5-year Bandiversary Message

Sep 07, 2011

Posted to the lap band forum 9/5/11:

It's hard to believe it's been 5 years since my lap band surgery.  I used to be very active on this board (TamifromAL), but sporadic in the last couple of years.  I thought I'd share a little about my lap band experiences and observations.

I opted to self-pay for my lap band surgery in Sept. '06, because my insurance only covered RnY, and I really didn't want to go that route.  I had been a life-long yo-yo dieter, and had lost the will to go through yet another long period of diet deprivation only to regain the weight again.  I knew that wls was likely my last chance at a permanent change in my health and weight.  

Although I was not "perfect", for the most part I followed my surgeon's guidelines, ate very healthy, and lost weight right off the bat.  I was down 30 lbs. before my first fill 6 weeks out.  I started exercising after I'd lost about half of my excess weight and the plantar fasciitis that I'd suffered from for 2 years had started to abate.  I lost 100 lbs. within 9 months, and was at goal (-120 lbs.) in a year.  

Then life started throwing a few roadblocks, including my mother's death, non-lap band health issues, economic issues, job changes, empty-nesting, a move to a new state, and menopause.  Through all this, I've managed to keep my weight within a reasonable range of fluctuation, and I have to thank my band for that.

I am happy to say that I've yet to experience any significant band issues.  I had my port swapped out for a low-profile port after I lost so much weight that it showed, and I had my gall bladder removed a couple years after surgery.  Neither of those would be considered a "complication" of lap band surgery.

But, I am now completely unfilled, and have doubts that I'll ever be able to utilize my tool again.  The reason I was unfilled was due to an ulcer that was diagnosed via endoscopy last spring.  It has healed, but I really want to get off of the PPI meds that I've been on for 2.5 years before I attempt a fill again.  I'm in the process of tapering off the meds, but I have to wonder whether the band is impacting esophageal function.  If that's the case, then PPIs will be in my future for the life of the band, and I probably won't rock the boat with more fluid in the band.  I was not educated about PPI meds, and their impact on nutritional absorption, and I'm lucky that my labs to this point have been good.  I'm now getting the appropriate supplementation to hopefully prevent deficiencies in the future.  

Based on my experiences, I have a few pieces of advice to those new to the band.  First, be pro-active in your own care.  Don't wait for restriction to *make* you lose weight.  Make the decision to do all you can to get healthy and lose weight quickly.  Use the band as a catalyst for change. Don't blindly accept medication (like PPIs) without knowing the possible impacts of that med.  On the other hand, don't ignore symptoms that need to be addressed.  

Wishing you all the best!  Hope your Labor Day is a good one!
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Acid Reflux and the Band

Aug 11, 2011

I'm not a member of the medical community, but an avid researcher on subjects of interest to me.  I thought I'd share some of my thoughts regarding acid reflux, in case it can be of benefit to someone else.  I've been pondering the association of the lap band to acid reflux for quite a while.  I've had problems with acid reflux, heartburn, gastritis, esophagitis, and an ulcer since having the band (even with a moderate fill level).  I know I'm not alone, because I've heard of several other bandsters with similar issues.  I've wondered about the cause, speculating that the band itself might be stimulating acid production somehow, or maybe impeding proper function of the esophagus.  I sincerely hope that someone, somewhere, does a study soon to see whether the lap band is a causative element.  Acid reflux control is important to every bandster because even if the *cause* is not band-related, the *effect* of acid reflux can be damaging to the band, your digestive system, and your overall health and well-being.

I've been on Protein Pump Inhibitor (PPI) meds for 2-1/2 years.  I was on Omeprazole for two years after an endoscopy indicated pre-Barretts esophagus (which is a pre-cursor to cancer).  Then, in January, I had a few episodes of break-thru acid reflux even while on the PPI.  An endoscopy showed an ulcer.  All fluid was removed from the band, and I was put on Dexilant.  The Dexilant has kept the acid reflux at bay, and the ulcer healed.   But, Dexilant is very expensive, even with insurance.  Researching PPIs, showed some surprising data, which makes me want to try to get off of them.

First of all, simply using PPI meds can lead to a viscious cycle of increased acid reflux.  If you think your PPI just isn't working anymore, or that you've developed a tolerance to it, and need to up your dose or switch to a different brand, consider this :
 "Doctors are aware that PPIs can...promote an abundance of gastrin."
www.health.harvard.edu/fhg/updates/do-ppis-have-long-term-side-effects.shtml
"Gastrin impacts lower esophageal sphincter (LES) tone, causing it to relax...[which] may play a role in the development of some of the more common LES disorders such as acid reflux disease."
en.wikipedia.org/wiki/Gastrin

Long-term PPI use correlates with an increased chance for esophageal cancer.  PPI's eliminate symptoms, even while damage to the esophagus continues.  Because symptoms are masked, patients may not be pro-active with monitoring (annual endoscopy), or seeking and treating the *cause* of the acid reflux, or trying alternative treatments.  
www.reporternews.com/news/2011/aug/08/heartburn-drugs-may-raise-risk-of-esophageal/

PPIs also impact the body's ability to properly digest foods, especially protein, because acid is necessary to break our food down so it can be absorbed and used by the body.  Low levels of stomach acid from PPIs also can prevent the absorption of nutrients, such as calcium, Vitamin B-12, and iron. Reduced calcium absorption can lead to osteoporosis and bone fractures.  *Plus* calcium is needed in the digestive process to help neutralize excessive stomach acid.  So, you take the PPI to reduce acid, it impacts your body's ability to use the calcium you consume, you produce *more* acid to compensate, and the needed calcium is leached from your bones.

