Delayed Onset Muscle Soreness

by Christine on April 21st, 2010

filed under Exercise, General Information

What are DOMS?

Delayed onset muscle soreness (DOMS) is that achy, sore feeling you get the day after a strenuous workout.  The cause of DOMS is actually unknown, but scientists think that they are caused by a breakdown of muscle fibers; this is particularly true when one is doing weight-training exercises.  Other research claims that the soreness comes not from the damage process but from the rebuilding process.  Either way, the exact cause is unknown.

DOMS is most common for those beginning an exercise program or working new muscle groups.  For example, someone new to doing situps will experience DOMS the next day while someone experienced at situps will not unless he or she over-trains.

You don’t have to get DOMS in order to get an effective workout. Highly-trained athletes rarely get DOMS because they are in such good condition. However, I personally see the DOMS as an indication that I did indeed get a workout. It’s like somewhat-instant gratification – your body says “YES! You kicked my butt! Way to go!” Perhaps that’s just an aspect of my “no pain, no gain” personality.  I get DOMS most often when I lift weights “to failure,” when I climb a LOT of stairs, or do a ton of squats/lunges.  Most body-building forums that I have read seem to seek DOMS out like a special prize. However, at least one article I read said that DOMS can be an indication of poor form and should NOT be sought after.  I’m a little unclear about the safety of DOMS, but they haven’t killed me yet.

In reading up about DOMS, I came across articles about eccentric muscle contractions and concentric muscle contractions. Apparently eccentric muscle contractions can lead to bigger (and better) DOMS. I didn’t know anything about these terms and wanted to delve into further study, primarily so I can figure out to have more DOMS after my workouts!

Eccentric Muscle Contractions

Eccentric muscle contractions are an overall lengthening of muscles as it develops tension and contracts to control motion performed by an outside force.  Muscles suffer greater damage when you employ eccentric muscle contractions than the opposite (concentric muscle contractions). An example of an eccentric bicep contraction would be a reverse bicep curl, or the act of setting a heavy object down gently.  Other exercises include going down stairs, running downhill, the downward motion of squats, pushups or pull-ups.

Concentric Muscle Contractions

Concentric muscle contractions are a shortening of the muscle as it develops tension and contracts to move a resistance. An example of a concentric bicep contraction would be a bicep curl, squat, or pull=-up. Running up-hill or climbing stairs causes the quadriceps to contract.  These are most common types of muscle contractions used in a gym when lifting weights but do not often generate the bigger DOMS.

Treating DOMS

There are no proven methods for getting rid of DOMS once they have come around.  You primarily need to let them run their course. However, some home-remedies for making the DOMS less severe include:

  • Taking an ice bath
  • Stretching
  • Using the RICE method of treating injuries
  • Eat protein-rich foods 30 minutes following the exercise

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200 snacks for under 100 calories!

by Christine on April 18th, 2010

filed under Diet, Food, Nutrition, General Information

Bread, Cereal, Pasta, Rice, and Snack Foods

Breads

Bagel, plain 1/2 medium (1 oz.) – 75
Bread, white 1 slice – 80
Bread, wheat 1 slice – 80
Bread, light 1 slice – 40
Breadsticks, soft 1/2 (1 oz.) – 75
Cornbread 1/2 piece (1 oz.) – 95
English muffin 1/2 medium – 68
Melba toast 4 – 80
Muffin, blueberry 1/2 (1 oz.) – 80
Muffin, bran 1/2 (1 oz.) – 80
Muffin, corn 1/2 (1 oz.) – 88
Popovers 1/2 (1 oz.) – 65

Cereals, cooked

Grits, cooked 1/2 cup – 70
Oatmeal, cooked 1/2 cup – 75

Cereals, ready to eat

Granola, low-fat 1/4 cup – 95
Oat cereal, toasted 1/2 cup – 55
Puffed rice 1 cup – 50
Raisin Bran 1/4 cup – 50

Crackers

Animal crackers, plain 6 – 85
Animal crackers, iced 3 – 75
Graham crackers 1 sheet – 55
Matzoh 1/2 sheet – 55
Oyster crackers 23 – 60
Saltines 5 – 60

Snack Foods

Snack cracker, butter 5 – 80
Popcorn, air popped 3 cups – 90
Popcorn, microwave 1.5 cups – 55
Popcorn, microwave light 3 cups – 60
Popcorn, oil popped 1 cup – 55
Popcorn, caramel 1/2 cup – 75
Popcorn, cheese 1 cup – 64
Potato chips, baked 5 – 60
Potato chips, regular 10 – 75
Pretzels, twists 4 large – 55
Pretzels, twists 8 small – 55
Tortilla chips, baked 10 bite size – 55
Tortilla chips, regular 6 rounds- 75
Tortilla chips, regular 3 restaurant style – 68

