advice for the recently banded

Monica S · December 14, 2005

I have a bunch of questions--go ahead and respond to anything that inspires you. I had the lap band surgery on november 23 of this year (3 weeks tomorrow). I lost 16lbs the first week and nothing since. I am supposed to be on liquids until tomorrow, but have been eating soft foods for 3 days with no problem. I am beginning to worry whether I should have had RNY because I want to lose weight so badly, but I haven't had a fill yet so I'm still open to the possiblity that this might work (although I have doubts).

So...am I obsessing over not losing weight or is it possible that I made the wrong choice? Right now I feel like nothing ever happened to me. I don't have a sensation of fullness after eating anymore, I can eat a lot, I don't have PBs or vomiting or nausea or anything. I got too full a couple of times in the days right after surgery (from drinking too quickly or having too much Jello or something) but here's the scary part: it felt good! I love the feeling of being very full. It's like a drug for me, it calms me down. I'm afraid that may never go away and I won't lose weight.

I also have the following questions:

--how many calories a day should I be getting? the nutritionist said about 700 per day but that seems low to me.

--would it benefit me to continue with weight watchers (which I was doing before the surgery)? I liked the plan, just had a hard time following it.

--I was told I could never take ibuprofen again. Is this true?

--I was told I can never have a carbonated beverage again. True?

--I was told I can never eat anything sweet again, both real sugar and sugar alcohols (manitol, sorbitol, etc.)

Also, I have had moderate to severe pain in my left shoulder since the moment I woke up from surgery. Tylenol doesn't help. Is this just me, or has anyone else experienced something like this?

Finally, I am struggling to stay on the diet until my first fill, scheduled for Jan. 4. I am worried I won't be able to maintain it for that long--I was never able to stop myself from eating before the surgery and I don't know how they expect me to stop myself now, without any restriction!!!

I really appreciate any advice you have to offer!!! THANKS

Jachut · December 14, 2005

Firstly you've lost 16 lb in less than a month, that's great. But you also have to realise that you lost it the first week after surgery, days of eating very very little, as do we all, there's no way that weight loss is not made up of lean tissue, mainly Water and a bit of fat. As you're body has healed and you can take in more, your body puts its Water levels back in balance and you wont lose as fast or maybe not lose at all. You havent done anything wrong, but nobody continues to lose like that.

Secondly, maybe for you its necessary to continue to keep a track of what you're eating to make sure you continue to lose. I think the band could work wonderfully with things like weight watchers if you have trouble knowing what and how much to eat. So many of us have spent so long fighting with food that we really have no idea what to feed ourselves anymore.

That feeling of fullness will probably come sooner and sooner for you as you're filled.

As to the calorie levels per day I think you have to listen to your body a bit. I cannot live on 700 calories, I had fainting spells on the pre op Optifast within a day or two and then yesterday (day 5 for me) I had several fainting spells and really bad leg cramps. I need to eat more than that, end of story. I ramped up what I was eating with some more solid liquids - Soups with meat and Pasta in them and I had a commercial smoothie this morning, not one made with fruit and skim milk, feel loads better today. I think about 1000-1200 will be OK for me for this liquid phase but I tell you honestly, there is no way I could be exercising or running round living my normal life on this level. I know from past experience I can easily lose 1kg (2lb) a week on 1800 calories a day, I think I have a fairly fast metabolism and I still managed to outsmart it and get fat, lol. So go with what you feel. But my surgeon did point out to me to try to get in 3 meals 2 Snacks on the liquid phase so Breakfast lunch and dinner should be something nutritional with a decent snack such as a milk drink in between to keep the energy constant and water and the rest of it in between those.

As to the shoulder pain, it's common but I've had none, I've really had no pain at all since the first day, but walking around is said to help.

leatha_g · December 14, 2005

Did you research at all before you were banded? Feel free to browse all the great informational threads here. These topics and so much more are discussed over and over.. Good luck..

Fauxnaif · December 14, 2005

See below.

So...am I obsessing over not losing weight or is it possible that I made the wrong choice?

No, it will take a while-until you get restriction with fills.

