Rules for Banding success by Jean McMIllian

Jul 12, 2009

Hey everyone! I recieved these from Jean Mc Millian off the Lapband forum. Hope you enjoy and it helps you!! Natalie

A MONTH OF RULES FOR SUCCESS WITH YOUR ADJUSTABLE GASTRIC BAND         
  INTRODUCTION These rules are based on information provided by my bariatric surgeon and bariatric nutritionist. They are not listed in order of importance.     DAY 1
DON'T DRINK WHILE YOU EAT OR FOR 30-60 MINUTES AFTERWARDS
1.  Drinking while you eat or immediately afterwards will wash the food through your stoma.
2.  The faster the food leaves your stomach, the sooner you're going to be hungry again.
3.  When the food vacates your stomach quickly, it is all too possible to overeat.
4.  When your stoma is full of food (especially dense food like animal protein), liquid can have
      a hard time getting through it.  A PB (regurgitation) can result.  Never PB'd?  Take my word for it - not
      fun, and definitely not socially acceptable.

Pre-op, I thought this rule was going to be the hardest to learn to live with, but it only took me a week or so to get used to it.  I don't even put a beverage on the dining table.

If you eat something spicy, or salty, or strongly flavored, and think you will die if you don't take a drink, rinse your mouth with water and spit it out.  Or suck on a Tic Tac. Better yet, go brush your teeth as soon as you've finished eating.  Your dentist will thank you!

I don't know why some surgeons say to wait 30 minutes while others say 60 or even 90 minutes.  My surgeon says 30 minutes is fine.  If I'm at home, I set the kitchen timer for 30 minutes and when it buzzes, I start drinking again. 

Some people say they can't get their 64+ oz of liquids in each day because of the no-drinking while/after eating rule.  That has never been a problem for me.  Except when you're newly post-op or adjusting to a new fill, you should be able to drink generously.  I estimate that I'm awake for 14 hrs a day.  6 hrs of that is devoted to eating my meals and snacks and a 30-min waiting period after each meal or snack (that's allowing 30 min/meal - sometimes I don't take that long).  That leaves 8 hrs for drinking liquids.  If I drink 8 oz per hour, I get my 64 oz in easily.  So I don't want to hear any more excuses about not being able to drink enough! (We'll take about the importance of drinking water in another post)


