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!

Getting more restriction now

Had another fill yesterday, of 1.4ml, taking me to 6.4ml now. I was pleasantly surprised to discover, when I got to the clinic, that the lady who filled me last time wasn't there (see my last post for an explanation!). Instead, it was the senior nurse who has seen me on and off for the last four years, and I've every confidence in her. The fill went extremely smoothly and I've no had adverse side-effects like last time. Phew! I've been on fluids and very soft foods since so it's difficult to tell exactly how much restriction I've now got. However, I definitely feel more restriction than I did before, but I suspect I will need another fill or two before I'm at optimum. With Christmas, and a house-move coming up, I'll probably wait until the New Year before going for my next fill.

I will be pleased to get some more restriction though, because I've been really struggling to control my eating over the last few weeks and have steadily been gaining a few pounds. It's such a shame because after a long time of struggling I had actually begun to start making some real progress earlier this year.

For now, my plan is simply to try to re-gain all those good habits - eating slowly, eating crunchy, healthy foods, controlling portion size, eating with a small fork (yes, really), and keeping a food diary. I'll let you know how I get on!

Horrid fill experience

Two weeks ago I had my first fill after having my band completely emptied before that. As I anticipated, my fill was 5ml, the same as it was the first time around - four years ago! However, my fill experience was not the same as previous fills at all. This was the first time I had been seen by this nurse. She said she had worked there for 18 months but I hadn't seen her before. She prodded, pushed, kneaded and pulled, and eventually stuck the needle in. Then she did some more prodding and pushing, pulled the needle out, and went through the process all over again. It wasn't what I would call painful, but most uncomfortable. She said a couple of times that it was difficult because the needle was "right on the edge". This worried me because last time I had been here at the clinic I got chatting to a lady who had had to have surgery to replace her port because it has somehow sprung a leak. She suspected the last nurse to give her a fill because it had been a difficult experience. I was starting to worry that putting the needle in right on the edge might cause a leak in my port too, and I'd end up having more surgery - at my expense of course.

Anyway, I gritted my teeth and thought of England, as they say! When I got home I did as I always do, and pulled off the plaster. I had expected to see one of those tiny round plasters, but instead it was quite a large one. This surprised me because none of the previous nurses had ever needed to use a large plaster, and also because it should have said clearly on my records that I am allergic to Elastoplast.....!

Later that day, the area where the needle had gone in was bright red and itching like mad. This was true for an area about 5cm (2inches) in diameter. It stayed extremely itchy for the next five or six days and was so bad at times I had to take a strong antihistamine to relieve the itching and swelling. The redness faded into a huge multi-coloured bruise and eventually the itching receded. The area is now finally back to normal after two weeks.

I've made another appointment for my next fill and am going to see the same nurse again. This wasn't by choice, but she's the only one available at the moment. When I booked my appointment I explained to the practice manager my concerns and she advised me to speak to the nurse on the day and tell her what happened. I'll certainly do that! Apparently the top man of the practice will be on duty that day, so I can ask for him to do the fill if the nurse starts to have any problems like last time. Not looking forward to it though!

Since my last fill I have felt a little restriction but nowhere near enough. I am eating like a horse to be honest and my portion sizes have definitely increased. I've also found that I'm eating a lot more carbs instead of focusing on proteins as I was doing previously. Hopefully the next fill will get me back on track...... Wish me luck!

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!!

A few light snacks......

Here's what I went out and bought this afternoon to meet my 'needs' - a small buttons Easter egg (yes, there are still a few left in the shops), a box of Weight Watchers (ironic, I know) carrot cake slices, a packet of cashew nuts, a chocolate muffin mousse, two kitkats (I ate one of them on the way home), two Freddo bars, a plain chocolate bar (apparently they're less addictive...?), some maltesers, a Dairy Milk bar, three strawberry trifles and a bag of mini chocolate eggs. I expect much of this will have been consumed by this time tomorrow - on top of my normal 'meals'. Of course, my meals are generally quite 'healthy' and I experience a good level of restriction when I eat them. But this lot - no chance - no restriction whatever.

