What reflux means to a bandster

Gastroesophageal reflux (GER) is a condition characterized by the abnormal movement of stomach contents (with acid) up into the esophagus, causing heartburn, chest pain, regurgitation, coughing, sore throat and/or swallowing problems.

The adjustable gastric band can decrease reflux by acting as a barrier to the stomach contents. When reflux occurs after AGB surgery, it needs prompt attention because it is often caused by a too-tight band and can be associated with band slippage, dilation of the esophagus and/or stomach, or a hiatal hernia (one that was unrecognized at the time of band surgery, or that developed post-op). Hiatal hernias (especially if larger than 1-1/2") increase the risk of band slippage, but can usually be repaired with laparascopic surgery.

The standard advice for reflux is to avoid eating before bedtime, sleep with the head of the bed raised, avoid caffeine, chocolate, acidic fruit, spicy or fatty foods, and take acid-blocking medication. These steps may alleviate the symptoms of reflux but do not cure it. It's not going to get better by itself and the longer you ignore it, the worse the damage. Reflux can cause esophagitis (inflammation of the esophagus), bleeding, ulcers, and Barrett's esophagus (which can lead to esophageal cancer), to say nothing of the threat to your band.

If you experience reflux more than twice a week, do not just live with it. Call your surgeon. You may just need a small unfill, or you may need and upper GI x-ray or endoscopy.

Physical Fitness

I've had my lap-band for over 20 months now, and have been obsessed with weight loss surgery for maybe 2 years. But once you get weight, and how to live with the band, under control....then what?

I've been writing a book about how to succeed with the adjustable gastric band, but even that project isn't going to last forever (I sincerely hope).

I've decided that my new project is going to be physical fitness. This is not something I have ever cared about before in my life - in fact, I assiduously avoided it. My parents didn't care about it, I hated exercise, I wasn't good at sports, so I just didn't do it. However, I have discovered that I enjoy exercise now. It improves my mood enormously. I like feeling stronger. It's a pleasure to be able to pick up something heavy without groaning because finally my arms (and back) are strong enough. I like seeing the muscles emerge from the flab. So I'm going to try to get good at physical fitness. I don't care about being an athlete or a bodybuilder, I just want to know that I'm as strong as I can possibly be.

Every bit counts as exercise

So far today I have burned 1574 calories (according to my BodyBugg), 360 of that while scrubbing the bathroom floor on my hands and knees with a scrub brush (what a life of domestic bliss I lead). That's more calories than I burned at the health club yesterday (300)!

Lowest sustainable weight?

I have been at the same weight (with daily fluctuations up and down) for two months now despite increased exercise and reasonable eating. I'm beginning to wonder if this is my lowest sustainable weight. It's as if my body prefers this weight. My brain does not prefer this weight because it's 14 lbs higher than my lowest weight since my band surgery. But I'm happy with my appearance (except for the thick middle, which I had even at my lowest weight), I'm wearing the same clothes despite the additional weight and I feel great. Should I put my energy into accepting this instead of struggling with it?

I need a pep-talk

I need a pep-talk.

Last night I went to Pilates class. I've done this class several times before and it never seems to get easier (I guess I need more practice). And last night two young girls - very young, skinny, pretty chickies -were there who made me feel like a gargantuan sea slug. I know it is useless to compare my 55 year old body to their 17 year old bodies.

After class, I had my second personal training session with Crystal (age 21, skinny, pretty). this week we did a different assortment of exercises (mostly weight machines, some free weights, some time on the treadmill), and she made me use much heavier weights and an extra set of repetitions for each exercise. It was brutal, and I felt even older and more inept. But I'm glad I did it. There is no way I would ever challenge myself that way.

I was exhausted when I got home at 9 pm. When I got up at 5:30 this morning, my left hip was very stiff and I thought, "No way am I going to survive aerobics class this morning." By 7:30 I felt a bit more limber so I went to class and survived it, but it was a struggle.

Meanwhile, my weight is stuck even though I'm working out more. I know, I know, I'm building muscle. But I'm beginning to wonder if I'm not eating enough. I'm eating an average of 1400 calories a day and according to my BodyBugg, I'm burning an average of 2000 calories a day. In theory, the 600 calorie deficit ought to produce weight loss of 1.2 lbs/week.

I am scared to eat more than I already do. It was a big deal for me to eat 1/3 cup of scrambled eggbeaters this morning instead of 1/4 cup, but I have got to get over it.

QOTD: what is restriction?

Restriction is a catch-all term for the feelings that limit how much a bandster can eat. What those feelings are varies greatly from one person to the next. Some bandsters experience restriction as a lack of appetite or interest in food, but for me, restriction is related to eating. It can be as specific as discomfort in my abdomen, a feeling of pressure in my chest, or a choking sensation in the back of my throat, or as general as a strong conviction that I absolutely cannot and must not eat another bite of food.

Hungry?

There's a weight loss surgery myth that goes: I WILL NEVER BE HUNGRY AGAIN.

This is a falsehood.

I’m talking about physical hunger here. The kind of hunger that makes your tummy growl. (Mouth hunger and head hunger are a whole other topic.)