DAY 2   TAKE TINY BITES The purpose of digestion is to convert large organic molecules that cannot be absorbed into the blood stream or cells into smaller molecules that can be absorbed. Digestion begins in the mouth, where saliva mixes with the food and begins to break it down. By taking tiny bites, you are aiding the breakdown of your food, so it gets digested properly and gets through your stoma without problems.   Try cutting all your solid food into pencil-eraser size pieces before you put it in your mouth. The very act of cutting up your food and chewing it one little piece at a time will slow down your eating and may actually help you enjoy it more. I used to hoover down huge bites of food so quickly and indiscriminately, I hardly tasted it. If I did that now, I’d make myself sick. Not a pretty sight.   Eating with a baby spoon or cocktail fork can help.     DAY 3   AVOID ALCOHOL Aw, what a party pooper! Well, I do enjoy a glass of wine, but…   My surgeon told me: no alcohol for 6 months after surgery because it can irritate the stomach.   Here are some other reasons to avoid alcohol:   1.     empty calories with no nutritional benefit 2.     alcohol lowers your inhibitions, making it all too easy to overeat, make poor food choices, and take yet another drink 3.     increased risk of liver damage, hypertension, some cancers (including breast cancer, stroke, accidents, and more 4.     potential for transfer addiction 5.     after WLS, your small upper stomach pouch may have trouble processing the alcohol, which can make you a cheap drunk, or get you into trouble   I know they say that a glass of red wine is good for your cardiovascular health, but before you take that drink, ask yourself if you’re using the health thing to justify something you would do regardless? Would you rather “spend” 100 calories on a glass of wine that runs right through your stoma, or spend it on solid food that keeps you satisfied for hours?   Here’s my alcohol testimony. I went on vacation in the Caribbean. I had great restriction at the time, did not overeat, but gained 6 lbs in 5 days. Why? Two words: rum punch.   If the prohibition of alcohol is enough to make you reconsider WLS, I would suggest that you need to address your drinking issues even more urgently than you need to address your eating issues.     DAY 4   EXERCISE REGULARLY   I know, I know. I hated exercise too. When you’re obese it can be hard to get your body to cooperate, your endurance may not be so great, and you may have medical conditions (like bad hips or knees) that make exercise difficult.   Weight loss is a pretty simple formula: you must burn more calories than you consume. You can lose weight without exercising if you cut your food intake enough, and the band certainly helps with that, but you can maximize your weight loss by exercising more.   Afraid that exercise will make you gain weight as you build muscle mass? Not too likely, especially if you’re a woman (women don’t bulk up the way men do because we don’t have enough testosterone). And I wouldn’t mind weighing 500 lbs if I could wear a size 6.   In addition to burning calories, exercise has the following benefits: lowers blood pressure, lowers cholesterol, regulates blood sugar (by helping the body handle insulin more efficiently), improves heart and lung function, prevents certain cancers, strengthens your bones, prevents strokes, prevents back pain, improves sleep, strengthens and tones your muscles (and more muscle means a faster metabolism), and best of all (for me) it improves your mood.   Exercise doesn’t have to be boring. I do a wide variety of activities to keep my workouts interesting. Walking is wonderful exercise (especially if you listen to music while you walk), and walking outdoors doesn’t cost a thing (except maybe the price of a good pair of walking shoes). I started out with several 5-minute walks a day and gradually built up to 40-60 minutes of exercise a day. If you’re chair-bound because of a disability or medical condition, there are chair aerobics DVD’s available.   So, get moving!     DAY 5   DON’T WATCH TV OR READ WHILE YOU EAT   For me, it’s way too easy to overeat, or to neglect my band eating skills and get into trouble, if I’m distracted while eating (by watching TV, reading, or even socializing). I get more enjoyment out of my food – and a higher satiety level – if I really pay attention while I eat. I can’t tell you how many times (in my pre-op days), I ate myself into a coma and didn’t even remember how the food tasted.   And stay away from that computer when you eat. Crumbs in the keyboard are not good for it or you!     DAY 6   SEE YOUR SURGEON ON A REGULAR BASIS   I see my surgeon once a month (more often if needed) whether I get a fill or not. I’m glad he follows me that closely. The long drive is well worth it to me.    Every time I see him, my surgeon answers my questions; offers helpful suggestions; and monitors my weight loss, any symptoms I’m having, and my general health.   He listens to my heart and lungs and palpates my abdomen. Every 3-4 months, he orders blood tests to check my cholesterol, triglycerides, blood sugar, A1C, potassium, calcium, iron, B12, folate, and other levels, and reviews the results with me.    Mine isn't the only surgeon who says that patients who don’t come for regular follow up visits after surgery are less likely to achieve their weight goals, and more likely to regain weight.   Don’t ever be afraid or embarrassed to ask questions of your surgeon (or whoever he/she designates to take care of you).  Don’t let them rush you through an office visit. It’s their job to answer your questions, address your concerns, (if indicated) refer you to another medical professional, and attend to your needs, however long that takes.     DAY 7   MAKE A PLAN FOR AFTERCARE   For most people, the band doesn’t work without fills. Achieving (and maintaining) optimal restriction can take more than one fill. Since joining OH, I’ve been surprised by how many members get banded by a surgeon located a considerable distance from their home (such as Mexico), with no plan for how to get fills, aftercare, or possible emergency treatment (it’s not safe to assume that your local ER will know what to do if you need an unfill). I realize that some people aren’t as lucky as I am in their geographic location. I would certainly travel a great distance to see a superior surgeon, or if I were self-pay and could only afford a Mexican surgeon. But you need to consider all this, and its effect on your budget (both in terms of time and money), before you go into the operating room.     DAY 8   EAT SLOWLY, BUT NOT FOR MORE THAN 30 MINUTES AT A TIME   Eating too fast is a good way to end up with food stuck in your stoma.   Eating slowly allows your brain to catch up with the news that your stomach is getting full (this takes about 20 minutes).   But if you can’t finish your meal in 30 minutes, put it away. It takes about 30 minutes for food to move out of your stomach. If you continue to eat after 30 minutes, you may end up overeating because by then you’ll have room for more food than you had originally planned to eat.   