Here is info will come in handy when thinking about fills/adjustments. Great information. I have seen this information before and it is really good.

How to Tell When You Are Perfectly Adjusted

You are losing 1-2 pounds per week.

If you are not losing 1-2 pounds per week:

A. You may need an eating adjustment

1. Are you eating 60 grams of Protein a day

2. Are you eating 25 grams of Fiber

3. Are you avoiding all liquid calories

a. Soup can be sign of “soft calorie syndrome”

b. Alcohol contains a lot of calories – 7 calories per gram

(1) It’s also a stomach irritant

c. fruit juice is just sugar Water

4. Are you making healthy food choices from a wide variety of

foods?

a. Are you avoiding soft foods

b. You can’t just eat what’s easy

c. cheese is glorified fat

5. Are you drinking 6-8 glasses of water a day between meals

6. Are you eating too much junk

a. chips, chocolate, nuts, ice cream, Cookies and other highly

processed junk foods are too calorically dense to be regular parts of a

healthy diet. But don’t avoid them completely to the point where you

feel deprived.

b. Stay out of fast food places

7. Are you getting in two servings of Calcium daily

8. Do you always eat the protein first

9. Then the vegetables or fruits

a. Five servings a day

b. Potatoes are NOT a vegetable

10. Is your portion size appropriate?

a. meat or fish

(1) 3 ounces – the size of a deck of cards

b. Vegetables

(1) ½ cup – the size of your fist

c. Starch

(1) If you eat the protein and the vegetables first you don’t need

much

(2) Avoid: rice, potatoes, Pasta

11. You might try avoiding artificial sweeteners

a. Some people think that artificial sweeteners stimulate the

appetite

b. They are HUNDREDS of times sweeter than sugar

c. They teach you to like things too sweet

d. There is no evidence that people who use them are any thinner

than people who don’t

12. Avoid most diet foods

a. Real food usually tastes better

b. Real food is more satisfying than low calorie substitutes

c. When you are only eating a tiny bit the caloric savings is not

that great

(1) Use a teaspoon of real butter instead of a tablespoon of diet

margarine

(2) The body has no way to break down artificial fats

a. They may go into permanent storage

b. Some people think liposuction is the only way to remove

hydrolyzed fats from the body

B. You may need a behavior adjustment

1. Are you eating only when you are hungry?

a. If you’re not sure drink 8 ounces of water and wait.

2. Are you eating three meals a day?

a. With maybe 1 or 2 small Snacks

3. Are you sitting down to eat?

4. Are you eating consciously?

a. No distractions, turn off the TV, put the book or newspaper

away, pay attention to your food and your companions

5. Are you eating slowly?

a. Put the fork down between bites

b. Take 20 to 30 minutes to finish a meal

c. Taking longer might cause the pouch to begin emptying

6. Are you taking small bites?

a. Tiny spoon, chopsticks, cocktail fork

7. Are you chewing well?

8. Are you drinking with your meals or too soon after your meals?

a. Practice water loading between meals

b. You won’t be thirsty if you are well hydrated before the meal

9. Are you stopping at the first sign of fullness?

a. Sometimes it’s a whisper: not hungry, had enough

b. Hard stop versus soft stop

10. Do not eat between meals. Stop grazing.

11. Do not eat when you are not hungry

C. You may need an activity adjustment

1. Are you getting in 30 minutes of physical activity at least 3

times a week?

a. Over and above what you would do in the usual course of your day

b. Could you make it 4 or 5 times a week?

c. Could you make it 45 or 60 minutes?

2. Are you taking advantage of opportunities to increase your

physical activity?

a. Taking the stairs instead of the elevators or escalators

b. Walking on the escalators instead of riding

c. Parking your car further away from the entrance

d. Getting out of the car instead of using the drive through

e. Getting off the bus one stop before your destination

f. Washing you car by hand instead of the car wash

g. Playing with your kids

D. You may need an attitude adjustment

1. Are you committed to your weight loss journey?

2. Are you totally honest with yourself about how much you are

eating and exercising?

a. Log your food and activity on ww.fitday.com for 3 days

3. Are you using food inappropriately to deal with emotional

issues?

a. Have you identified what the emotions are that drive your

eating?

b. Can you think of more appropriate ways to deal with those

emotions?

c. Are you willing to seek help from a qualified counselor?

