The pain in Spain….

….falls mainly on the grain.

Basically, I'm in Spain for a week, working in the field. I was here at the same time last year and experienced the same problems with my band then as I'm experiencing now. It's got really tight, and I'm struggling to know why. It's taking me ages to drink anything, I've just tried to eat half a banana and had to rush to the toilet to throw up, I can't eat any bread at all, and I'm only managing soup and soft stuff in the evenings. But why? Here are some thoughts:

Flying: Last year, I thought it might be something to do with the flight - the cabin pressure or associated dehydration. But the only things I can find on the web about bands and flying are anecdotal, and relate only to long haul flights, so this doesn't seem likely.
Activity: I've been getting lots of exercise, but I get intense periods of exercise at other times of the year too and have no effects like this.
The food: I've not been having my usual breakfast (half a litre of strawberry milk-based protein shake), lunch is a huge white baguette with cheese or tuna and salad (I don't normally eat bread, and never white), and evening meals are 3-course, large, and very low in fat (I normally have a small, protein-rich meal with a 'normal' fat portion).
Drink: Earlier in the week there is no doubt that I got dehydrated, but for the past couple of days I've been working much harder to make sure I get enough to drink.
Climate: Last year it was very warm, but this year has been much cooler - more like typical British temperatures in October. So this doesn't seem likely.
Medication: I am taking methylphenidate for my ADHD and it is known to suppress appetite - but I wasn't taking this last year.

So the most likely thing seems to be the change in my food and drink habits. I'll be back here again next year and I'm not sure what I can do to change things, to be honest. However, on the plus side, although I'm suffering a little at the moment, this glitch may result in kick-starting some more weight loss….

Last year, I arrived in Spain weighing 17st and 3lbs. I arrived home after one week sighing ten pounds less. Then, without any particular effort on my part, I lost a further 22lbs over the following six months or so. So when I arrived in Spain this year, I weighed 14st and 13 lbs. The way I am feeling at the moment, I will not be that weight when I get home tomorrow. And who knows, maybe the loss will keep coming?

After 4.5 years it's finally working how it should!

Since my last post in November things have changed somewhat. We moved house in December, Christmas was upon us, and then I went on a field trip to Spain with a group of students. Although I'd eaten a fair bit over Christmas - who doesn't! - something happened on that field trip..... I just struggled to eat the food they provided. Granted, there was a lot of stodgy, high carb food (ideal for teenage boys on fieldwork, but not great for a bandit!), but do you know what, I could hardly be bothered to eat! I came back half a stone lighter after one week away, and the trend has continued ever since. Slowly, but steadily I have continued to lose weight without really trying. It's as though my brain has finally caught up with my body. I need to explain that don't I?! All my life my body has screamed out 'you're not hungry, you're full, you don't need to eat any more'. But my brain - I'm guessing the emotional bit - has argued back 'yes I do NEED this food'.

For the past six months I just haven't been that bothered about food, for the first time in my life. In fact, also for the first time in my life, I have experienced actually being hungry on quite a few occasions! I'm getting great restriction and there is no way I need another fill, my band is working just fine as it is. In fact, I think that for the first time in the 4.5 years that me and Mr Band have been awkward housemates, we are finally starting to get along.

I've more or less given up eating bread all together and I really struggle with stodgy stuff like rice, pasta and potatoes - unless it's either (a) quite late in the day, or (b) has lots of sauce or fatty stuff with it. I rarely eat anything solid before about 2pm (I have a protein shake for breakfast and often have soup for lunch). However, I find I can eat quite a bit in the evening.

My only real challenge now is to try to swap the odd biscuits and cakes for fruit or something a bit healthier. But I've decided not to beat myself up about it too much, after all, I'm losing weight slowly (about 31 pounds since Christmas) and not having to work too hard at it!

Patience - an important lesson

I thought I'd give you a little insight into how things have been for me in the last year. A year ago I had a small fill, taking my total band fill up to about 7.7ml. This gave me a really nice level of restriction and for the first time in a while, I felt that my band could really help me to control my eating. However, the thorn in this theory was my binge-eating, primarily chocolate focused. At that time I was eating at least six or seven bars of chocolate per day, often eight bars, plus some other cakes and trifles. I estimate that I was consuming 1500-2000 calories per day through chocolate, ON TOP of a normal diet of about the same. It doesn't need a mathematician to work out that I was consuming nearly twice the calories that I actually needed. No wonder I was steadily gaining weight. I tried all kinds of things to cut down on the chocolate but nothing worked.

I have always subscribed to the view that a diet should be sustainable, otherwise it won't work. By the same token, I have always believed that since 'normal' people can eat a little chocolate, so should I be able to. And so my efforts over the years have been to cut down on chocolate consumption, rather than to cut it out all together. But I finally saw sense on May 25th this year, when I took the decision to completely cut out chocolate from my diet. Since that time I have very, very slowly begun to take back control over my diet and begun to lose weight again.

I thought I'd quote an anonymous comment on an earlier post (from 2010): "I too am a chocoholic and I have successfully lost weight in the past only to pile it back on (I was 5.5st lighter 2 years ago). I have come to the conclusion that I cannot eat any chocolate - total abstinence is the only way forward (I have managed to give up chocolate for years in the past and I always become complacent: "a little won't hurt....." - the trouble is I cannot eat just a "little". - Well there's at least a little comfort in knowing I'm not the only one!!

