The Fill...

Oh this story is a long one! I'm writing it because I want people to see the real side of lap band life. There can be issues with the band. Most don't have them, but for those of you who might, I just want to remind you that you're not alone and that we can get through it!

I went in for fill number 6 on the 4th of November. The new attending, Dr. Foster, was doing fills that day. I love this doc! She's so personable, funny, sympathetic and understanding. We were all joking about girl power in the procedure suite. Who needs those crazy boy docs--they're not anywhere near as fun!

I let her know up front I'm a challenge. My port is twisted just over 20 degrees and I am a scar tissue making machine. It took her awhile, but she finally got in there. We both kept reminding the nutrition intern who was watching that this is not normal. Usually they can get in the port quite easily. I like to make it a challenge to keep the docs on their toes.

Dr. Foster was great and was pretty aggressive with the fill, adding 1.5 cc to bring me up to about 8.5 in my 10 cc band. I was able to get the barium down with no reflux into my esophagus, so we wrapped stuff up and I went on my merry way.

Thursday and Friday went pretty well. For the first time, I had to sip, sip, sip. I knew that if I didn't, it would overwhelm my pouch and things would not go well.

The current post-procedure protocol is 2 days liquids, 2 days pureed and 2 days soft foods before working your way back into the regular textured diet. The 2 days of liquids went pretty well. I had a few moments of, "whoa!" but I was very excited that the band was finally doing its thing.

Then I got to the pureed stage. Friday night (48+ hours after the adjustment), I tried some mashed sweet potato. Yeah, Bandy was not thrilled with that. Bandy got revenge on me (jeez, it was like 2 teaspoons!) by conspiring with my brain and salivary glands to throw me into Major Slime Mode.

I'm writing about this not to scare anyone off from having a Lap-Band, but to remind you that it's not a cake walk. Bariatric surgery is not the easy way out. There is a price you may have to pay when you have surgery and that comes in the form of complications.

I found out the hard way that I am a massive slimer! Basically that means when I get stuck, or my stoma gets overwhelmed by something trying to slither its way through, my stomach swells, sends a signal to my brain, and my salivary glands kick into overdrive. Normally, having a little extra pharynx lube is a good thing when you have something stuck in your throat.

Not so much when you have a Lap-Band.

The swelling caused by the offensive food particle does not like slime, either. It's incredibly viscous and can't fit through the swollen hole. So it has to go somewhere.

You're welcome, as I refrained from taking a picture of one of my full spit cups. I'll just let you know that it's gross stuff. And I could easily produce 16 oz of slime in one session. Not that I'm proud of that. Trust me, if I never produced another drop of slime EVER, I'd be a happy camper. Huge deterrent, on par with dumping syndrome that the RNYers experience.

It took about an hour on Friday night for my glands to slow down and for me to stop retching. Okay, fine. I'll take it slow and stick to liquids the rest of the weekend. My friend Debra said that she'd keep an eye on herself over the weekend, when trying to determine if she was too tight, and then go to the clinic on Monday. Sounds like a plan.

Sometimes plans don't go as, well, planned.

A few more days...

Until fill #6.

I really hope that this one helps, as I am getting very frustrated. I'm interested to see if he is able to pull off more than 6 cc when he checks the volume. I'm half ass wondering if there's a leak in my tubing or something. There's got to be a reason WHY I'm not feeling the restriction yet.

I'm really trying hard to do my best. Today, I took advantage of the time change and put in 20 minutes on the elliptical and did my hip stretches before I did anything else. In spite of needing to pee desperately, I took the long route and walked in from the parking lots instead of taking the bus.

I hauled in yogurt and high fiber, high protein cereal, a container of calcium lozenges and of course my food journal. Brought my lunch (chili with some 2% cheddar for the top) and am drinking my Crystal Light.

I'm trying hard today to work my tool. Now if it could just reciprocate.

More thoughts from support group

I just want to write this down before I forget it. One thing that really made me think last night was that it's time for a paradigm shift.

I will clarify and say that my band is not giving me restriction yet. But, I do think I need to revisit my definition of full. Pre-op, my definition of full was I'm in pain. Discomfort. If I wore pants, unbuttoning them (I wear skirts, silly. Get your mind out of the gutter!).

Jessica pointed out that we need to think of the sensation we are looking for to be more satisfied than full. It's enough. I'm content. I'm not hungry any more.

Interesting how my perception of full is negative (pain, discomfort) while satisfied is positive (content). Could there be something to this new line of thinking?