4. Are you attending and participating in support group meetings?

5. Have you drummed up some support from your family and friends?

6. Have you dealt with saboteurs realistically?

7. Do you have realistic expectations about the weight loss

journey?

8. Are you still obsessing about food, weight, dieting, eating?

a. Obsessive – compulsive thoughts

(1) Obsess about something else

b. Perfectionism

(1) All or none, black and white thinking

c. Patience with the pace of healthy weight loss

9. Are you acknowledging your successes with non-food rewards?

10. Have you learned how to take a compliment?

11. Are you giving up diet mentality?

a. Stop weighing yourself several times a day or every day

b. Stop dieting

c. Stop depriving yourself

d. Stop defining food as “good” and “bad”

e. Stop rewarding and punishing yourself with food

12. How do you feel about all the changes taking place?

E. You may need a band adjustment

1. You feel like you are making healthy food choices in appropriate

portion sizes but getting hungry between meals?

2. You can still eat white bread, fibrous vegetables and large

portions.

3. You are having to struggle to lose

4. You are gaining weight in spite of eating right, exercising and

having a good mind set.

F. You may need your band loosened

1. There are times when you can’t get fluids down

2. You are vomiting too much

a. How much is too much?

3. Do you have frequent reflux or heartburn at night?

a. Do not lie flat or bend over soon after eating

b. Do not eat late at night or just before bedtime

c. Rinse your pouch with a glass or water an hour before bedtime

d. Certain foods or drinks are more likely to cause reflux:

(1) Rich, spicy, fatty and fried foods

(2) Chocolate

(3) Caffeine

(4) Alcohol

(5) Some fruits and vegetables

a. Oranges, lemons, tomatoes, peppers

(6) Peppermint

a. Baking soda toothpaste

(7) Carbonated drinks

e. Eat slowly and do not eat big meals

f. If you smoke, quit smoking

g. Reduce stress

h. Exercise promotes digestion

i. Raise the head of your bed

j. Wear loose fitting clothing around your waist

k. Stress increases reflux

l. Take estrogen containing medications in the morning

m. Avoid aspirin, Aleve and ibuprofen at bedtime

(1) Tylenol is OK

n. Take an antacid (Pepcid complete) before retiring

o. Try other over-the-counter heartburn medications

p. See your health care provider

4. See your health care provider immediately (or call 911) if

a. You have a squeezing, tightness or heaviness in your chest,

especially if the discomfort spreads to your shoulder, arm or jaw or is

accompanied by shortness of breath, sweating, irregular or fast

heartbeat or nausea. These could be symptoms of a heart attack.

b. If your symptoms are triggered by exercise.

c. If your pain localizes to your right side, especially if you

also have nausea or fever

d. If you throw up vomit that looks like black sand or coffee

grounds. Or if your stool is black, deep red or looks like it has tar

in it. These are symptoms of bleeding and need immediate attention.

(Note: Pepto-Bismol or other medications with bismuth will turn your

stool black. Iron supplements can also make the stool tarry.)

e. If your pain is severe

a few nights ago, I got a piece of chicken lodged. I vomiting for several hrs. and could not even swallow my saliva without throwing up. I decided to get on this site to see if anyone else had experienced this. It was a lifesaver!!!! I did not have the Papaya Enzyme, but did thankfully have pineapple juice. The juice was the only thing I was able to get down. I'm sure I won't explain as well as the other experienced ppl. on here did, but the juice helped break down the small piece of chicken and eventually send it on thru. It did take an hr. or so, but I read that some ppl. have to have the food removed or even get an unfill, if it won't pass.

This is the first I've heard of it. I can't eat fresh or canned pineapple so it is not something I would have ever thought of. I had an incident at lunch and my chest still hurts so I'm gonna get me some pineapple and or paypaya juice and see if it helps.

Thanks!

I wonder if it would help when taking pills. I have more problems with taking my medications than anything else.

If you have trouble taking pills, you should seriously consider crushing them first. My doctor came out last year with a big notice that LB patients should never take pills. There have been some incidents of people aspirating them into their lungs and dying.

