Jean McMillan

I know exactly how you feel, and I think that a lot of people have bariatric surgery (of any kind) hoping or believing that it'll work like magic without any effort on their part. Sometimes that's because of poor pre-op education...not that their doctor lied to them, per se, but the bariatric team didn't give them the whole story. But to be fair, I think that LBT members who are struggling, disappointed and suffering complications have as much right to post about their journeys as anyone else. If it seems that there are more negative posts than positive ones, it's probably because people tend to post more often when they're having problems than when they're doing fine. When I'm not in the mood to read the negative stuff, I do my best to ignore it.

Yes, learning when to stop eating is hard for most of us. Also, we have to redefine "satisfied". My pre-op idea of satisfied was Thanksgiving dinner full. It's not good to keep on eating after you've consumed 3 ounces of food because overeating can cause esophageal or pouch dilation and/or band slips. You may have to measure out your 3 ounces of food, eat it, and make yourself stop whether or not you feel "satisfied". Also, watch for satiety signals, such as a sigh, a hiccup, a burp, a runny nose, a tickle or fullness at the back of your throat, and stop eating as soon as you experience one. All of this should become a bit easier after you've had another fill or two, but in the meantime you'll need to be extremely careful and pay very close attention to how you feel when you eat.

I'm sure your surgeon or nutritionist would be glad to give you a refresher course in the post-op diet that worked well for you before.

I haven't been blessed with a baby since being banded (if I had been, I'd earn an entry in the Guiness World Book of Records), but I've had an experience that seems worth telling you about. When I was about 20 months post-op, my band slipped and I had a complete unfill. The unfill worked to cure the slip, but when I was in the middle of getting refilled, my port flipped so it was nearly impossible to get fills. I had to postpone surgery to fix my port because of personal stuff going on, including the deaths of my mom and my mother-in-law. So another year went by before I got close to the level of fill I'd had before the slip. And lo and behold, that time around, my experience of restriction was nothing like the first time. I felt like a baby bandster who had to re-learn all my satiety signals. Once I got it figured out, I started losing weight again. So, my message to you is that a fill level that worked before may not work later, but that doesn't mean your band is never going to work again. Maybe you just need another fill. Even a small fill could make a big difference, and if necessary, your band can be filled beyond its official 10 cc capacity. I know it's hard to return to the same level of excitement and commitment to weight loss as you had as a new pre-op, especially when your life has changed in such a major way. I don't know you and don't know what deeply motivates you, but if I were you, I'd want to become the healthiest woman possible so I could see that baby grow up. If you can't do it for you, do it for your child!

It think it's definitely time for a fill. And I think that if you try spacing out healthy meals & snacks throughout the day, it will help with your hunger and also with your blood sugar, as Melissa said. Sugars and refined carbs (like white flour) are bad news for your blood sugar, and you don't have to be diabetic to be concerned about your blood sugar. I happen to have Type 2 diabetes so have all the gear needed to check my blood glucose levels. A few years back during a very stressful time, I started "treating" my blood sugar lows with peanut butter crackers. They would magically lift my blood sugar (and mood), but that also caused big spikes upward and then big, miserable crashes about 30 minutes after I ate. Each crash caused me to feel voraciously hungry, so I would eat more crackers...and on and on...When I finally realized what was going on and gave up the crackers, I felt so much better I wanted to slap myself upside the head for putting myself through all that foolishness. I know that giving up the food you're addicted to is scary. If you just can't do it all at once, you might want to try stepping it down gradually (like weaning yourself off meds or tobacco). The tactic that works best for me is to eat some protein with every meal or snack. That way I get some longer-lasting fuel from the protein, and some quick-acting energy from the carbs in the meal. I feel less deprived, I feel better physically, and I crave the "bad" food less and less.

I haven't had BOB (band over bypass) but know a few folks who did that. It didn't help one of them, another did fabulously well and lost all the weight she'd regained plus another 10 or so pounds and has been maintaining fine. I've lost track of the other BOBsters. I would urge anyone who's considering revision to think carefully about exactly how their original surgery "failed". Did your original surgical tool stop working, or did you stop working it, or a combination of both? You really need to have that clear in your head before you have more surgery. Every bariatric procedure requires some degree of hard work on the patient's part. If your regain after RNY has been medically shown to be due to a stretched pouch or dilated stoma, you also need to talk to your surgeon about how to avoid those conditions once you're banded. Good luck, and congrats on the baby!