Right now I am having a huge battle of wills. Shockingly, my banded stomach is still content from lunch (which was a mega sized salad with chicken) but my head is dying for some yogurt with Kashi. Instead of indulging in that 150 calorie treat (Kroger Vanilla Carb Master Yogurt + 1/3 cup Kashi Go Lean Honey and Almond Flax equals 150 calories, 3 g fat, 16 g carb--8 g fiber--and 15 g protein), I am focusing on writing to distract me, plus drinking lots of Crystal Light while reminding myself, this is what your head wants, not what your body needs. The yogurt and cereal will be there when you actually are hungry. It's not like now or never. Sheesh.

Dear Head, just shut the hell up.

So far so good. Can I continue to pull this off and survive the battle over the next two hours? Only time will tell.

If that doesn't work, then I'll remind myself of another Jessica-tidbit from last night. She said, "What part of the memo that we are no longer eating for fun did you not get?!?"

I'm half tempted to put that on the cover of my next food diary! I just started a new 3 month one, but I definitely think I will write that inside the front cover until time for a new one!

Outsmarting myself

Long time, no write. I'm 28 weeks or just over 6 months out from my surgery and am at a very slow spot. I haven't really lost anything in 3 months. Just hanging in there.

I truly believe the band will kick in at some point, but it hasn't yet. I find this immensely frustrating. I can eat dense protein until the cows come home, but unless I don't chew well, it goes down fine and doesn't fill me up. Ugh. I attribute this to yet another medical goofiness. Typically, if there's a stupid side effect that 0.01% of the population gets, or a bizarre complication that's only been seen 3 times in recorded medical history, I get it. My band is no different.

I have had 5 fills and still am not in the "green zone." Most people start getting the sensation of restriction (fullness that helps you stop eating) at 3 or 4 fills, though I've heard it can take as many as 10. Ideal restriction with the band means you can not really eat more than about a cup of food and that cup of food makes you feel full for about 4 hours.

I'm scheduled for fill number six on the 4th of November, which I am very much looking forward to. Initially, my clinic was doing more aggressive fills, closer together. About 1.5 cc per adjustment, though even that is conservative by some clinics' standards. Now they're less aggressive (0.5 cc per adjustment) and the fills are farther apart, now at 6 weeks. Sigh. Until you get restriction from adequate volume of saline in the band, really, all you're doing is dieting.

I've been dieting for a year now (my initial consult with Dr. Williams was on Oct 3, 2007) and my willpower gave up about 3 months ago, when I was dealing with a stressful dog situation at home. I fell off the wagon amidst all the stress, and though I've been lurching along behind it, I haven't had the energy to jump back on board fully. No time like the present, though.

Last night was the October edition of The Missy And Kenny Experience, a SWL support group. Both Missy and Kenny have had the RNY surgery and they are just under a year out. They're witty and insightful and make for great group leaders. As always, last night's group did not fail to disappoint.

I took lots of notes in my journal and most of it was about getting my head back in the game until the band feels like showing up to play. One of the amazing women at the meeting was discussing her challenges a few years out from her surgery and mentioned the oft repeated phrase, "They do not do surgery on your brain." I knowwwwwww. I wish they didddddd!

Her stories made me reflect on how crucial thoughts are in this game. I can either roll up in a ball and say to hell with it and wait several more months for this band to kick in, or I can step it up now. I really need to step it up. I've spent the last 40 years rolled up in a ball and I'm sick to death of that.

So it's time to stop farting around and get with the program. The band will hopefully show up at some point, but I have to stop waiting for it.

The going has been rough the past several weeks. Once I got the dog situation remedied, I chilled out a bit, then started my morning routine of closely monitoring my blood sugar, being fastidious about my meds and skipping the shuttle buses in order to get two 20 minute walks in daily.

My morning blood sugar tends to be high, running around 150-160. My endocrinologist and I have been tweaking meds to get that improved. If my morning reading is >150, I have to take insulin, usually 4 units. This got my sugar level down fine, but when coupled with a morning walk after breakfast/before work, my sugar would plummet too low. I'd have my daily crash about 10:30, often having readings in the mid 80s. For me, that's really low.

I dealt with troubleshooting the blood sugar for a week or so . . . the low blood sugar episodes threw me off and I felt compelled to eat to make the shakes go away. I finally tried cutting my insulin back to 2 units, and that worked great! After my breakfast and walk, my sugar was down to only 100--no shakes or cold sweats! And after a few weeks of diligent tracking, there were a few mornings where I didn't need any at all!

