Nancy Degenmeister’s Posts

Nancy Degenmeister
on 8/14/07 7:59 pm
Topic: RE: 1 to 2 pounds a MONTH!
Thanks! "I was losing weight at a faster rate when I was eating about 1500-1700 calories before I had better restriction." Ok...go back and reread that a few times....wait for it....dingdingding...you're a bit too tight. You were losing better when you were eating a little more. If it ain't broke, don't fix it. If a big part of why you're not eating enough is restriction, get some fluid out. It's especially important to eat enough when you're exercising a lot. Nancy
Nancy Degenmeister
on 8/14/07 7:15 am
Topic: RE: What makes these Dr.'s MOVE?
What symptoms are pointing to a possible leak? Are your fills relaxing after a few days of getting them? or when getting another fill, is the fillgiver trying to withdraw the existing fluid to check it and it's not the same as what was recorded as going in? And while yea, it's frustrating to have to wait for appointments, it's not life threatening or band threatening...just annoying. You've already lost 28% of your excess weight in 2 months...that's way ahead of the target rate of 1-2lbs/week on average over time... Nancy
Nancy Degenmeister
on 8/14/07 7:10 am
Topic: RE: carbonation, once in a blue moon ok?
It's up to your surgeon. Some surgeons 100% forbid any carbonation. Some say it's ok if you let it sit long enough to get somewhat flat. It cannot "damage" your band...it can, however, cause bad discomfort for some people. The pouch is not sealed off so the notion that gas can stretch your pouch like a sealed balloon is fallacy. However, trapped gas (below your band in the main part of your stomach) can be extremely painful and that's never good. So, talk to your surgeon and do what he/she instructs. Nancy
Nancy Degenmeister
on 8/14/07 7:02 am
Topic: RE: How does your body know to stop losing??
As weight loss with the band isn't due to something like malabsorption (which pretty much automates loss for a good part of it for folks with those procedures), this is not a real concern for bandsters. We control loss with the band...the band doesn't control it. Nancy
Nancy Degenmeister
on 8/14/07 6:59 am
Topic: RE: Soooo Constipated
We should be aiming for at least 25g dietary fiber from food per day. Legumes are some of the best bang for the buck in terms of fiber and have the added-value of a lot of nutrition (good protein sources, nutrients, best sorts of  carbs). Make sure you're able to eat enough veggies, fruits, whole grains and legumes. If you can't, or are attempting to live on 1/2 cup meals so you're barely able to eat anything but protein at a meal), you're probably too tight. Remember that animal proteins don't contain fiber...only plant-based foods (all of which are carbs) do. Fiber supplements can help bridge the transition to getting your fiber from real food but it shouldn't be a long-term crutch instead of eating properly. Dietary fiber also seriously helps the body's satiety signals. Nancy
Nancy Degenmeister
on 8/14/07 6:54 am
Topic: RE: Sushi And Indian
I have no problem with either...I have sushi (usually a maki roll) about once a week. Indian is a nice treat and no I don't avoid rice because I don't low-carb...I do a sensible balanced approach because I like to feed my brain LOL) but just bear in mind that  anything in a sauce in Indian cuisine is extremely calorie-dense (very high fat content). Tandoori chicken (or other foods cooked in the tandoor) are better choices because they're not drenched in those yummy sauces. Keep something saucy as a small side dish. Nancy
Nancy Degenmeister
on 8/14/07 6:49 am
Topic: RE: Papya Enzyme
Better to start the meal with some hot tea or coffee to relax things before starting to eat. I too have read about the potential hazards of chronic use of papaya enzymes and frankly, I find it becomes a crutch instead of changing eating behaviors, just as much as folks who take little sips throughout their meals to "lube" things down. Nancy
Nancy Degenmeister
on 8/14/07 6:44 am
Topic: RE: Lap Band Help
It typically takes 3-5 fills to get to initial proper restriction (usually done about a month apart until things are working right). ANY weight loss prior to proper restriction is a bonus and not to be expected. The band doesn't "work" until proper restriction is achieved (and of course, you must be doing your part of the bargain, eating sensibly and exercising, etc.). Remember everyone is different...what anyone else needs in their VG band has nothing to do with what your band will need to work right with your unique anatomy :) Patience is the #1 requirement for new post-op bandsters. Nancy
Nancy Degenmeister
on 8/14/07 6:40 am
Topic: RE: 9 weeks out, no weight loss for 6, getting scared....
