Laura_MD

Try using two scoops of protein powder in each shake. It bumps up the protein and makes the shake taste better. I put half of a banana in my shakes to thicken them and make them taste better. It is still liquid and it really fills you up for twice as long.

Hey StefGray, I have been to that group as well and it is pretty good. I wish they met more often (like weekly) because I live on the Eastern Shore and it is not always easy to get over there so more choices would be good. They do have speakers on a regular basis as I understand it though, and I think that is great. My doctor is Kim Steele. She didn't do my surgery though, I switched to her after a problem with my local surgeon that did my band. Who do you see?

Hi Amy, I had the same experience with a migraine when I had my band. I ended up spending two days in the hospital on a morphine pump because of it. The bright side was that the morphine and the migraine made me forget all about the "pain" from the surgery! I only got it because I had to go off of my blood thinners for the surgery, and when my blood thickens, I invariably get a migraine. Next time you get one, or feel like one is coming on, you might try eating something with a lot of garlic or vinegar (garlic is better) to thin your blood and see if you notice a difference in severity or length of the migraine. Welcome to the losers club!

Cheri52, you don't have to sign up again but if you get an email notice of a new posting and don not visit the thread, you will not be notified of additional postings until you visit the thread again. You may also want to check your junk mail folder to be sure the notice wasn't auto-directed to the junk file.

Obesity Surgery, 16, 673 Correspondence Body Contouring after Weight Loss in Morbid Obesity: Gain in Health and Leap in Psychosocial Functioning To the Editor: The importance of an unsatisfactory body image in causing psychological distress in obese patients has been recently investigated.1 This psychological distress encompasses lack of self-esteem, depression, and tendency to avoid social and sexual relationships. Body contouring following a significant weight loss can re-establish a good psychosocial functioning because of the perception of improved body image. A 31-year-old morbidly obese man presented to my plastic surgery clinic for body contouring. He came accompanied by his mother who held his hand in a protective and sympathetic manner. As routinely occurs with these patients, I started describing the therapeutic path that he should undergo, consisting of a relevant weight loss first, through diet or bariatric surgery, followed by multistep body contouring. 2 While I was explaining this to him, I kept on thinking with human, rather than medical, sympathy about that 31-year-old man’s hand in his mother’s. I could not help feeling sadness for a human being psychologically and socially harmed because of obesity and with little hope of enjoying an emotional, social, sexual and familiar normal life. Years went by, while the patient underwent the routine procedures of both bariatric and plastic surgery. While he was under my care, I could gradually appreciate the progressive gain in body appearance allowed by body contouring. From an empty baglike aspect, a more natural human body was returned to the patient, despite the price of some scars. Plastic surgery procedures also allowed an improvement of the buried penis syndrome, which affects both obese and formerly obese patients’ sexual life.3 Some years after the end of the entire therapeutic process, 9 years after the first consultation at my office, I saw this man for a follow-up. While he was coming to me at the end of a busy clinic, with a heedless glance I happily noticed that his hand was no longer in his mother’s. After a more careful examination, I realized that the woman beside him was far younger than his mother. “I introduce you to my wife” he said “and here is my daughter” he added, caressing his wife’s abdomen. Giacomo Datta, MD, Consultant Plastic Surgeon; Filippo Boriani, MD, Fabrizio D. Obbialero, MD, Maurizio Verga, MD, Residents in Plastic Surgery; Department of Plastic Surgery, University of Turin, Turin, Italy. E-mail: filippo.boriani@fastwebnet.it References 1. Friedman KE, Reichmann SK, Costanzo PR et al. Body image partially mediates the relationship between obesity and psychological distress. Obes Res 2002; 10: 33-41. 2. Datta G, Cravero L, Margara A et al. The plastic surgeon in the treatment of obesity. Obes Surg 2006; 16: 5-11. 3. Fontana D, Rolle L, Ceruti C et al. [False penile shortness][ Article in Italian] Arch Ital Urol Androl 1998; 70, 241-5.

Don, it is not the band that expands, it's you. Your organs and tissue can swell because of the lower air pressure at high altitudes.

