Thursday, February 25, 2010

Advice For Us Newbies

I sent an update to my clinic where I had my surgery and received this great reply from the nurse within a few hours. I mentioned I was doing well but was a bit discouraged that I wasn’t seeing a weight loss. I also asked when the first fill would be (it will be at 4 weeks) and since I have to pay each time, I did request that they consider an “aggressive” fill to avoid the cost of multiple little fills over a short period of time. I thought the advice from the nurse was so encouraging and don’t think they would mind if I shared some of her reply (in blue below).

"Thank you for your email and I'm glad you are doing well. Don't think of this phase as a weight loss phase. Most people do not lose very much weight in the first four to six weeks, in fact some people gain. This is the healing phase and although you are probably eating far less your body may decide to hold onto some of your weight until you've had a few fills.

We completely understand the desire for a "big fill" due to the cost and inconvenience. For most people two to three fills, done at least two weeks apart are needed to reach that 'sweet spot' where one cup of food keeps the hunger away for approx. four hours. After that you will need the occasional tweak as you lose weight. After the first year most people need very few adjustments. If we fill aggressively we run the very great risk of missing that sweet spot all together and making your band too tight. This results in lost time due to having to defill, then refill etc., not to mention discomfort and the adoption of maladaptive eating habits.

When the band is too loose, as you know, food passes across too quickly and you are hungry in a short amount of time and that is when we fill, to slow the passage of food and increase the amount of time that you are not hungry. If we tighten the band too much you get into problems such as heartburn, reflux of fluid at night and difficulty with solid foods. This is why we are careful with adjustments. Sometimes you may just experience difficulty with solid foods and find that you are consuming mainly mushy/soft/slider foods which leads to a plateau in your weight or a weight gain as these foods pass more quickly across the band and tend to be higher in calories. Nobody ever wants to have fluid removed from their band as they think that this will make them gain, however contrary to this we always find that when the band is too tight, by removing some fluid it allows the patient to get back to consuming healthy solid foods and they lose weight.

Sometimes people wait for the band to "tell" them to stop eating. The purpose of the band is only to control your hunger when you choose to eat less food. Some people do get a "full" feeling when they have consumed the proper amount of food and their band is well adjusted, but others don't. This is why it is very important to stick to one cup of solid food. By eating more than a cup there is a very real danger of stretching the upper pouch. This usually presents with persistent heartburn and/or no feeling of satiety, i.e. you feel like you can eat and eat. This is confirmed by a barium swallow and results in having the band defilled for 4-6 weeks to allow the pouch to return to normal size. As you can imagine this is very distressing for patients as their hunger comes back and their weight inevitably goes up. These are just some things to keep in mind as you are starting out."

I felt much better after reading this. Not knowing the how’s or what’s or why’s of things that are happening are the hardest but this confirmed a lot of what I already knew. All the blogs I follow basically said most of the same things as the nurse did so I know I just have to trust and follow their advice—no more trying to manage this new life myself. Well, ok—I would still take out the stitch!
I’ll be gone for the weekend visiting some friends and family and will probably not post until next week. I will still read the blogs I follow so hope everyone has a great last weekend of February. March is here on Monday which means winter is almost over, my birthday and St. Paddy’s day is almost here, I get my first fill, and spring will soon bring flowers and green grass and warm temperatures. Yah for getting through another winter!!!!

12 comments:

TJ said...

Have Fun!!!

Gilly said...

That is very helpful information...wouldn't it have been nice to have it without having had to ask? lol!

I find that I don't have a feeling of "full" anymore like I used to. It is an effort for me to walk away after having my little tiny portion of food. Every. Single. Time. But I'm doing it, and honestly, the band IS definitely working in that I don't feel hungry after my little meals. In fact, I am debating cancelling my third fill...I will have to see how the week plays out.

Have a wonderful weekend visiting.

Band-Babe said...

That is a fabulous response from your NP. Glad you posted it.

THE DASH! said...

Hey girl,
Great info the nurse gave you. I hadn't heard about the total unfill to get the pouch to go back to normal - but its a good thing they have something up their sleeve in case the worst should happen.
I'm a big believer in the 'less is more' scenario. When I was starting out I found quite a few girls in the US were given aggressive fills - then within a few days couldn't eat at all - it was so distressing to read what they were going through. It must be painful to have to self-pay, but really, try to go easy especially first first up because you are so new and you don't want to shock your body with too much too soon when you are still learning to eat in a new way.
Have a lovely Friday.
Cara xx

workinprogress said...

Thanks for the info!!

I was especially interested about what happens if your pouch stretches. I'm glad it can go back to normal. I had it in my head that it would mean more surgery.

DawnB said...

Thank you! This is very helpful.

Barbara said...

That was a great response and has helped me understand the 1 cup for satisfaction (although I though it was .5 C) but the theory does make sense, eat for nutrition .. and then stop..thanks for sharing.. nice that the NP took the time to respond in this manner

Kristen said...

This was a great post!! Thanks so much for sharing this info :0)

Band Groupie said...

Perfect advice and the same as my doc told us exactly! It's your time to heal and MANY banders gain during this time...just try not to gain and you'll be doing great!

Jacquie said...

Thank you for sharing this great info!

Marie said...

Thanks Sandy. I always learn new things on these blogs. I guess the best way to think about it is this isn't a quick way to weight loss like the gastric bypass, however, it might be more longer lasting if it is used the right way. I know if you go through the surgery you feel like you should see results immediately. However, in keeping the mindset that its a journey (and a long one for some), there is light at the end of the tunnel!

Girl Bandit said...

Great info. I only have 2.25 mls in my band and have eaten about as much as I have PB'ed...if with friends I am sure they would notice the very small amount of food I can eat. From experience you do not want to be too tight. Take it easy and have a great weekend

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