very start so that the food I leave behind doesn't overwhelm me or provoke an attack of guilt that could bring down Dranny's loving wrath upon me. A simple way to keep your plate clean is to prepare smaller batches of food so you won't be tempted by serving dishes overflowing with food or burdened with an excess of leftovers. I can't speak to recipes for baked goods (not my department), but most other recipes can be easily cut in half, thirds, or even quarters through the use of simple arithmetic. Sometimes I prepare the whole recipe, subdivide into 2 or 3 batches, serve one batch immediately and freeze the other 2 for future use. When we lived in the northeast, the elderly widow who lived next door was delighted when we shared excess food with her. Sharing food with family, friends, and coworkers can yield multiple benefits. When I'm craving a food or recipe whose leftovers would be a problem for me to store (or resist), I prepare a big batch of it for whatever social event is on the horizon and keep only one or two portions of it at home so that we get to enjoy it without having to worry about to do with all that food. I use cheap, recycled, throw-away packaging so that no one can insist that I take my corning ware, Pyrex or Tupperware container of leftovers home with me. You can also keep your plate clean by using the portioning technique I recommend for bandsters who are still learning their band eating skills, food portion sizes, and stop signals. Here's how it works for me. When planning my day's food (which I commit to my food log and my accountability partner every morning), I might decide that I'll eat 4 ounces (by weight) of chicken thigh and 1/2 cup of barley and veggy salad for dinner. Come dinner time, I grab my small plate (a salad plate) and put half of my planned meal on it: 2 ounces of chicken and ¼ cup of the salad. If I'm able to finish that, great. If I'm still physically hungry when I'm done with it, I go back to the kitchen and dish up the remaining 2 ounces of chicken and ¼ cup of salad. At the end of the meal, I'll probably have only 1 or 2 tablespoons worth of food to save or throw out instead of a plateful of food, therefore much less guilt to deal with. When I do have a plateful of food leftover, I usually scrape it into a small plastic container that I can quickly grab and stick in my lunch bag when I go to work the next day. Fortunately, we actually like leftovers at our house, and arguments occasionally break out over unauthorized consumption of leftover food ("Who ate the rest of the eggplant Parmesan?!?"). The same approach works with restaurant meals. We're happy to take leftovers home in what used to be called a doggy bag (as if I'd share my Maryland crab cakes with a dog!). My sister-in-law used to scrape leftover food into a bucket to add to her garden compost pile. I have no idea if that's a good practice. We'd have to have a 40' high electrified fence dug 20' into the ground and topped with razor wire in order to keep dogs, cats, deer, rats, raccoons, and other critters out of that kind of compost pile. I've also known people (including my mother) who fed leftover food to their 4-footed garbage disposals (dogs & cats), another practice that we avoid because why would you want to cultivate a fussy eater? Our pets have survived eating (stolen) candies (complete with foil wrappers), latex paint, and kip tails (fishing flies), and at our house, a fussy eater will end up starving because someone else is always willing to clean your plate for you, sometimes long before you've decided you're finished with it. BUT WHAT ABOUT THE STARVING CHILDREN? After over 6 years of post-WLS life, I'm now better able to detach myself from my emotional attachment to the food on my plate enough to throw out what's left. If it didn't taste right because my tummy was in an odd mood, if it caused me eating problems, if it wouldn't reheat or store well, I let it go. I haven't been struck by lightning for doing that, nor has God punished me with plagues, floods, or infestations (apart from the dog infestation, that is). Like many, I was raised to eat every meal while listening to a chorus singing the Children Are Starving in (fill in the blank) hymn. I agree that in world where so many children (and adults, and animals) go hungry, it is just plain wrong for an overfed middle-class person like me to waste or throw out food. But the fact is that me eating more food than my body needs (rather than throwing out) is not the solution to the problem of world hunger. The solution to world hunger, and to diminishing global food resources, is far, far more complicated than that. Working in your community (be it a village, a city, a country, or a planet) to solve that problem is a worthwhile effort, but you taking personal responsibility for causing the death of a starving, unknown child in India or Appalachia because you threw out a chicken wing and 5 green beans last night is (in my opinion) a misguided and foolish use of your energy. And you eating that extra bite of food just because you can't bear the thought of throwing it away is also foolish from a medical standpoint. If that extra bite causes you to PB, get stuck, or over-pack your pouch, it could lead to messy and expensive medical complications like esophageal or pouch dilation and/or band slips, especially if you eat that way on a regular basis. Finally, as long as overeating endangers your health through co-morbidities and through disrespecting your band, you may never be able to help deal with the hunger problem, whether on an individual, local, or global basis. So, first things first: make a top priority of eating sensibly for your own sake before you tackle the rest of the world.