Right now I feel like nothing ever happened to me. I don't have a sensation of fullness after eating anymore, I can eat a lot, I don't have PBs or vomiting or nausea or anything. I got too full a couple of times in the days right after surgery (from drinking too quickly or having too much Jello or something) but here's the scary part: it felt good! I love the feeling of being very full. It's like a drug for me, it calms me down. I'm afraid that may never go away and I won't lose weight.

I love that feeling too. And you won't get it with the band. There is not really fullness but you know to stop eating when you feel the presence of food in your upper stomach (esophagus). You just feel it more when you are full.

I also have the following questions:

--how many calories a day should I be getting? the nutritionist said about 700 per day but that seems low to me.

Most bandsters do about 1000 calories.

--would it benefit me to continue with weight watchers (which I was doing before the surgery)? I liked the plan, just had a hard time following it.

I think it would be really really helpful. The band will make it easier to follow.

--I was told I could never take ibuprofen again. Is this true?

You should very very rarely take it. It can lead to erosion.

--I was told I can never have a carbonated beverage again. True?

I Water down my carbonated beverage until they aren't really fizzy anymore.

--I was told I can never eat anything sweet again, both real sugar and sugar alcohols (manitol, sorbitol, etc.)

Well, you certainly can. But you need to reduce them to very rarely or you just won't lose much.

Also, I have had moderate to severe pain in my left shoulder since the moment I woke up from surgery. Tylenol doesn't help. Is this just me, or has anyone else experienced something like this?

Yes and it should go away.

Finally, I am struggling to stay on the diet until my first fill, scheduled for Jan. 4. I am worried I won't be able to maintain it for that long--I was never able to stop myself from eating before the surgery and I don't know how they expect me to stop myself now, without any restriction!!!

Frankly, it's the holiday season, you haven't had a fill and I would just focus on eating well to heal from surgery.

I really appreciate any advice you have to offer!!! THANKS

Anwyn · December 14, 2005

I second LeathaG... You need to spend some time on this board reading old threads. You're not alone in your struggles. A few thoughts:

1. You will only lose 1 to 2 lbs a week (sometimes less) with a band. I hope that your doctor made this very clear to you. Since you're upset with a 16 lb weight loss over 3 weeks, I'm guessing not... The 1 to 2 lbs adds up quickly. It's important to focus on where you will be in 6 months and not get caught up in your daily weight. Losing slowly is easier on your body. Think healthy, not skinny.

2. It's very possible that you will gain some weight back between now and your first fill. I myself gained 5 lbs during this time. The first 6 weeks after surgery are for healing, NOT weight loss. I'm not saying you can't lose weight, just that it shouldn't be your primary focus. I know that's counterintuitive, but it's true. You'll get through it! Once you get proper restriction you will be able to control your eating.

3. Notice I said "proper" restriction. Warning: for some people it can take several fills to achieve restriction.

4. I've never heard of anyone being told that they can never have sugar again (unless there is an insulin issue of course). Of course we should all limit our sugar intake to maximize weightloss, but digesting sugar is no problem with a band. It's a common problem for gastric bypass patients... maybe your nutritionist thought she was talking to a GB patient. I'm assuming here that you don't have any sort of medical problem with sugar (ie diabetes).

It really ticks me off when I see people get banded and then get thrown to the wolves not understanding all of the issues we face after surgery. Fortunately for you (and me) we found this site. Read as much as you can. You'll feel much better once you're informed. Good luck!

mousecrazy · December 14, 2005

Just keep reading, read all you can. When you do, you will see that each person is just a little bit different, and all of us are alot alike.

The gas pains in your shoulder will go away, but it takes a while...I had some pain for maybe 1 1/2 weeks. All you need to think about now is healing well. Period. Don't panic over your rate of weight loss; it's too soon. Heal up, get a fill, try that out for awhile. It is a process, and it doesn't "stop."

I have been very happy with my band. I also had moments in time where my weight had to adjust, and the scale didn't move. I have learned to accept the flow and patterns, and find them interesting, but not totally frustrating.

Start thinking long-term. Take the time to heal and read and learn. This is a great place to do it!