Fruits and Vegetables

Juices

Apple juice or cider 1/2 cup – 60
Apricot nectar 1/2 cup – 70
Cranberry juice cocktail, regular 1/2 cup – 73
Cranberry juice cocktail, reduced-calorie 1 cup – 45
Grape juice 1/2 cup – 75
Grapefruit juice 1 cup – 95
Lemon juice 2 Tbsp. – 10
Lime juice 2 Tbsp. – 10
Orange juice 1/2 cup – 55
Pineapple juice 1/2 cup – 70
Prune juice 1/2 cup – 90
Tomato juice 1 cup – 50
Vegetable juice 1 cup – 50

Fruits

Apple 1 medium – 80
Applesauce, sweetened 1/4 cup – 50
Applesauce, unsweetened 1/2 cup – 50
Apricots, dried 4 halves – 40
Apricots, fresh 1 medium – 20
Avocado 1/4 medium – 80
Banana 1/2 medium – 55
Blackberries 1 cup – 75
Blueberries 1 cup – 80
Cantaloupe 1 cup – 55
Cherries, maraschino 1 medium – 10
Cherries, sour fresh 1/2 cup – 40
Cherries, sweet fresh 1/2 cup – 60
Cranberries, fresh 1/2 cup – 25
Fruit cocktail, canned in light syrup 1/2 cup – 70
Grapefruit 1/2 medium – 40
Grapes 17 medium – 60
Honeydew melon 1 cup – 60
Kiwi 1 medium – 45
Mandarin oranges, canned 1/2 cup – 50
Mango 1/2 medium – 65
Mixed dried fruit 1/4 cup – 85
Nectarine 1 medium – 65
Orange 1 medium – 60
Papaya 1/2 medium – 60
Peach 1 medium – 40
Pear 1/2 medium – 50
Pineapple, fresh 1 cup – 75
Pineapple, canned in light syrup 1/2 cup – 65
Plums, fresh 1 medium – 35
Plums, dried (prunes) 3 medium – 60
Raspberries 1 cup – 60
Strawberries 1 cup – 50
Tangerine 1 medium – 35
Watermelon 1 medium – 50

Vegetables

Carrots, cooked 1/2 cup – 35
Carrots, raw 1 large – 30
Celery, raw 1 stalk – 5
Cucumber, raw 1/2 medium – 20
Lettuce, raw 1 cup – 5
Potato, baked 1 (2 oz.) – 65
Potatoes, mashed w/milk and butter 1/2 cup – 100
Tomato, raw 1 medium – 25

Milk, Yogurt, and Cheese, and Frozen Desserts

Milk

Whole milk 1/2 cup – 75
Reduced-fat milk (2%) 1/2 cup – 60
Low-fat milk (1%) 1/2 cup – 50
Fat-free milk 1 cup – 90
Buttermilk, low-fat 1/2 cup – 55
Chocolate milk, fat-free 1/2 cup – 73
Rice beverage, plain 1/2 cup – 60
Soy beverage, plain 1/2 cup – 50

Yogurt

Whole milk yogurt, plain 1/2 cup – 90
Low-fat yogurt, plain 1/2 cup – 55
Fat-free yogurt, plain 1/2 cup – 50
Low-fat yogurt, flavored 1/4 cup – 58
Fat-free yogurt, flavored and artificially sweetened 1/2 cup – 50

Cheese

Cheese, regular (full-fat) 1/2 oz. – 55
Cheese, reduced-fat 1 oz. – 80
Cheese, fat-free 1 oz. – 40
Cottage cheese, 2% 1/4 cup – 50
Cottage cheese, fat-free 1/2 cup – 80
Cream cheese, regular 1 Tbsp. – 50
Cream cheese, reduced-fat 2 Tbsp. – 70
Cream cheese, fat-free 2 Tbsp. – 30
Feta cheese 1 oz. – 80
Mozzarella cheese, part-skim 1 oz. – 80
Ricotta cheese, low-fat 1/4 cup – 70
String cheese 1 oz. – 70

Frozen desserts

Frozen yogurt, regular 1/4 cup – 60
Frozen yogurt, fat-free 1/2 cup – 95
Ice cream, regular 1/4 cup – 70
Ice cream, reduced-fat 1/4 cup – 50
Ice cream, fat-free 1/2 cup – 90
Ice cream, fat-free with no added sugar 1/2 cup – 70
Sherbet 1/4 cup – 65
Sorbet 1/4 cup – 55

Processed and Deli Meats, Fish and Seafood

Processed and Deli Meats

Bacon, fried 1 slice – 35
Beef jerky 1 oz. – 90
Bologna 1 oz. – 90
Canadian bacon 1 oz. – 45
Pepperoni 1/2 oz. – 70
Roast beef, deli 1 oz. – 30
Sausage, smoked 1 oz. – 95

Poultry

Chicken breast with skin 1.5 oz. cooked – 85
Chicken breast without skin 1.5 oz. cooked – 70
Chicken breast, deli 1 oz. – 45
Chicken thighs with skin 1 oz. cooked – 70
Chicken thighs without skin 1.5 oz. cooked – 84
Chicken wings, roasted 1/2 – 50
Turkey breast, deli 1 oz. – 30
Turkey, dark meat with skin 1.5 oz. cooked – 94
Turkey, dark meat without skin 1.5 oz. cooked – 80
Turkey, light meat with skin 1.5 oz. cooked – 70
Turkey, light meat without skin 1.5 oz. cooked – 60
Ground turkey, lean 1.5 oz. cooked – 85
Ground turkey, extra-lean 1.5 oz. cooked – 60