I think you need to have a heart-to-heart talk with your surgeon and/or nutritionist. Also, try to identify what worked well for you at the beginning to allow you to lose weight. What's changed? You say that when you try to eat only when hungry, you eat and eat and eat. Are you letting yourself get TOO hungry? Maybe it would be better to eat several small meals & snacks spaced out evenly through the day?

Yeeeesh, Shirley! That sounds like a band erosion, not a slip. So, what happened? Did they remove your band, or reposition it, or what?

Thanks, Lorelei!

Tammy, I just got a date (5-3-12) for my revision surgery. My prep for it will be one day of Clear liquids. ONE day. I'm telling you this not to taunt you but to show how silly is your surgeon's insistence on you doing a 2-week liquid diet to prep for yours!

Where on your body did you feel the stabbing pain? Your chest? Your upper/middle/lower abdomen?

A lot of things can cause what you're describing, from stress to a band slip. A band slip isn't usually an emergency unless you're unable to drink even Clear Liquids. Most ER's won't do anything but palliative care for band patients, but if you're not even able to drink Water, go to the ER anyway. They'll give you IV fluids and may be able to help find a bariatric surgeon to take you on. Good luck!

Do you mean feel your port from the inside or the outside? I've been able to feel my port from the inside insofar as it's stitched to my abdominal fascia and felt sore when I was still healing from surgery. I couldn't feel my port from the outside for months after my surgery. It was buried under too much flab! But my surgeon and his PA didn't have any trouble finding it. If yours his hard to locate at your first fill, you can always have a fill under fluoroscopy.

You felt it slip? What did it feel like? A pain? Where? At the moment when my band slipped, I had no clue. Around that time, I had some reflux and eating problems, but I didn't know my band had slipped unntil a week later.

Tammy, if you give me your e-mail address, I'll put you on the newsletter mailing list. It mails every Monday morning.

I've never had a nosebleed related to a surgery. If it were me, I'd call my surgeon about it first thing Monday, or go to the ER if it's still bleeding this afternoon.

Sophia, you may have to avoid packaged, processed foods altogether in order to stay under 5 g of sugar & 5 g of fat per serving.

My guesses are that some of the eggs went back up into your esophagus when you were sleeping (presumably in a horizontal position), and/or your esophagus got irritated by the eggs or something else you ate yesterday. I would stick with liquids for 24 hours to allow the food to break down and your esophagus to calm down. One of the reasons bandsters must be careful not to overeat is that if we eat too much food for our upper stomach pouch, the food will back up into the esophagus. The esophagus is meant for transporting food, not storing it, so food sitting in the esophagus for too long will eventually cause irritation, regurgitation, dilation, and/or painful spasms.

Are you saying that everyone's port is near the right "last" rib? That's just not true. Mine's just below my waistline, to the right of my navel. My best friend's port is in the center of her chest, just below her bra line.

Transfer addiction can happen to any bariatric patient, not just bypass patients. I know an alcoholic bypass patient and a band patient who became addicted to pain pills. When we can't use food for comfort or numbing any more, it can be tempting to turn to some other substance or activity to deal with it. So we all need to be cautious because of the potential for transfer addiction.

This is a very personal decision, but if I were you, I'd give your band at least one more try. It will never magically make you lose weight, and if you don't follow the rules, it will never work for you at all. And you're going to have to follow the same rules if you revise to the bypass.

So, where is your port? Is it near your belly button? Do you have any other incisions (port or otherwise) near your belly button?