Cindy

Monica S · December 14, 2005

Thanks so much! I have received a LOT of misinformation from the nurses, psychologist, and nutritionist I see. I think almost everyone they see has RNY, and they told me the exact same info they told the RNY people. I was in the same informational class as the RNY folks and received the same packet of info that they received. I have no problem digesting sugar, not diabetic or anything, but was told I could never taste anything sweet again. I was also told I would have dumping syndrome, which I now know from this site is unique to GB patients.

To make matters worse, I was told some horrible things by the psychologist who evaluated me. Lucky for me I didn't believe her, or else I would never have had the surgery. She told me I would become angry and aggressive after losing weight and my fiance would probably leave me because my personality will change so much. Can you believe that? My fiance called the office to complain but they supported their psychologist. Does anyone have any idea how to report someone to the psychology licensing board in Texas?

Again, thanks for the advice, I could use it. And I'm SOOO glad I found this website!

CCBSTX · December 14, 2005

Keep coming to LRT for support! What folks have said before are true. Let your body heel and follow your surgeons directions. The first 2-4 weeks are some of the most difficult and confusing times. Your body is healing inside and out. Don't overdo the food. I figured I got in about 700 or so calories the first few weeks. Really I didn't feel very strong with that amount. It was too low. Soon, once I was on mushies I started feeling better. Let us know how you do.

CCBSTX · December 14, 2005

Keep coming to LBT for support! What folks have said before are true. Let your body heel and follow your surgeons directions. The first 2-4 weeks are some of the most difficult and confusing times. Your body is healing inside and out. Don't overdo the food. I figured I got in about 700 or so calories the first few weeks. Really I didn't feel very strong with that amount. It was too low. Soon, once I was on mushies I started feeling better. Let us know how you do.

Dody · December 14, 2005

I literally live on ibuprofen for my arthritis. No one has said that I won't be able to take it afterwards. I was originally on Celebrex, but heard so much controversary about it as related to the heart that I asked my dr. to take me off it. She did, and put me on ibrupfen. I take over 1000 mg a day for the arthritis.

As for beverages, she told me if you allow the pop to go flat you can have it. That doesn't sound very good to me...flat soda sucks. I have a neighbor that has had GB and she drinks loads of pop. I wonder if she is doing something she shouldn't. She literally lives on diet soda. Take away my pop and ibuprofen (and then tell me I can't have coffee with sugar in it) and I'm done for. Do I really have to give up all three of these things. I can't stand sugar substitute in my coffee but don't mind it in soft drinks at all. I only drink diet soda and caffeine free (love root beer). Now I'm wondering if I have to give all this up. I haven't started the nutritionist part of this yet, as I'm working on healing up an ulcer. It sounds like I'm in for some bad news about what I can drink and what drugs I can take. Tylenol for arthritis doesn't help me at all.

Another question, if you take liquid percocet or something like that after the surgery, why on earth would ibuprofen hurt you? Pain medications like Percocet are much stronger.

Anwyn · December 14, 2005

Dody, check out this thread re the ibuprofen. You can also find a lot of threads about the carbonation issue if you do a search. The majority of physicians do say no more ibuprofen (or any NSAID for that matter) or carbonation.

http://lapbandtalk.com/showthread.php?p=140701#post140701

donali · December 14, 2005

Dody, here's the info about why NSAIDs can be dangerous to the band, and some thoughts on carbonation.

http://lapbandtalk.com/showthread.php?t=12442

These types of medications can cause ulcerations in non-banded patients, so are particularly dangerous for banded patients where the medication in pill form has a chance to be caught in the upper pouch or stoma and lay against the stomach wall, burning a hole in the lining of your stomach and possibly increasing your risk of erosion. Also, it's not just the physical presence of the pill in the stomach that is problematic. There's something about the way the drug works in our bodies that causes increased susceptibility to ulcers and bleeding. liquid Tylenol is generally recommended as an aspirin substitute, but always check with your doc before taking any medications.