Fish and Seafood

Catfish 1.5 oz. cooked – 65
Clams 6 large – 90
Cod 3 oz. cooked – 90
Crab, blue fresh 3 oz. cooked – 90
Crab, blue canned 1/2 cup – 70
Crab, imitation 3 oz. – 90
Halibut, Atlantic 1.5 oz. cooked – 60
Lobster 1.5 oz. cooked – 55
Mussels 1.5 oz. cooked – 73
Orange roughy 3 oz. cooked – 75
Oysters 6 – 65
Salmon, Atlantic fresh 1.5 oz. cooked – 78
Salmon, smoked 1.5 oz. – 50
Scallops, bay 1.5 oz. cooked – 60
Scallops, sea 3 large – 60
Tuna, yellowfin fresh 1.5 oz. cooked – 60
Tuna, canned in water 1/4 cup – 60

Eggs, Nuts and Seeds, Sugars and Sweets, Alcoholic and Other Beverages

Eggs

Egg 1 large – 75
Egg white 1 – 15
Egg yolk 1 – 60
Egg substitute 1/4 cup – 30

Nuts and Seeds

Almonds 12 – 84
Cashews 9 – 83
Flax seeds 2 Tbsp. – 95
Peanut butter 1 Tbsp. – 95
Peanuts, dry roasted 20 – 80
Peanuts, oil roasted 20 – 85
Pecans 15 – 80
Poppy seeds 1 Tbsp. – 50
Pumpkin seeds 2 Tbsp. – 95
Sunflower seeds 1 Tbsp. – 50

Sugars and Sweets

Chocolate syrup 1 Tbsp. – 50
Honey 1 tsp. – 20
Jam/jelly 1 Tbsp. – 50
Maple syrup 1 Tbsp. – 50
Pancake syrup, regular 1 Tbsp. – 55
Pancake syrup, reduced-calorie 1 Tbsp. – 25
Sugar, white or brown 1 tsp. – 15

Alcoholic and other Beverages

Alcoholic beverages

Beer, regular 6 fl. oz. – 73
Beer, light 6 fl. oz. – 50
Bloody Mary 4 fl. oz. – 93
Liqueurs, 54 proof 1/2 fl. oz. – 58
Daiquiri 1 fl. oz. – 56
Gin, rum, vodka, whiskey, 80 proof 4 fl. oz. – 65
Sherry, dry 4 fl. oz. – 80
Wine, dry red, white, or blush 2 fl. oz. – 85
Wine, sweet dessert 4 fl. oz. – 90
Wine cooler 8 fl. oz. – 72

Other beverages

Café latte, with fat-free milk 8 fl. oz. – 80
Cappuccino, with fat-free milk 8 fl. oz. – 55
Club soda 8 fl. oz. – 0
Coffee, brewed 6 fl. oz. – 5
Hot cocoa mix, with water 4 fl. oz. – 60
Tonic water 8 fl. oz. – 85
Soda, diet 12 fl. oz. – 0
Soda, regular 6 fl. oz. – 73
Tea, brewed 6 fl. oz. – 5
Tea, sweetened iced 8 fl. oz. – 90
Water 8 fl. oz – 0

Content courtesy of www.bhg.com.

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A new me!

by Christine on April 14th, 2010

filed under Gastric Banding Surgery, General Information

So the last few posts have been about the gastric banding surgery. If you want to read about the surgery, read backwards in chronological order. I don’t think I ever mentioned it, but I had the Realize band put in. (Not “Lap-Band,” which is a trademarked brand, like Kleenex is.)

I had the surgery a little over a year ago, February 28, 2009. It is now April 14, 2010 and I have lost 71 pounds to date. Here are some before and after photos for you!

The picture on the left is me, 225 pounds. To the right is me, 154 pounds. (It’s pretty fun to look at photos over the last year. Watching my chin evolve from my mass of my neck is pretty amusing.) I’m only 5’2, so I’m a shorty, which means that I have even more weight that I should lose. But that brings to me to a few questions that I have been mulling over. How much can I lose? If this is all my body can do, is that okay?

My goal is to lose 100 pounds exactly, which would put me at 125 and at a healthy weight according to the BMI charts. However, I’ve never been less than 150 pounds, not since 8th grade or so. I’m not sure what my body is even capable of doing.  I’ve been losing weight, even recently, at a steady pace so I think I have a ways to go.  My dilemma is that if I get my heart and head stuck on a number that may-or-may-not be achievable, then I will end up being disappointed.

I’ve been trying to wrap my brain around the whole concept of “weight acceptance.” I found a good website called Second Helping that deals with the question, “I’ve lost a bunch of weight…now what?”  If you know of other resources that I should look into, please hook me up.

In the meantime, I’ve been diligent about watching what I eat and keeping a daily food journal.  I exercise regularly: I am currently taking a bootcamp class that meets at 5 a.m. three times a week. Plus I walk during my lunch hour, bicycle on weekends, and do other outdoor activities.  I’m looking into possibly taking a Zumba or kickboxing class next month in place of bootcamp, just for some variety.

