So how do you really know when you need a fill?

[utahmom]

Okay, so I was banded 3/20/08, and have had two fills. For the last two to three weeks I've hovered around the same weight. I have restriction, but I can eat more than I have the last few months. So, my question is really..Do I need a fill or am I at a plateau? I do not know...any advice would be greatly welcomed.

[MamaMichelle]

Adjustments

How to Tell When You Are Perfectly Adjusted

You are losing 1-2 pounds per week.

If you are not losing 1-2 pounds per week:

A. You may need an eating adjustment

1. Are you eating 60 grams of protein a day

2. Are you eating 25 grams of fiber

3. Are you avoiding all liquid calories [/color]

a. Soup can be sign of “soft calorie syndrome”

b. Alcohol contains a lot of calories – 7 calories per gram

(1) It’s also a stomach irritant

c. Fruit juice is just sugar water

4. Are you making healthy food choices from a wide variety of foods?

a. Are you avoiding soft foods

b. You can’t just eat what’s easy

c. Cheese is glorified fat

5. Are you drinking 6-8 glasses of water a day between meals

6. Are you eating too much junk

a. Chips, chocolate, nuts, ice cream, cookies and other highly

processed junk foods are too calorically dense to be regular parts of a

healthy diet. But don’t avoid them completely to the point where you

feel deprived.

b. Stay out of fast food places

7. Are you getting in two servings of calcium daily

8. Do you always eat the protein first

9. Then the vegetables or fruits

a. Five servings a day

b. Potatoes are NOT a vegetable

10. Is your portion size appropriate?

a. Meat or fish

(1) 3 ounces – the size of a deck of cards

b. Vegetables

(1) ½ cup – the size of your fist

c. Starch

(1) If you eat the protein and the vegetables first you don’t need much

(2) Avoid: rice, potatoes, pasta

11. You might try avoiding artificial sweeteners

a. Some people think that artificial sweeteners stimulate the appetite

b. They are HUNDREDS of times sweeter than sugar

c. They teach you to like things too sweet

d. There is no evidence that people who use them are any thinner

than people who don’t

12. Avoid most diet foods

a. Real food usually tastes better

b. Real food is more satisfying than low calorie substitutes

c. When you are only eating a tiny bit the caloric savings is not

that great

(1) Use a teaspoon of real butter instead of a tablespoon of diet margarine

(2) The body has no way to break down artificial fats

a. They may go into permanent storage

b. Some people think liposuction is the only way to remove hydrolyzed fats from the body

B. You may need a behavior adjustment

1. Are you eating only when you are hungry?

a. If you’re not sure drink 8 ounces of water and wait.

2. Are you eating three meals a day?

a. With maybe 1 or 2 small snacks

3. Are you sitting down to eat?

4. Are you eating consciously?

a. No distractions, turn off the TV, put the book or newspaper

away, pay attention to your food and your companions

5. Are you eating slowly?

a. Put the fork down between bites

b. Take 20 to 30 minutes to finish a meal

c. Taking longer might cause the pouch to begin emptying

6. Are you taking small bites?

a. Tiny spoon, chopsticks, cocktail fork

7. Are you chewing well?

8. Are you drinking with your meals or too soon after your meals?

a. Practice water loading between meals

b. You won’t be thirsty if you are well hydrated before the meal

9. Are you stopping at the first sign of fullness?

a. Sometimes it’s a whisper: not hungry, had enough

b. Hard stop versus soft stop

10. Do not eat between meals. Stop grazing.

11. Do not eat when you are not hungry

C. You may need an activity adjustment

1. Are you getting in 30 minutes of physical activity at least 3 times a week?

a. Over and above what you would do in the usual course of your day

b. Could you make it 4 or 5 times a week?

c. Could you make it 45 or 60 minutes?

2. Are you taking advantage of opportunities to increase your physical activity?

a. Taking the stairs instead of the elevators or escalators

b. Walking on the escalators instead of riding

c. Parking your car further away from the entrance

d. Getting out of the car instead of using the drive through

e. Getting off the bus one stop before your destination

f. Washing you car by hand instead of the car wash

g. Playing with your kids

D. You may need an attitude adjustment

1. Are you committed to your weight loss journey?

2. Are you totally honest with yourself about how much you are eating and exercising?

a. Log your food and activity on ww.fitday.com for 3 days

3. Are you using food inappropriately to deal with emotional issues?

a. Have you identified what the emotions are that drive your eating?

b. Can you think of more appropriate ways to deal with those

emotions?

c. Are you willing to seek help from a qualified counselor?

