Hello

I live in the uk and no one really knows the bandster rules, banding in the USA is so far ahead of us, can someone tell me the bandster rules, all the what to do and what not to do please.

Many thanks.

Cheire

This is what my doctor told me, but I have heard different things from different bandsters. Eat slowly, take small bites, and chew each bite like 30 times (until is mush). When you start to feel full...stop. No drinking liquids one hour before or one hour after you eat. Don't eat foods that are solid/liquid combined (Cereal with milk etc.). No sodas. Eat your protien first, then your veggies, then your fruit, then last of all your starch (potato, noodles). Avoid NSAID's (non-steroidal anti-inflamatory drugs)...I think these are things like Aleve, Tylenol etc. Supposedly they can contribute to erosion. Um...I think thats it!

Good luck!

. Avoid NSAID's (non-steroidal anti-inflamatory drugs)...I think these are things like Aleve, Tylenol etc. Supposedly they can contribute to erosion. Um...I think thats it!

Good luck!

I have occasional headaches I take Advil childrens liquid. No NSAIDS at all?

Had band for alomst 4 years fill at 4.4 cc for over 2 years.

I think they mean to try and avoid taking them on a regular basis. I take Excedrin Migrane every once in a while and I am sure that is ok. And like I said...I am not 100% sure what drugs are considered NSAID's for sure. : )

Tylenol is not considered an NSAID. Examples of drugs included in that class are: Asprin, Aleve, Ibuprophen. I'm allergic to codeine and pretty much any CII that is available in liquid form, so after my surgery my doctor gave me liquid Tylenol. Below is a link on NSAID's, what drugs fall in this class and what the side effects can occur from taking them.

As far as bandster rules, Protein first, lots of Water and exercise! Good luck in your journey.

http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=398&topcategory=General%20Information

Apryl, excedrin is a NSAID. FYI

I was given the following 10 rules:

No more than 3 meals a day;

eat slowly and chew thoroughly;

stop eating as soon as you feel full;

do not drink while you're eating; (30 min prior to meal and 1 hour after)

do not eat between meals;

eat only good quality foods; (organic fruits/veggys and grass fed meat)

avoid fibrous foods;

drink enough Water a day; (1 gallon)

drink only non-calorie liquids; and

EXERCISE at least 30 minutes a day EVERYDAY.

I am 3 weeks out and 25 lbs thinner. I have 70lbs more to go.

Good luck!

Jenn

Hi

thanks for all you help just 2 things i need to ask

1, Why no drinking BEFORE food?

2, i'm on Ibuprophen 600mg 3 times a day should i stop!!! :confused: and if yes what can i take instead.

many thanks

Cherie x

Hi again!

No Water before and after eating is VERY important from what I hear.

Call your doctor tomorrow for more info on that and the Ibuprophen - I'm sure they can tell you what to take instead of it.

Good luck.

Jenn

Now, for me, and patients at the clinic I use dink Water upto when you start eating, but don't drink for half an hour after eating.

The purpose of not drinking while you eat, and waiting to eat is so that you do not wash the food out of your pouch. The long it stays in pouch, the longer you stay full, or at least are not hungry. I typically don't drink for an hour after I eat, but that's just me.

Avoid fiberous foods because they can cause you to get stuck. I personally tolerate some food that are considered fiberous, so I eat them. Cooked Broccoli and fresh asparagass are favorites, but some bandsters cannot toleate them.

One of the prolems thought to be caused by NSAIDs is that they are corrosive to the stomach. If they sit in our pouches they can theoretically cause irritation. I was told that if I need to take them that I need to make sure that I take them with a large glass of water to make sure that I wash them down.

Cher, before stopping any medication, you MUST consult with your doctor.

Some doctors recomend 3 small meals and two small Snacks. Some recommend 3 small meals and no snacks. Some recommend 5 tiny meals. It it all depends on how you persoanlly need to eat. It might be that you do much better on 3 small meals with snacks, rather than without. You will only know what works for you once you start your journey.

I do not believe there are any hard and fast "rules," only guidelines. Because everyone is so different, and the band is adjustable, you will need to find what works best for you.

Cheers, and good luck

Hi Cherie...

I'm in the UK too ... i can scan and email you a copy of the post-op info sheets i got.

Basically for me it was:

post-op:1 -2 days : clear liquid ONLY, no creamy shakes or anything .. Water etc

Post -op 1- 3 weeks...creamy soups/shakes like slimfast or similar (my private clinic has their own range of products which are really nice)

post-op 3-6 weeks: start eating mashed up food (puree), i'm having fish as its quite nice mashed up

post-op 6 - 9 weeks: start eating small amounts of solid food

Basic rules:

Last drink before food 15 - 30 minutes. After food drink nothing for 2 hours, this is simply to allow the food to stay in the pouch as long as possible promoting feeling of fullness longer.