BJean, ask your doc how air travel contributes to blood clots. Part of the problem there is the lack of movement, but a huge contributing factor is the inflammation that causes swelling in the extremities and around your organs. I brought this subject up back in January as a warning to fliers because I had heard nothing about it before that and I had just experienced tightening during and after an international flight. Fortunately, I did anticipate some change (because I have had issues in the past with blood clots) and I planned accordingly. What I experienced was about a 2/3 reduction in the amount of food I could eat. How do I know that? I packed my 1 1/2 oz baggies of almonds and craisins, the amount I can normally eat and be satisfied with no problem. When I tried to eat my "trail-mix" mid flight (Philadelphia, PA to Antigua), I could only eat a third of the bag. That restriction stayed for about 1 1/2 -2 days and then I experienced the same on the return trip. Some things to consider in figuring out if your band tightness will be effected: Do you usually experience swelling in your legs and feet or feel bloated post flight? If you do, you are likely subject to inflammation that can cause additional band tightness. [*]How much of your band is filled? If less than half, you may experience some additional, but tolerable, tightness. If you half more than half of your band filled (i.e. 7cc in a 14cc band), you may some issues and it COULD be intolerable. Make sure you find a band doc near you destination, just in case, and bring copies of your records with you. To answer your question in short, flying has the potential to create additional tightness. Plan for the worst, and Celebrate the best and you will win either way.

WayOfLife, your name says it all. You are about to embark an a whole new way of life, of course you are nervous. Like Lana24 said, I'd be more worried if you weren't nervous and scared. It really is a very minor surgery, but I suspect that it isn't the procedure that has you anxious. If you are like most of us you are a little bit concerned about the surgery and scared out of your mind of your life with the band! That's normal too. About a week before my surgery, I started getting really nervous and watching the "Super Obese" series on Discovery Channel and thinking that I should be able to do this myself, why should I have this surgery, what's wrong with me that I can't lose this weight on my own. Then I decided to stop second guessing myself and realized that I NEEDED this procedure because I had tried in the past and I just couldn't do it on my own. Then I went a step further and realized that I deserved this surgery. I deserved to be healthy, and I deserved to LIVE! Most of our lives we have been told that we just need to get off our butts and do some exercises and eat better or eat less and we could lose the weight if we really wanted to. The secret code was that we were choosing to be fat and unhealthy and we weren't deserving people because of it. Well, guess what, it was all a big fat lie! You are worth the effort and you do deserve to be healthy and happy and if this is they vehicle that gets you down that road then jump on board baby and let's ride! Getting banded was the best decision I have ever made for myself in my entire life! I have never regretted it for a single moment, and I will bet that you won't either. Just repeat after me, then repeat until they put you under: I DESERVE THIS & I AM WORTH IT! :thumbup::cool2::thumbup::cool2::wink2::biggrin2::smile2::):thumbup::thumbup:

Here are some useful tips for those who just had the surgery and those of you being banded soon. They are just some observations, tips, and tricks that worked for me, and may or may not work for you. Take what you can use and leave the rest. <o:p></o:p> <o:p> </o:p> <o:p> </o:p> Before the surgery<o:p></o:p> There are a couple of things you should prepare for after the surgery, and some things you may want to have on hand just in case (in addition to what the doctors have told you, Vitamins, Calcium, etc). Even if you never need them, better to have and not need than need and not have! They are the following:<o:p></o:p> <!--[if !supportLists]-->¨ <!--[endif]-->A stool softener; the pain meds coupled with dehydration because you may be sick from the pain meds or the anesthesia afterward, can make it difficult to have a bowel movement. The last thing you want to do is strain your muscles when you have stitches and are trying to heal. <o:p></o:p> <!--[if !supportLists]-->¨ <!--[endif]-->Panty liners; for the women especially (I can't speak for the men) getting up from the chair or bed immediately after surgery to go to the bathroom can be slow and difficult. That stress can cause you to have some incontinence because you can't really hold your stomach muscles tight enough to control your bladder well, because it HURTS! So….having some of those little helpers can save a lot of laundry (especially if you have a long trip to the bathroom or stairs to climb).<o:p></o:p> <o:p> </o:p> <o:p> </o:p> Upset stomach <o:p></o:p> Make some hot tea and put ginger slices in it (either the sliced from a jar, but not pickled, or the crystallized pieces, even fresh will work). Leave the ginger in while your tea steeps and remove it just before you drink the tea. Ginger is a natural and potent cure for stomach problems (much better than ANY of the meds docs have given me over the years with my migraines!). It usually works really fast as well. Visit http://www.gingerpeople.com to get some ginger chews (savory little candies that work miracles) or you can buy them locally using the “Find a Store Near You” tool on this site.<o:p></o:p> <o:p> </o:p> <o:p> </o:p> Pain in your chest, and probably your back and shoulder (if it is not there yet it probably will be), <o:p></o:p> That is most likely from the gas left in you stomach from the surgery. They pump your stomach full of gas to distend it so they can get to what they want and not damage anything else (it's part of the laparoscopic technique). The trouble is they can't get all of it back out, you have to expel it. The gas rises in the body so it goes to the highest part of your body (your chest if you lay on your back, your hip if you lay on your side, your head if you sit upright for a long time without moving around). Two things you can do to help with that and neither is easy right now.<o:p></o:p> <o:p> </o:p> <!--[if !supportLists]-->¨ <!--[endif]-->Move! Walk around as much as you can, I know it is difficult but once you start passing the gas, it will get much easier because that gas is also pushing against your incisions.<o:p></o:p> <!--[if !supportLists]-->¨ <!--[endif]-->Lying on my stomach REALLY helped me expel the gas! It was hard to get there but it felt so good once I did. It didn't smell so good because I started farting like a sailor. I sounded like a slow leak in the Goodyear blimp, but boy did it feel good! Get some help getting turned over but if you can do it, I really recommend it. (I checked with the docs right after my surgery about doing that and they said it would not hurt anything.)<o:p></o:p> <!--[if !supportLists]-->¨ <!--[endif]-->Nullo works very well to eliminate the smell: www.nullo.com <o:p></o:p> <o:p> </o:p> <o:p> </o:p> Sleeping/Resting<o:p></o:p> One more suggestion is to get one of those body pillows (the big long ones). That really helped me for a couple of weeks until all the soreness was gone and I got used to feeling the port inside. I can't sleep on my back, only my side, or better yet, my stomach. So I would lay on my side wrap my body around the pillow to support my stomach and that way it wasn't pulling on my incisions and cushioned the "landing" so to speak.<o:p></o:p> <o:p> </o:p> Authored By: Laura Mitchell<o:p></o:p> Printable version attached. Surgery Tips & Tricks.pdf