Low stomach acid can also lead to a whole plethora of health issues because one of the purposes of stomach acid is to kill off bacteria and other "bugs" before they enter the intestinal tract.  (One of these is H. Pylori, which is often a precursor to stomach ulcers!)

Going off of PPI meds can be *very* difficult because of the rebound of hyper-acidity due to high gastrin levels which signal the body to produce more acid.  It's recommended to taper off PPIs with reduced doses, reduced frequency, and alternating PPIs with H2 blockers.  Gaviscon is the most commonly recommended acid-reducer for break-thru episodes of acid reflux.  DGL and Aloe Vera juice are often suggested as herbal alternatives to antacids.  Some suggest the use of apple cider vinegar (1 tsp in 4oz of water), either taken before or with meals, or when experiencing symptoms.  

Lots of sources suggest dietary changes to reduce stomach acid, like avoiding caffeine, chocolate, alcohol, spicy foods, citrus, tomato-based foods, soda, and fried foods.  But, quite frankly, I just can't live like that forever!  Plus, there are studies that show that dietary changes do not improve acid reflux.  (Of course, if *you* note a correlation, like "every time I drink red wine, I get heartburn", then avoid it, or take an acid reducer before you partake!)
www.sciencedaily.com/releases/2006/06/060629084452.htm

Lifestyle changes, like losing weight, eating small meals, quitting smoking, no food within 2 hours of bedtime, and elevating the head of the bed do seem to have an impact.  Eating more vegetables and less refined white flour and sugar certainly can't hurt.  

Although there are many risks associated with long-term use of PPI meds, there are also many, many risks with ongoing untreated acid reflux.  If PPI meds are the only treatment that is effective, there are some things we can do to improve our chances of good health while taking them, which include supplementing with Calcium Citrate, Vitamin D3, Vitamin B-12, a Probiotic, digestive enzymes, and a good quality multi-vitamin with minerals and trace elements.  It's also important to time supplementation so that you actually get their benefit.  The multi-vitamin, probiotic, and digestive enzymes should be taken with meals.  Calcium should be taken separately from other supplements, especially iron, because it can prevent absorption.  An annual endoscopy is a *must*.  

There's another school of thought that says that the culprit in acid reflux is actually too little stomach acid, instead of too much.  If the stomach is producing too little acid, the signal to the LES to remain tightly closed is not sent, so the LES relaxes, allowing stomach acid to flow through the esophagus.  Even though it's lower-than-normal acidity, it's still plenty to cause distress.  And, of course, if you have too little stomach acid, you get lots of those side effects noted above that are associated with taking PPIs (poor digestion and absorption of nutrients, increased chance for bad bacteria to thrive).  Proponents of this theory say the worst thing you can do for acid reflux is go on a PPI.  They suggest getting acid levels checked, and if low, following a therapy with Betaine HCL to increase the stomach acid.  
www.holistichealthbayarea.com/blog/low-stomach-acid-the-underlying-cause-of-common-digestive-problems/
www.youtube.com/watch

Medical science is changing all the time, and there is a *LOT* of conflicting schools of thought on acid reflux, all with data to support their position.  Please don't just follow my advice, but be proactive in finding what works for you, and discuss it with your doctors.  I know I will continue researching, trying alternative treatments, and getting appropriate medical care. But I will *not* blindly follow a medical doctor who takes the easy way out by simply writing a prescription.  

Tami

 

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The BEST tool for weight loss

Mar 10, 2011

  The BEST tool for weight loss is not the band.  And it's not gastric bypass, the sleeve, or the DS.  The BEST tool each of us has in our arsenal to fight the battle of obesity is our MIND.

Most of us who have been overweight have a lot of battle scars.  We have belief systems in place based on our own experiences, and on what we've learned from others' experiences.  A lot of that baggage can hold us back from success.  Have you ever told yourself things like, "I just can't lose weight"; "I don't like to exercise (or dont have time)"; "I always re-gain"; "Well, I ate one cookie, I might as well have five since I already blew it today", etc. etc.  We have to learn a new way of thinking about ourselves for long-term success, regardless of the method we choose to lose weight. 

Here are some techniques I used during my weight loss journey that really helped me.

