Jean McMillan

Go to my blog (jean-onthebandwagon.blogspot.com) and scroll down while looking at the left side of the page. If you want to pay by credit card, look for the picture of the book covers and click on it. If you want to use PayPal (with whatever form of payment you prefer), click on the yellow PayPal Add to Cart button to make your purchase. books ordered via the PayPal option can be autographed to you if you specify it when you order. If you have any problems ordering, send me a PM and we'll figure it out. Thanks for your interest! Jean Edited to Add: You can also order by clicking on one of the Bandwagon ads here on LBT.

LOL! And hey, hop right in!

Why on earth have you let that suffering go on for four years?

Obstruction? Of what? For the record: band slips do not necessarily require band removal, repositioning, or replacement. Often they're treated successfully with a complete unfill and rest period. Worked for me.

That hasn't happened to me, but it did happen to a friend of mine whose tubing had sprung a leak. A sudden loss of restriction can also be a sign of a band slip, so it might be a good idea to have an upper GI study done to check the position of your band.

You could try taking Gas-X. Doesn't work for me, but some people swear by it.

I'm so glad my articles & posts have been helpful to you. I hope one day you'll be able to think of your band as your friend instead of a foreign object! In the meantime, congrats on the weight loss!

And other things you need to know about WLS but are afraid to ask... I wonder sometimes if bariatric professionals forget to emphasize the importance of good band eating skills because they they've never had to live with a gastric band. Of course, a few bariatric professionals are also bariatric patients, and thank goodness for that. I also wonder if bandsters are unaware of the importance of good band eating skills because their brains slipped into neutral during that part of their pre-op education. You'll have a hard time convincing me that's never happened to you, because I am the Queen of Lists and Note Taking. In high school and college, classmates would pay me for copies of my class notes. (Not only were they thorough, they were neatly penned in my prize-winning handwriting and decorated with cunning cartoons depicting my teachers and professors in embarrassing situations.) I take a notebook and a list of questions to every medical appointment, I ask questions, I re-read my notes, but despite all of that, my brain tends to shift gears when I see or hear something that strikes me as unimportant or irrelevant. And aside from being The World's Greatest Living Expert on Everything, what exactly qualifies me to make the unimportant or irrelevant judgment? Nothing. Nada. Nichts. Niente. During my pre- and post-op patient education, which was tailored exclusively to bandsters and administered by well-prepared bariatric dietitians, nurses, physician's assistants, and so on, I must have heard the eating skills lecture a dozen times. I was told that if I didn't eat carefully, I would end up in pain or with my meal in my lap. I nodded my understanding each time I heard that and could repeat the lecture verbatim, but it wasn't until I took a huge bite of a grilled cheese sandwich 24 hours after my first fill that I truly understood what all those folks had been telling me. And that’s not an experience I’m likely to forget. Take Tiny Bites I talk about good eating skills a lot. Why do I go on and on about that? Is it because I like the sound of my own (editorial) voice? Well, sure - that's no secret. But for what reason besides that? Important information bears repeating, and repetition is one of the ways that we acquire new information and learn new habits. If you doubt that, pay attention to how many times the Geico lizard appears on your television screen each day. Good band eating skills must become a habit if you're going to succeed with your band and avoid side effects and complications. Those eating skills must be your habit every hour of every day, not just as a new post-op or after each fill, but every day for the rest of your life. That sounds like a pretty tall order, doesn't it? Don't panic, though. A well-ingrained habit doesn't take as much conscious thought as a brand-new one. Your own behavior has already proven that if you've ever found yourself with a half-finished Twinkie or a cigarette or a beer in your hand and couldn't remember how it got there. It works the other way too. Your healthy new habits will eventually dig themselves into your life and using them will get easier as you go along. When you forget your band eating skills, your band will give you a loud reminder in the form of side effects like PB's, sliming, or stuck episodes, but I beg you not to rely on your band's built-in warning system on a regular basis, because doing so will send your bandwagon skittering down the road to complications like esophageal dilation, stomach dilation, band slips and even band erosion. One of the problems with the band's alarm system is that the truly destructive behaviors it reacts to may trigger relatively mild warnings so long before the damage is done that it's easy to shrug them off. For example, let's say that you often take big bites, don't chew very well, eat quickly, and/or eat beyond your soft stops (soft stops are gentle stop-eating signals, like hiccups). Each time you do those things, you experience mild discomfort. Nothing horrific. It happens, you think, "Oops," and you go back to whatever you were doing before the discomfort happened. Eventually this mild discomfort becomes just a part of your post-op life - the same as the way you sneeze when you pet a cat, pass gas when you eat beans, or get a headache when you don't wear your eyeglasses. Hey, that's just the way it is, right? But one bad day after dozens of ordinary days you can't even swallow your own saliva. You rush to the doctor, who does an upper GI x-ray and tells you your band has slipped. "How can that be?" you cry, "Everything's been fine until now!" In fact, everything has not been fine, because your careless eating has been pushing, pushing, pushing at your band's limits, until finally it pushed your band up your esophagus or down your stomach. I don't like finger-pointing any better than you do, but whose responsibility is that band slip? Is it your surgeon's, for not stitching it on there well enough? Is it the band manufacturer's, for not making your band slip-proof? Or is it yours? There can be a happy ending to your story, though. Even if the band slip is clearly your fault, you won't get sent to prison to sip brackish water and gnaw on stale bread for the rest of your days. Your surgeon can unfill your band (or, less likely, re-operate to reposition your band), and you can revamp your eating skills, lose weight, and live happily ever after. Or better yet, you can avoid the pain, inconvenience, financial and emotional costs, and pay attention to your eating from now on. I ain't gonna lie to you...acquiring and practicing this new habit won't be easy, but I can think of a lot of things that could be worse. A lot worse. The official Bandwagon® Eating Skills are: 1. Don't drink while you eat or for 30 to 60 minutes afterwards. 2. Take tiny bites. 3. Chew, chew chew. 4. Eat slowly. 5. Eat the protein first. 6. Learn your stop signals. 7. Pay attention to problem foods. 8. Eat only when you're hungry. 9. Avoid liquid calories and slider foods. 10. Use a small plate. 11. Plan your food in advance. 12. Don't watch TV or read while you eat. 13. Don't put serving dishes on the dining table. 14. Eat sitting down at the dining table. 15. Follow the HALT rule (don't eat when you're too hungry, angry, lonely or tired). You’ll find full explanations of each skill in Chapter 12 of Bandwagon, Strategies for Success with the Adjustable Gastric Band, by yours truly.