Try putting your eating utensils down between each bite of food. This automatically slows me down. Instead of concentrating on shoveling up that next forkful of food, I’m able to concentrate on chewing and enjoying the food that’s already in my mouth. Some people find that using a baby spoon helps them take smaller bites and thus slows down their eating.   Eating slowly can help anyone’s weight loss – not just a bandster. A Japanese study of 3287 adults showed that those who ate quickly were 300% more likely to be overweight than those who ate slowly. A recent study of bariatric surgery patients indicated that it is the act of food moving through the stoma, regardless of stoma or pouch size, that provides satiety. The way to maximize this is to eat slowly.     DAY 9   HAVE REALISTIC WEIGHT LOSS EXPECTATIONS   Average weight loss with the band is 1-2 lbs/week. If you expect to have band surgery and wake up the next day 100 lbs lighter, you’re going to be disappointed (OK, I know I’m exaggerating).   The 1-2 lbs/week rate of weight loss average includes patients who lose no weight and patients who lose a lot of weight. It’s certainly possible to lose more than 2 lbs/week with the band (especially in people who start out heavier), but I see too many people berate themselves for being a failure when actually they’re losing very well.   And while it would be nice if we could all lose weight at a nice, steady rate, my own weight loss has been very uneven – a few pounds one week, one pound the next week, nothing the week after that, and so on. I have survived numerous weight loss plateaus that seemed endless – but they did eventually end. Try not to let the scale mess with your head. If you’re letting a daily scale reading ruin your day, I suggest that you lock your scale in the trunk of your car, or have a loved one hide it from you, and weigh yourself once a week.     DAY 10   AVOID CARBONATED BEVERAGES   Carbonated beverages include soda (diet or regular), beer, sparkling water, champagne, tonic, and soda water. And don’t forget effervescent products like Airborne and Alka Seltzer.   The theory is that carbonation can stretch your stomach pouch. I don’t know how likely that is, but why risk it?   Another consideration: the banded gastrointestinal system may not be able to handle carbonation as well as an unbanded system, so drinking carbonated beverages can cause discomfort, including burping (my experience) and intestinal gas. What’s so bad about burping? The act of burping can carry acid into the esophagus, which can cause lesions.   Carbonated beverages can be a gastric irritant. The stomach reacts to this by applying its own supply of “antacid” – the calcium in your blood – and the blood replenishes its supply by drawing calcium out of your bones.  And most sodas contain phosphoric acid, which also leaches calcium from the bones. Which is why some people call soda “osteoporosis in a can”.     DAY 11   DRINK AT LEAST 64 OUNCES OF WATER A DAY   Plus another 8 ounces for every 25 lbs overweight you are. And more when you exercise or spend time outdoors in hot weather.   There is some debate over whether adults really need to consume this much water, but according to information my nutritionist gave me, you need it because: 1)     drinking water can suppress your appetite 2)     a decrease in water intake will cause fat deposits to increase 3)     an increase in water intake can actually reduce fat deposits   Your kidneys can’t function properly without enough water. When they don’t work to capacity, some of their workload is transferred to the liver. One of the liver’s primary functions is to metabolize stored fat into usable energy for the body. But if the liver has to do some of the kidneys’ work, it can’t operate at full throttle, so fat remains stored in the body and weight loss slows or stops.   Inadequate water consumption can also cause: 1)     constipation 2)     dehydration 3)     fluid retention 4)     muscle spasms   I often hear bandsters complain about how difficult it is to drink 64 ounces of water a day when you’re not allowed to drink for a certain time period before and after you eat. As I mentioned in the Day 1 section, that has not been a problem for me.  Except when you're newly post-op or adjusting to a new fill, you should be able to drink generously.  I estimate that I'm awake for 14 hrs a day.  Six hours of that is devoted to eating my meals and snacks and a 30-min waiting period after each meal or snack (that's allowing 30 min/meal - sometimes I don't take that long).  That leaves 8 hours for drinking liquids.  If I drink 8 oz per hour, I get my 64 oz in easily.    If you don’t like water, try flavoring it with one of the billion flavors of Crystal Light or SF Kool-Aid. Or add a squeeze of lemon, lime, or orange (Real Lemon now sells packets of crystallized lemon, lime and orange – found near sugar and sweeteners in the supermarket). Or drink herbal tea. My nutritionist also counts other liquids (like skim milk, protein shakes, broth, juice, decaf coffee or decaf tea) as part of the 64 ounce daily minimum. Caffeinated and alcoholic beverages do not count because they can act as a diuretic.     DAY 12   AVOID LIQUID CALORIES & SLIDER FOODS   Calories in liquid form vary nutritionally (skim milk, low-sugar fruit juice, some fruit smoothies, tomato juice, V-8 juice, juiced veggies, and protein shakes are fine, while milkshakes, alcohol, regular fruit juice, some fruit smoothies, and fancy coffee/tea drinks are not so fine), but for most bandsters, they’re all the same in one respect: they don’t stay in your stomach long enough to keep hunger at bay.   Two of the purposes of the band are to (1) create a small upper stomach pouch and thereby limit how much food you can eat at one time, and (2) create a small stoma (the opening between the upper and lower stomach) which slows down the movement of food so that your smaller meals keep you satisfied longer. Drinking liquid calories circumvents both of these features because liquids run right through the stoma, so you get calories without satiety.   There are times when drinking liquid calories may be necessary – during a pre- or post-op liquid diet, or for a day or so after a fill (depending on your surgeon’s instructions), or when recovering from a stuck episode or anything else that irritated your stoma, or when treating a band slip.   What about protein shakes?  They do have a useful role in the life of a bandster. If your band is too tight in the morning to allow you to eat solid food, my nutritionist says it’s better to drink a protein shake than to skip breakfast altogether (for more on this, see Day 14). Some bandsters (especially those who have never been breakfast eaters) find that a protein shake in the morning is an easy option. Others may find it necessary to supplement with protein shakes if they’re struggling to get in enough protein each day.   Slider foods are foods that can slide through your stoma all too quickly and easily.  They may be nutritious, but often they're junk, and the bottom line is, they don't keep you feeling full for very long.  I still eat the nutritious ones, usually when my band is too tight for me to eat anything else (in the morning), but I have to keep a careful eye on this whole thing...