1.  Education.  Whether you are pre-op or post-op, continue to educate yourself about healthy living.  I subscribed to Prevention Magazine, and read it cover-to-cover during my first year out.  I attended healthy cooking workshops.  I read online.  I am *still* learning, and the things I learn often make it easier to maintain motivation to eat right.  Lately, I've been reading a lot about insulin resistance, metabolic syndrome, and the effects that carbohydrates have on our bodies and hormones.  What I've learned makes it easier to avoid them.  

2.  Set realistic goals and track progress.  The scale is just one measurement of success.  I also took body measurements and full-body pictures once a month or so.  Plus, I kept a food and activity journal.  Being able to actually see changes, and to review my progress and habits helped me appreciate small improvements, and to switch things up if I wasn't progressing.

3.  Be grateful.  I made a list of things I am grateful for, and add to it, and review it regularly.  If you focus on being thankful for the good things about yourself and your life, you spend less time with negative thinking.

4.  Fantasize.  Spend time thinking about how healthy you are becoming and the things you will be able to do at a healthy weight.  See yourself doing all the things you've had to miss out on.  A great time to do this is when you're exercising.  It takes your mind off how hard you are working, and empowers you to keep at it.  

5.  Look for role models.  We have some amazing people right here on OH, who have been through much of the same stuff as you.  Look for people who have achieved the success that you hope for, and learn from them.  Connect with people who bring you up, and avoid the toxic people who pull you down.  Use your BLOCK button.

6.  Get help if you need it.  If you need extra help overcoming depression, addictions, or eating disorders, see a therapist. Sometimes you just can't do it all on your own.  Ask for help.  

7.  Be kind to yourself.  Everyone screws up once in a while.  Be honest about it, learn something from it, forgive yourself, and move on.  Each day is a new day to be good to yourself.  You are worth it.   

Our beliefs are empowering and help us move forward in the direction of our dreams.  Keep on dreaming!

Tami
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Low-Carb Eating Plan

Feb 28, 2011

Response to a post on the lap band board:

http://www.obesityhelp.com/forums/lapband/4348767/Lost-when-it-comes-to-food/

 Low-Carb Eating Plan

Eat 3 small meals, plus 1-2 snacks (100 cal. or less) per day.  Don't skip meals.
Eat protein with each meal/snack.
Limit carbs to no more than 50g per day.
Avoid bread, potatoes, rice, pasta, corn, beans and peas.
Avoid all sweets and sugars, including fructose in fruit (exception:  berries)
Limit saturated fats and trans fats, use Pam, olive or canola oil instead.
Drink at least 8 glasses of non-caloric liquids per day.  Limit caffeine.
Exercise 3-5 times per week for at least 30".
Avoid alcohol.
Watch out for low-fat products that add starches/sugars.  

Eat mostly:
Lean protein:  poultry, beef, pork, lamb, fish, and seafood that is not breaded or fried.
Eggs
Cottage cheese
Soy beans and tofu
Vegetables, excluding starchy ones like corn, peas, and potatoes

Eat in moderation:  
Protein bars and shakes (check protein/carb ratio)
Processed meats
Peanut butter, olives, avocado, nuts
Unprocessed, natural cheeses (no American/Velveeta)
Berries

Condiments, etc.:
Unlimited:  vinegar, garlic, lemon, lime, boullion, salt, pepper, salsa, mustard, low-carb ketchup and pasta sauce, cocktail sauce, spices, artificial sweeteners, SF popsicles, SF jello, SF gum, pickles, Crystal Light

Limited:  mayonnaise, salad dressing
-----------

Here are some foods that I eat:

Breakfast:
Eggs, omelets, scramblers, sometimes with Canadian bacon
Cottage cheese and blueberries
Protein shake/bar
Smoothie made with cottage cheese, frozen berries, Crystal light

Lunch:
Leftovers
Egg salad
Tuna salad
Fast food burger, hold the bun
Taco salad (no beans, rice, or tortilla chips; top w/ salsa & a little sour cream)

Veggies
Tomato with mozzarella, fresh basil, drizzled with balsamic vinegar
Green beans, steamed, then sautéed with garlic, mushrooms, & parm cheese
Spinach sautéed with garlic & pine nuts
Cucumber, avocado, tomato, feta or blue cheese, Ken's Light N. Italian dressing
Salad with bacon bits and thinned blue cheese dressing

Snacks
Hard boiled egg
Lunch meat and cheese roll ups
Jerky
Cheese stick and a few nuts
Celery w/ peanut butter
Edamame

Easy protein sources:
Sadler’s smoked beef brisket (available at Walmart)
Tuna
Hormel pre-cooked entrees
Eggs & Cheese
Lunch meat
Rotisserie chicken
Peel & eat shrimp (get it steamed at purchase)
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Second phase, once I get back to my goal weight, is to add back fruit, whole grains, brown rice, sweet potatoes, beans, and staying away from "white carbs".
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About Me
24.7
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Surgery
09/05/2006
Surgery Date
Jan 25, 2011
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