A year ago, I weighed 17 stone and 4 lbs, and now I'm exactly a stone less. So it's taken me six months to lose a stone, but maybe this is another lesson that I have learned from the last four years of being a bandit - patience, patience, patience - you can never have too much! Don't rush things, it's a marathon not a sprint. It is better to take six years to lose all the weight I want to, and to keep it off by developing good habits, than to lose it all in a year and put much of it back on again (which is effectively what happened to me).

Next time, more about the acid problem over the last year.... Bet you can't wait!!

An acid-free night!

I'm back on solid food today after my complete de-fill last Saturday. I've had no problems eating, but then I wouldn't expect to with an empty band. I'm still surprised, though, that I still have a significant amount of restriction, presumably just from the presence of the band itself. I am still getting pretty full after eating small portions. The bariatric nurse said to book an appointment for. Re-fill three weeks after the de-fill, but the way I am going I will be a little frightened doing that, and afraid that my acid reflux will come back.

The news on my acid reflux is that last night, for the first time in over a year, I didn't take any medication at all, and I had a good night's sleep. I plan on doing the same tonight, and see what happens.

So what have I eaten today?

Breakfast: Strawberry protein shake made up with soya milk and water.
Mid-morning snack: A sneaky cake. It was very small, but I was stuffed afterwards!
Late lunch: Weight watchers ocean pie (only 190 calories).
Afternoon snack: Some olives and pistachios.
Dinner: Wholewhat rice with flageolet beans, steamed aubergine and red onion. Followed by a fat free Greek-style yoghurt.

I must say, I really enjoyed my dinner - the first proper meal I have had in more than a week!

Slightly confused.....?

After my complete de-fill two days ago I've had a slightly confusing time. I had expected to be extremely hungry, but I haven't been. I guess there's still enough restriction from having the band, albeit empty, that it staves off the hunger pangs. On Saturday night I had no acid reflux at all, so I had the first decent sleep I've had in ages. But Sunday night I woke up with a nasty dull ache in my chest - about where my band is. It went off after a while and I went back to sleep. But the pain came back with a vengeance about half an hour after I got up this morning. I'm not sure what it is or what causes it. All I can do at the moment is monitor it - but it is a little worrying. All the talk of possibly needing an x-ray on Saturday has got me wondering what could possibly have gone wrong? If anything? I suppose I just have to be patient.

As far as food is concerned, I'm all souped out! My diet has consisted of soup, smoothies, yoghurt and milkshake (not all at once!). At work today, I took a can of soup with me. I hadn't realised until I went to open it, however, that it didn't have a ring-pull, and I didn't have a tin opener! I ended up trawling around people's offices trying to find someone who might have a Swiss Army knife! I found one eventually (thanks Ade!).

Tonight I've already had some mushroom soup (blended to remove the bits), and I'll have a fruit smoothie soon. I'm planning on moving onto mushy food tomorrow, and am looking forward to an ocean pie for tea!

Sparkling insight

One of the comments on a post a few days ago, generously contributed by Sparkler, demonstrated incredible insight into some aspects of my predicament. I'm going to address them one by one and see where it takes me:

This is a really tough time in the journey...all the newness has worn off, you're nearly there so you're probably pretty comfortable with your weight right now, so the urgency has dropped.

That is SOoooo right. Truth is, if I didn't lose another pound - I'd be a little disappointed but I wouldn't be devastated, because the worst of the weight has gone. I started at 20 stone, I now weigh about 12 and a half. I'd like to be ten and a half - but I'm thin enough that I can walk, jog, swim - and all with relative comfort. I can buy 'normal' clothes in 'normal' shops for the first time in my adult life and so the urgency has gone. Spot on Sparkler. But when I sit down and really think about it - I don't want to settle for this - it is less than I wanted when I started out and I want better. I am not looking for perfection but I do want to be in control of my eating and my weight. No, I wouldn't be devastated if I didn't lose another pound, but I don't think I would look upon my band experience as a complete success either.

Everything about the band is so familiar which means it doesn't take much thinking about.

Yes, you're right again. But this is the problem. I often THINK it doesn't need thinking about because it's so familiar - but actually it does. For example, I thought I'd 'cracked' the think about not drinking after eating - I thought it had become second nature. But in the last few months I have got back into bad habits again. Also, I have had more slime and regurgitation events in the last few months than I've ever had. This is not because my band is too tight - it's because sometimes I just forget it is there and get back to old eating habits (eating too much, too quick, the wrong type of food, eating while distracted etc). I probably need to get out my old 'band manual' and re-read it again from start to finish and keep on reminding myself that I have a little friend inside me - and it's going to be there for life....

I'd be interested to hear what your restriction is like now on an average day. Do you still eat the same small portion sizes or are you able to eat more at a sitting? Do you still have certain foods that are a no-go area? What's it like once it all becomes routine, mundane and everyday?

When I make good food choices I have excellent 'sweet spot' restriction. My meals are small and they fill me up. I can't guzzle a drink down fast like I used to but have to take it in smaller mouthfuls and slowly. I'm much more restricted in the morning and can't really eat much till mid-morning. IF (and it's a big IF) I don't eat chocolate and other 'bad' foods, I exist very happily on about 1200 calories a day and don't feel physically hungry at all. There's no sign of my band getting looser. There are very fews that are a no-go area - mainly chips (French fries), very fatty foods like battered fish (chip-shop style), and the skins of cherry tomatoes and grapes! I avoid white bread but can easily eat whoolemeal bread (though not in large quantity). Many of the things that I used to perceive as big problems or difficulties - just aren't! I can eat out but do so very cautiously. So far I have avoided having any embarrassing incidents while eating out and would like it to remain that way!