When you say that your stomach hurts, do you actually mean your abdomen (the cavity that contains your stomach, liver, pancreas, intestines, etc.)? Or do you mean your stomach as in the organ, whose fundus (curved upper area) and your band are located (roughly)in area of your chest? If you're feeling pain in your chest, my guess (and it's only that, because I'm not a doctor) is that you're having esophageal spasms. It could also be a cardiac symptom. The vagus nerve that connects your stomach to your brain is also responsible for heart function. The band presses against the vagus nerve (thus sending satiety messages to your brain). Even an empty band can affect esophageal and vagal functions. You may be one of the unfortunate people who are very sensitive to the band. Also, you may be unwittingly perpetuating the symptoms if you continue to eat after experiencing a PB, sliming, or stuck episode. Following a liquid diet for at least 24 hours after an eating problem can help everything in there calm down. Since you've been having these problems for so long, it could be helpful for you to follow a liquid diet for 1-2 weeks. Did you have a hiatal hernia when you were banded? I ask because I have a hiatal hernia that my original surgeon did not repair (as he had promised) during my band placement. It's a hernia I've had for about 20 years. When it's bothering me, I feel a pinching pain on the left side under my ribs, which is one location you've identified as painful. The only treatment for a hiatal hernia is surgical repair. Nothing - not pain relievers, heating pad, ice pack, nothing - has ever relieved my hernia pain. Fortunately it comes and goes. If you didn't have a hernia at the time of your band placement, you could have developed one since then. The other things important to know about untreated/undiagnosed hiatal hernias is that they are associated with band slips and are extremely common in people who are obese and/or who suffer from reflux. According to my current surgeon, an upper GI study will not necessarily show a band slip. Finally, I agree with jad0264. Don't let medical professionals pooh-pooh your problems. I believe patients have to be very assertive advocates for themselves. If your current bariatric surgeon is unable to help you, I would seriously consider getting a 2nd opinion from another surgeon. Good luck!

My band slipped in June 2009, when I was about 21 mos post-op. The blog post whose link I posted on this thread has nothing to do with that. The damage from decades of reflux was diagnosed in January/February 2012, when I was 4-1/2 yrs post-op. My surgeon and gastro doc agreed that my band was aggravating the situation. My band was removed in April 2012 and I revised to VSG in August 2012. The blog post whose link I posted on this thread describes my 2012 experience. The OH post you quoted sounds familiar but I don't remember when I posted it. Probably in the spring of 2012, at which I point I may not have had all the test results and gastro consults done and was therefore not in possession of all the facts. I'm flattered because you must have done quite a bit of digging to find it. Or you've been saving it all this time, waiting for the opportunity to quiz me about it. Anyway, I'm sorry if I confused you. Yes, my band slipped, and yes, I had damage from 20+ years of reflux, and yes, I had general band problems related to reflux.

Are you saying you had small sharp pains and an achy/sore feeling? When? Before the unfill or after? Where exactly were the pains, aching and soreness? In your abdomen? Upper, middle, lower, left, right? I had a band slip, diagnosed after a sudden attack of reflux and eating/drinking problems. I felt absolutely nothing when all the fluid was removed from my band. The nerves in the upper GI system are kind of quirky and don't process stimulus the way nerves in your skin do (for example). When you cut yourself, you feel pain at the site of the cut. When the band presses against the stomach or the diaphragm, the sensation may be "referred" to another area - commonly the left shoulder. Anyway, I did feel relief after the unfill and was able to eat and drink normally the next day.

It's a long story. I wrote about it in a blog post here: http://jean-onthebandwagon.blogspot.com/2013/03/a-lot-of-people-especially-those.html

I think you need to talk to your dietitian about it, but it sounds to me like you really need to work harder at getting in more protein. It doesn't have to be animal protein, though that would help bring up your iron levels. Have you tried fish, shellfish, tofu, seitan, tempeh, etc? As for your metabolism - I think there are ways to test that, including checking your thyroid function.

You might want to rethink putting your band back in the box after you've lost weight. People who lose weight and have their band removed (for whatever reason) are very likely to regain all that weight. That's mostly because obesity is a chronic,. incurable disease.

Well, Jackie, I was fascinated to see in your profile that you are now 98 years old. That has to make you the oldest troll in the history of the Internet. I can see why you're so proud of yourself. If your parents were still alive, I'll bet they'd be mighty proud of you too.

I don't know what normal is, but I can tell you that I was starving hungry the day after my band surgery, and I've heard plenty of other bandsters say the same thing. In some patients, the swelling and irritation from surgery decreases hunger and appetite, but not in everyone. So you're in what we not-so-affectionately call Bandster Hell, and you'll have to white knuckle it until you get enough fill in your band to help it start working for you. That may take more than 1 fill, but in my opinion it's better to sneak up on restriction than to jump on it all at once. The other thing that may be affecting your hunger is your post-op diet. Most of us have to follow a staged diet progression, from liquids to purees to soft foods to solid food. If you're not on solid foods yet, your physical hunger could be due to the fact that solid food has the best potential for providing the early and prolonged satiety that's the band's claim to fame. Hang in there!