Here are my slider foods:

Nutritious:

yogurt
SF pudding
skim milk
cottage cheese
ricotta cheese
mashed potatoes
soft-boiled eggs
Scrambled eggs
protein shakes
smoothies
Refried beans Guacamole
anything pureed
applesauce
juice
soup

Not So Nutritious:
potato chips tortilla chips cheese puffs pork rinds alcohol candy
cookies
ice cream
milk shakes
cream cheese
thin crackers


Undecided category:
nuts (high in protein, often high in good fats, but overall high in calories, and I find portion control
   is a real challenge)
raisins and other dried fruit (good for you, but high in calories, and again, portion control is a challenge)
pretzels (sometimes they get stuck in my stoma)
thick crackers (can get stuck)
popcorn (the hulls can accumulate in your stoma)
soft cheese (like Boursin, Laughing Cow)
  Also related to this is what’s known as Soft Calorie Syndrome, which can happen when you’re band is chronically so tight that all you can eat are soft (and liquid) calories that tend to be higher in calories, carbs and fats than solid foods. And as a result, your weight loss stalls (or you gain weight). This has happened to me more than once during my WLS journey.     DAY 13   EAT ONLY WHEN YOU'RE HUNGRY   It sounds so simple, but it's not. Many overeaters, including me, have no idea what it feels like to be physically hungry because we're eating constantly and because we're eating for reasons unrelated to physiological hunger. We eat because we are happy, sad, angry or bored. We eat because the food smells so good, or tastes so good, or because it came from our mother's kitchen.   Even normal weight people occasionally eat when they're not hungry. They're not physically hungry after a huge Thanksgiving dinner, but they still eat that piece of pumpkin pie. But eating that way all day, every day, will jeopardize your weight loss success. So your assignment is to learn how to identify physical hunger, head hunger, mouth hunger, and satiety.   Physical hunger is related to your body's need for fuel, and you feel it in your body. Head hunger is related to your brain's need for stimulation, comfort, routine, habit, pleasure and expression. Mouth hunger is related to your need for the comfort and satisfaction of chewing, tasting, eating, sucking (and even smoking).   Satiety is the sensation of having had enough food. That's a hard one to figure out if you're like me and feel that there isn't enough food in the world to fill the hole inside me. After adjustable gastric band surgery, you will have to pay close attention when you eat and learn your body's full signals. I'll talk about those signals (soft stops and hard stops) another day.       DAY 14   EAT BREAKFAST   Your mother was right: breakfast is the most important meal of the day. Studies have shown that eating breakfast gives you a better attention span, greater focus, and more productivity. It can lower your cholesterol, thereby reducing your risk of heart disease, because people who eat breakfast usually consume less dietary cholesterol than those who don’t eat breakfast. Eating breakfast makes it easier to achieve your daily nutritional goals, and it minimizes impulsive snacking as well as overeating at other meals.  People who eat breakfast tend to consume fewer calories throughout the day than people who don’t eat breakfast.   When you skip breakfast, you are in effect subjecting yourself to a 15-20 hour fast during which your body is unable to produce the enzymes needed to metabolize fat. Your metabolic rate drops. Your blood sugar drops, which makes you hungrier and reduces your energy level. People who skip breakfast have a metabolic rate 4-5% below normal, which translates to a weight gain of 8 lbs per year.    My nutritionist recommends eating within one hour of waking each day. When you wake up in the morning, your blood sugar and glycogen stores (carbohydrates stored in your muscles and liver) are depleted and your body is searching for fuel. If you don't feed your body it goes into conservation mode, drops your metabolism, preserves your fat stores and eventually uses muscle tissue for the energy it needs.   In one weight loss study, two groups of women were compared. The first group followed a low calorie diet (1200 calories) that included a balanced protein/carbohydrate intake. This group ate 50% of their daily calories in the morning (600 calories). The second group followed a low calorie (1000 calories), low carbohydrate diet and ate 25% of their calories in the morning. The first group lost an average of 40 pounds over 6 months, while the second group lost 10 pounds (28 pounds in the first 4 months, followed by an 18 pound regain).   If you don’t like traditional breakfast foods, eat something you do like for breakfast. My husband eats leftovers from the previous night’s dinner for breakfast. If you’re too rushed to prepare breakfast, grab something quick: yogurt, cottage cheese, a hard-boiled egg, a slice or two of deli meat or cheese, a piece of fruit, a protein bar or granola bar. If your band is too tight to allow solid food in the morning, have a protein shake. Try to include both a protein (for long-lasting energy) and a carb (for quick energy) in your breakfast.     DAY 15   GET AT LEAST 8 HOURS OF SLEEP EACH NIGHT   How much you sleep affects the production of two hormones, grehlin and leptin, that are instrumental in managing your weight. Ghrelin, which is produced in the gastrointestinal tract, stimulates appetite, while leptin, which is produced in fat cells, sends a signal to the brain when you are full. Inadequate sleep drives leptin levels down, so you don't feel as satisfied after you eat, and causes ghrelin levels to rise, so your appetite is stimulated and you want more food. In a joint project, researchers at Stanford University and the University of Wisconsin studied 1,000 volunteers who reported the number of hours they slept each night.  Doctors measured the participants’ ghrelin and leptin levels and charted their weight. The result:  those who slept less than eight hours a night not only had lower levels of leptin and higher levels of ghrelin, but they also had a higher level of body fat.  Those who slept the fewest hours per night weighed the most.   DAY 16 KEEP A FOOD & EXERCISE LOG A recent study by the Kaiser Permanente Health Research Center in Oregon showed that people who log their food and exercise lose twice as much weight as people who don’t keep a food. Here are some ways food and exercise logs can help you achieve your weight loss goals:
  • Knowing a food will go into your log prompts you to make you make a careful choice about whether to it eat it not.
  • Knowing a food or exercise will go into your log keeps you honest about what you’re really putting in your mouth or how much you’re really moving.
  • Logs can draw attention to unhelpful eating patterns or things you might have been doing without realizing it (for example, eating in the car, or missing meals and then eating whatever you can get your hands on).
  • Logs can help you be more aware of situations, feelings or thoughts that make you eat more than you had planned to.