Good luck with getting that focus back to fight off that last stubborn stone and a half. Actually having a break from the strict regime probably won't do you any harm as once you get back to your walking and cut out the lovely but lethal chocolate you'll be like a new dieter who has a really rewarding first three weeks or so. A post-Easter resolution perhaps?

You may be right about having a break from the strict regime but I think I need to get back to it soon. Now that work has eased off I am finding time to get back to some exercise - walking, stepping and swimming mainly. I think you are right - I will wait until I am firmly back in the UK after my trip and then set a date to kick-start my band-life.

Many thanks for your insight and encouragement!

Back to bandland

Hello everybody - it's been a while! As I sit here wondering what to type, I look back on the past few months and ask myself what has happened? Why have I deserted my blog? It's not just the blog, I have also rarely visited the UKGastricBand forum in the last couple of months - which previously I had visited several times a day. I also kept a food diary - yes, that book in the kitchen that hasn't been touched for a couple of months now. I religiously weighed myself every morning - and now it's once or twice a week - if I dare. If I look through my cupboards in the kitchen, I notice some old favourites have crept back in - bottles of Diet Coke, and the dreaded chocolate. And yes, I know it's Easter, and we can all be forgiven a little luxuriating in the brown stuff at this time of year - but I've hardly stopped eating the stuff for weeks now.

So I ask again - what's going on? I think it's a combination of things - there's no straightforward answer. Here's a few stabs at what is going wrong:

1. The 'light-at-the-end-of-the-tunnel' blues. Looking at the UKGB forum, it's clear that this doesn't only apply to me. As we get closer to our goal weight - that elusive target that for the first time actually appears reachable - it somehow remains just out of our grasp. I've lost nearly eight stone and have a relatively paltry one-and-a-half left to go - yet it's the hardest few pounds of the lot. I've made all of the major changes to portion sizes, exercise, bad habits (though some have crept back in) - so every ounce now needs a monumental effort to lose. The result is, frustration begins to set in - and in my case - that leads to stress - which is relieved through eating. Back to the vicious circle.

2. Workaholicism (is that a new word I've invented?!). I know I can't blame everything on work - but this really has been the hardest extended period at work I've ever experienced. Since late August 2009 until the beginning of March this year - it has just been bedlam. I've literally done nothing but work, work, and work. Exercise has all but disappeared from my life, as has any social life, family life and relaxation. Don't get me wrong - I still manage to watch the goggle box from time to time - but it's not so much relaxation as complete collapse! On the bright side, work has definitely got better in the last three or four weeks and should remain so until the real pressure begins all over again in September (!). But I'm making the most of it and have already begun getting back on the exercise treadmill (not literally).

3. Chocaholicism (another new word). Mmm, yes, not sure how to lick this one (another awful pun!). I am clearly addicted to chocolate. Apparently it's not possible to be physiologically addicted to chocolate in the way that you can be addicted to drugs, caffeine, nicotine etc. But it IS possible to be emotionally addicted to chocolate - and I am. I actually booked an appointment with a hypnotherapist some weeks back, but then bottled out at the last minute and cancelled it! Having re-thought this - I'm going to have another go in the next few weeks definitely - what's the worst it can do? And it might actually help.

4. No longer a newbie. Sometimes I look on the UKGB forum and see the same old questions being posed by newbies - the questions I posed myself when I first started out on this journey. I answer questions occasionally but I'm not really sure what I can offer anymore. It's the same with this blog. I've probably said all of the really important things and I sometimes think can I really add anything useful anymore? However, one thing that strikes me, is that there is relatively little written on the web by long term bandits. I'd love to know what it's like to be bandit three or five or ten years on. It's also clear to me that the struggles I'm going through now are not the same as those I experienced earlier in my journey. That probably makes it worthwhile continuing to write. However, I'm aware that new bandits, or people thinking about getting banded, don't necessarily want to read about longer term bandits who are struggling and facing all sorts of problems. I'd hate to put anyone off - because whatever struggles I am facing now - I would not change one step of my band journey. If I time-travelled back to the start of my journey, knowing what I know now - I couldn't change a thing. It's been the best thing I ever did in my life.

So, there are several reasons why I will begin to write again - because I now have more time back to myself, because I still think it may help longer term bandits (and help newbies to better informed about the ups and downs of banding), and because I need to give myself some therapy. What's that last point I hear you ask? Well, I know that many of you have enjoyed reading my blog because you've told me so - and that's great. But it's also therapy for me. It's when I'm writing, or thinking about what to write, that I often make important breakthroughs in my own thinking, planning and behaviour analysis. Even as I write this, it has been brought home to me that I have drifted away from some of the cornerstones of my weight loss success so far - my food diary, daily blogging, daily trips to UKGB forum, and generally immersing myself in day-to-day thoughts, facts, ideas about weight loss, exercise, environmental control, habits, portion sizes, calorie counting and the rest. It's as though I've forgotten all of this - it has been put to one side for more important things to take its place. But what is more important than feeling good about oneself, being healthy and fit, looking good, having a respectable level of self esteem, and being able to wear great clothes?!

So, there are lots of reasons why I've been silent for a while but probably as many reasons why I need to get back on the case and start to get serious about my band, my eating, my exercise, and above all - sharing again. Thank you for staying with me.

Oh, and I'm seriously thinking about 'coming out' - watch this space.