ALWAYS check with your band doctor before taking any kind of medication. Many band docs will closely monitor those patients that must take NSAIDs for whatever reasons.

http://lyberty.com/encyc/articles/nsaid.html

NSAIDs

: non-steroidal anti-inflammatory drugs

Aspirin

(Anacin, Ascriptin,

Bayer

, Bufferin, Ecotrin,

Excedrin

)

Choline and magnesium salicylates (CMT, Tricosal, Trilisate)

Choline salicylate (Arthropan)

Celecoxib (Celebrex)

Diclofenac potassium (Cataflam)

Diclofenac sodium (Voltaren, Voltaren XR)

Diclofenac sodium with misoprostol (Arthrotec)

Diflunisal (Dolobid)

Etodolac (Lodine, Lodine XL)

Fenoprofen Calcium (Nalfon)

Flurbiprofen (Ansaid)

Ibuprofen

(

Advil

,

Motrin

, Motrin IB, Nuprin)

Indomethacin (Indocin, Indocin SR)

Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)

Magnesium salicylate (Arthritab, Bayer Select, Doan's pills, Magan, Mobidin, Mobogesic)

Meclofenamate sodium (Meclomen)

Mefenamic acid (Ponstel)

Meloxicam (Mobic)

Nabumetone (Relafen)

Naproxen (Naprosyn, Naprelan*)

Naproxen sodium (

Aleve

, Anaprox)

Oxaprozin (Daypro)

Piroxicam (Feldene)

Rofecoxib (Vioxx)

Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)

Sodium salicylate (various generics)

Sulindac (Clinoril)

Tolmetin sodium (Tolectin)

Valdecoxib (Bextra)<O:p></O:p>

Note: Some products, such as Excedrin, are combination drugs (Excedrin is acetaminophen, aspirin, and caffeine).<O:p></O:p>

Note that

acetaminophen

(Paracetamol; Tylenol) is not on this list. Acetaminophen belongs to a class of drugs called analgesics (pain relievers) and antipyretics (fever reducers). The exact mechanism of action of acetaminophen is not known. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before it is felt by a person. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body's temperature when the temperature is elevated. Acetaminophen relieves pain in mild arthritis but has

no effect on the underlying inflammation, redness and swelling of the joint

.

Paracetamol, unlike other common analgesics such as aspirin and ibuprofen, has no anti-inflammatory properties, and so it is not a member of the class of drugs known as non-steroidal anti-inflammatory drugs or NSAIDs. <O:p

* Naproxen Sodium

" Naprelan contains naproxen sodium, a member of the arylacetic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs)"

"The chemical name for naproxen sodium is 2-naphthaleneacetic acid, 6-methoxy-a-methyl-sodium salt, (S)."

No carbonation (CONTROVERSIAL - many do anyway) The number one reason cited for this is to avoid “stretching” the pouch, as carbonation expands. Personally I don’t buy that, since the pouch is not a closed system and gas can be belched up to relieve pressure. I would be more concerned about the high acid content and the possibility of that damaging the lining of the stomach. Regardless, some docs say “okay”, some say “never”, some say “as tolerated”. And regardless of what their docs say, some people indulge in carbonation. Some find they are unable to handle carbonation, as it is just too uncomfortable. Others have no problems with it, and still others will make some effort to eliminate at least some of the carbonation before drinking the beverage, either by letting it go flat naturally, or helping it along somewhat by stirring, shaking, etc.

Dody · December 14, 2005

Dody, check out this thread re the ibuprofen. You can also find a lot of threads about the carbonation issue if you do a search. The majority of physicians do say no more ibuprofen (or any NSAID for that matter) or carbonation.
http://lapbandtalk.com/showthread.php?p=140701#post140701

Wow, not sure what can be done to control the arthritis, but my hopes are that with weight off it won't be nearly as painful. I guess that is a bridge I have to cross when I come to it. My neighbor has had GB and she lives on carbonated beverages? What is the difference with the lap banders and the GB's do you know? I don't think she is supposed to be drinking all that pop but she does, and seemingly with no real effects. She has lost tons of weight, but she just doesn't really look good (not physically-she looks very thin, but she looks white and sickish). I think her body has been robbed of Vitamins and she isn't following the regimin she is supposed to.

Again thanks for the link.