So what’s different in my eating now versus before surgery? How and why is the weight actually coming off?

Foodwise, I eat approximately 800 calories per day. (Sometimes less, sometimes more.) I don’t necessarily watch what I eat and try to hit that 800-calorie target. Rather, I eat pretty much what I want, when I want. The food journaling is just to try to observe trends, look for ways to improve my diet, etc.  I eat all freaking day long these days. I eat probably six times a day, but I only eat about 150-or-so calories at any given sitting. Basically, I graze all day long.

I eat far more dairy than I ever did before. I don’t know if this is good or bad, but it’s just an observation. I eat cheese and pepperoni as a mid-morning snack. I drink skim milk (with ice) every other day or so.  I probably have a little more ice cream and yogurt than I did before.  I don’t shy away from dairy because it’s fattening. If I want it, I eat it.  Just remember, I don’t eat very much of it, so I don’t “overdo it.”

I eat less “bad” carbs, too. I never eat bread. I very rarely eat pasta. I will do rice, but only maybe once per month. The reason is solely because the carbs get stuck in my band, forcing me to puke, which is unpleasant. I just avoid it at all costs.

I eat tons of protein and meat. Probably more than I need to or should. I don’t eat enough veggies. This is too bad because I LOVE veggies, but they often get stuck and give me issues. (For example, last night I had steamed green beans, and boy…they got stuck pretty good. Stupid things!) I keep trying to find out which veggies are okay, and which give me issues. This is still a learning process. I’m trying to blend and cream things as much as I can to get the veggies in. I made HUGE pots of veggie soup (veggies chopped up really fine) to eat at lunchtime.  I make fruit smoothies when I remember to. (Add a dash of protein shake for good measure.) If you have any recipes for good mushy vegetable dishes, hook me up!

Other than those eating tips, I have to say — I’ve been working LESS HARD at losing weight than I ever did before surgery. Comparatively, this is easy stuff!  Like I said, I eat what I want, when I want. I work out because I’m feeling fit and healthy, so that’s easy, too and less like a chore.

All in all, considering the results that I have had, I would say that this surgery has been a blessing. I would do it all over again, in a heartbeat. Plus, it’s extremely reassuring to me to know that, if the weight ever starts to creep back on, I can always go back to the doctor and get another fill.  I shouldn’t ever need to go through horrible weight fluctuations ever again! Yay!

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Gastric Banding–Post Surgery Information

by Christine on April 13th, 2010

filed under Gastric Banding Surgery, General Information

This blog post is a continuation of the last three gastric-banding surgery posts that I have written. Please read from the original posting first and then move on to this one in order to view them in chronological order! This posting describes the post-surgery information, like “how does the band work” and what to expect with your fills.

Post-Surgery Information

What does the gastric band do?
It’s best to visualize the band in order to understand it:

Gastric Band

In this photo, you can see that the band is placed at the top part of the stomach. There is a hose attached to the band, and at the end of the hose is the port site.

THE BAND
The band is a flexible plastic material. The inside of the band is, for lack of a better description, kind of like a balloon. When they first put the band on, it’s very loose. (The “balloon” is deflated.) As they put liquid in your band, the “balloon” slowly inflates, making the opening between upper-stomach and lower-stomach much smaller. This happens gradually, over the course of several appointments with your doctor.

THE HOSE
The hose just joins the band to the port site, and there’s really not much more interesting to add about it.

THE PORT SITE
Apparently the placement of the port varies from person-to-person. My ex-boss had his port side right below his sternum. My port site is adjacent to my belly button, just to the right of it. Mine is attached to my abdomen.

When you’re overweight, you will have to press pretty hard to feel the port site. As you lose weight, it is easier to feel through your skin. I’ve heard stories of people being able to see it bulge through the skin (in fact, I can kind of see mine, too, these days!), but you’d have to lose a lot of weight for that to happen.

The port site has an opening on one end of it. (That opening is just BELOW the skin.) To access the opening, the doctor takes a big, scary needle and pokes it through your skin to access the port. Sometimes the doctor will miss, and the needle will stab into your abdomen, and that hurts. BUT — when they don’t miss and are accurate, it’s surprising how much the needle doesn’t hurt. I flinch from anticipation, but it does NOT hurt. I shut my eyes because it’s scarier to watch than to feel!

They inject a harmless solution of saline into the band. If they miss the injection or if the band leaks, the saline doesn’t hurt your insides at all. It’s harmless.

So How Does it Work?
Again, a photo will explain this well:

When you eat, the food passes down your throat and into your UPPER stomach. There it sits until it passes through the small band opening. The digestion process doesn’t happen until the food reaches the LOWER stomach.

Now, you must chew your food up nice and small! If you don’t, the food will get stuck and will not be able to pass through the small opening. When that happens, you will need to vomit all the food up and start over. Yes, this sounds bulimic, but it’s completely common with gastric band patients. The food it physically stuck.

If you eat too fast, the food will get stuck in the upper stomach, which will fill up too fast. You will literally overflow, and probably need to puke some up so it’s not so uncomfortable.