It’s Friday night, and your long-awaited bariatric surgery is scheduled for Monday morning. Ahead of you are two days of the freedom to eat anything you want, in any quantity. You’re supposed to be on a pre-op liquid diet, but when you walk into Cheesecake Factory with your friends, your resolution to order soup goes down the drain (literally as well as figuratively). You grasp the menu in sweaty hands. What to order, what to order? You’ll never be able to enjoy food like this again, you think. Don’t you deserve to order one of everything on the menu? After all, it’s your last meal! Sound familiar? Last Meal Syndrome is very common among people facing weight loss surgery, and chances are you've already suffered it sometime in your life, perhaps the day before you started New Diet #832. Since New Diets almost always start on a Monday (there may be a law of nature covering that), you spent every minute of Sunday gorging on all the foods you could no longer eat come Monday morning. You ate so much that you made yourself slightly ill, and you probably didn't taste half of that food in your haste to cram it into your mouth. Overeating because of anticipated deprivation is an old, old habit. Until the earliest humans learned to plant seeds and cultivate their own food supply, nutrition was largely a matter of opportunism. If you caught a big fish or felled an animal by heaving a rock at it, you ate it all because you didn't know when another meal would swim, crawl, walk, or fly by. Although I sometimes joke that being self-employed as a writer is terrifying for me because it's a hand-to-mouth existence, at no time in my middle-class American life have I ever been truly threatened by significant food deprivation. My repeated bouts with Last Meal Syndrome have been caused mostly by my emotional over-attachment to food. When starting a new weight loss diet, or contemplating my coming bariatric surgery, I was terrified not that I would starve, but that I would suffer from emotional pain, boredom, or stress unrelieved by my usual comfort: whatever food I wanted, when I wanted it, in any quantity I wanted. Intellectually I knew that I would be able to eat small amounts of healthy foods and thus lose weight and gain better health, but the spoiled, petulant child within me feared and hated the very thought of that. A few days before I was banded, my husband asked me, "Are you going to have anything special to eat before your surgery?" I said virtuously, "I'm on a clear liquid diet for the next three days. I can't eat anything at all, never mind something special." My surgeon had told me that if my liver wasn't in good shape (that is, having a manageable size and texture), he would bail out of my surgery. After all I had gone through to get to the operating room, I wasn't going to blow it, and it wasn't (as I reminded myself) as if I would never be able to eat again in my entire life. I was facing food deprivation, yes, but for a matter of days, not years. Now, let's get one thing clear here: I'm not claiming superiority over pre-ops who give in to Last Meal Syndrome and celebrate their own private food festival a day or a week before their surgery. My compliance with my surgeon's instructions was driven by fear, plain and simple. I wasn't (then or now) a paragon of virtue. But in the last 4-1/2 years, I've learned something important that newbies and wannabes may not realize about the adjustable gastric band. And that is: The only food deprivation you will suffer after band surgery involves the QUANTITY, not the quality or nature of the food you eat. With a properly adjusted band, you should be able to eat a wide variety of foods you like. You don't have to give up Cheetos or Haagen Daz or McDonald's or prime rib of beef forever. All you have to give up is eating those foods in excess. It's true that when your daily calorie budget is limited, your health will depend on your making the best possible food choices - eating a piece of cheese instead of the Cheetos, a Skinny Cow ice cream bar instead of a gallon of Rocky Road, a Happy Meal instead of a quarter-pounder, two ounces of prime rib instead of the whole cow. You and your band will still be able to tolerate just about anything, so when you look down the road that your bandwagon will travel, you should see plenty of nice places to stop and eat instead of a dry, barren desert in which you'll have to subsist on stale melba toast and lukewarm water. That's the good news. Now here's the bad news: After band surgery, you'll be able to eat a wide variety of foods you like. Yes, I know I already said that, up there in the good news paragraph. But the tolerance of almost any food you can imagine means that you will have to exert some self-control to avoid overindulging. Now you may be thinking, "If I had any self-control, I wouldn't need weight loss surgery." If the need for self-control is a deal-breaker for you, maybe you should consider a different bariatric procedure, one that will allow you to eat anything at all and lose a pound a day. I'm not convinced that such a procedure exists, because I've heard too many gastric bypass (and even duodenal switch) patients moaning about significant weight regain, but by all means give the Magic Weight Loss Surgery a go. Maybe self-control will never be an issue for you again. My thoughts about self-control would fill up another whole article, so right now I just want to reassure you that eating with your gastric band is not necessarily going to involve an endless series of bland, dreary meals. It's not going to be like the mysteriously popular diet that requires you to eat nothing but cabbage soup three times a day. It's going to involve eating like a normal person who enjoys food but has a small appetite. Depending on your experience of restriction after each fill, you may have to forgo certain foods at times, but just because you can't comfortably eat a bagel with cream cheese today doesn't mean you'll never again be able to have a few bites of toasted bagel. Your food tolerance is going to depend not only on your fill level but also on your eating skills. The day after my first fill, I suffered my first stuck episode after taking a huge bite of a grilled cheese sandwich. A year later, with a lot more fill in my band, I could eat that same sandwich for lunch because by then I was used to eating slowly, taking tiny bites and chewing the food very well. I probably wouldn't eat the whole sandwich because I'd get "full" so quickly, and that's a good thing!

Sounds like you're suffering from the Last Supper Syndrome!

Your BMI is your Body Mass Index score. It's a way of measuring how obese you are. Some surgeons will not operate on patients with very high BMI's because surgery is riskier for those patients. Ask a member of your surgeon's medical staff what their limit is, and what your BMI score is. Or you can calculate it yourself using an online calculator, like the one here: http://www.nhlbisupport.com/bmi/