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.