I looked up 'how do I stop emotional eating' on the web today and came across an organisation called Food Addicts in Recovery Anonymous - they're U.S-based and styled on A.A. (Alcoholics Anonymous). Unbelievably, there's a group operating in Liverpool so once I am back from my travels (I am away in Washington D.C. from Thursday for a week), I may give them a call and see if they can help.

I used to call my bingeing 'comfort eating' but I've given it a lot of thought and I know I don't just do it for 'comfort' - it's also when I'm lonely, stressed, fearful, bored, anxious, lacking courage, self esteem or confidence, and just about any other negative emotion you can think of. It's clearly a serious problem for me and one that threatens to jeopardise my band success so far. I have to get it sorted.

As I say, I'm off overseas for a week in a few days and my eating habits will be at the mercy of travel arrangements, hotels, conference organisers and the like - so I'll make do with what I get and when I get it. But once I return I have to tackle this problem head-on or I'll be back where I started. I'm thinking I may make an appointment with the hynotherapist I cancelled a few weeks ago - anyone got any experience of hynotherapy? Does it work? Can I be hypnotised to hate chocolate for the rest of my life? Will it help me gain* control of what food goes into my mouth?

*I was going to write 're-gain' - but I'm not sure I ever had any control to start with! I wonder why..... what happened in my childhood that made me this way? If I get control of eating, will I start to crave something else - will I become an alcoholic or smoker instead? .......or perhaps a sex-maniac - now that would be something!!!!!!

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!

The goodness goes on...

Wow! Not sure what is happening. Two more excellent days where my eating has been totally under control, I've felt real restriction and nit been hungry or craved food at all! Today, for example, I had orange juice and Actimel drink followed by banana and a small cereal bar for breakfast (200 calories). For lunch I had a pre-prepared salmon (200 calories), bulgar wheat and vegetable snack pot. This evening I prepared two veggie sausages, boiled potato and sprouts (315 calories). So far I've eaten about 35% of it and I'm stuffed!

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.

Very tight this morning

Odd this band isn't it? I really struggled to drink a cup of tea this morning and then an hour later only got half way through my usual bowl of Oatso Simple porridge. I ate a very light lunch with some white fish and veg and potatoes left over from yesterdays' evening meal and was stuffed after a small portion. Now I know that this is how many bandits start their day, but it doesn't usually hapen this way for me. I'd be delighted if it stayed like this but I fear that within an hour or two I'll be back to my normal self and eating moderate portions again.

I've heard that stress can lead to tightening of the band, also mentrual periods, de-hydration and various other things. And I am a little stressed - but I have been for weeks and nothing about my band has changed before now. I can't really think of any obvious reason why it should have suddently tightened up like that but I guess I will just make the most of it and hopefully lose a pound or two in the process!!

Finding a twin and turning a corner

At last - I have found another bandit who is exactly the same as me!!!!! A lady posted on the UKGastricBand forum all about her typical eating and drinking during the day, and some stuff about her philosophy on the band and restriction - her experiences of PB'ing, regurgitating, iron fist and all that - and she's SOooooo similar to me - it's scary!!

Like me, she has hardly ever done all the nasty stuff like vomiting and regurgitating food. She doesn't get any pain. She can eat anything but in smaller portions and with a great deal of chewing. She also drinks a lot so she's fully hydrated. She has moderate restriction but finds it harder to eat in the morning until after she's had some drinks. Like me, she can eat chocolate and biscuits for England. The foods that she eats during the day are very similar to me - Oatso Simple for breakfast, or a small banana and Muller Light yoghurt. She has crispbreads and protein and salad for lunch and very similar evening meals too! She also loves Alpen Light cereal bars and doesn't hesitate to take a healthy snack if it's needed.

It brought tears to my eyes as I was reading her post because I am sure I've never encountered another bandit who shares so much in common with me. For months I've read stories and had face-to-face discussions with bandits who get loads of pain / iron fist, vomit / regurgitate and can only eat three peas before feeling full (!) and I've never had any of that - so I've always felt as though I just must be a bit weird!!!

