Wednesday, July 21, 2010

Sliming, Stuck and PBing, Oh My!

I decided I had to comment on Gilly’s post on Monday. One line stuck out: “I've spent a lot of time on blogs reading about sliming, and PBs and stucks...and I think that most of us seem to think it's the hallmark of being successful with a band. But I'm not sure it is.” -end quote-

As someone who is sliming and PBing and getting stuck, I will categorically state for all those newbies (and everyone else) that it is NOT success to have this happen. In fact I consider it a failure to properly use the band. I have been miserable for a few days now and have an un-fill this afternoon (just an itty bitty bit). When you spend the last two evenings vomiting, that isn’t normal. I don't want to be bulimic. I have no idea how this band got so tight. I was fine for 5 weeks and then on Sunday was barely able to keep anything down. By Tuesday, I could only tolerate liquids and when I started having problems with applesauce, I knew things weren’t right. Let me tell you, it is extremely difficult to have a rousing conversation with your new manager for half an hour when you are in pain and feel like you want to barf all over her shoes!

**Warning**: The following may be too graphic for some readers. Reader discretion is advised. And please don't take this as any sort of medical advice. This is how I see some of the definitions that have become common in the banding community and is just my opinion:

Stuck: you are merrily chewing away and swallowing with no problems. Then wham an ache happens, then a pain and you know that if you take another bite you will vomit. Your first instinct is to “wash it down with a big gulp of water”. Resist the urge. It WILL NOT help. In fact you will feel worse and most likely a projectile of water will come spraying from your mouth. This can go on for hours and is sometimes followed by:

Sliming: At this point the small amount of food you just ate is not passing through the band. But your mouth continues to produce saliva. Lots and lots of saliva. It is like the taps have turned on. It feels like a cup of saliva is being produced every minute, so spit it out. If you keep swallowing the saliva and the food hasn’t passed through the band, you will then enter into the stage called sliming. Basically, whatever is above the band will now just float out of your mouth. Sometimes your stomach will react to this assault and you will heave. Sometimes it is food. Sometimes it is slimy saliva and sometimes it is just foam.

Update with info from Tina to add: Slime can also happen if you over-eat. If you eat one or two bites too much the food takes up all of the space in the pouch and esophagus. The natural saliva that is excreted to work the food through then builds up on top of that food and causes you to slime. See her full comment below. In other words, you don't have to be "stuck" to slime or PB.
If you were stuck, beware. At this point the lining of your stomach is swollen and can possibly be obstructing the inside opening of the band. Some people feel a lump at the back of their throat and sometimes heartburn. DO NOT eat or drink or you will repeat the sliming or move into the next stage:

Power Burping of PB’ing: What actually is a PB. For me it means a burp and food/liquid comes up. You know when you get to enjoy your previous bite of food again. My theory is that the lower stomach has some air in it. When the band is blocked with food, some air escapes and pushes said food up the esophagus. For some there is a great burp. Others just little burps. Sometimes it feels like those Pop Rocks candies that kind of pop in your mouth. I see it as a good sign, that something is passing through the band. By now you are probably praying for relief but for some of us with “sensitive” stomachs we move into:

Vomiting. Oh yes, been there done that lots of times. When I was pregnant I was nauseated and vomited for most of the first 5 months. In my mind it is the worst sensation ever. Which makes me wonder if my stomach is just “sensitive” to any trigger. A full vomit means the entire stomach contracts and stuff comes up. If you have kids you know exactly the type of stuff when they have stomach flu. When I hear that some people never have this problem I am so envious. But vomiting doesn’t always help because by now the band compresses the upper stomach and when it is irritated the stomach lining gets inflamed and swells, blocking the opening even more. There have been times when I wasn’t even able to drink liquids or swallow my spit. Crisis. You are blocked and nothing is going down. If the swelling doesn't abate you will probably need an un-fill. A bit or a lot depending on your doctor.