  • Exercise logs help you plan to be more active on a daily basis.
  • Food logs can help you meet your daily nutritional goals by tracking your protein, carb, fat, and other intake.
  • Logs give you something to look back on to see how things have changed over time, and can help explain unexpected weight gain.
  • Logs give you a tangible record of your accomplishments and can help facilitate your meetings with your nutritionist or surgeon.
Online services make keeping logs easy. Most services have extensive databases of foods and activities, with a feature that allows you to add custom foods or meals. You just look up the food using a search function, specify the quantity, and add it to the log. Many of these services will calculate what your daily caloric intake should be based on your height, weight, activity level, and weight loss goals. I like the software that I bought at www.dietorganizer.com because it’s user-friendly and has lots of neat reports, but there are many free sites, including: www.myfooddairy.com
www.sparkpeople.com
www.my-calorie-counter.com
www.myfitnesspal.com
www.fitday.com
www.thedailyplate.com
www.calorieking.com www.myfitnesspal.com   I plan my meals in advance, so it takes me maybe 5 minutes every morning to log my food. If I stray from my plan, I revise my log as I go along.   Note: food logs don’t work very well if you don’t weigh and measure your food before you eat it.   It’s perfectly possible to succeed at weight loss without keeping a food and exercise log. Some folks might think I’m an obsessive-compulsive, and I’ll admit that I love stuff like logs, journals, charts and reports. But if you’re struggling to manage your food intake, why not give it a try?     DAY 17   EAT THE PROTEIN FIRST AT EVERY MEAL   This rule contradicts what most of us learned in our pre-op dieting days, when we were told to fill up on low-cal or low-carb veggies. Veggies (and fruit) are an important part of a healthy diet, but if you fill up on them you may find yourself too full to eat your protein.   Eating your protein is important because: 1)     protein gives a greater, and longer-lasting, sense of satiety than carbs do 2)     your body needs protein for muscle repair 3)     the body can’t store protein the way it stores carbs (it stores carbs in the form of fat, by the way) 4)     protein deficiency can cause anemia, fluid retention, poor wound healing, hair loss and fatigue   Both protein and fats can be converted to glucose when needed for energy, but glucose and fats cannot be converted to protein.    I’m not advocating a no-carb diet. I’m the only person I know who gained weight on the Atkins Diet. You do need the fiber, vitamins and minerals found in vegetables, fruits, beans and whole grains. But neglecting your protein intake can have serious consequences for your health and can slow your weight loss.     DAY 18   GET COUNSELING for issues related to eating disorders (like binge eating, purging, compulsive overeating) and emotional or stress eating.   If you can’t afford counseling, consider attending OA (Overeater’s Anonymous) or FA (Food Addicts Anonymous) meetings. If you belong to a church, pastoral counseling is often available at no cost. The pastor of my church has a degree in psychology and work experience as a counselor, and the counseling he has given me has never been overloaded with religious messages.   In my opinion, no weight loss surgery of any description is going to cure eating disorders or emotional eating. Most of us became obese because we struggle with eating demons that live in our heads. Having stomach surgery is not going to banish those demons.   Seeing a counselor or therapist doesn’t mean you’re crazy. If you had a child (or pet) who was struggling with emotional issues or health problems, wouldn’t you do everything in your power to help that child? Think of your emotional self as a needy child, and do your best to take care of her/him.   Counseling has been very helpful for me, especially because my counselor is experienced with WLS and eating disorder patients. I found her by calling the Behavioral Services Department at my local hospital. You can also get a referral from your bariatric surgeon, PCP, or GYN. Or you can get a list of participating mental health providers from your insurance company.     DAY 19   TAKE YOUR VITAMINS, MINERALS & MEDICATIONS faithfully   Physicians vary in their recommendations for vitamin and mineral supplements, but take whatever your doctor or nutritionist recommends faithfully. Most adult women need a multivitamin and a calcium supplement. This is such a simple thing to do for your health. Yes, ideally you should get all of your nutrients from food, but when your caloric intake is drastically reduced, it may not be possible to get everything your body needs from food alone.   There is some disagreement about whether the banded stomach can absorb supplements and medications as well as the unbanded stomach. I can only think of two things that might affect absorption: 1)     the small upper stomach may provide less digestive enzymes because of its small size (but the lower stomach will still provide necessary enzymes) 2)     supplements taken in pill or capsule form may not pass through the stoma immediately, so they sit in the upper stomach pouch dissolving slowly (which could affect their absorption, to say nothing of irritating your stomach)   Is calcium citrate better than calcium carbonate? Calcium citrate is alkaline-based, while calcium carbonate is acidic-based. Calcium is more easily absorbed in an acidic environment, so in theory calcium citrate is better. However, I haven’t been able to find a chewable calcium citrate supplement that I could gag down, so I take calcium carbonate (Viactiv brand).   I take my multivitamin and calcium in chewable form not because I believe my body will absorb them more easily but because it’s easier to get them through my stoma. The only problem I’ve had since being banded was the result of taking a medication that was too big to go through my stoma. It irritated my stoma so badly that I ended up in the ER and had to get a major unfill. So I encourage you to take your vitamins, minerals, and medications in chewable or liquid form whenever possible, or to cut them up in small pieces with a pill-splitter (unless your doctor or pharmacist tells you not to do that – time-released formulas, or pills with enteric coating, should not be cut up). Your nutritionist may advise differently, but if you read the labels on multivitamins, adult formulas really do provide more than children’s formulas. You can choose from expensive bariatric vitamins (like Bariatric Advantage), or more affordable brands (like Centrum) or “generics”. I know from my past work experience that generic nutritional supplements are made in the same facilities, according to the same quality standards, as brand name supplements – but they may not be made from the exact same formulas.    So read the labels!   