Jean McMillan

I know just how you feel. When I was obese, I just did not see anything below my chin when I looked in the mirror. I could only see how big I was in photographs....and I avoided that as much as possible. But one day you'll be glad you have those before photos, to show you how far you've come.

I'm not a low carb gal, but I want to share a great website for low carb recipes: http://www.ibreatheimhungry.com/ This blogger is an inspired cook and a great photographer. You will drool when you see her dishes!

"Soft stops" can be subtle and may not happen consistently. Watch for a sigh, a sniffle, , a hiccup, a burp (or the need to burp), fullness in the back of the throat, the urge to take a deep breath, watering eyes, runny nose, excess saliva, the urge to cough or clear the throat.

The fact that you can recognize already that weight loss surgery is just a tool, and not magic, means you're already on your way to success. I like #3 on your list. I'll carry your bags for you, if you want.

When did the feeling start? During a meal? After a meal? Out of the blue? For me, a sense of fullness or pressure at the back of my throat could be a satiety signal (that I've had enough to eat and should stop). When it feels bigger, like a lump, that's a sign that I've overeaten. As I understand it, the sensation comes from your esophagus. It means that food is sitting in your esophagus (which is designed to transport food, not store it) and your esophagus is unhappy about it and possibly spasming to get rid of it.. Are you able to drink Water? You could try taking a few sips of a hot liquid, but stop if that makes the lump feel worse. If it gets worse and/or you can't drink Clear Liquids, call your surgeon's office.

Nicole, I'm so sorry you had to go through that. Please don't beat yourself up over regaining weight. I had to say goodbye to my band 3 weeks ago and I've regained also. My band was removed because of a congenital problem with my esophagus that contraindicates the gastric band, so eventually (when my esophagus is sorted out) I hope to revise to the sleeve. People often say that the band is the least invasive of bariatric surgeries, but let's face it. Any surgery that requires the patient to be anesthetized while a surgeon cuts holes in their abdomen, pokes instruments into those holes, and implants a medical device, is pretty invasive. People also say that the band is good because it's removable. Well, that's true, but it doesn't mean that removing it is easy and safe. RNY is reversible, if need be, but that doesn't mean it's easy or safe. So I guess you have to choose the lesser of the evils. I think we'd all like to say we can lose and maintain our weight on our own, but if we had a big enough problem that we qualified for weight loss surgery, it's not likely that another attempt to do it "on your own" is going to work longterm. On the other hand, presumably you've acquired some healthier habits since being banded, and can rely on those now, at least until you're healed and ready to consider a different surgery. Good luck!