That’s all the band does. Your body will still digest food the same way it always did. You will digest the same amount of calories per food item. You can still eat the same foods that you did before, probably, except that you will just need to chew a lot more. However, because food often gets stuck when you eat chunky things like steak and chicken, you will probably just opt to eat soft items (applesauce, soup, etc) just because it goes down easier.

The small opening in the band means that you eat less. You eat slower, too, which makes you feel satiated for longer.

Diet
It is very important that you follow the strict dietary guidelines following your surgery. Although it’s hard to be on a liquid-only diet for so long (ESPECIALLY after being on the vile medifast shakes!) they do this because your stomach and your band is healing. Your band needs to settle in and you need to get it tightened. You risk having it slide around on you if you eat too much! Then you have to go in for more surgery, and it gets very complicated.

The first 3-4 days you will be required to follow a clear liquid diet. That means water, water, and oh yeah, more water!

You cannot have any caffeine for at least three months after surgery. You shouldn’t have been drinking caffeine during the Medifast period, so you shouldn’t be tweaking on caffeine withdrawal….you should have gone through that already. Carbonated beverages can cause gas and bloating and increase stomach size. They are not recommended for any banded patients pretty much ever again. Assume (and try hard) to avoid this forever.

The next food phase is 5-6 weeks of a modified full liquid diet. This involves adding some diluted juice, drinking protein shakes, having pureed soup, applesauce, baby food, jello. I had tuna fish as well, and that worked out well. (I just made sure I mashed it up really well and smoothed it out with some mayo.) You can have other foods so long as you blend it up and puree it really well.

Part of the reason why they want you to do this long pureed food phase is because when you start eating real food, you ARE going to get food stuck and you ARE going to puke. The effort it takes to puke the food back up may cause the band to slip until you have received a few fills and the band fits tighter around your stomach.

Regular diet
After 6 weeks you can slowly start adding “real” food to your diet. You take this at your own pace, according to what works for you. As stated above, you ARE going to end up not chewing well enough or eat something that does not agree with you and you ARE going to puke. This is normal, so don’t freak out. Just remember to chew thoroughly and eat mushy foods at least at first.

You should be okay with eating lots of protein, vegetables, salads, etc. You are most likely going to have problems with bread, potatoes, and rice getting “stucK” and causing you to puke. Even a year later I really can’t eat bread at all because it nearly always gets stuck.

You will notice a huge difference in how much (quantity) food you can eat. It’s not unusual to become full after 4 or 5 bites of food. (Yes, 4 or 5 bites!) That happened to me, and I’d discover that I would be hungry again an hour later. That’s fine — grazing on small meals throughout the day is healthy!

Because you are eating so much less food than before, be sure to watch how much protein you are eating. If you are lacking in protein, go ahead an have a protein shake for breakfast. This will keep you full longer, spur on your metabolism for weight loss, build healthy muscles and bones, and other healthy stuff. You should also take a multi-vitamin every day. However be careful! Multi-vitamins are usually in big horse pills, and they WILL get stuck in your new band. Find smaller capsules or even flinstone chewables.

Foods that are typically not processed well by band patients:
(This completely varies from patient to patient. For instance, I’m fine with eating steak but many people cannot eat it at all. It also depends on how you prepare it and how well you chew. But this is a general guideline.)

* Bread, potatoes, rice
* Meats that are especially tough such as steak and pork chops. Some band patients have difficulty digesting other meats that contain gristle such as hamburger.
* Oranges and grapefruits may not be tolerated unless the membrane is removed before eating.
* The seeds and/or skins of all fruits and vegetables.
* High fiber vegetables such as celery and sweet potatoes.
* Spicy foods.
* Fried foods.
* Certain spices including cinnamon, pepper, or onion or garlic salt.
* If you are unable to tolerate milk, it’s important to add other calcium and protein rich foods such as cottage cheese. Dry milk can be added to foods for added protein.
* Asparagus
* Pineapple
* Rhubarb
* Corn (especially popcorn)
* Grapes (I think it’s the skin and seeds that cause the problem.)
* Carbonated beverages
* High calorie foods/drinks

When will I start to see weight loss happen?
For the first couple of weeks after surgery you are probably not going to see any weight loss. Firstly, your body is filled with after-surgery liquids and gasses, so it’s going to retain some water. Secondly, you’re going to be on a starvation-level diet for a few weeks, so your body isn’t going to let go of its fat without a fight. Thirdly, it’s going to be several weeks before you feel comfortable doing any kind of exercise, so your metabolism is going to slow down a bit.

Again, each individual is totally different. Their weight loss depends on how fast they recooperate after surgery, how receptive the body is to weight loss, speed of metabolism, etc. For me, I didn’t see any weight start to come off for approximately 2-3 months. This was VERY frustrating for me. I thought to myself, I went through all this surgery for nothing! My advice is to stick with it and see your doctor regularly. The weight WILL start to come off. After all, it’s in your doctor’s best interest to see you succeed because your statistics become part of his or her success rate as a surgeon. They will help you!