Working with my band

Here is the essence of what I replied to an anonymous comment - you may find it useful:

Stretching your pouch: If you eat very slowly, which is what we are advised to do, then food will gradually pass from the upper pouch into the lower, main stomach. However, if you eat too quickly, or eat too much in one go, there is a small danger of stretching the pouch. This is usually temporary but if serious this can lead to band slippage. However, long before you get to the point of stretching your pouch it is likely that you would experience pain (often referred to by bandits as 'iron fist') behind the breastbone - this is your body's way of warning you that you should slow down when eating!

Anti-hunger pills: The whole point of the band is that by retaining food in the upper pouch, you 'trick' your brain into thinking that you are full, and so don't feel hungry. Therefore, if you work with the band, you shouldn't feel hungry and there should be no need to use additional drugs or supplements to reduce hunger. Personally, I would never use Reducteel or anything similar - I have paid a lot of money to have gastric band surgery and am determined to work with it.

The band and liquids: The band does not restrict liquids at all and we are always encouraged to drink plenty - therefore you should never experience thirst with the band - you can drink as much as you want (however, try to drink calorie-free drinks).

Dealing with hunger: I can honestly say that I have rarely experienced real hunger in my entire life. However, the biggest difficulty that many obese people experience is not real hunger, but what we often refer to as 'head hunger'. In other words - emotional hunger. This is something that the band cannot deal with. As a result of my emotional craving for food, yes, I have eaten loads on occasions, including binge-eating of chocolate. However, most of the foods we eat when over-eating and binging are foods that slip through the band easily anyway (e.g. chocolate, cakes, biscuits, crisps, fast food etc). Therefore, these foods generally don't increase the risk of pouch stretching - but of course they increase all sorts of other health risks.

Advice for new bandits: I think the important thing for a newly-banded person is to find out as much as you can about the band and how it is supposed to work - ideally from medically-trained people. The band will only do 30% of the work in weight loss - we have to work with the band to achieve the other 70% of effort necessary. This is far from easy and requires a considerable effort and commitment on our part. I've fallen flat on my face many times in my band journey because of my own weakness and lack of self-control, but at the same time I know that my band is my friend and if I work with it, it is a friend indeed.

As with all of the things I post on this blog, this is all just my opinion, based on my own research and most importantly, my experience. We all have very different bodies, needs, personalities and histories, so my experience may not be the same as yours! Always try to get support and advice from your band provider, dietician or bariatric nurse.

Some advice to a potential bandit

After a previous post, a reader posted some questions to help her decide whether to go ahead and have gastric band surgery. I posted my answer as a 'comment' but I know some of you may not read the comments section - so here it is:

I'm pleased that you find the blog useful and helpful. I will try to answer each of your queries - but do remember that (a) this is only based on my experience - the experiences of others may vary, and (b) I'm not a doctor (well, not a medical one anyway!)!.

Loose skin: Yes, I have loose skin and it was one of my greatest fears before I got the band. However, it is much less of a problem than the health problems, humiliation and lack of fitness that go with being obese. I will need to have a tummy tuck and am considering other cosmetic surgery too. However, you are only 22 years old and your skin will be much more elastic than mine (I'm 45 years old). That means it is more likely to 'spring' back into position after you have lost weight. Therefore, you should have a very good chance of not getting excess skin after weight loss. You can do lots of exercise and muscle toning activities,and there are also lotions you can apply to help keep your skin taut. I'm not sure how much these are effectve. The main factors are how overweight you are, your age, and how rapidly you lose weight. You are young, you're not as heavy as I was when I started out, and people don't tend to lose weight too rapidly with the band (compared with a bypass, for example).

Diet: In theory, it shouldn't be necessary to 'diet' with the band. It is not about following a special diet; more about healthy eating, good nutrition and portion control. However, I find that my willpower is so weak that I need to count calories and keep a rigorous food diary to keep me on the straight and narrow most of the time. Most of my meals are healthy and portion-controlled. I also tend to have healthy snacks most of the time. However, I also slip up on a regular basis - yesterday, for example, I managed to fit in two bars of chocolate and a mince pie....!

Multivitamins: I take a daily multivitamin - just a common off-the-shelf variety from Tesco. I use a chewable one. I can swallow small tablets but prefer the chewable ones anyway - they are much like eating a sweet! As a bandit, you should find that after the initial liquids only phase, you can eat a fairly normal diet - albeit with much smaller portions. Therefore, it is not usually necesary to take any other supplements as it is if you have a bypass. I don't use any effervescent tablets but I could if I needed to - I am still a regular drinker of Diet Coke. As long as you pour it into a glass to allow the worst of the gas bubbles to escape, and drink it slowly and carefully, - I've never had any real problem.

Thank you for your kind words. I do hope that your surgery goes well. Do make sure that you get a good aftercare package that includes follow-up appointments, fills and an emergency number just in case you need it. I've never needed to use the emergency number given me - but it's a great comfort knowing that there are people available should anything go wrong. I've just read about a lady who had her op done in Belgium and her surgeon os only over in the UK once a month. She urgently needs a de-fill but has to wait a month for it - I, and some other bandits have advised her to get a de-fill from somewhere else and not wait. So - make sure you get a good aftercare package included with your surgery!!

All the best, Trees x

Pre-band fears part 3: Being called a cheat!