Any weight loss prior to proper restriction (which typically takes 3-5 fills) is a bonus and not to be expected. Your surgeon, to be honest, should be seeing you about once a month for at least the first several months to check how things are going and to add fill. I don't understand the idea of giving a patient one fill and not wanting to see them again until their loss stalls...a banding surgeon familiar with how the band works would understand that one fill is extremely unlikely to do the trick. You do, however, need to give each fill a fair tryout which is 3-4 weeks, making sure you're focusing on solid foods, and making sure you're putting portions on your plate and not having the expectation that the band will force you to stop eating midway through a pre-op portioned plate. So, put 3-4 oz solid protein, a serving of nonstarchy veggies (1/2 cup) and a serving of starch (1/4-1/2 cup, emphasis on complex carbs) on the plate, take small bites, chew to mush, put the fork down between bites so you don't rush, don't eat for longer than 30 minutes and evaluate how you feel. You're not looking for any sort of discomfort/pressure/stuck feeling...you're looking for the moment physical hunger is turned off (we call this the Soft Stop and it'll be something like a runny nose, sneeze, hiccup, burp, a little sigh) and stop eating at that point. It's highly likely with only one fill that you won't get a clear soft stop and very likely that a sensibly portioned meal isn't going to shut off hunger...so right now, when you're done, get up and go do something else instead of looking for more to eat. If you're lucky and get satiety on a proper bandster meal, check how long it takes for physical hunger to return...when properly restricted, it'll stay away for 3-4 hours after a meal. We need a fill when: 1. we're not losing and we know we're doing our part; and/or 2. our sensibly portioned meals aren't turning off hunger; and/or 3. hunger is returning too quickly after a meal. In terms of weight loss, the target is 1-2 lbs/week ON AVERAGE OVER TIME so you're already very far ahead of that and it's not uncommon after a rapid drop for the body to stall. Nancy
Nancy Degenmeister
on 8/14/07 6:28 am
Topic: RE: OK I am confused now...fill/restr. Q
Well, typically folks need 3-5 fills to get properly adjusted. You're still very recently banded so I'm guessing you've just started the process. Some swelling is very common and that goes away in a few days/week or so after a fill. Here's my advice, however... "Just because you can, doesn't mean you should."  I didn't coin this but I use it a lot when I read posts like yours. The band's job is NOT to force you to stop eating. It's there to help you get to satiety (not physically hungry anymore, NOT pressure/tightness/stuck/discomfort of any sort) and to keep physical hunger away for 3-4 hours after a sensibly portioned meal. So...start working now on putting proper portions on your plate. Put away any notion/belief that it's the band's job to force you to stop eating midway through too much food. That is not its job. Put 3-4 oz solid protein, a serving (1/2 cup) nonstarchy veggies and a serving (1/4-1/2 cup) starch (emphasis on complex carbs) on the plate. Don't let the meal last longer than 30 minutes or you'll be training yourself to eat around whatever restriction you have (think of an hourglass...the moment you put sand in it, it starts trickling through the "stoma"...your job is to fill that top part up faster than it trickles...not so fast it overflows or backs up, but not so slowly that it's trickling out and giving you more room to fill up). Also, Lean Cuisines are measured in weight not volume. A 10oz LC is  not 1 1/4 cups of food...different types of measurements. They have proper dietary portions in them. You don't want to be restricted to the point of only being able to eat a couple of bites or the "1/2 cup meal" thing...3 oz of chicken breast, when chewed, is 1/2 cup. You can't live just on that...you cannot get a balanced diet eating so little. We are not RNY patients...Bandsters eat sensible, balanced diets of real dietary portions. Nancy
Nancy Degenmeister
on 8/14/07 6:17 am
Topic: RE: Throwing up???
You are very obviously too tight. PBing (which is puking from the pouch) should be so infrequent you can hardly remember the last time it happened. If you're PBing several times a week, that's the number one huge symptom of overrestriction. I have to wonder what your impression of good restriction is? It shouldn't be blatant. It's merely getting to "not physically hungry anymore" after a properly portioned meal and then not getting physically hungry again for 3-4 hours afterwards. The band isn't there to force us to stop eating but to simply help give us satiety on a sensibly portioned meal. We should only "feel" restriction if we've screwed up (overeaten beyond the soft stop, forgotten to chew, eaten a food our band just won't tolerate, or eating too quickly). If every meal is ending with pressure or a "stuck" feeling, that's not good. I'd strongly suggest a slight unfill before you end up with a slipped band... Nancy
Nancy Degenmeister
on 8/14/07 6:13 am
Topic: RE: Poll- What was your last meal?
