Sunday, March 20, 2011

First Band Fill Last Wednesday + Results

I had my first band fill last Wednesday in Olympia.  I've decided to make the best use of the hour-long drives by listening to Byron Katie's audiobooks.  I was able to finish "A Thousand Names For Joy:  Living in Harmony with the Way Things Are" .  What a mind-bender this book is.  She goes straight to the big scary things in life (cancer, death of a child) and using "The Work" challenges the reader/listener to see the Tao in all of it.  The beauty in all of it, just exactly the way it is.  Never the way you think it should be.  Promise me, if you get interested in Byron Katie's work, please start with her earlier books like "Loving What Is:  Four Questions That Can Change Your Life" so you have a foundation in her concepts. 

Onwards to The Fill:  My band, model AP Standard LAP Band has the capacity to hold 10 ccs of saline.  I received a 4.4 cc fill on Wednesday.  The procedures was done under the guidance of a seated flouroscopy machine (a streaming xray machine), similar to this picture.  There was a nurse and a technician with the nurse administrering the barium and band fill.  The procedure was simple: 
1. drink barium,
2. watch the flow through rate between the upper pouch and the lower stomach
3. add saline until the flow through rate looks right and the contents of the upper pouch empty very slowly into the lower stomach.

The nurse and technician were amiable and were happy to answer technical questions and followed sterile technique.  I was grateful this practice uses a flouroscope to help the nurse know specifically how much to fill the band by direct visualization and not guessing or sensing the pressure by hand.  All around a pleasing experience.

How was the pain?  Bigger than a bee sting for sure but not as bad as some dental novacaine experiences I've had.  No involuntary tears leaking out the corners of my eyes.  That's a large gauge needle and I certainly felt it pierce my skin and connect with the lap band port.  I didn't flinch and the nurse asked if had a high tolerance for pain.  Ma'am, flattery will get you a compliant patient.  The sensation of the actual fill was startling; a strange, electrical shock-y feeling as the saline is put in and drawn back and put back again.  Not horrible, but not nothing, either.

The reccomendation is to eat a full liquid diet for the next 48 hours after every band fill.  I continue to struggle with this reccommendation as I did the first two weeks after the surgery.  Shhhhh.

The experience of eating, getting full with a small quantity of food, and staying satisfied longer with that small quantity has been interesting.  More to tell later.

Tuesday, March 8, 2011

A Recent E-Conversation... (Three Weeks Post Surgery)

Kim, Let's put all your research and experience to work! I need a favor. I have a lot of patients that need the kind of help that you yourself have sought out for conscious eating. Do you have references, groups, etc that you'd suggest?  Thanks!!  - K

Thanks for asking, K, I’m doing great!  Started working out at the gym again this week after an almost six week hiatus (blah!!!!) and the only thing that’s a little trouble is lying down on a mat and holding position on a training bike for more than 20 minutes.  The little port that is sewn into my upper abs is still a little sore and likely has another 2-3 weeks before it’s completely healed. 

My first fill is on the 16th  and I’m quite looking forward to it since I can (and want) to eat everything and I’ve had lots of night-time and emotional eating urges return.  I can’t say they are at the forefront of my brain, but as I get tired and especially at the end of the day, I want that “release” that food so faithfully provides.  So, onwards towards lifestyle and mental changes that prevent some of the needs for those “big releases” at the end of the day.  How about a bunch of little releases accomplished via means other than food?  Onwards, I say. 

And tying in the above to your question, here are my greatest resources for lifestyles and mental health changes:

Greenlake Nutritionhttp://www.greenlakenutrition.com/  Specifically their women’s emotional eating support group.   The counselors are excellent and the prices are right.  New group starting in two weeks!

Nourishing Wisdomhttp://www.amazon.com/Nourishing-Wisdom-Mind-Body-Nutrition-Well-Being/dp/0517881292?&camp=212361&linkCode=wey&tag=myqua04-20&creative=391825   When I started studying how the mind and body interact and how emotions come into play while eating, this book was helpful in sorting everything out.

The Work of Byron Katie:  http://www.thework.com/index.php  This is the real mental work I do to find out what’s going on inside my head and to release suffering.  Super good.  Hard to get at first, but it works really well for folks who respond well to the cognitive behavioral therapy approach, which I do.

Anything by Karen Koenig:  She’s a great CB therapist who writes crisp, enlightening books and articles on eating normally.  Love her.  Love her books.  Anything she writes is excellent.  http://www.eatingnormal.com/

Tuesday, March 1, 2011

Day 15...Sort of Back To Normal

I've delayed posting since I've been busy teaching all-day workshops (at days 12 & 13 post surgery) and getting ready to begin a new childbirth education series tonight.  Here's what's been going on...

I still supposed to be on "mushy", pudding-like consistency foods to allow the stitches holding the band in place to heal.  There is no saline in the band at this time, hence little restriction to how much food goes into the pouch.  The food that lands in the upper pouch can pretty much flow through the open stoma into the rest of my stomach.  Now, combine low restriction with eating food the consistency of baby food that's designed to have no resistance as it travels through the new stomach pouch and you've got a recipe for...HUNGER. 

My food volume at meals is about 1 cup.  I am trying eat that cup of food slowly to feel the first inklings of satiety.  If I'm very hungry when I sit down, though, every fiber, every cell of my being is screaming "Throw away that baby spoon, get a ladle and fire it down NOW!".  I try to imagine that I have a small, very expensive sports car wrapped around my stomach that requires a driver that is attentive and knows how to drive it, how it like to be handled in the turns, for optimal performance.  It requires special fuel, a knowledge of when to release the clutch and when to downshift.  Pop the clutch too early, and it's going to stall.  Don't flood the engine.  And God forbid, don't run off the road by eating a 2-3 cups quickly and popping out all those stitches!

The medical advice for this phase of the process is to increase protein intake (via cottage cheese and a high-protein/low-carb drinks).  Two more weeks.  Two more weeks.

It's been helpful to be told and to remember that "you just have to get through this hard part".  Once I get my first band fill (March 16th), the restriction begins and presumably (and as promised), the hunger ends.

So far, I'm down about 14 pounds, with the majority of that occurring the first week.  This last week, I consumed a higher percentage of carbohydrates than the first week and added back about 300 - 400 calories a day so that I'm at 1,100 - 1,200 calories per day now and consuming about 60-80 grams of protein a day.  I also exercised for the first time since surgery yesterday.

I have a couple ideas for posts coming up:

Restricted eating and consequent emotions
How I chose my bariatric surgeon
Eating in social situations with a band.

Let me know you're out there!