Once I got through the blood sugar issue, then I hit the ravenous phase, which I am in right now. As I said before, the band should help you feel full after a limited amount of food, and that sensation of satisfaction should tide you over for about 4 hours. Also, you really should just be eating 3 times a day, preferably with no snacking.

Yeah. Not so much. I was stomach growling hungry (SGH as I call it in my food journal) by lunch time, even with a low carb, high protein yogurt + cereal snack mid morning. And forget the afternoons. I'd sit there and rumble and growl and have a protein bar about 3pm. I would drink 64 ounces of Crystal Light while at work.

By the time I got home at night around 7, I was so ravenous I could have eaten Jack! Mmmm, meaty! Once I got dinner made and sat down, it was like I couldn't stop. I got the band because I'm a volume eater and it was supposed to help you stop. Not yet, but I'm still hopeful.

Each night now, it's like a switch is flipped when I sit down to eat. I have an incredibly hard time stopping. I want my band to step in and help some, desperately. Until that day, I've got to come up with some kind of proactive attack plan to walk away from the food, signal to myself through my head (not my stomach) that the eating is done.

I'm having to figure out how to outsmart myself.

I told my nutritionist Jessica about my latest tactic. Each night before bed, I prep Kongs for Jack and Map. Just poking a cookie in there is not enough to keep them occupied for long. So I had taken to smearing some peanut butter in there. But I was smearing peanut butter for Jack, then eating some peanut butter. And smearing a little more for Map, then eating more for me. 2T of peanut butter is nearly 200 calories and 16 grams of fat! I was doing that--or more--without thinking about it, right before bed. Every night.

I decided it had to stop. But how? Deny the dogs their treats? I tried switching to cheap peanut butter, but I liked that even better! Less thick and sticky than my treasured Jif. Sigh. I decided to switch to cheese. But not cheese-cheese. Canned, aerosol cheese-like foam!

I'm not a cheese snob in that I must have a lovely melted brie or smoked gouda. But I'm not a processed cheese food person, either. So there's no way I'm eating that canned crap! I'll feed it to my dogs (ha!) but I'm not inclined to taste it at all. I got the canned cheese, thinking it might be cheaper than the spray foam peanut butter (equally not appetizing) by Kong, but apparently it's not. So I'll switch to a more dog appropriate, lower sodium product after pay day.

At least for now, though, the Cheez-Wiz keeps me from eating a big gob of peanut butter at 10 pm.

One mental monkey off my back . . . how many to go?

I. Am. Starving.

I have really neglected my WLS blog--sorry! I've just been all over the place and haven't had much time for any kind of blogging. I guess for now, I'll start with today and work back in time.

I am just over 6 months out from surgery and one of those lucky ones *sarcasm!* that is going to take forever to get decent restriction. You know, it's gonna take a lot of juice in my band for me to feel full. And I'm not really losing any weight.

My next fill is not until the 4th of November, so I have about 3 more weeks of being ravenous (or eating enough to not be ravenous and maybe gain 5 pounds). I'm going to do my best to behave, but without restriction, it's not an easy task.

Lest I be chastised at my next visit, I should switch to the politically correct terms pertaining to my band:

• I don't go in for fills, I go in for adjustments
• I will not hit the sweet spot, I will someday enter the green zone
• It is not juice in my band, it is saline

Whatever! ; )

While I patiently wait for my band to WORK, I have worked on getting focused. It was quite easy right after surgery and until I got on solid, normal diet. Since then, it's been very tough. I'm very happy that other people get restriction (are in the green zone) a few fills out. I just wish I'd get there. 6 months later with no restriction is a big, fat pain in the butt. I know it's not super common, but it's totally a PITA when it happens to you.

In my plot for success, I am trying to set up my environment to help rather than hinder. I put a picture of me 60 pounds ago and a current picture side by side on my fridge.

I bought fresh vitamins and calcium in tastier flavors. I got a new edition of my food journal that has enough pages for 3 months and has a snazzy cover. I carry it EVERYWHERE and it is always lying open to the day's page. If it goes in, it goes down on paper. Helps me think twice about grabbing impulse food, especially realizing how much I've already eaten so far today.

I've also ditched the shuttle bus and have been walking 20 minutes twice a day. And drinking at least 64 oz of Crystal Light.

Being stomach-growling hungry (SGH) is annoying. But it's not like I'm gonna keel over or anything. Plus, by not going crazy at night, I have had good morning blood sugar readings the last two days in a row! Normally, I have to take 4U of insulin each morning. Now I take NOTHING! We'll see how tomorrow goes and if I can make it 3 days running.

Wish me luck. Or intestinal fortitude to not fill my cavernous, gurgling belly!