A banded friend of mine got me over the idea of a "last supper" when I was going through this. She reminded me that "You aren't giving up food. You aren't giving up foods you love. You're only giving up huge quantities of them and, if they're really unhealthy, you'll be giving up the frequency and allocating them to special treats. So get over it because you're not giving up food and you're not going to be on the same sort of strict food list as RNY folks. You WILL get to eat your favorites again, just much more sensibly like a healthy normal person so don't act like you're going to be living on boiled chicken, steamed broccoli and brown rice with no seasoning for the rest of your life." So, I got over it and got myself out of that mindset. Letting go and indulging in a mega snarf-fest doesn't put you in the best frame of mind for surgery. Remember why you're doing this...I'm sure that part of it is a desire to develop a healthier and more sane relationship with food. Start today...remind yourself: "It will be there tomorrow...I don't have to eat it all today." And I enjoy sushi (my fave food) about once a week. :) Nancy
Nancy Degenmeister
on 8/14/07 6:06 am
Topic: RE: Need fill advice please!
Restriction is not about how easily or not easily food goes down. You shouldn't be feeling much "overt" sensation to begin with. Proper restriction is not really a feeling...this is a common mistake new bandsters often make. Proper restriction simply is getting to "full/not physically hungry anymore" on a properly portioned (real dietary portions, not this 1/2 cup meal nonsense...3-4 oz solid protein, 1 serving (1/2 cup) nonstarchy veggies and up to 1 serving (1/4-1/2 cup) starch if still physically hungry) meal and not having actual physical hunger return for 3-4 hours after the meal. You cannot tell a thing in terms of hunger/satiety on liquids/mushies...solid food is required for this purpose.  If you're eating to the point of feeling pressure/stuck, you're doing something wrong such as overeating and ignoring your soft stop (which will be something like a burp, hiccup, sneeze, runny nose, a little sigh, an involuntary moment where you sit back and pause) or eating too quickly or not chewing properly. Remember to take very small bites, chew to mush, put your fork down between bites (this serves 2 purposes...prevents having the next bite ready to go and gives you enough pause between bites to assess satiety) and don't allow meals to go on longer than 30 minutes or you'll be training yourself to eat around your band. You need a fill if: 1. you're not losing and you know you're doing everything you're supposed to be doing; and/or 2. your sensible bandster meals aren't making you "not physically hungry anymore"; 3. and/or hunger is returning too quickly after a meal. Nancy
Nancy Degenmeister
on 8/14/07 5:59 am
Topic: RE: 3rd fill tomorrow.
The typical range to get to initial proper restriction is 3-5 fills. The VG band with its larger capacity, thus more "wiggle" room for fine tuning, often takes more adjustments to get right initially. However, that being said, fills are only part of the equation. You need to work on getting into the habit of putting proper portions on your plate. It's better, prior to proper restriction, to eat small meals more frequently than to continue overportioning meals. The band isn't there to force you to stop mid-way through a pre-op sized meal...it's there to help you feel full (full = not physically hungry anymore) on a bandster-sized (proper dietary portions, not micro-portions) meal and then not get physically hungry again for 3-4 hours. You can't tell if you're properly restricted unless you're eating proper portions so you can judge hunger/satiety based on those portion sizes and how soon hunger returns after the meal. Folks who force their bands to force them to stop often end up with complications such enlarged pouches/esophagal dilation. Nancy
Nancy Degenmeister
on 8/14/07 5:52 am
Topic: RE: Finishing up 3 month pre-diet and haven't lost a pound!
