Hi Everyone,

I went to see if I could get another fill today. I have been gaining weight since I quit smoking and I cant seem to get back on track. I explained to the radiologist how hungry I am and that I am snacking between meals, eating more etc. He looked at my present level of restriction on the flouro machine after I swallowed barium and said if he closed me up anymore, I would not be able to swallow.

I guess I dont understand. i dont have pouch dilatation, I dont have a slipped band, I dont have leakage, I dont barf and PB very often (maybe 3x per year). I can eat bread both toasted and untoasted, any kind of meat or vegetable and I dont get full til I have eaten at least 5-8 oz or more of food. So whats the deal? Where did my satiety go? Last year, I ate 4-6 oz and I was full. Or is it just me not listening to the signals? To prove a point, before my fill appointment, I brought a small Wendys Chili and a 3 pieces chicken nugget and 2 packages of crackers with me so I could eat it all in 5 minutes and show them how much I can eat. I ate it in the waiting room and then found out that my radiiologist was not there for the appointment and had to wait an hour to see another one. I had a lengthy discussion with the radiologist, but I am sure the guy thought I was crazy. He did compare my restriction after my previous fill with my present restriction . He said that I had more now than before , but he was absolutely sure based on the flouroscopy and barium swallow that I did not need another. I grabbed the thick barium and proceeded to guzzle it to show him that I wasnt upchucking or refluxing anything I drank or ate. Altogether, I drank 6 oz or more quickly of very thick barium the consistency of yogurt. He watched it, said it was going through slowly, it was sitting in my pouch comfortably and said everything looked normal. I explained that I quit smoking. He thinks that this is the only reason for the gain. I guess I will have to find low calorie oral fiaxations!!! LOL Anyway, he sent me on my merry way.

So back to basics for me. My plastic surgery is scheduled for August 3rd 2005. I am going to attempt to lose the weight I have gained before surgery. I was really hoping to be in the 170's now, but quitting smoking was more important for my overall health. I am a little depressed and frustrated. It seems I am maxed out at fill, not at goal and slowly gaining weight. This is not making me feel too good....

Any ideas?

Babs in TX

This is just more evidence that flouro can't tell much about what "proper" restriction looks like anymore than blind fills.

If you can eat that easily, you are not almost closed off and I don't see why this fillgiver wouldn't give you a teeny tweak.

Gotta say, it really ticks me off when these folks put more faith in flouroscopy than what the patient is actually sensing.

Unless you have tried to get a tiny tweak and that's made you too tight, you are not maxed out.

Nancy

I was instructed not to eat for 3 - 4 hours prior to an adjustment because it would affect my level of restriction. Now I don't know how or why. BUT if you can eat all that food in less than 5 minutes something is defineatly up! What size is your band and how much fill do you have in it? I might consider going to someone for a fill that does it without flouro. When I get my fill the NP putes in the saline and takes the saline out based on how much water I can drink. Just throwing some ideas your way!

But I really want to praise you for quitting smoking! I do not smoke but my mom did practically up until the day she died. She told me quitting smoking is the absolute hardest thing someone could do- but she never had a weight problem. So I think you are doing fantastic! Loosing weight and quitting smoking- you are unstoppable.

Babs,

That stinks. I'm sorry that he didn't at least try to give you a tiny bit...I got .2 cc's last time I was in and it made all the difference in the world. Maybe you could talk him into trying?

Megan

Hi Megan,

Yeah, I wished I could get more fill, but I fear the radiologist may be right. I have 2.50 in my band now. The last time I got up to 2.6, I refluxed one time and had it taken back to 2.0 by my doctor. (not intentionally). I think I am walking the fine line between too much and too little. I dont know if more fill will help me or just trying to go back to the basics. I do have some restriction since I get full with about 6-8 oz of food. I just wish it were less. I see some bandsters that get full on half a chicken nugget. Last year, I could go all day without food and not be hungry. Now I wake up and want to eat Honey Nut Cheerios!

Babs in TX

I have the same problem, except that I have never had good restriction. I have lost 46 lbs since my surgery 6 months ago, but it has all been from being on the Atkins diet. I can eat entire burgers, bun and all, half a large pizza, etc. I have 4.0 cc's in my 4.0 band. My surgeon says it needs to be moved down, so he's going back in in a few weeks to move it. He says everything looks normal according to all the tests he's run. I appear to have proper restriction during the barium swallow. Hope that's not what's going on with you. I find it strange that you had restriction before, but don't now. And they're sure it hasn't slipped? :ermm

Kat

What about discussing this with your surgeon?

IMO, it is actually up to him as what needs to be done.

Just a thought!

6-8 oz? We did a poll on the main Bandsters list on yahoo about a year ago...there are around 8000 members there...the average meal size for longer-time-out bandsters who were doing well was 1 to 1 1/2 cups...so you don't need your meals any smaller, in all honesty. If you're getting full on that amount, you have plenty of restriction...you just need to re-evaluate what you're eating and the order, etc. We all need to touch base with the basics now and then...

