I'm newly banded, and have yet to be filled. (I'm guessing this understanding comes with time) What i don't understand is once at good restriction, how do you get in all your calories, in 3 meals? And sometimes, if you are well restricted, maybe you couldn't eat a cup? Sometimes that could be too much? Didn't most of you that lose/lost well, eat about 1,200 calories a day? How do you get that all in just 3 meals?

Also, how long after you eat can you drink? Is it 30min. or 1hour?

It is all a bit confusing but it works out, and you are right that it will get better with time. But for now, let me see if I can help. Most docs, the ones that I know of anyway, say three meals a day but they also allow two or three "snacks" per day. My doc just calls them meals if they are over 100 calories, and says to eat every three hours regardless of what you call it.

I have what I consider perfect restriction (I have found my "sweet spot") and my calories range between 1100-1300 calories per day. I can only eat about 4-6 ounces of food at a time so I try to focus on my Protein first by following the 3-3-1 rule. It goes like this:

• Each meal should consist of:
  
  • A protein the size of the palm of your hand or a single deck of cards
    
  • A fruit or vegetable the size of your cupped hand
    
  • A complex carbohydrate the size of your cupped hand
    
  • Note - you portion sizes will get smaller as you get more restriction but this is a good place to start
    

  [*]Follow the 3-3-1 rule

  • First have 3 bites of your protein
    
  • Next have 3 bites of your veggie
    
  • Finally have 1 bite of your carb
    

  [*]Take small bites, chew very well, and pace yourself so you will know when you are full. (Using baby spoons and forks is a good way to train yourself to to take smaller bites.)

  [*]STOP as soon as you feel satisfied. Do not overeat!

If you are hungry again in less than 2 1/2 hours, you probably didn't eat enough. If you are not hungry in more than 3 1/2-4 hours, you probably ate too much. You should adjust your portions accordingly beginning with your next meal.

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Laura_MD, Thank you, thank you for your suggestion. When allowed only 3 meals a day I was always afraid I would get hungry before the 4 hours was up so I would eat beyond feeling satisfied and thus ended up eating too many calories/day. Today, using the 5 meal plan, I ate only until I was satisfied, knowing that I could eat again in 3 hours. Thus, I did not have to grit my teeth until the next meal since it was only 3 hours away. As a result of not being afraid I'd get hungry before the next meal, I ended up eating fewer calories for each meal and had no difficulty staying between 1000-1200 calories today. I also liked eating 3 bites of protein, 3 bites of vegetable, 3 bites of complex carb. and then repeating sequence. I felt like a normal person mixing up the kinds of food I ate at a meal rather than eating ALL the protein first, ALL the vegetable next, etc. I really like thinking in terms of having 5 meals a day rather than just 3. Even though the total calories for either plan (3 or 5 meals) might be the same, it just feels like I'm not having to deprive myself on the 5 meals plan.

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.

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.

- 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.

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Laura_MD, I think I'd like to try a bedtime protein shake for the reason you gave. Would you please give me the breakdown on the ingredients (amounts and calories) in the protein shake. Thanks .

Laura_MD, thanks so much for all of the wonderful info given! I am currently awaiting my approval, and will definitely be saving this thread for future usage! It must feel wonderful to have lost so much so quickly! You are truly an inspiration and I look forward to one day soon being one also! Keep up the great work! And please keep the info and advice coming.

how did u know that u hit your sweet

how do u know if u reached your sweet spot

how do u know if u reached your sweet spot

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:

Lorrie1, I am glad I could help. as for the "liquid diet", you are right it is mostly things like yogurt and strained Soups etc. Basically, you are trying to shrink your liver before the surgery and not irritate your stomach afterward. My docs' rule of thumb was "If you can get it through a straw, you can have it". I almost had that NY Strip through the straw by day 7, but.....no, I am kidding. I was so excited and nervous about the surgery, and busy second guessing myself, it really went by quickly.

I started watching those shows on the Discovery channel like "Super Obese" and some others and thinking that I should be able to do this on my own, I shouldn't need the surgery, blah, blah, blah. Then I decided that I should not "should" on myself. This was something I wanted to do and needed to do so I could lose the weight and keep it off, once an for all! I wanted to be healthy, and now I am. It was one of the best decisions I ever made.