I would like to pass on some of the things that have worked for me:
1. Chew, chew, chew your food until it is pulp. And then chew some more.
2. Pay attention to every bite of food (I wasn’t thinking when I was scarfing down the applesauce and was stunned when the pain hit). Don't get distracted and swallow before you have completed #1.
3. DO NOT try to eat or drink anything to push the stuck food through the band.
4. After the episode is over, gently drink some liquids (water, tea, coffee, milk, juice). If the stuck/PBing went on for a few hours, you should stick to liquids/purees for at least a day to give the swelling a chance to go down. Try to rehydrate yourself and gradually work your way up to solid foods.
5. If you continue to have pain, wait it out without eating or drinking anything for a few hours (or overnight in my case).
6. If you have heartburn try sucking on a TUMS (although this seems to induce vomiting in me!) or another antacid. Note: if you still can’t swallow your saliva, hold off until you can. If saliva isn’t going through your band, nothing else will.
7. Prop yourself up on multiple pillows. I also find it better to lie on my left side. I think the way my band is placed, the pouch seems to open up a bit and drain. I usually have little burps as fluid passes through.
8. Always carry Ziplock bags, napkins or Kleenex to spit into. I have just found that those Sanitary bags they put in the bathroom are actually waterproof so scarf a few of them to carry with you. During my worst episodes, I stand over the sink and just spit or sit with an opaque glass as a spittoon (gross I know, but I warned you at the beginning).
9. Papaya enzyme has worked for some, but I have had limited success. I found it just created more acid reflux and then vomiting. I have also not had any success with aspirin or Tylenol.
10. Do not watch any food shows, especially Guy’s Big Bite or Diners, Drive-ins and Dives. The vast quantities of food will make your stomach feel even worse.

And last but not least:
Know that you won’t die. Come on, most of you got through childbirth. If you don’t feel better after a day or two, call your doctor. Chances are everything is ok, but there are some who have had a slipped band, or erosion (both rare). Most times an un-fill is needed. In some cases they do a complete un-fill to give the band stoma and pouch time to heal but in most cases they only need to take out a little bit of fluid.

What can make the band tight: Who knows. I had a 0.1 cc fill on June 9th. I was gradually losing about half a pound a week and then on July 18th, over 5 weeks later began to have problems. The only thing that changed is that I started working out with my trainer and she had me doing a lot of abdominal crunches—I like to think of these reasons so I don’t have to do crunches. I was enjoying about ½ cup to 1 cup of solid food every four hours and didn’t feel hungry in between. I was truly at my sweet spot. When I noticed I had dropped 5 pounds in 5 days, and could only drink liquids, I knew something wasn’t right and I needed to call for an un-fill.

So getting back to my first statement. It isn’t a right of passage, or a cool thing to have sliming, PBing or stuck episodes. I so envy those that have been free of them and still continue to lose weight. So thanks Gilly for bringing this out in the open (I know she loves being mentioned in posts!). If there was an award for most stucks/PBs/slimes, I would be in contention for winning. But the pain isn’t worth any award. Really.

Right now I have about 4.5 cc in my 10 cc band. I will let you know how I feel after getting 0.1 to 0.2 cc of fluid out. BTW, that is a drop or two.

29 comments:

DB said...

Oh Sandy - I love this post!!! I agree, we should not be vomiting, sliming or PB'ing. I know for a fact I get stuck because I am careless & d not chew my food. I too, have vomited a few times - no fun!

Lily's Mommy said...

Sandy,
thanks for this post. I am a newbie, and still on liquids, however, will probably need this info in the future. Thanks!

Mary said...

Awesome awesome awesome! This is a great post!!! I am like going to bookmark it and save it to my favs!! Seriously!!!! This is great info that I really need!! I pray you feel better soon!!!!! I need to put your email on speed dial incase I ever have an episode!! I'll probably need you to walk me throught it :) Love ya girl!

Cindylew said...

Great post...thanks for taking the time to impart your wisdom.
I for one appreciate it powder puff.

amandakiska said...