Fighting Weight, Khaliah Ali’s book about her weight loss surgery experience, proclaims that the adjustable gastric band procedure “eliminates hunger – forever”. If that’s true in her case, I’m happy for her, but as successful as I consider my lap-band, I still get hungry.

Everybody reacts to the band differently. Some people get a break from hunger for a while after surgery because of surgical swelling. Every now and then I hear someone say that they rarely feel hungry after they’ve gotten a few fills. But I was starving hungry the day after my band surgery and I’ve been hungry ever since then. The greatest benefit I get from my band is portion control. A secondary benefit is that my small meals keep me feeling full longer – but sooner or later, I get hungry again. Even with great restriction, I find that I get hungry every 2-3 hours (and even if I don’t experience hunger then, I start feeling faint because my blood sugar has dropped). Others might be able to go 4-5 hours.

Eat Your Veggies!

My mother did right by me in many ways. For one thing, she taught me to eat my veggies and like them. Fifty years later when I was trying to serve her a meal that included (turnips or something), she confessed that she actually hates all vegetables except fresh tomatoes in the summer. She was LYING to me all those years! This news was more startling to me than discovering (when I was 11-12 years old) that my father had been previously married, had romanced Mom before he was divorced, and that the man I called Uncle Andre was actually my step-brother.

But I still love veggies. And how can you not love them when you see a display of them like in this photo taken in Seattle by my friend Lisa?

It's not a magic trick!

I'm writing a book about strategies for success with the adjustable gastric band, and I'm strongly tempted to title it, IT'S NOT A MAGIC TRICK!

There is nothing about the band that makes you lose weight. What it does is make it easier for you to eat less and therefore burn off stored fat. It is not going to do all the work for you. It is not going to make good food choices or exercise for you. It's not going to stop you from grazing on potato chips all day long. It's not going to erase the thought that a bag of cookies would make you feel better after a long, hard day. It's not going to take responsibility for your bad habits and unhealthy lifestyle.

It's just a piece of plastic, folks. It's not a magic trick!

Sure don't miss the extra chin

For months after my band surgery, every time I looked in the mirror, I saw the same old fat girl. I had to look at photographs, comparing current shots to before shots, in order to comprehend the change in my body.

Yet when I was obese, I didn't see a fat girl when I looked in the mirror (probably protecting myself from the awful reality). I would look at photographs of myself and think, "Surely I'm not as big as I look there!"

I found this today when looking for a photo of one of our dogs, and thought, "Oh yeah, I was big."

I took the photo into the bathroom and checked myself in the mirror. What a relief: that extra chin is gone!

QOTD: am I too young/too old for weight loss surgery?

Surgeons’ and insurance companies’ age policies vary. While most won’t accept a patient under age 18, there are some surgeons who specialize in younger patients (frankly, I wasn’t mature enough at age 17 to deal with something like weight loss surgery, though it would have been nice to grow up without an obesity problem). Some won’t accept a patient over age 60, but I’ve encountered any number of older people (into their 70’s) who’ve done very well after weight loss surgery.

Muscle vs. Fat

I often wonder about the muscle vs. fat thing, especially when I hear people say, "I'm afraid to exercise because it'll make me gain weight."

While one pound of muscle weighs exactly the same as one pound of fat, in theory it takes up less space. If you measure these substances by volume - packing one measuring cup with, say, chicken fat, and another measuring cup with, say, chicken meat - and then weigh them on a scale, the fat will weigh less than the meat (muscle).

I've been distressed about having gained 10 lbs in the last six months (largely the fault of overeating when my band was unfilled in December 2008), but I've been exercising a lot and I realized yesterday that I'm still wearing the same clothes. In the past, a 10 pound weight gain would have meant going up a size.

So I think it's entirely possible that I have gained muscle mass, and that's a good thing!

Acai berry progress report

Well, so far so good. It's been a week

since I've been taking the acai berry

supplement and I've lost 1 lb!

More About Mederma

I continue to be amazed by the way Mederma is improving my scar.

After 2 days of using it, the scar, which was rough, ragged, and raised before, is completely flat and smooth. Instead of being angry red, it's pale pink.

Mederma Testimonial

When I had my breast reduction, my plastic surgeon recommended using Mederma to reduce my scars. I bought a Walgreen's version of it that worked quite well. I didn't need to use it on my lap-band scars because they disappeared so quickly on their own. Later I used it to reduce the appearance of a scar from a mole removal.

Recently one of my puppies scratched the top of my hand badly. Even after it healed, it was fierce-looking. I don't mind scars where my clothing hides them, but this one is very noticeable. I had used up my original tube of scar gel, so on Saturday I went to get another one. I couldn't find a "generic" version, so I bought the real Mederma (it ain't cheap). I applied it to the scar on my hand on Saturday night and forgot about it until Sunday morning. Literally overnight, that scar had been transformed from this angry red, raised, gaping gash to a faint pink, flattened mark. I was amazed.

So I would have to say that in the case of Mederma, it really is worth paying extra for the real thing.