Back to the liquids, my hubby made me this awesome pumpkin Soup when I was on the pre-op and post-op diet and it was a lifesaver. It's not sweet so it does not taste like pie, it is a savory soup that is very dinner like (I first had pumpkin soup at an upscale restaurant). Pumpkin has a lot of Fiber so it makes the soup really stick with you for a while and keeps things moving in the lower regions. You can also substitute butternut squash if you want. I have attached the recipe in a Word document. I think you will like it if you give it a try.

I also have a list of pre-op tips like doing all of your shopping including getting a stool softener ahead of time. The combination of pain meds and reduced Fluid intake (while you learn to coordinate you food/fluid intake) tends to constipate a lot of people and you don't want to strain, so a softener REALLY helps. You don't want to take a laxative because you have so little food intake that you don't want to rush the nutrients out of your body.

Anyway, I will look for that list and post it for you. Meanwhile, here is the pumpkin soup recipe.

Thanks Laura, I printed out your soup recipe, I will definatly give it a try, sounds yummmy. I would love to see your pre-op tips. My pre-op appointment went very well, 7days liquid, sugarfree popsicles, italian ice, jell-o, skim milk, 100% fruit juice, vegetable juice, crystal light, strained chicken or beef broth, strained low fat cream soup, tomato soup, each day required to drink, 2 to 3 Protein shakes consisting of 2 scoops of Protein powder in 12 ozs of Water. Doesn't seem impossible. I am hoping that w/some creativity I'll do fine. Just wondering why not use the skim milk to mix w/ the protein powder and why only 12 oz of water w/each shake, when not 16 or 20 oz:confused: Had my blood drawn this morning and the ekg. So I am all set, just waiting till may 20 to start the liquids.

Have a great weekend all.

Hey Laura - a northern convert to the great Australian tradition, pumpkin soup! Here's another recipe: Pumpkin Soup

If you google, you'll find dozens of other variations on this theme. I was surprised to learn recently that this soup is virtually unknown outside of Aus. It would have to be one of the most popular soups here - easily as common as tomato soup.

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!

I must not be restricted enough because I can still eat 2 cups or more per meal. I do notice that I feel "fuller" if I eat my protein first. I have been having great difficulty with pork and hamburger. I have been eating quite a bit of tuna fish lately. I have also been stuck about 3 times a week and find that I have been eating sweets again because there is no cause for concern over being stuck and I can eat more of them as well. I have had one fill (2 cc) in a 10 cc band. I am due to go back to the doc in about 10 days. At the last visit we decided not to fill again because I was getting stuck so often. I am starting to worry about pouch stretching. Since 1/25/08 I have lost 30 pounds. So, something must be working. At least I know that I am not able to gorge myself as I have in the past. Even without the sweets, I seem to be able to eat quite a bit. Hm........... Karen

thanks for the post laura! I copied it into word on my computer for future reference lol!

I haven't tried putting seafood in, but I love seafood so might try it - never occurred to me to mix those two! I did find one recipe that used a little bacon, and I think that would be yum too but haven't tried it.

And you haven't had pumpkin properly till you've had it in with the lamb roast and potatoes - now that's what I 'm talking about!!

I must not be restricted enough because I can still eat 2 cups or more per meal. I do notice that I feel "fuller" if I eat my Protein first. I have been having great difficulty with pork and hamburger. I have been eating quite a bit of tuna fish lately. I have also been stuck about 3 times a week and find that I have been eating sweets again because there is no cause for concern over being stuck and I can eat more of them as well. I have had one fill (2 cc) in a 10 cc band. I am due to go back to the doc in about 10 days. At the last visit we decided not to fill again because I was getting stuck so often. I am starting to worry about pouch stretching. Since 1/25/08 I have lost 30 pounds. So, something must be working. At least I know that I am not able to gorge myself as I have in the past. Even without the sweets, I seem to be able to eat quite a bit. Hm........... Karen

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.