But probably the best thing about her post was what she said about her philosphy on restriction and getting fills. She said: "On a bad day I eat chocolate/biscuits/cakes/sweets/lattes but no matter how tight my band I'd still manage them so why have it that tight and suffer even when I'm being good?". Wow - she is so right. For ages now, as you know if you're a regular reader, I've to'ed and fro'ed about whether I needed another fill. But the truth is this: On a good day when I make good, healthy food choices, my restriction is perfect. I can eat anything I like but in small portions and with a lot of chewing. On a bad day, when I make poor food choices and scoff chocolate, cakes, biscuits and such, the band has no effect. It doesn't stop me eating that stuff - I knew it wouldn't and I know it never will - no matter how tight my band is. So what would be the point in making myself suffer with over-tight restriction when I'm being good, to gain no advantage whatsoever when I'm not being good?!

Mentally at least, I feel as though I may have turned an important corner.

SO much to remember!

I used to think banding was simple - it restricts your stomach, you can't eat as much, you feel full sooner and for longer. Oh if only it were that straight forward! Here are a few of the 'rules' I have to remind myself of daily:

1. Eat three small meals per day
2. Chew everything to death and eat small pieces
3. Don't drink after eating
4. Use small utensils and a side plate for meals
5. Practice environmental control
6. Keep reminding your husband to hide the baguette and biscuits
7. Take a bagful of food with you to work every day (breakfast cereal, milk, orange juice, Actimel, lunch, healthy snacks)
8. Write everything down - food, calories, drinks, exercise, steps.....
9. Make sure plenty of your meal is made up of protein to keep you feeling full for longer (it takes away the hunger)
10. Don't overcook the vegetables - the crunchier the better
11. Beware when eating fruit with skins or peels - eat extra slowly and not in front of everyone (hiccups can be violent)
12. Take healthy snacks to work - better than eating chocolate
13. Keep reminding your husband to add healthy things to the shopping list (fruit, yoghurt, cottage cheese) - and to remove things that are too tempting (biscuits and baguettes)
14. Drink, drink, and drink some more
15. If you think you're hungry, have a drink first - then eat if you still feel hungry after half an hour
16. Is it real hunger or just head hunger?
17. If you start thinking about chocolate, do something to distract yourself.... (MUCH easier said than done)
18. Keep reminding your husband not to bring you a cup of tea immediately after you've eaten
19. Worry about whether you've got the right level of restriction at least every five minutes......
20. Remember to cook a double portion of dinner so you can take half of it to work for lunch the next day
21. Cook meals that are nutritionally balanced
22. Take your daily multivitamin, and calcium tablets, oh, and lactulose occasionally......
23. Stop buying huge amounts of fod on the weekly shop - it will end up going mouldy
24. Get excited about strong restriction in the morning - and then get disapointed when it wears off in the aftrnoon
25. Find time to walk
26. Find time to go to the gym
27. ...or do anything else physical
28. Keep reminding your husband to put most of the bread in the freezer - I can't eat so much these days so it will go off if left in the bread bin
29. Refrain from getting annoyed when every other person you see asks you, in a loud voice, how much you weigh....

Oh I could go on! There are so many lessons to learn in living with the band but it's just impossible to keep them all in your head at the same time. So as fast as I remember one lesson, I forget the rest. Today, I went to work with what I thought was a lovely lunch (leftovers from last night - but nice, nonetheless). However, whereas last night I put quite a lot of low fat melted cheese on it - today I didn't. The result was a very bland meal with absolutely no fat in it, unappetising and completely lacking in protein. End result? One hungry lady mid-afternoon - looking for snacks and 'nice' things to eat.....

When will I ever learn?!!

Plodding on

Work is still a nightmare. I'm still working silly hours and it's still having an adverse effect on my eating and exercise. I know from past experience that when I don't exercise I don't feel fit - I feel fat - and that makes me feel low - so I eat to make myself feel better......... Oh dear, it sounds bloomin' silly even as I write it - but that's how my head is!