I suppose it was the 'outing' of Fern Britton that did it - she was 'found out' with the gastric band and called a cheat in the British media. I suppose that in the early days of the band I didn't know enough about how it would work so I think a part of me believed that there was an element of cheating involved. Of course now I know different. I know from experience that if I want to, I can eat pretty much anything. I can eat all of the unhealthy foods that I used to be able to eat. I can eat chocolate in volume and binge on the stuff almost as easily as I used to. I know that other famous celebrities gave had their band removed because they gained weight eating loads of chocolate! I know from months of hard work that band success means careful calorie counting, rigorous maintenance of a food diary, tonnes of exercise and constantly making good, nutritional food choices. It means sticking to a whole heap of rules, like chewing everything to death, eating slowly, not getting distracted while eating, using small utensils, eating off a side plate, practising environmental control and balancing proteins, carbs and veggies. It also requires sticking to the hardest rule of all, which is not to drink for at least one hour after eating!!

Because I was uncertain about how the band was going to work, I was careful early on not to tell anyone except my husband, that I had a band. Over time, and as I've learned more about what is involved in making the band work for me, I've become more relaxed about telling people. I guess I feel more confident that I am not a cheat! I feel I can explain to people properly how the band works and I can justify my reasons for having one. Some would say why do I need to justify anything to anybody - but that's just the way I am!

About six weeks after getting banded I told my immediate family. Since then, I've told several close colleagues and friends. Even just today, I told my office mate (as he was stuffing his face with a muffin!). Whereas many months ago I couldn't really see myself telling anybody, now I firmly believe that I will probably eventually tell everybody! I think that basically I'm just a coward, and am scared of telling people in case it doesn't work. That's why I expect I will eventually 'out' to everyone only once I reach my target!! I said I was a coward!

So, as far as people calling me a cheat is concerned - I no longer have that fear. At the end of the day, it's my body, my money and my health. As is plainly clear for anyone who knows me to see, the band has done wonders for me and it clearly does work. If having something that only does 30% of the work is being a cheat - then I confess to being one. But I jest. I am not a cheat, I don't feel a cheat, and anyone who thinks I am one is plain and simple WRONG! There.

Pre-band fears part 2: Being sick

Before I got banded I'd read and heard so much about bandits being sick that it really began to worry me. I got the impression, from various forums and web sites, that vomiting was a normal everyday part of life being a bandit. I read stories about people throwing up while they were eating out - much to everyone's embarrassment. I'd also read about people who more or less threw up every time they ate. But then, to add to my confusion, I read advice and guidance from bariatric surgeons and doctors saying that being sick was not a normal everyday occurrence for bandits - or at least that it shouldn't be. So, I decided to plough on ahead with surgery anyway and deal with vomiting if, and when, the time came.

Over a year on, what has the reality been? Well (and I advise you to read this before you eat if you've got a weak stomach!), first, there are three different kinds of vomiting with the band:

1. The 'slime'
2. Regurgitation
3. Vomiting - proper

I'm going to break with tradition and deal with these in reverse order.

3. Vomiting: We've all done this, whether from over-eating or too much of the amber nectar! This is when we bring up partially or fully digested food from the stomach. For bandits - this means the main, lower stomach. In the normal run of things, this shouldn't ever happen to a bandit purely from eating too fast etc because the lower stomach has much greater capacity than the upper pouch. However, vomiting could result from a tummy bug or other illness. Proper vomiting is dangerous for bandits because 'it' has to come up through the stoma created by the band, past the pouch and into the oesophagus. If the band is quite tight, forcing partially digested food past at a great rate of knots can cause band slippage. This is why if you ever go to a country where tummy bugs are likely, always take a supply of anti-sickness medication with you. Personally, I have not vomited at all since having the band.

2. Regurgitation: This is bringing back undigested food from the upper pouch. This occurs if we eat too fast, too much, without chewing enough, and sometimes with particular types of food. It can also occur if you drink after eating. This is the type of 'vomiting' that most bandits are referring to. Regurgitation is unpleasant, to say the least, and if it happens too often, can begin to cause damage to the oesophagal wall. This is because of the acids that accompany food digestion which can attack the walls of the oesophagus, and also because of mechanical damage. It's best to avoid regurgitation! Although brought on by not sticking to the basic rules of eating slowly, chewing well and taking small mouthfuls - it is much more likely to happen if the band is too tight. So, if it's happening to you on a regular basis and you are sure you're sticking to the rules (and not drinking after eating) you should get your band checked out - it could be too tight. It is a misnomer to think that a 'too tight' band is a good thing because you will lose weight more quickly - you may also cause permanent damage to your oesophagus and there are a variety of other complications too, some of which require surgical intervention and the removal of the band. So it's not worth it. My personal experience is that since being banded I have regurgitated three times. The first time was when I got angry with my iPhone because it was misbehaving(!), and in my anger I scoffed down two thirds of an iced bun before I remembered I had a band.....! By then it was too late and I had a very unpleasant 20 minutes leant over the sink. The second and third times both happened at work while eating my lunch and working at the same time. In other words, I got distracted and ate too big a mouthful without chewing properly. Mia culpa.