Nancy

HI

Im so thinking of you.Shout at people around you if you must,they must understand.

Suck a ginger root,or a clove...disgusting I know but reduce cravings.....stick it out...it is so worth it.....out of the blue one day you'll realize your not trying to put something in your mouth all the time.....we also miss the ritual of smoking a lot...keep something in your hand that you can stick in your mouth if you need to.I played with prayer beads all the time and that really helped a huge amount (a kiddies plastic necklace will also do..)A medium size carrot to hold and suck on also help.Sounds rediculess but it works....

Go girl,in a year you will not believe that you ever smoked and you will be to scared to touch one for fear of starting again and having to suffer again....

Hi Babs

Hang in there. You've done fantastic work so far (and yes, it's work) - I'm sure things will get better.

I'm having many of the same issues you mention - though my ability to eat varies tremendously throughout the day. Sometimes, I can't eat more than a few bites, and other times I can eat an entire meal and then some. As you may recall, we started about the same time - and we seemed to be on a similar path - for the first year. Then.... I've been on a plateau for almost a year. I've had fills and unfils, I've struggled with not being able to eat much at all and lots of reflux and vomiting. But - the doctor wasn't sure what was going on - or if I maxed out my weight loss. I have plently more to lose.

So... after several upper GIs - the doctor has decided I may have a slight slipped band - and my pouch seems larger than it's supposed to be - so I'm going in for new surgery July 19th to have the band repositioned and the pouch tightened. I really hope that's the answer.

I'd enourage you to keep track of what you're eating or at least if there's a pattern of eating more or less, etc. And don't go the route of getting another fill and then ending up with reflux and vomiting. "Perhaps" you might have something similar to me - with the "start" of a slipped band, etc. By the way - the radiologist thought everything looked fine. It was my surgeon who thought that it wasnt' exactly right.

On another topic - I missed your previous posts about plastic surgery - other than a brief comment that insurance is paying. Can you share how you got insurance to cover the plastic surgery? I'd really love to know. (and feel free to email me privately if you'd prefer.)

Good luck.

Mary

Babs - Quitting smoking was one of the hardest (but best) things I ever did for myself. Not only was it very stressful, but food tasted so much better, and yes I did gain weight. Give yourself a little time to adjust to not smoking, it might make a big difference in your weight loss. Right now, you are making a big step in making your life healthier.

Good luck!

BABS,

YOU HAVE LOST 154 POUNDS AND QUIT SMOKING!!!!!!!!!!!!!!!!!!!!!!

WOW WOW WOW.

You should sit back and congratulate yourself on a job well done. Give yourself some time and be kind,VERY kind to yourself. Your body is treaing you well.

YOU CAN DO IT!

Maybe you stretched your pouch? If you can't stop eating then I guess you can exersise more. I found that its easier for me to work out more than it is to eat less.

Keep us posted.

Hi nancy,

I noticed you mentioned the smartbandsters poll. I was trying to say that I can eat 6-8 oz of solid Protein. If you add all the other stuff I can eat with it, it would be far more than a cup of food or even a cup and a half. It is true that I am not making wise decisions, not exercising as much, but I simply dont feel full for a long time when I eat.

I think I need to do liquids for a while, get rid of all the trigger carbs and start all over again. I have 6 weeks til my plastic surgery!!!

Babs in TX

I'm another long-termer who can eat a lot more, sometimes, than before. I'm also, I think, on that razor's edge between not tight enough and reflux-tight. But I'm not worried about losing the last 10 lbs, so I'm not interested (yet) in going for another fill.

I think that the "full" feeling is less not because the restriction isn't what it was, but because our nerves aren't what they were. So to me it's perfectly plausible that food or Fluid would be moving slowly through the stoma but we can't quite sense it in the same way anymore. This would be so, I think, even if the band is in perfect position and everything is exactly the way it should be.

Maybe it's an inevitable passage of being banded long-term. Our lower esophageal sphincter may not be looser than it was, but the nerves around it may be losing sensation due to much more unaccustomed pressure over time. The good news is that the physical capacity of the pouch is still MUCH smaller than that of our pre-banded stomachs, so we're not without any assistance at all. But indeed our challenge is going to be a bit more difficult than it was when one tiny extra bite was enough to let us know we were overdoing it.

Hi Alex,

I was thinking that too, but you said it more eloquently. I think with the passage of time long term bandsters become accustomed to the restriction and the signal to stop is a more vague feeling. I am still eating far less than I had before. I also believe as we get further out we know how much we can tolerate and push to the limits. Afterall, we all have an incurable disease here and I still love food as much as I did before. Nothing has changed there!

Babs in TX