I bought a book to help me overcome emotional eating but I haven't found time to get past page one! I've browsed on the web looking for ideas and all I get are distraction techniques. This is the idea that when you feel like grabbing a bar of chocolate - for emotional reasons - do something to distract ourself. Activities include taking a hot bubble bath or going for a walk.

Well that's fine - but I haven't got time to go for a walk and a quik shower at 5.30am is about all I can manage - no way is there time to have a long soak!!! I tried putting some chocolate in the bread bin so I could have small amounts of it when I needed - that's beter than going out and buying six bars and scoffing the lot in my book. But I haven't been as restrained as I thought I might be.

I just read on the UKGastricBand forum about a lady who's got really good restriction at last - and I can still eat a lot more than her. Tonight, I'm thinking I should phone in the morning and book myself another fill. If you read my blog regularly though, you'l know that I may change my mind again tomorrow!! I really think I might go for it this time though - and settle for much tighter restriction than I have at present. It's got to be better than trying desperately to cling onto an ounce of willpower, hasn't it?

Emotional eating

My roller coaster journey continues apace! Things are still really tough at work and I'm struggling on a daily basis to stick to healthy eating. As soon as I begin to struggle emotionally, I seem entirely incapable of resisting chocolate and other psychologically uplifting foods. What's worse is that I don't just get one bar of chocolate - I get two or three or more. Today I bought seven and so far I've chomped my way through five :-(

I'm mulling over a couple of things at present. First, was I right to gave a band rather than a bypass? People say the band is less suited to emotional and binge eaters but I wasn't aware of that at the time I made the decision. That said, the long term prospects for weight loss are better for bands than bypasses according to research on long term success rates. Second, do I need another fill or do I just need to get my head right? Sometimes I get quite good restriction but it disappears when I eat the wrong foods. On the other hand, I can still eat far more than many people.

I've a seriously hard week coming up and am not at all sure how I'm going to get through it without gaining half a stone. Watch this space!

Mmmm luverrly!

I've had a good day food-wise. I'm sticking to my plan of eating when I feel hungry - regardless of what time it is, whether it's official 'meal' time or not. I started out the day with a glass of orange, an actimel drink and a cup of tea. On the way to work (about 9am) I ate a small banana, slowly. This is one of the few foods that I feel going down my oesophagus - every step of the way. I also find bananas really filling. Once at work, I ate some cereal - high fruit Alpen muesli with a little All Bran thrown in. This was about 10am. By noon I was peckish again so went on the prowl for some lunch. I went to my favourite sandwich shop where they make up sandwiches while you wait. I obviously haven't been there for a while because I found out it's under new management. I didn't discover until after she'd put the salad in the bun that the new management don't do cottage cheese anymore! Everything else on offer was either carnivorous or high fat - so I just went for the salad roll. On the way back to my office I popped into the local vegetarian cafe /shop (The Eighth Day in Manchester) and bought some carrot pate to put in my sandwich!! I followed lunch up with some strawberries at about 2pm.

I arrived home about 5pm and soon after had a Weight Watcher's yoghurt. Dinner, at about 8pm, was a Weight Watcher's microwave pasta meal with a piece of salmon I added to it (otherwise it had no protein - tut tut Weight Watcher's!!). That was great, but by 10pm I was feeling peckish again! I decided that I needed a protein boost (there wasn't much in my lunch) so I had some scrambled egg with Rosemary Conley's cheese melted in, on top of a small slice of wholemeal bread. I have to say, this was absolutely delicious and really filled me up. I think it just goes to show that what they say about protein-rich foods filling you up is absolutely true.

My total calorie count for the day is about 1260 which is fine, especially since I have burned off more than 650 calories walking!! When I read back over this report though, it seems on the surface as though I've been eating all day! I'm certainly not sticking to the 'rule' of having three meals a day and no snacking. However, I've tried this and it just doesn't work for me. This regime, however, really does seem to work. Eat when you're hungry - simple. It means that although some days I might eat on several occasions, on other days I might go long periods without eating. Yesterday, for example, I ate my lunch at 1pm and my dinner at 8.30pm - and that was fine - I simply wasn't hungry in between.

So, I'm back to being optimistic about my level of restriction!!! I dunno, talk about roller coaster!!!

