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.

Raw Carrots are Evil

Raw carrots are NOT my friend, in fact they are evil. I was trying to be healthy and bought a lovely vege/fruit tray to eat at lunch. The watermelon, cucumber & celery went down well, and then came the carrots. Well 2 went in but it seemed like 10 came back up. Haven't had a sliming episode like that for months. My esophagus is still a bit sore so will stick to soft food and liquids tonight. Live and learn. I think I will have to revert back to my cooked veges.

Carrots are now on my "Do Not Eat Ever" list. As a matter of fact, they are the only thing on that list right now. Do any of you have something on your list that you can't ever eat with the band? Maybe a good question for BYOC on Friday.

Just when I thought Buddy, my band had left me, it shows me who is boss.

Un-Filled

I just got back from my Doctor where I waited in tears for an unfill. I told him to take it all out, but I’m sure he left some in. I had my first fill two weeks ago, where he added 1 cc to the 3 cc that were there at surgery. So one would think, I wasn’t even close to a “sweet spot”. But what a weekend I had. I'm pretty sure I have the 10 cc Lap Band VG (the one with the little pockets in the right photo)—that is the one he showed me.

Last Tuesday, I had a problem keeping food down so was on fluids, gradually working back up to soft foods by Thursday. Friday seemed fine so I didn’t call the doctor for an unfill. Then one lousy bite of chicken did me in after the meatloaf and squash I had for dinner on Friday. Saturday was no better—12 hours of vomiting—and I hadn’t even eaten anything. Sunday, I could only sip on some water and broth and the spasm pain around the band was bad. I couldn’t even swallow anything for pain. I had been dissolving two aspirin in some water but just that small gulp of liquid wasn’t staying down. I was only able to sleep with 4 pillows propping me up and leaning on my left side. I was sure the band had slipped and that my stomach was going to be squished in two. My doctor assured me that it was almost impossible for the band to slip as they suture it in place. Amazing the things that go through your head when you are in pain.

By Sunday night. I was ready to grab a knife and tear out the band. I was so unhappy that I had done this stupid, stupid surgery. I was in countdown mode until 8:00 am when my doctor’s office opened. After finding out he was actually in the office and could give me an unfill, I burst into tears. Afterwards, he also gave me his emergency contact number to call in case this happened again—a number he had forgotten to give me at my last appointment. So it is back to square one (no Gilly—not the mall). Most of the weekend I kept thinking back to when I was pregnant—I was nauseated and threw up for most of my two pregnancies. I remember then thinking that throwing up is the worst feeling in the world. It still is.

I am off work again today. Pretty weak—but so would anyone that has dropped 8 pounds in a few days. I know I am pretty dehydrated so will be drinking fluids most of the day. Right now the inside of my stomach is so inflamed, I need to take it easy and slow. I want to get this right, but also want to be able to eat my food, not drink it. I feel like I am back on the pre-op diet, b!tchin’ and complaining. I only read a couple of blogs over the weekend but gave up when I noticed a few postings about Chinese Food, subs, pizza and other good things to eat. That got my stomach growling and the pain started so I had to stop reading. I do hope you all enjoyed your food. I am so envious.

I am working on patience—not my strong suit—it took me years to get to this weight and maybe I need to remember that I am only 6 weeks out of surgery. I have to take each pound as it comes and give it time and work with this band (my buddy). It’s being very stubborn right now so I need to make friends with it again. I’m sorry, little Buddy, I really didn’t mean it when I said I wanted to cut you out. Can we make up and be friends again?

Ho Hum Back at Work

First day back at work. I think I want to do something crazy like run down the hall naked or maybe make funny faces at my boss. Just thinking of ways to have them send me on stress leave! Only had 150 e-mails to delete and file when I got back after 4 weeks away. Not even any juicy gossip to excite the day except for the cute pictures and jokes sent my way. These cats made me laugh because there is always one in the crowd (I'm the one sneaking into the picture at the bottom left. The other one is like all the people I work with, although he does look a bit stoned). Can't wait for the end of the day. I have a dentist appointment at 1:00 to fix an abscessed tooth and then have to be back at work for a meeting. Can this day get any more exciting. OMG, it's time for lunch!

Back to the grind lunch. I have pulled beef in BBQ sauce, a whole wheat bun and coleslaw. We'll see how things go down. It went down totally smooth last night for dinner along with a couple of glasses of wine and some cupcakes. Dinner out on Saturday at a Thai restaurant also went down smooth except I didn't eat as much as normal, so a small victory. I am hungry and I am eating. Tomorrow should be more exciting: My first fill. Will I start to lose some weight or will I continue to be able to eat practically everything. Not looking for miracles here but I so want to move my ticker down.