Eat food slowly and chew it to death

Stop as soon as you feel full. You can always reheat and eat more later

Let me know if you're interested and i'll get that info out to you.

Thanks

Jamie

The bandster "rules" as I remember them (many of these rules are variations on rules for RnY patients to maximize the benefits of their pouch). These are not necessarily in any particular order:

1. The Water rules:

I. Drink at least eight glasses of water a day.<O:p</O:p

II. No drinking with meals - the liquid either washes the food through the pouch/stoma faster allowing you to eat more before feeling full, or it makes you "stuck" and you PB.<O:p</O:p

III. Waterload prior to mealtimes so that:<O:p

a) you're hydrated

your pouch gets that initial stretching so that the "full" sensation can kick in sooner. Even though the water should pretty much drain right through, the stretching effect can last 30 minutes or so, which helps you to feel less hungry.

To waterload - start drinking water an hour before you want to eat. About 15 minutes for you want to eat drink as much water as fast as you can until you feel full.<O:p</O:p

IV. Wait at least an hour after eating before drinking again. Again, this helps the pouch stay full longer, maximizing the stretching/full sensation.<O:p</O:p

4. CHEW CHEW CHEW. Worst case scenario, inadequate chewing can result in obstruction requiring doctor intervention to remove the offending piece. Less drastic ramifications of inadequate chewing can be severe pain and/or recurrent vomiting until the offending piece has been expelled.

5. SLOW DOWN when eating. Eating too fast, even if the food is well chewed, can result in your pouch filling faster than it empties, resulting in the “golfball” feeling (which is really, really painful/uncomfortable), and/or vomiting the overflow.

6. Eat solid foods. Solid foods pass more slowly through the stoma, allowing the pouch to fill and create the stretch that turns off hunger and creates a feeling of satiety.

7. Protein first, veggies, and then if you have room, other stuff. Since your portions will become much smaller, you must make every bite count nutrition-wise. Get your nutritious foods in first before you indulge in empty calories, otherwise you will be too full to eat the stuff your body needs to be healthy.

8. Stop eating after 20 minutes. It is possible to eat so slowly that the pouch empties either at the rate of eating, or faster than the rate of eating, which means you can eat too much in one very long sitting. Limiting your eating to twenty minutes at a time helps keep your portions under control.

9. Avoid liquid calories. liquids generally pass right through the stoma and don’t create a lasting feeling of fullness. You can really go overboard on calories by consuming caloric liquids. (Yes, ICE CREAM is considered a “liquid”… )

10. Keep up with your correct fill level - too loose and you will eat more than your body needs before you feel full. Too tight and you will resort to mushies/liquids and eat around the band (or vomit a lot, which is the number one cause of slippage).

11. 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.

12. NO NSAIDS!!!! 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)."

13. Be extremely careful of food/products that expand with water. Rice, Pasta, potatoes and bread are the most common food items that people have problems with. These food items either swell in liquids and/or tend to combine in the pouch into large, globby, sticky balls that are too large to pass through the stoma, which results in the “stuck”/“golfball” feeling, and/or vomiting until the offending piece is expelled. Eating these foods in combination with other, less sticky foods can often help reduce the incidence of problems. Fiber products, such as Metamucil and psyllium husks SWELL in water to many times their dry volume. VERY, VERY dangerous if this swelling takes place in the pouch. If you need to add fiber to your diet, try a non-bulking agent such as Benefibre. If you do taking a bulking agent such as Metamucil/psyllium husks, be sure to wash it through with lots and lots of water so that it will bulk in your lower stomach, not your pouch.

14. Avoid Vomiting/PBing (productive burping) at ALL Costs. Vomiting/PBing is the NUMBER ONE CAUSE of slippage. In addition to being the number one cause of slippage, vomiting/PBing usually results in (and/or from) an irritated stoma/pouch, which causes swelling. Continuing to eat after a vomiting/PBing episode is likely to increase your chances of repeating the episode, and people can be caught in a vicious cycle where they eventually will have to get an unfill to allow the stoma/pouch/esophagus to heal.

The best ways to avoid vomiting/PBing:

a)

CHEW CHEW CHEW

SLOW DOWN your eating

c)

Avoid overly dry foods. Help lubricate dry foods with gravy/sauces.

d)

Avoid/be extremely careful with foods that swell/recombine in the pouch, such as rice, pasta, potatoes and bread. Take extra care to consume these items slowly, and chew them very well.

e)

Avoid/be extremely careful with foods that do not breakdown well even with chewing, such as hardboiled eggs and rubbery foods like calamari.