RUN, SPOT, RUN! The phrase "sweet spot" pushes me into my swirling stream of consciousness, where I hear: Sore spot, hot spot, weak spot, sweet spot. Spot the dog. Run, Spot, run! That's what the bandster sweet spot does. It runs ahead of us, wagging its tail, taunting us, "When you catch me, you're gonna lose weight like never before! But first you gotta catch me!" And off it goes again, dangling that precious weight loss carrot just out of reach while we follow, huffing and puffing and worrying that we may never catch our errant Sweet Spot. What if we don't? Will our weight loss surgery be a waste of time and money? Sweet spot. Just two words. Short words, endearing words, simple words, but loaded words. For such a little phrase, the sweet spot is a very big deal. But is it real? Is it even possible? I can think of other little phrases that are also big deals, and after several decades as a voting citizen of the United States of America, I have to wonder if they're just a dream. World peace. Cancer cure. Justice for all. Sweet spot. THE ELUSIVE SWEET SPOT The concept of a sweet spot was unknown to me until I shortly after my Lap-Band® surgery. It's not a term exclusive to bandsters. In tennis, baseball, or cricket, a swing will result in a more powerful hit if the ball strikes the racquet or bat on its "sweet spot". In the world of music recording, the sweet spot is the focal point between two speakers, where a listener is fully capable of hearing the stereo audio mix the way it was intended to be heard by the mixer. In general terms (that might make more sense to those of us who are athletically or musically challenged), a sweet spot is a place where a combination of factors results in a maximum response for a given amount of effort. That's exactly what we're hoping for when we have weight loss surgery, isn't it? After years of useless struggle and unsuccessful dieting, we want to expend the least possible effort for maximum weight loss results. Unfortunately, there's a trick phrase hidden in the paragraph above: a given amount of effort. It's not “no effort”. A given amount of effort…but an undefined amount. How much effort? How long, how often? Does making the sweet spot work for us take an hour a month, a week, a day? In Bandwagon, I wrote that the sweet spot is a myth that does bandsters a great disservice because it's a mistake to think of restriction as a single point (or sweet spot) on a line. Let's pretend that you've found your sweet spot. It looks like the diagram above. Can you balance on it indefinitely, like the green triangle poised on one precarious corner? I couldn't. All it would take to knock me off that little spot is a strong breeze, and if I had to devote all my attention to keeping my balance, I wouldn’t be able to make good use of the imperfect but quite useful areas to the left and right of my sweet spot. It’s more useful (and balanced) to think of restriction as a range, not a single point, with the sub-optimal yellow zone (not enough restriction) to the left and the sub-optimal red zone (too much restriction) to the right. According to Allergan, the band's optimal performance is in the middle “green zone,” where to greater or lesser degrees you experience early and prolonged satiety and reduced appetite and hunger. Now let’s try thinking of restriction as a river or stream that flows along, sometimes slowly, sometimes fast, and sometimes it's quite still. If you try to catch that river water in your hands, crying, "This is it! My sweet spot!" the water will run through your fingers. If you step into the stream, your restriction is with you all the time, sometimes optimal, sometimes sub-optimal, but always there. DOWNSTREAM WITH JEAN Does my stream analogy sound too much like something Yoda would tell Luke Skywalker? I'll climb out of the stream now, shake off the water, and tell you about my own "sweet spot" experience. The #1 thing I want you to know is that you can lose weight without ever catching hold of your sweet spot. I lost 100% of my excess weight (90 pounds) in my first year post-op, with far less restriction than I had later on. Except at the very beginning, when everything about banded life was a mystery to me (including the Green Zone poster at my surgeon's office), I didn't have a lot of anxiety about whether or not I'd found my sweet spot because I was losing weight without even knowing what my sweet spot looked like. I didn't have to starve myself or take diet pills or any of my rarely effective pre-op weight loss techniques. My band was most definitely helping me even though sometimes I felt as if I didn't have a band at all. As time went on, I sometimes took my band for granted, and only when I had to have unfills to treat symptoms of careless eating or overeating did I realize how much my band had in fact been doing for me. After each unfill, my appetite and my physical hunger immediately increased, which both scared and pleased me. As in many things, it was a matter of perspective. One day I whined about getting hungry 3 hours after eating and being able to eat 1 cup of food. The next day (after the unfill) I whined because I got hungry 1 hour after eating and was able to eat 2 cups of food. There's a popular saying that claims you never appreciate what you have until it's gone, and that's certainly true for me. Hearing my story, you might want to argue that before those unfills, I had reached my sweet spot and just didn't know it. That's entirely possible. After all, how would I know what the weight loss sweet spot looked or felt like? I'd never been there, never held it in my hot little hands - I probably wouldn't recognize it any more than I'd recognize the mayor of Kansas City or the invisible line where the Eastern time zone ends and the Central time zone begins. Of course, one of the reasons we choose WLS is to make losing weight easier. When people criticize WLS patients for "taking the easy way out", I want to laugh and then scream. Of course I chose the easier way, that's the whole danged point! But at the same time, it's not as easy as you might imagine. It's not magic! Losing weight "the hard way" hadn't worked for me, so it wasn't unreasonable of me to want my band to work perfectly right from the start. If it didn't work that way, I really can't complain (much). After all, I didn't learn how to ride a bike, multiply 9 x 7, or play the piano on my first try either. And if I'm completely honest, I'm not sure I would have been able to handle it if I arrived at my so-called sweet spot the day after my surgery or even after my first fill. One of the reasons most surgeons administer fills in small amounts over a period of weeks or months is so the patient can gradually become accustomed to the change in their body and eating, and thereby avoid unpleasant side effects and complications. If I had walked out of the hospital on September 20, 2007 with as much restriction as I had 3 years later, and with virtually no practice of band eating skills, I would've been calling my surgeon the next day, crying, "Take this thing out of me!" Since I'm an extremely stubborn person, I needed plenty of time to adjust to everything going on in my life after surgery. In the year it took me to reach my weight goal, I learned perhaps 50% of what I needed to know to manage my weight for the rest of my life. I hadn't once heard the Sweet Spot bells chiming, but I was mighty happy with myself and my band. I had changed a lot, in my mind, heart and body. Just standing in that river of restriction, going with the flow, was such an enormous improvement over my pre-op life, all I could feel was gratitude.