This is Memorial Day weekend – a time of picnics, cookouts, and other food-centered fun – and a time to remember the past sacrifices of fellow Americans who serve(d) in the military, and to thank them for their service to our country. It’s also a good time to remember the fat girl or guy we once were. I used to cringe when I saw photos of Fat Jean, but now I want to hug that unhappy girl and tell her that life is good. When I look in the mirror now, I see a "normal" sized woman who strangers would never guess had once been morbidly obese. I think we all need to remember where we came from, and to forgive ourselves for our pre-op weight loss failures. But halfway through the first sentence of this article, I thought of an equally important aspect of Memorial Day that turned this article's theme upside down. The meaning of "lest we forget" is more complicated than you might think. It represents more than three sappy words and planting a flag and a geranium on your grandfather's grave. It expresses an important message for a bariatric patient like me and you. The phrase "lest we forget" forms the refrain of "Recessional," a poem by Rudyard Kipling (1865-1936). It warns about the perils of hubris and the inevitable decline of British imperial power. After World War l, "lest we forget" passed into common usage as a plea not to forget past sacrifices and was often used on war memorials and as an epitaph on tombstones. So it’s an appropriate title for a Memorial Day article. Hubris is the extreme haughtiness, pride and arrogance that makes us think we're as invincible and all-powerful as Great Britain thought it was back in the days when it was taking charge of big countries (India) and small (Singapore) all over the world. One of my jobs in life is to resist the urge to be conceited about my weight loss success and to remember that I’m not invincible. I don’t ever want to lose sight of the fat girl deep inside me who's just waiting to get out again. Losing 100 pounds is such an enormous accomplishment that at times it seems like the most magnificent and significant achievement of my entire life. I'm justifiably proud of that achievement, but having weight loss surgery is not a guarantee of continued weight loss and weight maintenance success. As a boss once told me on the occasion of my promotion to management, "Remember, you're only as good as your last act." In other words, my great performance won me a place on the stage, but I'm going to have to repeat that performance over and over again in order to stay on the stage. WLS is a wonderful tool that will improve my ability to manage my weight for another 30 or 40 years, but it doesn't make me bullet-proof. Weight loss is no longer the centerpiece of my life, and I think that's a healthy thing. Some days I even ask myself why I'm still writing about eating, obesity and weight management. Why can't I let go of it? What will happen to me if I run out of things to say about it? But while I'd like to know the future, or at least know it will be a happy one, a long, straight road with the same scenery for mile after mile sounds boring to me. I'll stay on this road, with its twists and turns and steep hills, and trust God to keep me from getting too far off course. Writing about obesity is one of the things that keeps me going in the right direction. When other bariatric patients ask me questions about how to live and succeed with the adjustable gastric band, it forces me to think, and being forced to think is much healthier, and more interesting, than switching on the cruise control for the rest of my life. Along the road to your weight goal, I hope that you, too, will be able to acquire new interests and activities that you can take with you into your new life as a "normal" weight person, but don't forget to look backward every now and then. Don't throw out all the fat photos and fat clothes. They're memorials to your past obesity.

My nutritionist is a skinny minny also, but that doesn't mean she's not qualified to teach me about nutrition. And what you eat is directly related to your weight, so sending you to see her was actually a good idea. What's wrong with tuna on cucumber slices? Do you not like tuna or cucumber? What else did you expect her to say? She's not a doctor and isn't qualified to advise you on medical or surgical issues. There are far too many factors that could be affecting your disappointing weight loss to address in a single forum thread. I just want to reiterate that giving up on yourself and your band now is literally throwing away that $16,000. Don't you believe that you and your health are worth some extra effort? Finally, I think it's extremely rude of people to play with their cell phone when they're supposed to be giving another person their attention. I suggest that you call her on that should you ever cross her door again. I can give you suggestions for ways to say it that will solicit her sympathy instead of turning her off. Just let me know if you need help with that or anything else related to your WLS journey.

I'm sorry to hear your band experience has been disappointing. It sounds like you've given up on yourself. Why? If I spent $16,000 for WLS, I'd be determined to stick it out come hell or high water. But like many Scotsmen,I'm extremely stubborn. Have you considered getting a 2nd opinion from a different bariatric surgeon, perhaps one that has a better post-op education and support program?

So, have you lost any weight in the past 4 weeks? Weight loss isn't actually the result of a fill. It's the result of consuming fewer calories than you burn (or burning more calories than you consume). Getting fills will make that easier for you because you will experience early and prolonged satiety (the sensation of having eaten enough food, which is not the same as feeling "full"). Also, keep in mind that just because you feel like your band isn't working yet (if that's the case), that doesn't mean it isn't working. I lost weight before my first fill because I was following my dietitian's eating plan to the very best of my ability.

I'm with Carolina Girl. That was a big, big stumble but it's history now. Stumbles like that are probably part of what made you obese enough to qualify for WLS. It's good that you recognized it as a stumble instead of saying, "So what?" Learn from this mistake and move on. You can do it!

I can sympathize because I know from personal experience that it can be hard to concentrate on good band eating skills when you're in a restaurant or other social situation that involves food and conversation. Eventually you're going to have to master that, but in the meantime you can play it safe with soup or the softer foods mentioned by the other people who've responded to your question. My personal favorite is to order crab cakes (usually found on the appetizer menu). I love them anyway, they're easier to eat, but more satisfying than soup.