DAY 20 USE A SALAD PLATE INSTEAD OF A DINNER PLATE And consider using a baby or toddler spoon if you tend to take bites that are too big. I have some 8” diameter salad plates that are part of a set my aunt gave me. The dinner plates from that set were broken and discarded years ago, but I couldn’t bear to part with the remaining pieces because they’re beautiful and have sentimental value. So I was happy to find a use for them after I was banded. My small servings of food don’t look nearly as lonely on these plates as they do on a regular 10” dinner plate. I don’t feel deprived with that (small) plateful of food. And my (non-banded) husband has discovered that he can easily cut down his food consumption just by using the smaller plates. His tendency (from childhood) is to “measure” his servings by how much food he can pile onto his plate. If you gave him a turkey platter, he’d fill that with food and (because he’s a member of the Clean Plate Club) eat every bite. Give him a salad plate and he’s happy with that amount of food. Sometimes he’ll have a second serving of a favorite food, but usually one plate will do it. If you don’t have any salad plates, you don’t have to invest a fortune in new ones. Many discount stores sell dishes on an open stock basis, or you can find a plate at a flea-market, the Goodwill Store, or a dollar store.   DAY 21 DON’T PUT SERVING DISHES ON THE DINING TABLE When you serve meals “family style”, with serving dishes on the dining table, you will be tempted by the sight and smell of that food to give yourself second or third helpings. At my house, we serve ourselves at the kitchen counter, right from the cooking pans. I keep my kitchen scale on the counter next to the stove, so it reminds me to weigh my food before I put it on my plate. We take our loaded plates to the dining table (about 7 steps away from the counter, in a different section of the kitchen). If we want more food, we have to get up and go back to the counter to get it. When we have guests (like my elderly mom) who are unable or unwilling to serve themselves from the counter, I gladly plate their food and serve it to them at the table. This method also cuts down on dishwashing, because there are no serving dishes to wash!   DAY 22 FORGIVE YOUR TRANSGRESSIONS Nobody’s perfect (except God). We all make mistakes. Learn from your mistakes, try not to repeat them, and move on. Perfectionism is all very well (I’m inclined that way myself) when it makes you strive for excellence, but when you don’t forgive your own transgressions, it’s too easy to get stuck in a negative cycle like this: 1)     you screw up and eat something you shouldn’t, or miss a workout, or whatever 2)     you beat yourself up about it (“I screwed up again!”) 3)     you feel like a failure (“I’ll never get this right”) 4)     you think, “I’ve ruined this day, so I might as well have another (chocolate bar, or whatever)” 5)     you feel even worse about yourself (“I’m out of control!”) 6)     you screw up again 7)     and so on This kind of cycle will keep you going in circles instead of moving toward your goal. A more productive approach would be something like this: 1)     you screw up 2)     you notice the mistake 3)     you learn from the mistake (with a realization like: “Oh, I tend to snack when I watch TV”) 4)     you make a plan for how to deal with similar situations in the future (“I’ll walk on my treadmill instead of snacking while I watch TV”) 5)     you stick to your eating, exercise, or other plans for the rest of the day 6)     you feel good about yourself (“I’m on my way!”) 7)     and so on Hint: if sticking to your eating, exercise, or any other plan for a whole day seems like too gargantuan a task, concentrate on sticking to the plan for an hour. Or 15 minutes. Or 5 minutes.  So many times I see people demonstrate far more tolerance and understanding towards other people than they ever give themselves. Be kind to yourself!   DAY 23 EAT SITTING DOWN AT THE DINING TABLE When I eat sitting down at the dining table, I’m making an occasion of my meal and am much more likely to pay attention to my food – and my band eating skills – than if I eat standing up (eating at the kitchen counter is all too easy for me, especially while I’m cooking – it’s like the food eaten standing up doesn’t count somehow), or sitting in my armchair (especially while reading or watching TV), or in the car, or in front of the computer, or sneaking food in the bathroom (ever done that?). Mindless eating is deadly for me. It almost guarantees overeating and/or stuck episodes. Sitting at the dining table, using nice plates and cutlery and a pretty cloth napkin, makes me feel that I’m treating myself well, and I enjoy my food more.   DAY 24 DON’T KEEP TRIGGER FOODS IN THE HOUSE As my father used to say: if you stick your head in a lion’s mouth, you’re probably going to get bitten. For me, bringing home a gallon of ice cream is sticking my head in the lion’s mouth. You know what your trigger foods are. They’re the ones that tend to trigger an eating binge. Maybe your trigger food is chocolate, or ice cream, or potato chips (or all three). Trigger foods can be “healthy” foods, too. One of my trigger foods is Skinny Cow ice cream dippers. I have no “off” switch when it comes to these treats. I cannot eat just one at a time, so I had to stop buying them. If you share your home with a spouse, partner, children, roommates, or whoever, this rule can be a challenge. Hopefully you’re sharing your home with someone who cares about you and wants to help you achieve your weight loss goals. Ask them to help you by not bringing trigger foods into the house. My husband has been very good about this. He’s an adult. If he wants junk food, he has plenty of opportunities to eat it when he’s at work or out and about. On the occasions when he’s slipped and brought home something I have a problem with, I have asked him to hide the food where I won’t find it. If you have young children who expect to be fed junk food and treats, now might be a good time to reform their daily diet. It won’t kill them to do without that stuff when they’re at home. Surely there’s someone else in their life – their other parent, a grandparent, a friend’s parent – who can take them out for an ice cream cone or a Happy Meal.   