Changing my mind?

I don't know - yesterday I posted in a more positive vein about the success, or otherwise, of my latest fill. I'm already doubting the wisdom of my optimism! Earlier today I asked for advice from the readers of the UKGastricBand forum. I don't normally do this, but I tought I would post the same basic text here in case any of my blog readers can offer any insight and post a comment.

I need some advice on whether I need another fill or not. It's been just over a week since my NINTH fill and I've been eating solids for most of that time. I have 7.7ml in a 10ml band. My sequence of fills has been:

• Op 15th November, first fill ten weeks later.
• 5ml under x-ray, followed by 1.5ml then 1ml. This took me to 7.5ml which was too tight (slime, indigestion).
• Had de-fill of 0.5ml, then later top-ups of 0.3ml and 0.4ml - taking me to 7.7ml. That was way too tight (acid reflux, couldn't drink properly, slime, constant indigestion etc).
• Had second de-fill of 0.5ml, then later top-ups of 0.3ml and 0.2ml - taking me right back to 7.7ml which is where I am now!

I definitely have restriction - there's no way I could eat a big plate of food now like I used to. I have more restriction in the morning. I can eat absolutely anything, including the so-called 'difficult' foods (e.g. crusty bread, asparagus and pineapple, chewy fish etc) although I have to go slowly with some veggies and fruit that have skins. Having said that, I have never experienced 'iron fist' and never regurgitated, been sick or had a PB. After both of the occasions when my band was too tight, I did experience 'slime'. I keep hearing or reading about other bandits and the typical meals that they eat. I just read a magazine article that described people who could only manage one potato, a small piece of meat and some veggies. And another who said that a meal out consisted of just a starter. And another who said they couldn't manage more than 900 calories a day. A lady at a support group said she takes ten minutes to be able to drink a glass of water - it takes me about ten seconds!

Well I can still eat more than all of them. Although I generally stick to about 1200 calories a day - I have to work quite hard at this. If I ate entirely guided by my hunger I could easily manage quite a bit more than that. A typical evening meal is four baby new potatoes, half a side plate of veggies and a 'normal' sized piece of salmon. This leaves me feeling pleasantly satisified or even full - but within a couple of hours I'm getting hunger pangs again. I think they really are hunger pangs, rather than 'head hunger'.

Don't get me wrong, I am losing weight - but I feel I am having to work so hard at resisting the hunger - which is what I got the band for. I'd love to be able to relax and just eat when I'm hnugry and know that that amount would keep me losing weight.

I don't want to be so tight that I take an hour to eat an apple, say (!) - but does this level of restriction seem right to you? Am I being fussy? Do I need another fill or is this risking going through the de-fill cycle all over again?

To be too tight, or not to be?

Although a few days ago I was a little pessimistic about the success of my latest band fill, I am progressively getting more optimistic. I think the difference it has made is very small, and subtle, but I do think it may have made a vital difference. I have given a lot of thought to something a lady said on the UKGastricBand forum the other day. She was explaining to someone what the so-called 'sweet spot' was, and she said, rightly I think, that it is different things to different people. In theory, of course, it is simply the level of restriction that is not too much that you get the awful side effects of regurgitation, heartburn, indigestion and acid reflux, but tight enough that you get a feeling of fullness and lose weight steadily. However, this is a somewhat simplistic view that omits the perceptions, objectives and coping strategies of inviduals. When you begin to delve into this and explore how different bandits perceive the sweet spot, it is clear that some people prefer to be very tight, even if they do get the side effects, because they cannot 'trust' themselves to live with the band being any looser. On the other hand, some prefer to be a little loose so that they can continue to enjoy eating out and living a fairly 'normal' life.

So where am I with this? Well first, I feel I should point out that I might change my mind about this next week!! At the moment (!), I feel that I do not want my band to be very tight. I've heard all sorts of horror stories about side effects, but even if you get away without them, there is always the fact that it could take an hour to eat a small meal or half an hour to drink a glass of water. I've had a little experience of living like this when I was too tight a few months ago and it is no way to live - well not for me anyway. I like the fact that I can still eat out with friends and although I am the last to finish my meal (even if I've had much less than them!), I'm not SO slow that it's awkward or embarrassing.