That's actually a 2-part question. There are foods that you shouldn't eat, because they're not healthy, contain empty calories, don't meet your nutritional goals, and/or don't provide satiety. Then there are foods that you may not be able to eat at various points (like bread, fibrous veggies, dry cooked meats, apple skins, etc.) because it's so hard to chew them enough to get them past the band. Carbonated beverages should be avoided because the carbonation supposedly can dilate the stomach (same goes for straws) and because the carbonation can be extremely uncomfortable for a bandster. Alcohol is empty calories that loosen your inhibitions, so that eating potato chips or Cookies or whatever seems like a great idea. Alcohol and caffeine can be gastric irritants. food tolerance is very individual and it changes often. Surgeons' and dietitians' nutritional instructions vary widely, and so do bandsters' willingness and/or ability to follow those instructions. None of us are perfect. So it's hard to come up with a single plan for "how to do it the right way". The best approach is to follow your surgeon's and dietitian's instructions. If they don't give you instructions, ask for them. If you don't understand their instructions, ask for clarification.

Jerky (beef, turkey) Protein Bars Granola bars Tuna salad "kits" Canned fruit (single serving) Single serving starchy goodies (cereal, crackers, cookies) Have fun!

There's nothing in a fill that will magically make you lose weight, unfortunately, and it often takes several fills to achieve optimal restriction. And yes, just 1 cc can make a big difference. Please try to avoid eating a big plateful of food. Doing that can overload your esophagus and stomach and eventually cause your band to slip. If you're physically hungry between meals, have a small healthy snack. The best foods to eat (with or without restriction) are SOLID foods because they provide the most satiety. Avoid soft or slider foods (milk, yogurt, cottage cheese, crispy crackers or chips, mashed potatoes, pudding, ice cream, milkshakes, Protein shakes, fruit juice or smoothies, scrambled eggs, anything pureed). Emphasize solid animal protein, fish/shellfish, soy/tofu, hard-cooked eggs, beans; non-starchy vegetables & fruits; and whole grains (brown rice, bulgur, barley, quinoa, thick crackers (like Wasa). You're actually doing fine. You're making good lifestyle changes with better food choices and exercise. I know it's frustrating to be stalled like this, but hang in there!

Here's another week of dinner menus to inspire you, including the page numbers for the recipes in my cookbook, Bandwagon Cookery. Enjoy! SUNDAY Mini meatloaf Italiano (p. 260) Cheesy potato & veggy mash (p. 321) Cooked green veg of your choice MONDAY Chicken & white bean stew (p. 170) Leafy green salad TUESDAY Deviled halibut (p. 272) Carrot & craisin salad (p.193) Orange bulgur pilaf (p. 208) or bulgur cooked in broth WEDNESDAY Meaty ricotta casserole (p. 235) Marinated zucchini Italiano (p. 323) Pasta (optional) THURSDAY Roasted veggy & cheese thin crust pizza (p.237) Leafy green salad FRIDAY Cioppino fish & shellfish stew (p. 176) Crusty bread (optional) or baked pita chips (p.156) SATURDAY Tofu & veggy cannelloni (p. 294) Roasted green beans (p. 312)

Well, you've had a little band vacation, and now it's time to get back to work! First of all, consider getting another fill. If you don't know how many cc's you had before the unfill, ask your surgeon or the person who does the fills. Then ask for a fill that's not quite as much as that. For example, if you had 8 cc's and they took out 1 cc, ask for a fill of .5 cc (that's just an example - there's no magic fill amount that will get you going again). Then, pick one thing to change about your behavior. If you've been drinking alcohol, that would be a good place to stop since alcohol is empty calories and loosens your inhibitions so that a bag of chips or Cookies looks like a dandy idea. When you've got that behavior under control, pick another one, like exercise. It might help if you found yourself a "jalkwing" buddy who'll expect you to show up to walk/run at a given time, and keep you company while you do it. Then pick another behavior, like eating sugary stuff. Go through your kitchen, pantry, fridge, freezer, car, desk, locker, or wherever else that stuff might be stashed. Throw out opened packages and donate the unopened ones to a food bank or neighbor or friend. You can do it!