First, let me say what a good guy you are for looking after your girlfriend like this! She's a step ahead of the game with your support. Your girlfriend's symptoms really need to be discussed with the doctor. They're not going to be able to release her from the hospital without her surgeon's OK, so I would expect him/her to visit her at the hospital today to answer questions and go over post-op instructions. Her symptoms are pretty common. Incisions are very painful for the first week or so, and nausea is a very common reaction to general anesthesia and pain meds. I doubt very much that she'll be released from the hospital until they see that she can keep down Clear liquids. Did she give you any details about the really bad stomach ache? Is she talking about abdominal pain in addition to the incisional pain? If so, she's probably got a bad case of gas, which can be very painful indeed but eventually will dissipate via the usual means (burps or farts) over the next week or so. The nurses should encourage your girlfriend to get out of bed and walk around a bit today. No marathons, but movement will help prevent blood clots and help get that gas moving along. I suspect that some of the reasons your girlfriend is anxious and uncomfortable is the combination of general anesthesia and narcotic pain killers, which can cause depression. If she continues to have bad reactions to or lack of pain relief from morphine, percocet, or the like, she could ask for an alternative pain medication like tramadol.

That's a common reaction to the liquid diet. If you drink some OJ or other fruit juice, it may give your blood sugar a quick spike so you feel better, but that spike won't last long and you'll be back where you started (I'm diabetic, so I speak from experience). Are you only allowed clear liquids, or can you have liquids like milk or protein shakes? Having some protein combined with a carb is my best solution to this kind of thing. Protein from protein powder and carb from milk works for me.

Officially, a soft food is one you can cut with the side of a fork. Do that to an oyster and it'd probably end up on someone else's plate. You really should call your surgeon's office to ask about this. I adore raw oysters and although I didn't eat them as a new post-op, I have eaten them within a week or so of getting a fill and had no problems.

A can of green beans? I love that! Under normal circumstances, I wouldn't eat a can of green beans if you paid me, so for me, that's a great "test" of hunger!

Please don't take this comment as judgmental - I just have to speak to the suggestion that having some alcohol helps dealing with restriction fluctuations. I can't imagine any medical reason or believe that any doctor would endorse the idea that alcohol would help. It's a diuretic, it's a gastric irritant, and if it "helps", that's probably because it makes you care less about eating problems, not because it actually fixes them. Finally, alcohol is empty calories and loosens inhibitions, so that taking an extra bite or an extra serving that you don't need suddenly seems like a fine idea. Just my opinion, mind you, but I speak from experience!

Do you have a fill scheduled yet? If not, make an appointment. That will give you something to look forward to. In the meantime, do your best not to overeat, because that can interfere with healing and the settling of the band against your stomach. Don't worry too much about losing weight right now. Bandster Hell is one thing I wish I'd known about before my surgery. It wouldn't have changed my decision to have surgery, but at least the Hell part wouldn't have been an unpleasant surprise. Hang in there!

Well said!