OMG the gas!
Okay, seriously. My doctor told me, “You’re probably going to experience some gas” but jimminy christmas, they didn’t tell me that I’d be producing enough gas to blow up a small planet!

You are going to fart. A lot. Small farts, usually not smelly. But seriously, maybe 500 times a day. Nonstop, all day long. It’s embarrassing and awkward. If it’s horrible, plan on spending a few weeks at home and away from social situations. Ask your boss to stay at your desk and away from client contact. And know this:

1.) It’s totally normal!
2.) It DOES go away and get better. I don’t think it really started to get better for me for 3-6 months.

I think you’re gassy because your body is processing your food slower than usual. You may be gulping in air between bites. Also, your food choices are probably changing as well. For instance, I have beans in my food nearly every day now. As we all know, beans = gas!

OMG the heart burn!
Immediately after surgery, your doctor probably handed you a prescription for nexxium or another antacid. You’ll probably think to yourself, “Gee, what’s this for? I don’t even have heart burn!”

Oh, but you will!!! I don’t think mine set in until I was in the solid-food-eating-stage of the diet, but when it did, ugh! My heartburn is pretty mild and it’s annoying more than anything. I’ve read other stories from people who have really horrible heartburn. When the acid starts to annoy your stomach, it’s important to treat that right away. If you don’t, the acid will start to irritate your stomach lining, and you’ll be at risk for eroding your plastic band THROUGH your stomach. So take your heart burn meds like a good little patient and be happy about it.

What about exercise?
It took me a few weeks to feel human enough to even walk. The doctors recommend that after surgery you walk around a bit. If your stomach is still sore from the surgery, avoid heavy lifting, situps, etc. Once you start to heal, you’ll feel better. Once you lose weight, you’ll feel even BETTER! Amp up your exercise little by little as you are feeling good. I was jogging, doing situps, and doing all forms of vigorous exercise within about 3 months of surgery. My advice is to play this by ear and do as much as you can without hurting yourself.

So what are the fills like?
I was really really nervous about the fills. I was more nervous about the gigantic needle than I was nervous about the surgery! Honestly, it is NOT THAT BAD.

You will want to see your doctor once every two weeks for follow-up appointments. During this time they will fill your band with a saline solution and make your stomach opening smaller. To do this, they stick a needle through your skin at your port site, which on me is near my belly button. You may not get a fill EVERY time, and that’s okay.

My band is a 10cc band. That means that it can hold 10ccs worth of liquid. The first time I got a fill, I got 3ccs. The second time they gave me 2 ccs. The third time they gave me 1 cc. After that the amount got smaller and smaller. I think I “maxed out” around 7 ccs. By “max out” I mean that I am able to eat food without the hole/opening being so small I need to puke everything up *AND* I’m still able to lose weight. It’s the happy medium. This happy medium is different for everyone, and your doctor will work with you to find where your sweet spot it.

Now, this was the ONE complication that I had following surgery. I had approximately four appointments after surgery when I met with the doctor’s assistant. Bless her heart, she was very nice, but after each fill I wouldn’t notice any discernible change. I would come in for my next appointment not having lost any weight and finding no difference in what I could eat, etc.

Finally my lack of weight loss for 3 months had the nurse concerned, so she made me see the surgeon again. He inserted the needle into my port site and went to suck OUT all the saline just to see how much was in the band. NONE! Apparently the assistant was injecting the saline into my flab, NOT into the port site. She was missing entirely. From that point I demanded to see the surgeon for every fill afterwards.

Boy, what a different experience! The doctor filled me up with saline and instantly I could tell a difference. After a fill, I would eat only tomato soup or pureed food. (Your stomach gets irritated by the squeezing of the band. The inflamation causes the opening to be even smaller than when it heals. The inflamation also causes heart burn.) This should only last for about 2-3 days, then the inflamation goes down and you should eat proper solid foods again. My doctor always gives me a drink of water just to make sure that the opening isn’t so small that you can’t swallow ANYTHING.

The first time I got a fill, I asked for a numbing solution. This is kind of like novacaine that makes the big, huge needle hurt less. Theoretically. They use a needle to inject the numbing solution, and to be honest I found that that hurt MORE than the giant needle! (Don’t know why, that’s just me.) It honestly doesn’t hurt too much to get an injection. The worst part is when the doctor’s aim sucks and he misses and jabs you in the abs instead. That is uncomfortable, but it shouldn’t even hurt as much as a bad feminine cramp day or a migraine.

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Gastric Banding–Pre-Surgery Stuff

by Christine on April 11th, 2010

filed under Gastric Banding Surgery, General Information

This blog post is a continuation of the gastric-banding surgery post that I began yesterday. Please read from the original posting first and then read this one in order to view them in chronological order! This posting describes the pre-surgery testing and medifast period that I had to undergo prior to gastric banding surgery.
 
Pre-Surgery Stuff
Before I could do anything, I had to attend a mandatory informational meeting. This meeting was held at the hospital, and all it was was an informational “what is LapBand and Gastric Bypass, and which one should I pick” kind of meeting. I personally decided that lap band was a better option for me than gastric bypass only because I know someone that went through GP….and GP alters your diet for the rest of your life….as in, you cannot have sweets, sugar, alcohol, etc….EVER again. That’s DEFINITELY not something I want to consider. Lap Band limits the quantity of food and requires some dietary restrictions, but none as severe as the GP. Anyway, I digress.