1. The 'slime': This happens - a bit like regurgitation - when you eat too much without chewing properly. Food gets 'stuck' in the pouch, unable to get through the stoma because some less well chewed food is blocking the way. It can also happen if you drink after eating - the liquid can't get through the stoma because the food you ate, nicely sitting in the pouch and making you feel full, is blocking the way. So, the body produces what seems like tonnes of saliva to lubricate the oesophagus and pouch to try and remove the blockage. Usually, this does eventually work and you get a real sense of relief when the blockage clears. But meanwhile, your body is producing loads of this saliva and until the downwards blockage is cleared it has to go somewhere - upwards! The slime (as most bandits call it - I'm sure there's a correct technical term for it somewhere!) builds up gradually. You'll be eating something and start to feel an unusual heaviness around the breastbone (where the band is). Then you'll feel gurgling and things happening in your gullet, and then in your throat. Then you'll notice that your mouth is filling with saliva, and it's no good trying to swallow it because your mouth just fills up again. At the point when I notice the gurgling sensation, I know I've just got time to make it to the toilets at work - as long as no-one tries to stop me or talk to me on the way. Once, while rushing to the loo at work, my mouth full of saliva to bursting point, I passed a colleague in the corridor. Inevitably, he said "hello" and I just grunted. I often wonder what he thought.... Anyway, persaonally I went through two phases of doing lots of sliming - both were when my band was too tight and both times I ended up having an aspiration (de-fill). Since then, I still occasionally get the slime - but it's always when I've eaten too quickly, not chewed, or drunk after eating.

So, if you chew well, eat slowly, eat small portions, don't drink after eating and take anti-sickness tablets with you when you go abroad, you need never have any fear of vomiting with the band! On a more serious note, if you're already a bandit and regularly regurgitate or vomit, there's something wrong - either with your eating behaviour or with the band. Get it checked out. Vomiting, of any kind, is NOT a normal part of everyday life post gastric band surgery - and don't let anyone tell you that it is.

Pre-band fears part 1: Eating out

I promised a couple of weeks ago that I was going to post a few articles exploring some of the concerns I had before I got banded - and how those things have panned out. Funny, when I look back at those concerns, none of them were about the surgery itself, any medical issues or worries about complications etc. Here's some of the things that occupied my anxious thoughts at the time:

1. Eating out
2. Being sick
3. People calling me a cheat
4. Eating cold food
5. Not being able to eat enough when I need extra energy (like when on a long hike)

I might think of some more as I work through them. So, here's for the first one - eating out:

A couple of days before surgery I went through a 'cold feet' phase of asking myself was I really doing the right thing? I'd somehow got it into my head that never again, would I be able to eat out. I'd never be able to go out for a meal with my family again and I probably wouldn't even be able to join colleagues eating lunch in the staff canteen! I'm not sure exactly where I got these ideas from, perhaps from the consultant I saw who said I wouldn't be able to eat a 3-course meal again and I'd have to order a starter instead of a main course.

So what has the reality been? Well the first thing to say to any would-be bandits out there, is DON'T PANIC! You WILL be able to eat out! I don't eat out on a regular basis but have eaten out with friends and family groups on a number of occasions since being banded. I guess when I eat out I don't attempt to stick to all of the usual rules, but neither do I completely 'blow it' by stuffing myself silly. A happy medium then, is what I aim for. Typically, I would have a small starter (usually soup but no bread) to begin with. Soup goes down nice and easy so doesn't make me feel full. Then I usually choose a starter for my main course. I did try a main meal a couple of times but they were just too big. I felt bad at leaving so much food and attempted to eat more than was comfortable. So, a starter as a main course suits me fine. A typical starter would be Thai fish cakes, tuna salad, salmon. I tend to avoid 'mixed' food like curry, bolognaise etc because they have lots of unknown fats in the sauces. In the past, I ALWAYS had dessert. Nowadays, my brain wants dessert but my stomach doesn't! I also like to have a sweet taste in my mouth at the end of a meal. So, my solution has been to order a dessert to share with my husband. He's quite a fast eater and I'm so slow, so that he ends up eating 75% of it - which is fine!

So that's what I eat. Now what about the eating process itself? Well, I was never a particularly fast eater before, but now you can bet your last dollar that I will be the last to finish every course! This has been slightly embarrassing at times because people who don't know about my band obviously wonder why on earth I'm such a slow eater. However, I just pass it off with a comment like 'sorry I'm a slow eater' or 'sorry - I've been talking too much'. I also have to be doubly careful not to eat or swallow too big mouthfuls in case I end up getting hiccups, slime or worse. I don't suffer too much with any of these but am more likely to if distracted. Therefore, when I eat out I am particularly careful to focus on the eating process and avoid any mishaps.

I've seen a number of info-bites from bariatric surgeons and associates commenting on eating and drinking while eating out. Most have said that bandits should not try to stick rigidly to separating eating and drinking while out. In fact I again, try to go for a happy medium. On the one hand, it's usually impractical to avoid drinking when you're put for a meal. I generally try to swig down as much fluid as I can before the meal begins, and limit my intake afterwards. On the other hand, however, I have to be careful that drinking after I've eaten doesn't bring on an attack of the slime. If there's food sitting my pouch and I have a drink, one of two things can happen. Either the fluid washes the food through (no problem there then), or it gets blocked, turns the food into liquid mush which only has one way out - UP!! DefinItely to be avoided.

So is it possible to eat out when you have a band? Absolutely yes. However, if you have good restriction you won't be able to eat a normal three meals. You'll also have to eat slowly and be careful not to get distracted. In the weeks coming up to Christmas I have several celebratory meals coming up. I'm looking forward to them every bit as much as I would have before being banded. Looking back to my pre-band fears I realise they were largely unfounded. While what and how I eat are slightly different to what they once were, I can still go out and fully enjoy the company of family and friends. I guess that's it really - the emphasis is more on enjoyment and company and less on food. That's the band for you!

Why I've not gained weight

I recently responded to a post on the UKGastricBand forum to someone who was asking how to get the self control needed to overcome the desire to eat chocolate and other unhealthy things. I've copied some of my response below. Some of these things I have said on here before, but thinking about it helped me put into perspective exactly why I hadn't gained weight during some of the bad times I've experienced in recent months.