Karen, you have to be really careful about slipping back into old habits with the sweets and chips, etc. They do go down easily, but then they always have, haven't they? The band is just a tool that controls the quantity, you still have to control the quality of the food that you put in your body. You can completely circumvent the band if you are not careful. I could take a candy bar and cut it into three pieces and make that my three meals, but it wouldn't do much for my health or my weight loss. You are right that the band helps keep you from going too crazy when you do have those weak moments or have head hunger, but please do not convince yourself that you should eat those foods because they will go down easier. That, my friend, is a very dangerous path. Instead, try some salmon or other soft fish, the tuna is good if it is in Water (not oil), or crab meat, snow crab is my favorite! Experiment with foods to see what works for you now even if you didn't like it before. I cannot explain why, but there are at least a dozen foods that I have NEVER liked in my life, despite several attempts, that I truly enjoy now. I guess that eating smaller portions and eating slower has made me appreciate the flavor of foods more and my taste buds have changed. I heard this story over and over again in group too, so I am not the only one. As for the food, getting "stuck", if it is truly stuck you should consider a slight unfill. but consider this first, it is something that I wrote about my experiences with what I initially thought was "stuck" food. I have actually only had it happen 2 times in the 18 months that I have had the band and it was the same food two days in a row. Needless to say, I don't eat conch anymore, regardless of how it is cooked! Shoulder Pain/Food Stuck I can't tell what is causing your pain but I can tell you that I experienced the same thing from time to time and I can tell you what has caused mine and what has helped in the past. For me, it was either something got stuck (I took a pill that was too large, or ate sushi rice, or the doughy part of bread), or it was just that I really needed to burp, usually the latter. You see, I have made the discovery that for me, there are very few foods that actually get stuck or that I cannot eat. The problem usually occurs when I let myself get too hungry and my stomach gets filled with a lot of air. Then, when I eat, as the food tries to pass through the band the air is being displaced by the food, but it has nowhere to go because the food is blocking its escape at the band site. This is much like the air bubbles you get when you try to sink an empty glass or bottle into water. Until that bubble breaks and the air escapes, the water (or food in this case) cannot get in. When this happens, the pressure builds up in your esophagus and presses on your diaphragm and causes the pain in the shoulder. This will sometimes happen, even with my Protein shakes, so it is not that my food pieces are too large or the wrong consistency, it is just the mechanics of the band and our stomachs. My solution has usually been to ask my husband to burp me. Yeah, I know, it sounds crazy, but I know now why babies cry if you don't burp them properly, it hurts! Sometimes I can make myself burp if it is not too bad, but I have never been very good at that, so I usually ask for his discreet help. I doesn't usually take too much, just a few well placed pats on the back and it dislodges the food or pops the air pocket and I burp like a sailor and go on eating as before. I hope this helps you some, but do follow up with your doctor if it continues. I have read many stories of people waiting it out and making the problem much worse than it needed to be. And if you have a true blockage (say from a pill or something) that is nothing to mess around with.

