Why stress makes the gastric band tighter

by Christine on September 15th, 2011

filed under Gastric Banding Surgery

My blog reader Kris was able to link me to an article explaining why our gastric bands feel tighter when we are stressed (or PMSing).  How very interesting! The article can be found here. The answer is that the gastric band is a semi-permeable membrane that actually can absorb fluids in the body!

Often times patients will come in because their Lap-band feels too tight. They find more difficulty with some foods, and are uncomfortable. They ask me “does stress cause the band to tighten?” The answer is, yes, it does.

The biology of stress is this: when you have stress, be it physical stress (like an illness) or mental stress (like your mother-in-law coming by for a short two week visit)…the body reacts by retaining fluid. You may notice that wedding rings are tighter, and there is more swelling in the legs at night.

The balloon of the adjustable Lap-band is a semi-permeable membrane, meaning it is osmotically active. In plain English: the more water you retain,  some is transmitted to the band, so it swells.

If a patient has 5.5 cc in their band (we measure it) and they come in and it feels tighter, we find they have 6 cc in the band. Where did the ½ cc come from? That is from the extra water the body is carrying. Since the balloon on the band is semi-permeable it will retain more water also.

This is the same reason that most people find the Lap-band to be tighter in the morning. In the evening you may notice you have some swelling of your ankles – by gravity your body water has gone down to the legs.  In the morning that swelling is gone, and the water has gone back to the central compartment of the body where the band is. If we measure the band in the morning it can have 0.25 to 0.5 cc more in it (which can make a difference).

This is also why we don’t like bands being too tight. People need room for stress – of all kinds. Leaving room in the band to allow for this, means that patients will have fewer difficulties.

 

Upon further web searching, I see that there are several scientific studies that have been performed that have verified this claim, such as this one here.

This knowledge makes me realize two things: (1) When your band is too tight or too loose, don’t go running to your doctor to get it fixed right away. Give it a little time to see if the saline levels balance themselves back out. Also, (2) If you experience a “looser” band, it doesn’t necessarily mean that your band is leaking or is broken. First try increasing your fluid consumption and see if that fixes the problem. If there is a noticeable decrease in “restrictive feeling,” then go see your doctor.

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Too much restriction!

by Christine on September 14th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

I really think this is the first time in 2.5 years that I’ve had TOO much restriction with my gastric band! And I’m not sure why.  What correlation does stress have on the band? Unless it’s getting an injection, the band is a relatively static piece of plastic. So why am I suddenly so tight I can’t keep any food down? Does stress somehow cause irritation of the stomach lining or something? That doesn’t seem like a reasonable physical response to me.

Yesterday I went to Paneras for lunch and ordered the creamy tomato soup (my favorite). And hour later I had only had 5 spoonfuls, and I had to barf the last of that up. NOT NORMAL!

I have an appointment scheduled for next week with my surgeon’s office. I had originally intended on getting a fill because I was feeling like I could eat too much and I was hungry all the time. Now, I’m wondering if I should cancel my appointment or even get a little Un-Fill?  I wonder if this will pass.

In better news…my medicine is finally kicking in, and today I feel more human than I have felt in a week. Much less depressed and much better focused.

Also–my weight is creeping back down. 130.0 today and going down by the day.

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No time to celebrate…

by Christine on September 12th, 2011

filed under Christine's Life Updates

Last year I posted about my memories of September 11th. A few years ago, when I was working for an architectural firm, we won a project working on Tower 4 of the World Trade Center, and I got to go for a personal tour of “The Tub.” Check out that post here.

Last night we watched the 9/11 Ten Years Later tribute. I remember watching that documentary about the rookie fireman when it was first released. Hearing the updates, how 9/11 has affected all of the members of the fire squad, was very compelling.  Hubby even got a little angry and punched a cushion; I think he has always wished that he joined the military so he could get a little revenge for what happened to us.

It was a very low-key, boring weekend at our house. My antidepressants have me feeling loopy and nauseous. I can’t keep any food down, and as a result I’ve lost about 4 pounds (hooray!). I lack any ability to concentrate and focus on the tasks at hand. Consequently I pretty much slept all day yesterday. Today I feel well-rested, but space cadety. At least I’m feeling numb, and not the emotional rollercoaster wreck I was last week.

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The blues have me restricted.

by Christine on September 9th, 2011

filed under Christine's Life Updates, General Information

I’m not doing very well over here.  Mentally. Depression, you know. It’s been a rough few days, honestly.