4. Are you attending and participating in support group meetings?

5. Have you drummed up some support from your family and friends?

6. Have you dealt with saboteurs realistically?

7. Do you have realistic expectations about the weight loss journey?

8. Are you still obsessing about food, weight, dieting, eating?

a. Obsessive – compulsive thoughts

(1) Obsess about something else

b. Perfectionism

(1) All or none, black and white thinking

c. Patience with the pace of healthy weight loss

9. Are you acknowledging your successes with non-food rewards?

10. Have you learned how to take a compliment?

11. Are you giving up diet mentality?

a. Stop weighing yourself several times a day or every day

b. Stop dieting

c. Stop depriving yourself

d. Stop defining food as “good” and “bad”

e. Stop rewarding and punishing yourself with food

12. How do you feel about all the changes taking place?

E. You may need a band adjustment

1. You feel like you are making healthy food choices in appropriate portion sizes but getting hungry between meals?

2. You can still eat white bread, fibrous vegetables and large portions.

3. You are having to struggle to lose

4. You are gaining weight in spite of eating right, exercising and having a good mind set.

F. You may need your band loosened

1. There are times when you can’t get fluids down

2. You are vomiting too much

a. How much is too much?

3. Do you have frequent reflux or heartburn at night?

a. Do not lie flat or bend over soon after eating

b. Do not eat late at night or just before bedtime

c. Rinse your pouch with a glass or water an hour before bedtime

d. Certain foods or drinks are more likely to cause reflux:

(1) Rich, spicy, fatty and fried foods

(2) Chocolate

(3) Caffeine/Alcohol

(4) Some fruits and vegetables such as; oranges, lemons, tomatoes, peppers

(5) Peppermint

a. Baking soda toothpaste

e. Eat slowly and do not eat big meals

f. If you smoke, quit smoking

g. Reduce stress

h. Exercise promotes digestion

i. Raise the head of your bed

j. Wear loose fitting clothing around your waist

k. Stress increases reflux

l. Take estrogen containing medications in the morning

m. Avoid aspirin, Aleve and ibuprofen at bedtime

(1) Tylenol is OK

n. Take an antacid (Pepcid complete) before retiring

o. Try other over-the-counter heartburn medications

p. See your health care provider

4. See your health care provider immediately (or call 911) if

a. You have a squeezing, tightness or heaviness in your chest,

especially if the discomfort spreads to your shoulder, arm or jaw or is

accompanied by shortness of breath, sweating, irregular or fast

heartbeat or nausea. These could be symptoms of a heart attack.

b. If your symptoms are triggered by exercise.

c. If your pain localizes to your right side, especially if you also have nausea or fever

d. If you throw up vomit that looks like black sand or coffee

grounds. Or if your stool is black, deep red or looks like it has tar

in it. These are symptoms of bleeding and need immediate attention.

e. If your pain is severe

(Note: Pepto-Bismol or other medications with bismuth will turn your

stool black. Iron supplements can also make the stool tarry.)

This was written by

Jessie H. Ahroni, Ph.D., A.R.N.P., C.D.E., B.C.-A.D.M.

[bandgroupie]

When you eat more than 1/3 of what you normally would eat pre banding! I am eating way more than 1/3 and am heading to Roswell for an adjustment.

[utahmom]

When you eat more than 1/3 of what you normally would eat pre banding! I am eating way more than 1/3 and am heading to Roswell for an adjustment.

When I sit down to a meal I cannot eat very much, but a little while later I seem to eat whatever I want. Somehow I think this is not good. I live in Park City and there is a Fill Center in Salt Lake City about 20 minutes away. Problem is the doctor is really really weird and made me very uncomfortable. I guess I bite the bullet and go back there or I find a cheap flight to San Diego and go to OCC. My weight hasn't budged in a few weeks.

[cckcsharp]

When I sit down to a meal I cannot eat very much, but a little while later I seem to eat whatever I want. Somehow I think this is not good. I live in Park City and there is a Fill Center in Salt Lake City about 20 minutes away. Problem is the doctor is really really weird and made me very uncomfortable. I guess I bite the bullet and go back there or I find a cheap flight to San Diego and go to OCC. My weight hasn't budged in a few weeks.

There is a bariatric doctor in SLC that will do fills for $100, $150 for the first visit. He is not just a fill doc, he actually does the gastric banding and gastric bypass surgeries. The only down fall is that he does not use flouro. If you are comfortable with trying a blind fill, and trying another doc that is close, his name is DR. Cottam. He is affiliated with SL regional hospital. Him and another female baritric surgeon were just recently in the process of charging there office. So the first number I called said he longer was in that office but gave me the forwarding number. I however, have misplaced that number at this moment( I was going to post it) So I would say to just check the phone book. Or the way I first found him was a google search of bariatric docs in Utah. The number that you come across will probably be the old one, but if you call it they should be able to give you the new number like they did for me. The other female doc (can't remember her name) will not do the fills for Mexico patients but Dr. Cottam will. At least that was the current info as of last month. So let me know if you are having trouble locating him. I have the number somewhere and can get it to you if you need. Also, if you decide to go, let me know how it goes.

Jessica

[Clynn]

What's your daily caloric intake? Are you getting enough protein? Are you eating enough for breakfast? Not eating enough is just as bad as eating too much as your body will go into starvation mode and hold onto every bit of fat with white knuckles.

[Guest CaraMBA09]

Great info...but that made me tired...have I done anything right?