I don't have trouble taking the two pills I have to take on a regular basis - they're small. But I only take chewable vitamins. He tells all of his patients to take Centrum chewables.

You might ask your doctor about this business of crushing your pills.

hey bjean,

i havent had my first fill yet, in 3 weeks, but im on 4 meds twice daily and a mutivitamin in the morning, they all dissolvable or chewable, not sure about the mutivit, but i have no problems, and i asked my surgeon and he said cos they are small she'll be right.

can someone actually tell me what im to expect when i have my first fill, ive herd so many different stories.

thanks

sus

My doctor told me that NO pill should be bigger then an M&M. If it is it will get stuck. NO capsules because they can go down side ways and get stuck.

I keep my pills to a limit, most of my stuff i take are chewable or liquid.

Would like to know more about this pineapple juice thing. Sounds like something I should keep in the house. Since having my band almost 3 years ago I haven't been able to eat meat of any kind, there's also alot of other things that I can't eat. Everyone is different and everyone just has to figure out what works for them. Everyone here is here to help, but you can't ever just go by them because they don't know you and what works for you.

hey bjean,

i havent had my first fill yet, in 3 weeks, but im on 4 meds twice daily and a mutivitamin in the morning, they all dissolvable or chewable, not sure about the mutivit, but i have no problems, and i asked my surgeon and he said cos they are small she'll be right.

can someone actually tell me what im to expect when i have my first fill, ive herd so many different stories.

thanks

sus

Everyone is different. My Dr said any pill that will fit through the top of a 16 oz water bottle is ok. I had no problems until after my 3rd fill which was too tight and I am glad to have unfilled!!

about the pineapple juice thing. After having my last fill, I was tighter than I had ever been in the past. I didn't know that chicken wasn't a recommended protein. The first time after that fill, that I tried to eat a VERY small piece of chicken, it got lodged. For several hrs. I couldn't even swallow saliva without throwing up. Then I decided to get on here and see if anyone else had experienced this. This site and you people are such a great support system :thumbup: There were several ppl. that suggested to sip on pineapple juice, to dislodge the chicken. That was the only thing I could keep down and after about 2 hrs. the meat was gone.

Someone else will need to help me out with this, but there is also a chewable that you can get, that will help with the same thing. Sorry, I can't remember the name of the chewable.:thumbup:

Sounds like every doctor has a different take on the pill swallowing issue.

For the first 1.5 years, the only thing my doctor's office told us was that we had to be very careful taking pills and they suggested that we crush our pills. They also said that there are some pills that say "do not crush" on them and that we would need to get those changed into another form of liquid or crushable medication if we had any trouble swallowing the uncrushable pill.

Then last year they made a big announcement in their monthly newsletter and they made sure to tell us in person when we went for our visits, that there had been recently documented cases of people aspirating pills. Some of those people died. So they were warning us of the dangers and telling us that we shouldn't take pills at all.

I told them that I didn't have trouble taking the two meds I take everyday and asked if I could continue taking them whole. They said that it was a risk but that as long as I understood the risk, it was up to me. At that time they also reiterated that I should never take multivitimins in pill form and that I should only take chewable vitamins - preferably Centrum.

I had a teeny tiny bit of a veal chop lodged once that caused the most stress and pain and throwing up of any that I've ever experienced. It went on for hours and hours and it was incapacitating and I thought I was going to die. Not your regular version of a PB, which I've had many times. That episode made a believer of me and I am more careful now than I was when I had the major problem with the veal chop.

I listen to my doctor and take what he says very seriously because I know he doesn't tell me stuff just to scare me.

You should ask your own doctor and listen to him/her. I only posted about this because some people were discussing it and I hoped that if someone who had their surgery in Mexico or elsewhere and wasn't using that same doctor for fills or is getting fills and seeing a doctor very rarely, the potential dangers of swallowing pills might be something that they had not heard about.

As for fills, doctors do that differently too. My doctor believes in being extremely conservative with fills and over a two-year period, I've seen him on the average of about once every 3 or 4 weeks. My fills and other support care were included in the price of my surgery.