DAY 25 ATTEND WEIGHT LOSS SURGERY SUPPORT GROUP MEETINGS If you frequent OH, you probably already know how much support and information you can get from other people who have had weight loss surgery. We understand things that even our well-meaning friends and family just don’t get. Attending a “real life” support group meeting can be even better than participating on an online message forum. There’s a special energy in any gathering of people with like interests. It’s inspiring to see the physical and emotional transformation of fellow members. It’s an opportunity to make new friends. While listening to other members speak, you may learn unexpected things (and being forced to listen even to tiresome people can teach you something about patience and compassion). Some support groups (like my surgeon’s) bring in speakers to talk about issues related to weight loss surgery. And according to Dr. Duc Phuong, a band surgeon who spoke at the adjustable gastric band conference in Dallas (October 2008), patients who attend support group meetings succeed better at weight loss than patients who don’t. In fact, he runs his support groups himself twice a week and requires attendance of all his patients at least once a week – if you don’t attend, you don’t get fills. I do realize that attending support group meetings can be a challenge when your surgery took place at a considerable distance from your home, but a few phone calls to hospitals near you may reveal meetings that are more convenient for you. The disadvantage of attending a meeting not sponsored by your surgeon is that you may get information that conflicts with your own surgeon’s instructions, but a phone call to your surgeon should be able to clear up any confusion or doubt. And I do realize that not all support group meetings are good meetings. Some meetings combine all weight loss surgery types, and it can be discouraging to hear gastric bypass patients brag about losing a pound a day. A friend of mine stopped attending her lap-band support group because the woman who ran it had such poor control of the proceedings and the discussion tended to veer off onto 101 Ways to Eat Around Your Band. If you’re dedicated and enterprising, you could start your own lap-band support group. Hospitals and churches often make space available for support groups. Here’s a link to some how-to information: http://add.about.com/c/ht/01/06/How_Start_Support_Group0991535632.htm.   DAY 26 REWARD YOURSELF You’re working hard to achieve your health, fitness, and weight loss goals. You deserve rewards for achieving those goals, but try to choose non-food rewards. I used to celebrate just about everything with a meal or a food treat. Now I’m more resourceful in my prize selection, and I do it often (to reward the accomplishment of intermediate goals) rather than making myself wait for the final goal.  Be creative! Chose something that will pamper you, challenge you, reinforce your accomplishments, or realize a dream. Buy a music CD, an exercise video, a piece of jewelry, or a bottle of perfume. Get a manicure, a pedicure, a massage, or a glamour photo of yourself. Go dancing, go bowling, climb a mountain, or run a race. Take a bubble bath, a class or a vacation.    DAY 27 PLAN YOUR FOOD IN ADVANCE There’s an old saying that goes: if you fail to plan, you plan to fail. If I plan my meals and snacks in advance, I’m always well-prepared with healthy food. When I’m not well-prepared, I’m far too likely to make poor food choices or shovel whatever’s most readily available into my mouth. I cannot make wise decisions about eating when I’m too hungry or too rushed. Once a week, I plan a week’s worth of dinner menus and make my grocery list. Each evening, I check the next day’s menu and check that I have all the ingredients on hand and get anything that needs to be defrosted out of the freezer. In the morning, I spend about 5 minutes planning the day’s meals and snacks. If I’m going to be out for an extended period of time during the day, I make sure that my tote bag contains protein bars or other non-perishable foods. This may not work well for everyone, but it sure works for me.   DAY 28 FOLLOW THE HALT RULE There’s an old Overeaters Anonymous saying that you should never eat if you are too: Hungry Angry Lonely Tired Eating when you are too hungry, angry, lonely, or tired is asking for trouble because you are all too likely to eat too fast, eat too much, and experience negative symptoms as a result. So, don’t let yourself get too hungry (don’t skip meals; plan healthy snacks into your day), and look for non-food ways to deal with emotions and exhaustion.   DAY 29 CHEW, CHEW, CHEW To avoid problems, you must chew, chew, chew.  Digestion begins in the mouth, when saliva mixes with the food and starts breaking it down. If the food isn’t well chewed to paste consistency by the time it gets to your stoma, it’s going to get stuck there. And although some people say that chewing papaya enzyme tablets (or drinking pineapple juice, or a solution of meat tenderizer and water, or hot liquids) can help a stuck episode, only patience works for me. So it’s much better to avoid stuck episodes in the first place. I find it helps to put my cutlery down while I chew each bite. If my fork is still in my hand, I’m too likely to be spearing that next bite of food and shoveling it in before I’m even done with the previous bite. Until thorough chewing is a habit, try to chew each bite 30 times. The may not be very appealing by the time you get done, but so what? You’re eating for nutrition as well as pleasure. Some people ask, “If I have to chew my food to a paste, why not just eat purees?” The reason is that the act of chewing your food gives you greater satiety than just swallowing something pureed.   DAY 30 LOOK FOR THE SOFT STOP After a lifetime of eating the equivalent of Thanksgiving Dinner every time I sat down to a meal, it took me a while to learn when to stop eating. I was a charter member of the Clean Plate Club. If the food tasted good, I ate second and third helpings.  During a pre-op consult, my nutritionist told me that if I didn’t start paying close attention to how I feel while I’m eating, I was going to discover the “hard stop”: my food would get stuck, I would PB (productive burp or regurgitation of food), or slime (excess saliva production). Further, she told me that there is a delay of about 20 minutes from the time the stomach is filled to the time the brain receives the “full” message, so I should stop eating before I feel full. Therefore, I must learn my body’s “soft stop” messages. After each and every bite of food, I ask myself, “Am I still physically hungry?” That is, is my tummy still grumbling? Do I still have hunger pains? How do I feel? By taking the time to check in with myself this way, I have discovered my soft stops: a runny nose, or a feeling of pressure (not pain) in my chest or the back of my throat, or a deep conviction that I just cannot eat another bite (note: that last one didn’t start happening until I’d had 2 fills). Other bandsters report that they hiccup, burp or heave a big sigh. My soft stops don’t happen every single time I eat, and that’s fine. I weigh and measure my planned food, put it on my plate, and when it’s gone, I’m done. But if I get any inkling at all that I should stop eating before the food is gone, I stop. I’m no longer a member of the Clean Plate Club. I put the leftover food away, or (don’t tell my mother!) throw it away. If I get hungry later, I eat the rest of the food (I don’t microwave it though – microwaved leftovers don’t agree with my stoma), but often I forget about it altogether. On the subject of throwing out food…I have had to learn to cook smaller batches of food (I used to cook as if I was feeding the 101st Field Artillery). Sometimes I will mix leftover food (depending on the food) in with my dogs’ kibble for their supper. I used to have an elderly neighbor who
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Starting Walking Away the Pounds