That sounds about right. I hope you feel better later after your unfill.

I had an unfill once. I had the fill and was tight for about 2 weeks, but could tolerate solids and then all of the sudden I was tight I couldn't eat and much of the time I couldn't drink. I don't know why it happened all of the sudden like that.

Nella said...

Another great post my friend!
Just what we needed to remind ourselves about one of the steps in this amazing journey!
Cheers!

Genise said...

This is a great post! Your descriptions are so vivid that I could almost feel it.

I just copied it and I'm going to add it my newbie guide for later reference. Thank you!

Pamela E. Williams said...

If I could turn a couple of flips, I would. If I could kiss you from Memphis, I would. But since I can't please except this vitural hug (((((HUGGGGGGGG)))))

I have a binder that I have started for my band journey and this is going in the very front. Thank you so much for this!!!!

I vomited when I was pregnant with my son for up to 6 months myself. Couldn't even keep the nausea pills down so the doc gave me suppositories.

Jacquie said...

Oh Sandy...I hope this unfill relieves your band! I am fearing the same thing myself. I had a fill of .35 on 7/1 and .15 taken out on 7/7 and felt fine for two weeks. Now, out of the blue, I am pb'ing and sliming like crazy. My doctor is in China for another week or so too! I am having trouble with liquids even and than I can eat 1/2 bag of chips with no problem!

Great post, thank you!

Gilly said...

I DO love being mentioned in posts!! And this is a great post! I wish I'd found one like it when I was first banded, and I think it will help a lot of people.

Jennifer said...

Great Post Sandy! You are right on the money with the descriptions of all of the phases.
I also do not think it's a good thing - I wish It never happened to me. When it does I stay on liquids for the rest of the day and usually I'm fine. Mine tends to happen when I eat too fast or when I've had a fill.

Barbara said...

Geez.. I really hope that you feel better.. but I have to say you captured each point exactly.. I could have used this advice a few months ago. When you are a new bandster, you don't understand why the chew chew chew rule is in place until you get true restriction. and then it is holy sh*t, the sliming and puking is the worst.. great great post.

Marie said...

So so true. I think what happens with me is I do really well for a while then I forget that I have to follow certain rules and I can't eat like I used to. When I'm not paying attention all of the above happens.

tessierose said...

Great post Sandy, I sure hope you feel better soon. I so agree with this, I have PB'd very few times, but it is not something I ever want to repeat, that's why I've just had one fill and I'm 4 months out.

V said...

awesome post. i hope you feel better VERY soon!

Gwen said...

Smartie. Love how Guy Fieri is a no-no for you. (Well, don't love it, but find naming the specific shows amusing.) Maybe Food Network should just be on the list in general? :)

Joey said...

Great info for newbies! You're the (wo)MAN!

Carmen said...

exccellent post! :-)

Lonicera said...

I so admire someone who is willing to spell all this out... thanks Sandy. Please may I add two things?

1. That after chewing a lot, the hardest thing to do is then wait a couple of minutes before the next mouthful - because chances are you're feeling very hungry. But it helps to pause between mouthfuls because it seems to give me time to assess whether all is OK or not. Sometimes I have to pause for five minutes or more. But to my mind anything is worth it if it will avoid having to throw up later.

2. The other point is more of a suggestion. When I'm stuck, dealing with the industrial quantities of saliva by standing over a basin and spitting non stop, gives the blockage a bit of time to clear itself. If that doesn't work, sometimes (not always) holding my breath for as long as possible seems to accelerate the process (something about creating a vaccuum or something?? - not sure).

I agree that PB'ing is not a sign of success - feeling distressed and causing internal inflammation can't be right... I really fear the "big time" retching because I'm so afraid that the port will flip, so try to take action long before I get to that - but it's not always possible.

Caroline

Michelle said...

Great post!! I was banded on friday but this will deffinitly come in handy in the future. Hopefully I'll be one of those lucky people that never go through that but with my luck I probably will.