How many times a day do you eat? If you're eating only 3 times a day, it's not surprising that 2.5 ounces of food per meal doesn't keep you going for very long. I've had to eat 6 times a day even with plenty of fill. Try not to eat more than 2.5 ounces at a time because eating more than that can interfere with the healing of your stomach and the settling of your band against your stomach. I know it's hard - you're in what we call Bandster Hell now. It'll get better after you've had a few fills. In the meantime, hang in there!

I haven't experienced that...your story is unique...but I do want to congratulate you for your weight loss and your persistence. I have had a port flip and repaired, as you have. That's not uncommon. I'm not clear on what happened when you went to your original surgeon for a fill after your tummy tuck. If he felt that you didn't need a fill and didn't give you a fill, why would you expect him to palpate your abdomen to check the position of your port?

I'd never heard of the Endo Flip, so I Googled it. Supposedly the device allows the surgeon to adjust the band to the mythical "sweet spot" during band placement surgery. Sounds nice, but there are a lot of other factors that affect restriction that I don't think the Endo Flip can account for or control. From what I read, the Endo Flip is used only during surgery, not to do adjustments after surgery. http://www.stopobesityforlife.com/obesity_surgery/correcting_obesity/procedures/endoflip_during_lap_band_surgery_to_increase_your_weight_loss/ As for getting feedback about Dr. Corvala, you might want to post a question here: http://www.lapbandtalk.com/forum/7-lap-band-surgeons-and-hospitals/

AND WHAT’S SO GREAT ABOUT ACCOUNTABILITY, ANYWAY? Accountabiity is a popular term in the WLS community. When I first saw it used in an online forum post, it reminded me unpleasantly of a company I worked for a decade or so ago. We were acquired by a much bigger company whose watchword was ACCOUNTABILITY. Seemingly overnight, our procedures changed so that every action had to be accounted for with a signature (or 2 or 5), a report, a committee vote, and/or an Act of Congress. This approach was intended to ensure ethical behavior in a group of employees who had never dreamed of committing unethical acts before, so it seemed to many of us that Big Brother was watching our every move, and that we had to ask him for permission for even the most trivial things, from a restroom visit to changing the toner cartridge in a copier. The initials, signatures and codes we were forced to append to every piece of work seemed designed to enable a complicated system of extravagant punishments and meager rewards. Needless to say, all that had tainted the word "accountability" for me, so that I reflexively cringed every time it appeared on my computer screen. Despite my unpleasant history with accountability, curiosity got the better of me. I began to read about accountability and accountability partners. I discovered a more positive and less punitive approach, in which reporting your eating, exercise, and other behaviors to a partner (or group) can help keep you honest about those things. For a long time, I had resisted any public declaration about my eating. When you're ashamed, you don't want to tell your secrets to friends, family, doctors, or the cop sitting in a speed-trap chase car. Even when I was active in OA (Overeaters Anonymous), I sometimes lied to my sponsor about whether I had followed my food plan for the day. I didn't like myself for that, so I attributed my own negativity to the whole accountability thing. It made me feel bad, therefore it was bad. But here were all these WLS patients seeking accountability partners online. Were they all masochists, or was I missing something? I must sheepishly (but happily) report (report? aargh! there's that word again!) that I had been missing something important and useful. Months after I'd reached my weight goal, when I was busy enacting the part of the Model Bandster, a friend and I joined up as accountability partners. She had lost over 100 pounds but found herself struggling with weight regain, and we thought a partnership might help her get back on the bandwagon. Little did I know how much it would help me! Almost 2 years later, my partner still tolerates me, and I actually look forward to our daily e-mail check-ins. We tell each other our food plan (or lack thereof) for the day and report (aargh!) how well we stuck to the previous day's plan. My partner hasn't caught the exercise bug like I have, but I also tell her my workout plans. We share anything else that's affecting our eating and weight management, be it travel, stress, holidays, work, illness, or apathy. We ask each other questions and offer suggestions and advice. I don't hesitate to point out the lack of protein in my partner's food plan; she sees when I'm slipping into maladaptive eating with a few days of soft and slider foods and asks, "Have you been satisfied with your meals this week?" We cheer each other on and prop each other up. We laugh and cry, complain about obstinate husbands, and brag about our dogs, children and grandchildren (human and canine). And sometimes all we do is listen. The bottom line? Accountability is not just about dotting your I's, crossing your t's, and signing "John Hancock" every time you take a pen out of the supply cabinet. It's about taking responsibility for your weight management while using the support of peers who know firsthand what that job is all about. HOW DO YOU FIND & CULTIVATE AN ACCOUNTABIITY PARTNER? A good place to find an accountability partner is in a WLS support community - at in-person support group meetings, in your surgeon's waiting room, or at online support communities like LBT. Go to a few meetings, eavesdrop on conversations and read forum postings until you identify someone "simpatico". By that, I mean someone you identify with for any reason, whether it's his/her age, profession, hobbies, geographic location, you name it. Try to avoid someone who would baby you when you need to be kicked in the butt. Initiate a conversation with that person. Introduce yourself, ask a question, give them a compliment, tell them a joke, express an opinion. If your interaction with this person goes well - they seem to "get" you and respond to you in a positive, caring and responsible fashion - ask if they'd be willing to try an accountability partnership with you. Tell them why. It might be, "I really admire your band success," or "Like you, I travel a lot for my job, and I'm wondering if you can share any eating tips with me." When you find a partner and agree on how you're going to run the partnership, begin communicating immediately, every day without fail. If you're not going to be able to check in daily for a period (be it one day or one week), tell your partner in advance or as soon as you know - don't just disappear. Be as honest as you possibly can be with your partner, and demand the same thing of her/him. Listen carefully to what your partner says or writes. You may not have the magic answers to all your partner's problems, but you'll be helping just by listening closely and respectfully. If you and your partner seem to fall into a rut, it might be time to shake things up. You can give each other a challenge, like exercising 5 minutes longer every day or giving up fast food meals for a month. You can decide to read a book together and discuss each section or chapter. A good book for this purpose (besides Bandwagon!) is The Emotional First Aid Kit by Cynthia Alexander (available on amazon). You can pledge to list three positive things that happened to you every single day. You can take a short vacation and give up talking about weight loss completely for a set period of time, but go on talking about other events and issues. When you return to the task of daily eating accountability, you might bring new energy or ideas along with you. If at some point the partnership doesn't seem to be working for you, tell your partner and ask him/her for ideas on how to improve the relationship. Your joint decision might be to end the relationship altogether, or to check in once a month instead of once a day, and that's OK. Finally, here's an example of the kind of message I send to my accountability partner each morning: Dear Partner (name withheld to protect the innocent), It's 15F this morning. FIFTEEN DEGREES!!! WTF?! I moved all the way to Tennessee to get away from 15F weather! I didn't eat according to plan yesterday, but I did OK. When I got done with my teeth cleaning and errands, I didn't have time to go home for lunch, so I got a chicken salad wrap at the coffee shop and ate most of half of it. It was pretty good, with grapes in the salad. This morning I have a Zumba class. I've taken Zumba before at a different place and liked it a lot, but so far I'm not liking the new class because the instructor doesn't explain the moves or call them out before they start. You just have to play follow the leader. I'll be at work from 11:00 am to 4:30 pm today. Food will be: B&S: the usual (protein shake before workout, a latte afterward) L: 2 oz catfish salad (like tuna salad), 2 Wasa thin & crispy sesame flatbreads S: 1/4 c. trail mix D: 3 oz crab cake, 1/4 c. barley & veggy salad S: granola bar I'm liking granola bars for an evening snack because they're so chewy. Gotta chew! Have a great day and STAY WARM! Jean