I’ve always dealt with depression, from as young as I can remember really. All my earliest memories are of crying myself to sleep and feeling unconsolable, out of place, unwanted, unnecessary. Even at 4 or 5 years old. I had a suicide attempt when I was 19, and ended up in the hospital, stomach pumped and all that jazz. After that, I thankfully recognized that the never-ending melancholy was depression (you’d think that would be a real “duh” thing, but I grew up in a family that refused to go to doctors, and “you’ll get over it” was our family motto.) and finally got some medication for it. What a lifesaver that was–literally.

Medication helps a lot.  But medicating depression is one of those tricky things because after you take it for a while, you feel better, and then you decide that you don’t need the medicine anymore! And then after a while the depression comes back, and it’s kind of this never-ending cycle.

For the longest time I was convinced–CONVINCED!!–that the cause of my depression was my weight.  My weight prevented me from doing the things I wanted to do. My weight kept people at bay, made it hard to make friends and be outgoing. My weight kept me from having a decent amount of self-esteem or even self-respect. While all of these things are true–my weight did create obstacles for me all the time, every day–I’ve also learned recently that sometimes depression is just a medical/chemical thing, and isn’t necessarily caused by any one thing, like weight. Sure, it can be influenced and triggered by circumstantial events, but it’s not always the cause of the mood.

Although I know that there is a lot of things going on with me right now that is triggering the depression, I wonder how depression has been affected to some extent by the weight loss surgery. For instance, I think there’s a kind of let-down once you reach your goal weight. It’s kind of like a bride after her wedding; there’s a kind of “Now what?” feeling? That exhilaration you feel every time you step on the scale and see a drop is no longer there. There’s nothing to be fighting for. It’s a let down in some ways. For me, I think the fact that I’m slowly regaining some of my weight is causing the depression. It makes me feel like I STILL don’t have control over my body and my weight, even after all this time and surgery. It’s extremely frustrating.

But really, this total sense of tiredness, listlessness, emptiness inside…it’s coming on for multitudes of reasons. Yesterday I pulled out my last stash of anti-depressants, and I’ll call my doctor for an official prescription renewal. I informed hubby about how I’m feeling, so he’s on “Christine-Watch” now and will help me monitor my mood and stuff. He’s super awesome like that.

Because of how I’m feeling, I can’t eat a thing. I never experienced my gastric band reacting to my mood quite as much as it currently is doing right now. I tried having some chicken noodle soup for lunch yesterday but it was so tight and restrictive I ended up barfing it all up. For dinner (out at pub trivia) I had a cup of cream of chicken soup–totally blended and creamy–and barfed all that up too.  This morning I woke up at 3 a.m. (I was at work at 4 a.m.!) and have been dry-heaving all morning. I don’t know if it’s the medicine making my stomach wonky today. Maybe.

Can’t sleep. Can’t eat. Can’t think straight. My anxiety is off-the-charts. (OMG because I left the house so early today, I forgot to turn off the alarm clock and it’s going off RIGHT NOW and it might go on all day! I feel like driving home to take care of it. I can’t believe I screwed up the freaking ALARM CLOCK!) Smothering feelings of being unnecessary, worthless, guilty, anxiety and worry…I simultaneously feel like I’m drowning and feel completely empty inside, too. Just flat, emotionless.  I either want to eat everything in sight (which I’m sure I’d barf up from the restriction) or want to eat nothing at all. I’m a wreck and really not doing well.

Sorry to be such a downer today.

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Adventuresome day driving in flood zones…

by Christine on September 7th, 2011

filed under Christine's Life Updates

Today for work I had to drive to a project meeting in Cooperstown. That meant driving through the affected flooding area in Schoharie County. Well, it was raining like hell all day long. I counted 8 cars that had driven off the highway due to hydroplaning. In fact, I called 911 for two cars that went off the road right in front of me! One was particularly scary…he was doing probably 60-70 mph and zoomed off the road, down a huge ditch and towards a row of trees! Yikes, I sure hope that they were okay!

It turns out the flooding was a big deal. All the areas I drove through had evacuations because of the flooding. These poor people already dealt with flooding on Sunday! They don’t need this! What a shame. I wish there was more I could do to help.  I wouldn’t have been allowed into the towns to help though; they were only allowing traffic to leave the small towns, not go into town.

As for me…it was oatmeal for breakfast, a Subway salad for lunch (tuna fish, no cheese or dressing), and then chicken & a teeny baked potato for dinner. No snacks in between meals, which is a little unusual. I’ve been enjoying cucumbers with low-fat Ranch dressing as my mid-morning snack. That’s not such a good idea to eat in the car though.

Weight is still up. I have my next fill scheduled for 2 weeks.

“Maintenance mode” is such a daily struggle. Turns out it doesn’t get any easier, peeps.

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