Darlin1 said...

I'm totally with you on all your definitions---
#1 chew-chew-chew works pretty well for me ---it's the wait to see what happens --that's the hardest part for me!

Thanks for putting it all into words!!

XO

Bonnie said...

Such an extremely helpful post. Thanks so much.

Joia said...

Thank you so much for commenting on my blog today and alerting me to this post...you are RIGHT! My doctor says I wasn't too tight at 9cc? Sorry...I vomited out nearly everything I ate (two bites into a meal) and slimed when I wasn't vomiting. It was absolutely miserable and my weight loss came to a standstill because my body was starving (about five weeks of this before I could back in to see my doctor since I was on vacation). I didn't sign up for weight loss by bulimia - I'm with you all the way!

Bianca J said...

I remember the first time I got stuck and foolishly thought drinking some water would help. It was beyond anything imaginable. Great post, a must read for all of us.

Tina said...

I disagree a little bit...not about the whole tone but about some of the specifics. Maybe different experiences for different people?...

first I define a stuck episode much like you. Pain is the biggest sign. I usually want to vomit but cannot. Usually it takes three or four trips to the kitchen to pop the offending piece of stuck food out. I cannot always tell what will get stuck so this sometimes happens. Very often leftovers are the culprit so I avoid them.

Slime-happens not when I am stuck but when I over-eat. If I eat one or two bites too much the food takes up all of the space in my pouch and esophagus. The natural saliva that is excreted to work the food through then builds up on top of that food and causes me to slime. This is when I use a cup or stand over the sink.

PB-If I eat way too much (3 or more bites too much and I pushed the food way up to the base of my throat (I can feel it from the inside) there is no room for any spit. When this happens I very often vomit a little bit of food and spit to make room for the rest to digest. This happens more after a new fill and less often when i figure it out.

burping-I was lucky enough to burp while having a flouro and I got to see what was going on. The burp came and the food and flouro that was sitting in my stomach passed through. I agree that it is an air exchange issue from our bottom stomach to our top--but it happens when our top stomach empties or food passes through. When I burp it is a heads up that my stomach is ready for water or is not stuck.

So then-should we look for or desire stuck episodes, sliming or pb's? I guess I like to have them sometimes but not frequently. The reason I like to feel restriction which might mean one of the three. the stuck means that I am trying to eat solid protein but it also might mean I am not chewing enough. if it is the trying then that is good. If it is the not chewing enough that is bad. Sliming or pb means that I am not listening to my body enough and need to stop eating sooner. sliming or pbing once in a while prompts me to re-evaluate how much I am eating.

If any of these are happening every day then you could set yourself up to irritate your band and a cycle of problems. I don't think it is too bad on occasion though.

That is my two-cents anyway

Seeing in colour said...

Great post... although some of it did confuse me as im still in the early stages.

I have no felt stuck, not vomitted or had any of these things happen except burping (ALOT). I try to chew and i need to be careful if i eat when im super hungry causei just wanna ho it down....

thanks for your post sandy!

Maria said...

I agree whole-heartedly Sandy! It's definitely not a good thing. While it does seem like a rite of passage for bandsters, vomming and the like is to be avoided. This coming from a person with a lot of experience in the yakking with a band department!

Aunt Janet said...

Thanks for the info! I am still a newbie, 3 weeks banded. I believe that I have been somewhat stuck by eating too fast or talking while I'm trying to eat. I have to learn to focus. It is so hard after years of mindless eating. Thanks again for the info!

DiZneDiVa said...

I don't know how I missed this post... I am so glad that Seeing in Color mentioned it as her blog/comment of the week so I could check it out. I wish this one was around when I was learning and first banded... Your descriptions are perfectly descriptive... I don't know who would think It is a good thing but it remonds you not to take your band for granted.... It is always there. *Maria*-Blogger from "This one time at Band Camp..." Check out my blog at mybigfatbandgeeklife.blogspot.com

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