If it's for insurance approval purposes, the whole point is to prove you cannot do this on your own. If it's for pre-op liver-shrinking, it's not about weight loss but reducing the fatty deposits in your liver. If the surgeon is a sadist and thinks you should prove you're "serious" by showing you can do it without the tools surgery puts into place, I'd be trotting off to another surgeon frankly. If we could do this on our own we wouldn't be employing a surgeon. Nancy
Nancy Degenmeister
on 8/14/07 5:49 am
Topic: RE: Update on "Lying Surgeons Office" Post
First person I met in all 3 top-notch practices I consulted with in my search was the SURGEON. I wouldn't bother with any practice where that was not the case. I don't care about the NPs or psychs or whoevers if I don't feel comfortable with the person holding the knife. You just cannot select a surgeon without MEETING and CONSULTING with the surgeon first. Nancy
Nancy Degenmeister
on 8/14/07 5:44 am
Topic: RE: 1 to 2 pounds a MONTH!
You mentioned in your post on the other forum that you were burning around 600 cal in the gym...so really, your body thinks it's getting 600 cal/day if you're eating 1200 cal/day. I think you need to feed your body a little more...it thinks it's starving and is slowing loss down. With that much exercise, you need to eat more than someone who isn't exercising as much. Nancy
Nancy Degenmeister
on 8/14/07 5:42 am
Topic: RE: Questionabout fill??
Generally speaking, 0.1cc (one tenth of a cc). Nancy
Nancy Degenmeister
on 8/14/07 5:41 am
Topic: RE: HELP! MY HAIR IS FALLING OUT!
As long as you're eating a healthy balanced diet, you can rule out nutritional issues. In general, this is a normal delayed reaction to surgery and/or the hormonal issues involved with weight loss and it will stop soon and it will regrow. Nancy
Nancy Degenmeister
on 8/14/07 5:39 am
Topic: RE: lap RNY to Lap band???
It's not actually a "conversion" to the band but the addition of the band to the existing RNY in order to correct an enlarged stoma. If that's not your mechanical issue, adding the band won't help. Regains happen for a variety of reasons...some are mechanical which can/should be medically addressed and others are behavioral. Seeing your surgeon is the first step in determining what the problem is. Nancy
Nancy Degenmeister
on 8/14/07 5:35 am
Topic: RE: Band removal - converting to RnY
Did you also look into the Vertical Sleeve Gastrectomy? The nature of that surgery leaves the pyloric valve intact (thus a fully functional, just much smaller stomach) and no risks associated with malabsorption as it's another restrictive-only procedure. The nature of the RNY pouch is also potentially problematic for reflux sufferers. The VSG doesn't seem to have that potential problem. The RNY is very likely overkill since you don't have much to lose but instead need/want to lose a smaller amount and are of course most concerned about maintenance. Nancy
Nancy Degenmeister
on 4/27/07 10:39 am
Topic: RE: Where is Bridget that wrote the cookbook?
She, like me and many others, has gotten sick of the drama and one person's need for an incredible amount of attention... Nancy
Nancy Degenmeister
on 3/31/07 9:40 am
Topic: RE: VITAMIN WATER? OK TO SUPPLEMENT OUR VITAMIN INTAKE?
What brands have you tried? Viactiv might be more tolerable. And frankly, most bandsters don't need to avoid pills. The vitamin I have used most of the time is GNC's Solotron liqui-cap. Goes down fine with hot tea and I don't worry about it because it dissolves quickly. You do need to take a multivitamin...that's really part of the deal and especially important when reducing calories. You just need to try some other types to find something that works better. Frankly, the liquid formulas, IMO, are by far the gaggiest/nastiest...they're like hyper-sickly-sweet children's cough medicine...barf. When I tried them (and I tried 3 brands), they all gave me the screaming huhs.... The least offensive chewable true multi for me was GNC's adult chewable. Nancy
Nancy Degenmeister
on 3/31/07 8:01 am
Topic: RE: VITAMIN WATER? OK TO SUPPLEMENT OUR VITAMIN INTAKE?
If you're taking an adult formula multivitamin, what is there to supplement? Nancy
Nancy Degenmeister
on 3/31/07 7:59 am
Topic: RE: What do you do when you eat something mega spicy or hot and can't drink water???
Well, drinking water when dealing with very spicy food is about the worst thing you can do, banded or not LOL That only spreads the heat onto more sensitive mucous membranes. That's why cultures that have very spicy cuisines always have some starch with those foods. If you're going to have something very spicy, make sure you have a little rice or similar...you don't need a lot, but a bite of rice or a cracker with absorb the heat much more effectively than drinking something that only spreads it around. Nancy
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