Following the Informational Meeting, the Bariatric Center then called me for an appointment. This appointment involved a general physical. I had to get into one of those awful hospital gowns with my ass sticking out. The doctor asked me questions about cancer/diabetes, etc in my family history. He checked the size of my liver and listened to my lungs. He checked my blood pressure, looked into my eyes and mouth, etc. Nothing evasive or very uncomfortable. He told me after this meeting that I am an “excellent candidate” for lapband surgery.

He then walked me over to the surgery planner. She called me in a week with my surgery date already planned! My surgery date was February 28, 2009.

There are many pre-qualification doctor visits needed before my surgery, including a psychiatric evaluation, a meeting with the nutritionist, etc. I had about one month to make those visits.

Before surgery, you need to lose 10% of your body weight. This will reduce the size of your liver and make it easier for the doctors to find your stomach and wiggle their way into your insides. For me, 10% of my body weight was 20 pounds or so. In order to achieve this goal, I went on a Medifast Diet, which is essentially just a protein shake diet, for 6-8 weeks prior to the surgery. I started the medifast diet on January 1, 2009.

Psychological Visit
In order to qualify for the surgery, you need to pass a psycholigical exam. I believe the point of this exam is to determine that you aren’t suffering from depression (I mean, that you’re not well-adjusted and actually suffering, not being treated for it, etc.), to check for past suicide attempts and find out what the deal is with that, and to make sure that you have a good support system during surgery and the weight loss time. They want to make sure that you aren’t keeping your surgery a secret from your family and friends.

My appointment went amazingly fast. I was worried a little bit beforehand because I DO have a past suicide attempt and am currently being treated for depression. However, he felt confident that my meds are straightened out and that I’m secure and in-tact. (Which I am. I am not suicidal or anything like that.) There was a form to fill out about family medical history, which he looked over. Then he informed me that I’m an excellent candidate for surgery and he will recommend me to the doctor!

I had to pay a $30 copay for this psych appointment.

Pre-Hospital Testing #1
I had to go in to the hospital for a half day worth of testing. Now, the tests that they want you to take are really dependent on your physical condition and existing ailments and whatnot. For instance, my ex-boss who had the lapband surgery had tests for his gall bladder, which involved gall bladder surgery BEFORE lapband surgery. For me, the gall bladder wasn’t a problem at all, so they didn’t even test me for it. Before testing you couldn’t eat or drink anything after 10 p.m. the night before.

I showed up at the hospital and gave them all my insurance information. Then they got me into a gown (which, surprisingly, wasn’t as awful as I was expecting. Yes, the shirt was one of those open-backed dealies, but they also gave me loose pants to go with it AND a robe for over the gown.) First they called me in for some X-rays. Turn this way. Then turn that way. Snap snap snap. Less than 2 minutes and I was back out in the waiting room.

Then they called me in to do gastrointestinal testing. This involves drinking a barium “milkshake.” It comes in a milk bottle, like maybe 16 ounces of the stuff. And….it’s not as horrible tasting as I thought it would be, but it was still VILE!!! The woman laid me down on this metal bench with a big old contraption (another X-ray machine?) above it. It was pretty intimidating looking. So I’m laying on my tummy and they pour this drink into a plastic cup and give me a straw to drink through. She said, “I’m going to take some pictures of you while this stuff is going through your body. So follow my instructions and don’t move!” Then she goes into the other room and says, “Drink! Now breathe. Drink! Now breathe!” To be honest, the stuff was super gross so I was like Drink – gag – gasp for breath – drink – gag – gasp for breath. Tears were running down my face from the gagging. The lady was really nice though. She gave me a few minutes breather before she wanted to try the whole thing again. UGH.

I guess some people digest the stuff slower than others, so the barium liquid doesn’t make it all the way down into your tummy like it should, so with some patients they ask them to walk around to get the liquid moving, then bring them back and do another round of tests. I guess my body works pretty fast, so one shot was all that was needed. Fabulous!

Then they told me to get dressed and go to meet the repiratory people. I went to that person. She needed to take blood from me, but from an artery instead of a vein. It was still in my wrist, and it didn’t hurt very much. It felt like normal when you give blood. Just make sure you don’t wiggle and move too much. That was fast. Then she had me breathe into this contraption to see what my lung capacity is. All you do is blow as hard as you can, then HOLD your breathe (don’t breathe in) and you get dizzy and think you’ll pass out then, she says, “good!” and you get to gasp for a breath. I had no problems with that test, and it wasn’t hard or intrusive or anything. (I have to imagine that swimming would greatly enhance your ability to hold your breath for this test.)

After that I was done!

Medifast Diet
On January 2nd I started on the Medifast diet. Now, I went online and I saw that anyone can buy their products online. http://www.medifast1.com/ However, there are real FOOD items online, but my doctor only wanted me to do a shake diet. I’m not entirely sure why, but okay, that’s what the doctor wanted.