Let us know what the doctor says. I'm curious now!

Glad to hear you're finally making some progress!

Some protein drinks are actually formulated to make you GAIN weight (like bodybuilders do). How many calories are in one of those protein drinks? Do you enjoy drinking them? Do they keep you satisfied for 4 or so hours? Are 3 protein drinks a day what your surgeon or nutritionist recommended?

I'm sorry to hear you're struggling, but it's good that you're not giving up and that you're looking for help. You might want to post your question in the Texas group: http://www.lapbandtalk.com/forum/2025-texas/ Also, I have a friend (who revised from the band to the bypass earlier this year) who is a support group leader in the Austin area. She used to live in Dallas so might be able to suggest how to hook up with someone in your area. Let me now if you'd like her contact info. I'm sure there are dozens of things going on with you and your disappointing weight loss, but one of the first things that strikes me is your Protein drinks. Why are you doing 3 Protein Drinks a day? Because you can't eat solid food? If so, your band is too tight and you need some saline taken out of it. If not, you really should be getting your protein from solid food. liquids may fill your nutritional needs but they do not provide any satiety. Finally, please stop comparing yourself to others (like your cousin). That does you no good unless you use it for inspiration instead of to berate yourself.

It could be a reaction to latex, surgical adhesive, the antibacterial liquid that gets swabbed on you before surgery, or meds (pain killers, antibiotics). Is it all over your abdomen, centered around your incisions, or what? Is it itchy, painful, hot, swollen, bumpy, flat, oozing? Is the affected area getting bigger or about the same? How long have you had it? When you've come up with answers to those questions, call your surgeon's office and describe what's going on. It's probably nothing terrible, but better safe than sorry.

Mrspopeye, it's funny because I tend to assume that an obese medical professional knows exactly how hard it is for me to manage my weight and is less likely to judge me, so I'm less likely to judge them. That's why I was disappointed that my formerly-fat doctor coudn't empathize with me. But maybe the sight of obese people reminds him too much of where he used to be.