I think that having a sweet spot that is slightly on the loose side does have its downside. For instance, I could eat larger portions than I am doing - it takes quite a lot of willpower to resist the temptation sometimes. But this can be overcome to some extent by religiously sticking to eating the 'right; kins of foods - especially dry textured, crunchy salad vetetables, fish, lightly cooked potatoes, pasta and rice, and so on.

At the last support group meeting I went to, the consultant said that when bandits get to their goal weight, he feels that it's nice if they can have a very small aspiration - say 0.2ml or so. Since he said that I've actually had 0.2ml put in my band. It occurs to me now, that if I had that amount taken out again when I reach my goal weight, I think I would be at exactly the right level to stick at for the rest of my life!! In other words, I could quite happily exist at that level of restriction but manage to eat more than I am doing at present (i.e. enough to maintain weight rather than continue losing). So I suppose that's another good reson for sticking at the level of restriction I have now - it won't be such a big change when I get to goal weight. I am, in effect, already starting to 'train' myself for the big post-goal weight world awaiting me out there!!!

Post-fill progress report

Well, it's been three days now since my ninth fill of 0.2ml and things are going OK. I am far from convinced that this fill has made any real difference but am keeping an open mind as I begin to experiment with 'harder' foods. Today I ate Ryvita crispbread, cottage cheese and tuna for lunch together with crunchy salad vegetables (yellow pepper, cucumber, tomato, spinach and onion). This all went down without any problems, though I did feel quite full afterwards. After I had eaten about three or four mouthfuls I had to pause for ten minutes or so before I could continue. But once I re-started, I was able to continue to the end.

I am starting a new experiment today that I haven't mentioned before. I have decided that I rely too much on calorie counting to dictate how much I eat. From today I have decided to give my kitchen weighing scales a holiday! Having been weighing all my food for the past nine months I already have a pretty good idea of portion sizes and calories. So, from now on I am going to try to judge how much to eat from a combination of (a) how full I am after eating, and (b) using my side plate and small utensils.

This will mean that I'll have to try to be more disciplined about stopping eating when I am full. This is something I haven't really had to do before now because I have simply ploughed on beyond the 'full' point, knowing that the calorie count was OK. But now I will have to re-learn how to judge the 'stop eating' point based on the above. I am doing this because I'm conscious of the fact that although the end of the tunnel is still a long way off (more than two stones), I can start to see it shining in the distance. I need to adopt eating habits that are sustainable in the long run - and weighing everything is not something I want to have to do for the rest of my life!

Having said all of that, I am going to adopt a compromise position for a few weeks. I am certainly going to continue to keep my daily food and exercise diary. I'll write down what I eat and how much I eat - but no weighing, and no calories. However, at the end of the day (just before I go to bed - so it can't influence what I eat during the day), I will make an estimate of how many calories I have consumed. This is so that I can continue to make an estimate of my daily calorie deficit (based on calories burned during exercise).

One of the things we discussed at the Healthier Weight support group last weekend was the importance of keeping a food diary - and I have no plans to stop doing this valuable exercise in the near future. I'm just tweaking the way that I record in order to begin to adopt habits that hopefully, will be sustainable in the long run.

Come in number nine....

I had my ninth band adjustment today (0.2ml) and am hoping and praying it will be my last (apart from any long term MOT adjustments). I've been so close twice before but never quite found my sweet spot. I've had a couple of drinks already and satisfied myself that I can get liquids down ok. Then I tried a Weight Watchers low fat yoghurt. I finished it, just, but it's left me totally stuffed! Hopefully this is a sign of things to come.

I know that some newer bandits might be a little off-put at the thought of having so many fills - especially if you don't gave an inclusive aftercare package as I do. However, it might also reassure those who've struggled to find their sweet spot that (a) you're not abnormal, and (b) it's still possible to lose weight even while you're waiting to find that elusive sweet spot.

I'll keep you informed of my progress but wish me luck!