The “After the Vomiting/PBing” Rules:

a)

Stop eating immediately

Do liquids only until the next meal.

c)

If you still have problems at the next meal, do 24 hours of liquids before trying solids again.

d)

If after 24 hours of only liquids you still have problems, you should probably make an appointment with your band doctor, and stay on liquids until you can be seen by them.

e)

If you are unable to tolerate even liquids after 24 hours you MUST see your doctor right away. Dehydration is a very serious risk.

15. Don’t Cut/Crush Pills without Doctor Approval. You shouldn’t have to break/cut/crush your medications as a general rule, but people on the tight side, or those who must take very large pills oftentimes will have problems. NEVER break/cut/crush a medication without checking with the prescribing doctor first. Some medications are meant only to be taken in whole form, and it can be dangerous to take them cut or crushed. Time-released formulas are a good example – cutting/crushing a time-released pill means you would get too much of the medication too quickly.

16. Get a prescription for an anti-nausea medication and keep it on hand. Phenergren is one of the common medicines for this, and comes in oral and suppository forms. If you have a tendency towards motion-sickness, make sure you take Dramamine or the equivalent BEFORE the motion-sickness activity – I believe 30 minutes is the suggested timeframe. Read the instructions and plan ahead.<O:p

17. Don’t Skip Meals. Eating regularly helps keep your blood sugar stable, and helps keep you from being too hungry at the next meal and then eating too fast or too much.<O:p

18. Exercise. Exercise is always an important part of a healthy lifestyle, and will help keep your metabolism revved and your goals on track. Exercise also increases muscle mass, which takes up less room than fat mass of the same weight. So even if the scale isn’t moving downwards, you’re losing inches – plus, muscle is what burns fat, so the more muscle you have, the higher your metabolism. This is why men generally tend to drop weight more quickly than women – they generally have more muscle mass, so their metabolisms are faster.

<O:p

19. AFTERCARE. FOLLOW-UP, FOLLOW-UP, FOLLOW-UP. Regular follow-up with a band doctor will help ensure your success and band health, and keep problems to a minimum or nip them in the bud. If your banding doctor is far away, make sure you line up an aftercare doc BEFORE you get banded. This cannot be stressed enough.<O:p

20. Be your own best advocate. Learn everything you can about being banded, and the common warning signs of trouble. TRUST YOUR GUT. If something doesn’t feel right, CONTACT YOUR DOCTOR. Sometimes relatively minor problems can escalate into major problems because of delay in diagnosis/care.<O:p

21. Find and participate in some sort of support group. Most people are more successful when they have a support group. Plus it's lots of fun, and you learn a lot about being banded, and life in general.

22. Do not lay down sooner than 2-3 hours after eating. Laying down with a full pouch can cause reflux.

23. Do not leave reflux untreated. Reflux is a symptom that something is wrong – you are either too tight, are eating too close to bedtime, or are suffering from an esophageal problem.

Unfortunately, reflux is the bain of many long time bandsters. If you are already following the guidelines for reducing reflux then you need to see your doc for prescription antacid medication. It is critical that you do NOT leave this untreated, as stomach acid in the wrong places can cause severe damage, and create pre-cancerous conditions.<O:p</O:p

"ACID REFLUX CAN KILL YOU. YOU CAN ASPIRATE STOMACH ACID, GET REALLY BAD PNEUMONIA AND DIE." - GeezerSue<O:p</O:p

The only solutions I know of are modification of diet/habits, medication, reduction/removal of fills, band removal (worst case scenario).<O:p</O:p

You may find that something specific you are eating/drinking is contributing to this problem. If you're not interested in having a little fill removed, you may try eliminating these things from your diet for a while, and see if that makes a difference:

1. acidic juices/fruits, like citrus

2. caffeine - coffee, tea, chocolate

3. spicy foods

Guidelines for reducing/avoiding reflux (in order of least to most aggressive):<O:p</O:p

1. Do not over eat.

2. Avoid acid producing foods/drinks, like caffeine (coffee, tea, chocolate), peppermint, citrus fruits/juice, spicy food.

3. Do not lie down sooner than three hours after eating.<O:p</O:p

4. Do not eat or drink 3 hours before bedtime.<O:p</O:p

5. Switch evening medications to morning if okay with your doctor.<O:p

6. Take an OTC med to control

reflux

.<O:p

7. Elevate the head of the bed (helps keep the esophagus above the stomach so there's no backflow).

8. Have your doc prescribe anti-reflux medication.<O:p

9. Get a slight or complete unfill.<O:p

If these things do not help you, you must seek the care of your physician for additional help.

24. After the fill protocol. Most docs recommend doing only liquids for a day or two after a fill to allow the stomach to adjust to the new restriction and allow any residual swelling to go down. Also is a cautious way for you to test out your new fill level.