"I am a self-confessed emotional eater and complete chocaholic and yet I've lost nearly 8 stone (if I can do it - anyone can!!!). When things in life are going well, my desire to eat chocolate and other bad stuff just goes - and if anything, I crave good, nutritious, healthy foods. During these times I lose weight. However, when life is difficult, as it has been for me over the past 2-3 months (work pressures), I utterly crave chocolate. Over the past 2-3 months I have regularly (i.e. every 2-3 days) binged on chocolate. By that, I mean, I've gone out and bought 6-7 bars of chocolate and eaten my way through all of them in an evening. On top of that I've eaten cheese sandwiches (cheese comes second to chocolate in my head), muffins, iced buns and all sorts of other rubbish.

HOWEVER (this is the good bit) - during these times I have NOT GAINED any weight! This is because:

1. My metabolism has speeded up because I've lost weight so my body uses calories more effectively,
2. I do more exercise (though nothing like as much as I do when life is going well),
3. The portion sizes of my main meals is much smaller than it ever used to be - because of the band,
4. In between the bad days I have relatively good days where I have a negative calorie balance (i.e. I use more than I put in).

So, if you still find you can't keep off the chocolate (and incidentally, I never keep any in the house), it's not all doom and gloom - stick to good eating habits as much as you can and this should mean that at least you won't gain any more weight. On good days, and at good times in your life, you should be able to lose with the band - and keep it off during the bad times".

ONE YEAR TODAY!

It's my bandiversary today! One year ago I was recovering in hospital after my early morning surgery. In fact, at this precise time, I was sitting in the chair watching TV and trying to take my mind off the discomfort and general fuzziness that was my head. Reading back over my blog post the day after surgery, I am reminded that on the evening of my surgery I watched the X Factor before getting a nurse to help me back into bed for the night. Well nothing new there a year on then, because I'll be glued to it again this evening!

So how has the last year been? Well, on the plus side, I am 110 pounds lighter than I was a year ago, I am MUCH fitter and healthier, and can now fit into size 16 clothes. I still have 25 pounds to lose and a couple more clothes sizes to drop, but even if I don't lose another pound, I would still consider my band journey to be a success. On the minus side, it hasn't been easy. There have been some low points as well as highs and it has been a complete pain the bum having to keep a daily food diary! That said, it will be the last habit I break becuase it has been enormously valuable and I wouldn't have achieved what I have had I not kept it religously. I've had a long route to finding my sweet spot, including seven fills and two de-fills. I've spent 48 days of the last year on fluids and a further 48 on mush!

This blog was started on day one of my pre-op diet, on 10th Novemeber 2008. Since that time there have been more than 6,000 visits to the site and about 350 posts. I have communicated with hundreds of fellow bandits through the blog and through the UKGastricBand forum (and other similar sites) and feel I have made some firm friends, albeit virtually, for life. In fact I will be meeting up with a group of bandits in Manchester next weekend - we've never met before but have all shared the ups and downs of band-life on a regular basis and Im sooo looking forward to it.

My daily life isn't hugely different from what it was. I don't eat breakfast before I leave for work any more - I eat it later in the morning. I also don't eat in the staff canteen any more. I don't eat 'on the go' any more - my daily eating is carefully planned out, prepared in advance, weighed, measured and written down! The contents of the food cupboards in our house are different - there's no chocolate, very rarely any cheese in the fridge (except Rosemary Conley's low fat cheese sometimes), and no biscuits or cakes. I still eat out occasionally, but I'm always the last person to finish now. I can still eat anything. I very rarely take the lift at work and can now take the stairs up to my fourth floor office two at a time. I do a bit of jogging, visit the gym, swim and do lots of walking. I get much less sweaty than I used to!

My wardrobe is completely different. There is now nothing left in my wardrobe that I wore before getting banded. There are relatively few clothes in there because I don't want to buy too many before I reach my final target weight. What has surprised me is the fact that most of my shoes are now too big and my wedding ring now fits!

Looking back to the days before I had surgery, I know that I had a number of concerns - not least of which was 'would the band work?'. But there were other things too, like, would I still be able to eat out? I had visions that I would never again be able to go out for a meal with my family. Anyway, to celebrate my 'coming of age' today, I have decided to start a short series of posts (starting later this week) where I will explore some of these pre-op qualms and look at how they have panned out, how I have dealt with them, was I right to be anxious about x, y and z, or were they empty fears?

If you have any pre-op fears that you'd like me to focus on, please leave a comment and I'll do my best!

Putting things into perspective

I'm feeling positive today! I've been making healthy food choices for a few days and am experiencing good restriction. In fact I had a bit of a shock yesterday - it just struck me that this restriction, chewing, eating slowly and eating small meals is with me for life!!!! It's so easy to think in terms if the short run - focussing on a target weight, where I want to be next week, next month, six months time etc. But I had a realisation yesterday that actually, the band and all the habits and paraphernalia that come with it will feature with me for the rest of my life. It puts things into perspective when I have a few bad days - or even a bad month or two!

Today I ate a slice of cheesy beans on toast for breakfast and was really full afterwards. For lunch I ate half a pot of Innocent veggie curry. It was packed with veggies and low in fat. Lovely, but again, left me feeling really full. This evening, I prepared a fishcake, rice, green beans and courgettes. I got half way through it and had to put the rest aside for a couple of hours! I'm going to tuck into the rest right now! It's this kind of thing that makes me feel so optimistic about the future.