He uses a very tiny needle to deaden the area around the port first. It stings a little, but it is quite bearable. Then almost immediately he uses a larger needle (I don't watch) and a large syringe and withdraws any fill solution that is in the band to see what amount of fill I currently have. Then he pushes the solution back in with the amount of fill I had and an additional bit of solution (if I need more - or puts less in if I need an unfill) and then extracts the needle, puts a bandaide over my port and gives me a small cup of organic tea to drink while he gives me a pep talk. Once he sees that I can tolerate the tea, I go on my way back to work or whatever. I am not uncomfortable in any way afterwards.

The first few days after a fill I usually can't tell any difference and then after a while, sometimes a week or so, the fill seems to take effect and I learn that I can't eat as much. Yay!

Good Day To Everyone. I am so glad BJean that you posted this comment at this time. I am to see my dr. tomorrow for a fill. And sort of forgot about certain foods the body will not tolerate for us. The description you gave about receiving your fill resemble that of mines.

We must also be reminded to chew, chew and chew some more.

Keep a log of what foods are tolerable after fills so that you won't have to go through PBing. As for the pills, that's a tricky one. To get your meds in smaller pill form, may result in taking more at one time. Bummer.

Most medication do not come in liquid or powder form. So what are we to do in place of taking our meds in pill form? Some of these pills start out as horse pill size. So, now what are we to do? This procedure we had done does not get us off our meds right away. I'll look for that article but from what you've written those doctors scares me.

tcampbell 3 - next time just take a bite, and I mean a bite of meat. What to see if you will tolerate it before enjoying the rest of the meal. That may be one sign you may be in trouble with eating that.

Also, to help with digestion is papaya pills (Tropical... can't remember the rest of the brand name). You may be able to find pineapple pills. The health food store or internet may be able to help. Also, try drinking something warm/hot before your meals. Preferably tea not so much coffee even warm water. This may help open and relax your throat for eating.

So, remember to go back to the basics of eating and make the necessary adjustment to get through this.

Since I've cooked and portioned our all my meals for the week, I now have to go and redo them. For most of them are foods that will require a lot of chewing and digesting.

Good Luck to us all. Thanks again BJean.

Hey Whitepants - you've lost 107 lbs! That's fantastic!! You're definitely doing something right!

I haven't have had as much success with drinking something before I eat. In fact, this phase I'm going through will not allow me to drink anything at all and warm drinks are the worst. Go figure!!

Last year, if I drank something (not huge amounts of course) right before my meal I was able to tolerate more, like you said. So I don't know what this latest wrinkle is, but I've tested it over and over and everytime I drink anything at all before a meal these days, I wind up having a PB episode.

That's the interesting thing about the band. It keeps you constantly working to keep from getting something stuck. About the time you think you have it figured out, that doesn't work anymore.

You can't say it isn't an interesting journey!

I haven't tried the pineapple or paypaya pills or juices. When I have something lodged and am in pain, the last thing I am willing to try is adding something else to the mix. I mean at that point, I can't even swallow my saliva. But I would be interested in hearing exactly how people use those things to fix a problem.

Good Day To Everyone.

BJean, you are right when once you get into a PBing stage there's nothing you can do. It just has to take its course. But in the mean time I haven't read anyone doing anything to quicken that time.

The longest mines has lasted is 45 min. Only when I try to eat everytime I feel some sought of relief. And I know when my PBing is over. I have a bubble type sensation that comes up and then I'm done.

I am greatful for sites like this and others to help in this journey. This is the only site I am on. I'm quite others are just as helpful. But, this seems to be user friendly.

So, I'm not looking forward to what might take place after my fill today. But, I'm just going to do liquids, broths, pureed soups till Friday to not upset the sensativity of my band.

Well, let's all work with our bands for it is only a tool and we are the handlers of this tool.

Is it possible to get too filled. I feel like I am too tight. like even water is getting stuck. I was ok the 2nd day, then on the third day at night I tried to eat a little salad and i feel like its still stuck, a whole day later.

I dont' feel good. should i go back and get it loosened. I was fine before this.

Is it possible to get too filled. I feel like I am too tight. like even water is getting stuck. I was ok the 2nd day, then on the third day at night I tried to eat a little salad and i feel like its still stuck, a whole day later.

I dont' feel good. should i go back and get it loosened. I was fine before this.

You need to go get a bit of fluid removed. As soon as possible if you cannot get water down!!