You can click on my Bandwagon ads here on LBT (you may have to wait for them to cycle onto your screen because the ad spots are shared with other advertisers), or you can go to jean-onthebandwagon.blogspot.com and look at the purchase options on the left hand side of the screen. Thanks for your interest!

I'm sorry you had to go through that and are facing a few weeks without much restriction, but I think your doctor did the right thing by pulling plenty of fill out. With symptoms like you were having, leaving it alone could lead to a band slip. I've had unfills of all sizes (including complete unfills) and have to be honest: I gained weight while waiting to get more fill again. But once my restriction was back, I lost that regain. Good luck!

What part of your back is sore? If your legs ache, I would wonder if it's related to a blood clot, but that probably wouldn't be in both legs. I hope you've been able to contact your doctor by now. Good luck! Jean

You're very welcome!

If you can drink liquids without problems, you're OK for now. When you first get a fill, the increased pressure of the band against your stomach causes some irritation. As the irritation subsides and you get used to the new fill level, you'll find it a bit easier to eat. Remember, the whole idea of fills is to help reduce how much you're eating each day! Also, bananas can be iffy, though I don't know why since they're soft.

Congrats on the start of your WLS journey! You'll get more replies to your question about caring for your son if you edit the title of this thread to include the question, such as "child care during recovery" or something like that. I didn't have an infant to care for but bending over, reaching, turning, and lifting can all be uncomfortable when you're a new post-op, so you're wise to start thinking about this issue in advance. Also, I wouldn't want to be left alone to care for a baby when I'm taking narcotic pain relievers. good luck!

I think eating 1200 calories a day of healthy food would be fine, but strongly suggest that you break it up into 6 small meals or Snacks a day. Whatever you do, don't eat 3 meals at 400 calories each because that's likely to be far more volume than your still-healing stomach and band can safely handle. If you eat Saltines or another starchy food, try to combine it with a Protein. If you don't, the starchy food will temporarily spike your blood sugar, and when it crashes, you'll feel hungrier than ever. And...hang in there!

You're the first person I ever heard say that his band banished his sweet tooth! I know a lot of bandsters who still struggle with sweets years after being banded. When my band was at an optimal fill level, most foods just didn't taste so wonderful any more, but sweets still tasted pretty good!

Congratulations on taking positive action to improve your health and quality of life. The pre-op stuff varies tremendously depending on the patient's medical history and the surgeon's protocol, and how long it will take you to get to the operating room depends on how long it takes to do any pre-op tests & evaluations, and on how busy your surgeon's practice is. It took me about 4 months to get through all that, but I know people who've waited a lot longer and also know someone who was banded ony a week after her surgical consult. At the first appointment, your surgeon will probably do a physical exam, discuss your medical history, and explain the surgical procedure. You'll probably also have a nutritional consult with a dietitian and a psychological evaluation with a mental health professional (not to find out if you're crazy, but to establish that you understand what you're getting yourself into, can follow directions, and have a support system). If your insurance policy requires you to have an obesity-related health problems (co-morbidities), you'll need to have some blood tests, maybe a cardiac evaluation, maybe a pulmonary evaluation, maybe a sleep study. Also, the surgeon needs to make sure you're healthy enough to undergo surgery while anesthetized. I could go on and on, but those are the basics.

I know just how you feel. With my ex-PCP, I wanted to say, "Hey, I've done everything you told me to do. I improved my diet, lost weight, & started exercising, but how am I supposed toi erase my genetic predisposition to elevated cholesterol?"

Symptoms of a band slip usually include eating problems, possibly with pain or pressure in the center of your chest. Did you have a hiatal hernia repaired when your band was placed? Because I've heard that can cause discomfort in that area. I have an untreated hiatal hernia and when it's complaining, I get a painful pulling sensation at the top left side of my abdomen, right under my rib cage.

Don't forget to check out my cookbook too - Bandwagon Cookery.

Weight loss alone can stop diabetes in its tracks. In July 2007 (2 mos before my surgery) my A1C was 7.4. In December 2007 (2 mos after my surgery) it was 5.9.