Jul 06, 2009

Hey everyone just giving an update. I have been having lots of issues with getting my walking ineveryday because it is so hot here in ATL. So I already had an Walk Away the pounds DVD but it was for 3 miles. So I went out and purchased 2 more WATP DVD so that I have some to pick from. My commitment for this week is to get up early i nthe morning and walk at least 1 mile. Every week afterwards I will increasr my miles so that in 1 month I have the strength to start working out with my personal trainer. Have a good one.
3 comments

Returned to work. Only lost 3 lbs this week... down 18lbs

Jul 02, 2009

Hey everyone! So I returned to work this week. I only took 1 week off but should have taken an extra week. I just didn't feel right leaving my work for my co-workers at the end of fiscal year so I returned. This has been an very challenging week. I am hungrey all the time. The small amounts of food that I am suppose to eat only last a few hours. So I have only lost 3 lbs since I last checked in. Since returning to work it has been very hard to find time to work out. This weekend I am going to start walking everyday for 30 min to get started and hopefully keep it up when I return to work. Take care everyone.
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Down 15 lbs since surgery on June 19!!! Can't believe it!!

Jun 25, 2009

Hey there OH family! Just wanted to share my status. Yestersday I started the soft/pureed food because I was sooo hungrey with just the protein shakes. So my Nut... stated that I could start today. Man the taste of the food was wonderful. For breakfast I had cheese grits and fruit cocktail which totaled 4oz. I was full until about 5 pm. I wanted to cook dinner for my boyfriend because over the past week he has felt bad eating in front me. He is doing a 2 week cleanse so we can eat the same foods. While cooking I became hungrey so I had 2 oz of protein shake while cooking. I cooked chicken breast in fat free cream of chicken soup, mashed potatos and peas. I cooked in the cream of chicken soup to help puree the meat. with the MAGIC BULLET. At first I was scared of how it would taste but is was really good. I eat about 4 oz of food before I felt some restriction so I stopped eat.

This morning I was scared to get on the scale because I just started on solid foods. Well I lost 2 lbs yesterday. So my total lost is 15 lbs since my surgey.  I am down 15 lbs in 6 days. I am returning to work on Monday so I hope to be down 20 lbs. But my uncle passed and the funeral is in KY on Sat. So I will be leaving tomorrow returning on Sunday. I am going to pack the right foods so that I dont eat the wrong foods on the road and  to eat while at my parents so that I don't eat the wrong things.
Things that must be packed with me are the following:
1. Applesauce
2. Protein shake (parents drink the same milk therefore don't need to take that along)
3. Fruit in light syurp
4. Magic bullet to puree the foods
5. Campbell's Select harvest soup- so that I can puree the food. They contain the protein and vegs.
6. Diet White tea and water

So wish me luck.
4 comments

Down 12 lbs in 4 days

Jun 23, 2009

Just giving an update. This morning I got on the scale and I am down 12 lbs. I know I can't get used to this sudden weightloss but just trying to be positive and watching/ measuring everything I eat.
3 comments

Sooo hungry today

Jun 22, 2009

Ok.. Today was a trial for me. My stomach is sounding like a thurderstom and my brother and boyfriend could hear it. I have been hungry all day. the instructions from the doc is to drink 3 protien drinks and 1 liquid snack. For the past 2 days I was fine. But after eating breakfast this morning I was starving. I don't know if it is the gas thunderstorm going on in my stomach or that I am hungery. So I emailed my dietian from the doc office. She told me slow down eating and increase my  liquid snack. If I am still hungrey tomorrow she told me to start the soft/pureed food on Wed. That is 5 days after the surgrey. let see how tomorrow goes.

Also I haven't had any pain meds today because I was sooo tired of sleeping all day. I will take some at night only because i toss and turn trying to find a good spot to get comfortable.
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3 days after being realized

Jun 21, 2009

Hey everyone. Just letting you know that everything is going good. So far I have lost 8 pounds since friday. My doc has be on Unjury protein  3 times a day and one clear liquid. I will be on this until Saturday when I will be able to eat soft/ pureed foods. The only problem that I am having is gas, gas, gas... Does anyone know why?
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2 days before surgery

Jun 17, 2009

Well I am having my surgery on June 19th. I just learned that I will be on an all liquids diet tomorrow. Hopefully I will not be snapping at people because I am hungery. Wish me luck.
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About Me
Location
42.4
BMI
Surgery
06/19/2009
Surgery Date
Mar 28, 2009
Member Since

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Latest Blog 8

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