My Medifast diet was a little different than my boss’s was, so I have to imagine that they tailor this diet on a case-by-case basis. My boss had to do 5 shakes per day, with NO FOOD AT ALL during this period. He was on the diet for, oh, what, 4 or 5 weeks? During that time he lost 40 pounds. Of course, he was much heavier than me and had more weight to lose. He did very well following the shakes-only diet, although he expressed to me that he got really sick of the flavors.

If you decide to order these shakes (again, anyone can order them!) or embark on this diet, let me warn you — the strawberry shakes are truly putrid! I had a really hard time choking the stuff down. The vanilla is pretty bland and neither good nor bad, but you can add other flavors to it for a little variety. For instance, if you go to the grocery store and buy some extracts, you can make root beer flavored shakes or whatnot using the vanilla base flavor. I personally think the chocolate and the orange flavors were the best.

Like I said, my diet was different than my boss’s. Because I have less weight to lose (although I explained to the doc that I am weight-loss resistant) they gave me MORE time to lose weight but put me on a four-shake-a-day diet with one small meal per day in addition. The small meal should include some kind of lean meat (grilled chicken, fish, etc.) along with 2 cups of a vegetable. There are some limitations as to what kind of veggies and meat is ok and what isn’t. They want you to stay away from the real starchy veggies (so no potatoes, corn, etc.). There is to be no soda (diet or regular), no sugary beverages, etc. Only 2-3 cups of a caffeinated beverage per day is allowed. One strange thing about the diet, whether you go with the meal or not — you need to have 1 Tblspoon of an oil per day, which I believe is to keep the gall bladder working. This can be used in grilling your meat or in a salad dressing, etc. I have to be honest, I didn’t do entirely well following the diet…..like, I went out to eat a lot and I even had a glass or two of wine, too. I had pasta once, and carbs/starches are NOT allowed. Either way, I’m still lost weight so wasn’t that big of a deal. I found that having the one small meal a day was pretty hard sometimes because I’m an all-or-nothing kind of person. My boss agreed that doing one meal a day would have been really hard for him, and he was glad that he just did all milkshakes.

Over time, I found it difficult to do a full four shakes per day, especially as the weeks progress. I got so sick of them, the mere idea of them made me feel like BLAH. I decided that I’d rather eat nothing than have to choke down another chocolate shake. Even from the onset, I was only doing three shakes a day. 6 weeks into the diet, I was really only doing 1-2 shakes per day. I was so glad when the Medifast period was over! 

I had to go into the clinic every week to weigh-in. They tracked my weight loss progress on the Medifast. I also bought my supply of shakes at that time. (A pack of 5 shake mixes costs me $11.) Every time I went I neededo pay another $30 co-pay, which got a little expensive but I knew that it wouldn’t last forever. I purposely rescheduled my appointments for every 9-10 days instead of 7 days in the hopes of shaving off a week in the long run and saving me $30. (Ha ha, the scheduling lady didn’t catch onto my reuse!)

After the 8 weeks of the medifast, I lost, I think 20 of the 25 pounds they wanted me to lost. I was freaking out that if I didn’t lose the exact amount of weight that the surgery would have to be rescheduled. However, my doctor felt confident that I had lost enough weight, so the surgery progressed as planned. However, it’s worth noting that if you don’t meet your weight goal by 10 or more pounds, your doctor may decide that it shows a lack of determination, ability to follow the diet, or an indication that something is going on medically; the doctor may decide to postpone your surgery.

Pre-Hospital Testing #2
A week to go to the surgery, I went in for more testing. They call this “Pre-Admission Testing” or PAT. The first part involved filling out paperwork and signing my life away (ha ha, literally). Then I paid my co-pay for the surgery itself, which was $100 for me.

Then I went upstairs where I was asked to pee in a cup. Then they drew more blood (4 vials worth….one to determine my blood type, one was a pregnancy test, and I have no idea what the other two were for, I forget). Then they did an EKG, which involved putting little stickers around my left boob and hooking them up to the electrical machine. (It didn’t hurt a bit.)

Then a nurse came in to ask me a bunch of general medical questions (when was your last period, have you ever had surgery before? are you allergic to anything?) and then a pharmacy intern came in to ask me questions about what drugs I’m currently taking. This was all routine stuff….things I’ve answered about 4 times now!

I then met with my doctor….the actual surgeon who will do the work. He seemed nice enough. He went through what the surgery was and the side effects, which is all stuff I’ve heard about 4 times now. I also did my last formal weigh-in and bought more Medifast. He gave me the results of some of my past tests, recommended that I take Vitamin D vitamins, and told me to stop eating my one meal a day on the metafast and just do shakes-only.

The Pre-Hospital Testing #2 event was very easy and nothing at all to worry about.

Before the surgery, I was required to get a sign-off from my Primary Care Physician. I had my appointment the next day with my Primary. He weighed me, took my blood pressure, had me pee in a cup again, listened to me breathe, asked me how I was doing, and then said, “yup sounds great, you’re good to go!” and that was that! That appointment cost another $30 copay.

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