Some reassurance

As far as my healthy eating goes, I've had a fairly wretched few weeks. Just in the last week I've had about three or four fairly serious chocolate binges. HOWEVER, for any new or inexperienced bandits out there I can offer you some great reassurance. Despite my poor eating habits of late, largely down to work-related stress, I haven't gained an ounce!! I haven't even been doing much exercise at all but gave managed to keep my weight stable. I think it's partly because the band has controlled my portion sizes (apart from the chocolate!), and partly because I suspect my metabolism has speeded up with the muscle I've added over the last few months.

This is all very reassuring to me because it suggests that the long term outcome if my band will be favourable even if I'm not as 'good' as I should be. It has also really emphasised to me just how effective my band us when I make good food choices. I'm glad things are stable at the moment because my bandiversary is coming up in two days.....!

Time for re-commitment

Two weeks to go till my bandiversary! I'm struggling a bit the last couple of days to 'contain' my eating. I think it's partly because I have less structure to my time at the weekends and so am more tempted to graze and get bored. Also, it's because after my very stressful period at work, I haven't really got back into a regular exercise habit. I'm still working quite long hours which doesn't help, but I am determined to get back to the gym and swimming this week

A year ago I promised myself that for the first time in my life, I would make my health and diet and well-being my top priority in life - ahead of work! With my one year anniversary coming up soon it is timely to re-affirm this as a commitment in my life. At the end of the day, success with the band is largely down to exactly that - to what extent are we prepared to make it No. 1 priority? If it gets top spot then there's every chance of success.

Blood pressure

Over the last couple of weeks I've experienced several temporary bouts of dizziness. It seems to occur if I'm bending down and then stand up too quickly. I checked my blood pressure the other day and it was only 99 over 51. This is classified as hypotension - i.e. too low. It's not dangerously low - my kit says to see a GP if the low blood pressure is accompanied by fainting. So I'm OK, just a bit curious as to why it has apparently fallen. It's never been high - even when I was 20 stone my blood pressure was always normal. I noticed when I first got the band that my blood pressure was low but this was down to dehydration. It can't be that now because I make sure I drink at least 2.5 litres per day. The only thing that's changed in the last two weeks is that I've got 'back on the wagon' and begun to lose weight again. Maybe it's just my body saying "Whoa! What's happening?!"

Back on track

I'm pretty sure I'm back on track now. I've managed to stick to healthy eating for several days now, and the scales have dropped by two pounds this morning! I'm now just seven pounds away from being a 'normal' weight! I'm so pleased about this - there is a realistic chance of reaching that interim target by Christmas. I posted a few days ago about the pros and cons of having another fill. I said at the time that I was fairly sure I am happy where I am. I can now say with certainty that I DEFINITELY AM!! There's no doubt about it, when I eat healthily I get enough food with about 1200 calories a day. I still get hungry mid-afternoon but as I said the other day, I simply get around this by having a selection of healthy snacks available.

Although I've been at a plateau fir a few weeks, things have started moving again. I really feel as though I have turned a corner in terms of understanding how to make the most of my band!

Craving anonymity

I never imagined I'd have this problem.......not in a million years! Here goes. In the past, particularly when I was a child living at home, whenever I went on a diet I got loads of stick from my Dad. Every time I put anything near my mouth I got quizzed about whether I really should be eating that...? - you know the kind of thing. I truly hated that kind of intrusion. Despite being a regular blogger, I'm actually a relatively private person and like to just 'get on with things' without too much fuss - especially where my weight is concerned.

It's one of the main reasons why I didn't tell any of my family or friends about my band early on - because I feared people would poke their nose in and make comments about what I was eating, when I was eating, how much I was eating etc. However, time has moved on and I'm much more comfortable about telling selected people about my band now. All of my immediate family know and I have told quite a few people at work. Last night I told a lady in my swimming club and it was quite nice chatting to someone about it freely and openly. Having said that, I tend to tell people who I am unlikely to find myself eating with!

And that brings me to the point of this post. Up till now, all my life I am sure many people have known me or regarded me as 'the fat woman'. There was nowhere to hide because I was so fat - it was obvious. I got into bad habits of eating in secret - even eating away from my husband at times. I went to great lengths to avoid any situation where people might say anything about my weight or what I was eating. I felt, because of my size, that I was 'on show' all of the time and I craved the anonymity of being thin. So, having lost seven-and-a-half stones now, how has this aspect of my life changed?

Well, it's not good. I'm longer known as 'the fat woman'. Now I'm known as 'the woman who's lost loads of weight'! I can't go anywhere without someone commenting on it. People who I don't really even know comment on it. There are some people I know quite well who now never seem to have anything to say to me that doesn't, in some way, revolve around my weight. What's a bit scary is that some people even seem to think I've discovered the Holy Grail of weight loss and I can somehow solve all of their weight problems too!!

I must confess, if it wasn't already obvious, I'm getting a bit cheesed off with all of this attention. I want to go back into hiding. I want to erase people's memories of me being fat so they just accept me as I am, now. When will people stop seeing me as someone who is fat, thin, lost weight, gained weight, whatever, and start to see me just as a normal, everyday human being? When will people just forget about my weight and just treat me normally. Ask me how I am, or where I'm going on holiday, or what I'm doing for Christmas, or how work is going or what I did at the weekend. But please stop talking about my weight and please stop seeing me as a 'weight issue'.

Am a misery guts or what?!