Lorrie, I am glad to hear that your appointment went well. Speaking of creativity, I used to put steak seasoning in my tomato soup to make my brain think I was actually eating "food". It worked pretty well, so break out your spices and experiment. As for the oz of Water and water vs milk, perhaps the doc fears the extra calories or that the liver has to work slightly harder to digest the milk rather than water. I only started using milk about two months ago, I always used water. Maybe they want you to use less water so that the shake is a little thicker and will stay with you longer and some people really develop a brain block for them and they won't finish it if it is 16 or 20 ounces but they can make themselves drink 12 oz.. The milk will make the shake stay with you a little longer and give you some extra Calcium, but you should follow what your doc says, or just call the office and ask about using milk (if you didn't already). Good luck, we are here for you! Fanny, thanks for the recipe. I love pumpkin soup. Do you every put shrimp or other seafood in it? I have had it with shrimp and lump crab meat, delicious!

Truthfully, I didn't know for a while. I kept thinking that maybe I needed one more fill. But then, with my husband's objective observations, I realized that I was only eating about 4 oz, on average, of food per meal to be very satisfied. Then I would be fine for about three hours and the bottom would fall out and I would be really hungry, so I would eat again. Then, every once in a while, I would have to eat something reallyslowly to get it down, sometimes even my shake was slow going and I would have to stop and burp before I could finish it. With an upcoming appointment with my doc, I began talking about another fill and my husband reminded me of those times when things were slow to go down and just how little I was actually eating at a meal or even per day. He suggested that I might want to rethink whether I actually needed a fill. I took a good look at those things, and decided that I probably didn't need a fill, I was just frustrated because the weight wasn't coming off as quickly anymore because I was down to my last 30 pounds (23 now). Then my doc ordered an upper GI before even considering another fill, and we saw how small the stoma and the opening in the band are, I realized that I am where I need to be with the band for now. The rest is up to me. Those last few are always going to be the hardest to lose anyway, and if I have another fill right now, I am afraid that I would not be able to eat a lot of great foods that I really love. Basically, your sweet spot is the point where you are able to eat enough food to sustain your body at a healthy level (all your blood work is good, Protein is sufficient, Vitamins are good, not anemic, etc.), but you are not able to totally pig out when you get frustrated, upset, or lonely, etc. Remember too that you may find your sweet spot and lose it several times before you reach your goal, because as you lose weight, you also lose fat around you organs including your stomach. So the band may be perfect for several months or longer and suddenly, you can eat a side of beef . The reason is that you lost some fatty tissue around your stomach and now the band is looser than it was before. It really doesn't happen overnight, but it sometimes feels that way. This is where keeping a food journal comes in handy, you can see in black and white (if you are being honest and diligent) when you started eating more and how much more. That helps the docs know when you need a fill too. Then you get another fill or two, find your sweet spot again, and start over. I have not had a fill since mid August 2007 (8 1/2 months), and I am still good. I think most of the fat around my stomach is gone now, so there aren't as many changes to be made. Plus, I have 10cc in a 14cc band, so there isn't much more that could be done, so it's a good thing I have found my sweet spot. BTW-all of my blood work was great, the doc even commented that she wished everyone's protein levels were as good as mine. I celebrated that news with a Protein Shake too! :frown:

Perhaps the Protein requirements that I was given are higher than the old school recommendations or maybe it was based on my beginning weight. Either way, I actually get in about 200g of protein (on average) per day because I love seafood and I eat a lot of salmon and scallops which are very lean, very high in protein, and very digestible. I like shrimp too, but they sometimes don't go down as well. As for the protein shakes, when I add the cocoa and the banana they are more like eating ice cream than a liquid, and they stick with me for about 2 1/2 - 3 hours in the morning (I have it for Breakfast because I don't like "breakfast" foods). At night, they keep me from waking up hungry either during the night or in the morning. So I am not "adding" calories, just substituting the way I get them. My shakes are my treat to myself so I won't give them up anytime soon. Since I have lost 108 pounds in 18 months doing it, I don't see a reason to do so. There are a lot worse things that I could indulge in, so I am pretty happy with they my "shakes". But hey, to each their own.

lee41, I am glad that this helped you. You are exactly right about the 3 vs 5 "meals" per day, the number of times you eat per day really doesn't matter nearly as much as the total caloric intake. And if you are stuffing yourself beyond the point of satisfaction to make sure that you won't get hungry again before the next meal, chances are that you are eating many more calories than you actually need and you are risking stretching your pouch. Once I saw the pictures from my last upper GI, I was shocked into eating smaller, more frequent meals. That stoma is REALLY small! So, good job making adjustments to meet your needs.