Dissatisfied Lap-Bander needs advice concerning food, vomiting and weight loss!!!

Hello,
It's been more than a year since my lap-band surgery. Things were going well for about six/seven months, in the beginning. Then I hit a plateau, and eventually began gaining weight back. Also, I've been having issues with vomiting after eating in the past three months. Lately, I have been feeling rather dissatisfied with my surgery. 

My questions for my fellow lap-banders are:
* What foods should I be eating to lose weight?
* Has anyone had issues with vomiting after eating? How did you correct this, or are you still struggling with it?
* Are you satisfied with your surgery?

Thank you for your replies in advance. I'm really looking for some advice. Thanks again!

I think you need to see your Doctor!
You are either too tight or have a slip.
I have had no problems with my band I was banded July 25. I am a every other week loser for the most part.
Good luck, but see your doctor please.

I've been seeing my doctor, and he says he thinks the issue of vomiting is caused by not chewing my food well enough, but I'm wondering if other people have this vomiting problem too. I haven't been able to get any adjustments on my lap band because I'm not losing weight, and my doctor doesn't want to make it smaller because of the vomiting.

I think the problem might be the food I'm eating. I was wondering if anyone on here could tell me what kind of diet and exercise program they're following to lose weight with thier lap band.   

Also, congratulation on your 60 lb. loss, marymcd54!

Hi AJ,
You might want to ask your doctor to refer you back to a nutritionist to get reacclimated to a band diet..or maybe the surgeon's office has a nutrition class.

I eat about 2oz of protein at lunch and dinner, with a vegatable. I make chicken at home, I have a marinade that makes it really moist and I often use dark meat chicken. Sometimes I'll grill a burger or steak and have a couple ounces. Monday we had salmon burgers. Sometimes I'll have a cup of chili but I think thats a bit heavy on carbs (but low in fat...try Trader's Joe 99% fat free chili).  For breakfast I'll have a protein shake or a an egg white omlet.  If I want a snack, LF string cheese, raw almonds (small amount) or portion of fruit (can't eat the whole thing). You have options for protein - yogurt, cottage cheese, eggs...   Check some of the posts here "What Did You Eat Today".

Get your 64oz of water in, dehydration might make you more restricted.


Good luck!

Thanks minnie_cat for that! I really appreciaite your detailed run-down. And thanks for suggesting that part of the website. I'll definitely check it out.

Great work on your weight loss, by the way! 

Sorry but your doctor is an uneducated, money hungry ass, and he is putting you at risk of having throat cancer in the future. Get your band out NOW !

I strongly urge you to get your band removed as soon as possible.

I've been doing a teeny tiny bit of digging regarding post op long term lapband related esophageal damage, and it's link to esophageal cancer. I have absolutely NOTHING conclusive to back up this suspicion that I have, HOWEVER I have serious concerns about long term lap band reflux and what all that acid is doing to our esophagus.

A risk factor is something that increases your chances of getting a disease or condition:.

Obesity. A number of studies suggest that obesity contributes to GERD, and it may increase the risk for erosive esophagitis (severe inflammation in the esophagus) in GERD patients. Having a large amount of fat in the abdomen may be the most important risk factor for the development of acid reflux and associated complications such as Barrett's esophagus and cancer of the esophagus, studies indicate. Researchers have also reported that increased BMI is associated with more severe GERD symptoms. Losing weight appears to help reduce GERD symptoms. However, gastric banding surgery to combat obesity may actually increase the risk for, or worsen symptoms of GERD.

www.healthcentral.com/acid-reflux/introduction-000085_3-145. html

GERD, often known as acid reflux disease, occurs when stomach contents regularly back up into the esophagus. When the stomach acid irritates the esophagus, it often causes heartburn. Some individuals who suffer from GERD develop a condition called Barrett's esophagus, when the lining of the esophagus is damaged by stomach acid, which can also increase the risk of developing esophageal cancer.

www.medicalnewstoday.com/articles/234982.php

How does the normal esophagus function?

The esophagus has three functional parts. The uppermost part is the upper esophageal sphincter, a specialized ring of muscle that forms the upper end of the tubular esophagus and separates the esophagus from the throat. The upper sphincter remains closed most of the time to prevent food in the main part of the esophagus from backing up into the throat. The main part of the esophagus is referred to as the body of the esophagus, a long, muscular tube approximately 20 cm (8 in) in length. The third functional part of the esophagus is the lower esophageal sphincter, a ring of specialized esophageal muscle at the junction of the esophagus with the stomach. Like the upper sphincter, the lower sphincter remains closed most of the time to prevent food and acid from backing up into the body of the esophagus from the stomach.

 

What is achalasia?

Achalasia is a rare disease of the muscle of the esophagus (swallowing tube). The term achalasia means "failure to relax" and refers to the inability of the lower esophageal sphincter (a ring of muscle situated between the lower esophagus and the stomach) to open and let food pass into the stomach. As a result, patients with achalasia have difficulty in swallowing food.

http://www.medicinenet.com/achalasia/article.htm#tocb

What is dysphagia?

Dysphagia is the medical term for the symptom of difficulty swallowing, derived from the Latin and Greek words meaning difficulty eating.

http://www.medicinenet.com/swallowing/article.htm

What is esophageal spasm?

Esophageal spasms are irregular, uncoordinated, and sometimes powerful contractions of the esophagus, the tube that carries food from the mouth to the stomach. Normally, contractions of the esophagus are coordinated, moving the food through the esophagus and into the stomach.

There are two main types of esophageal spasm:

• Diffuse esophageal spasm. This type of spasm is an irregular, uncoordinated squeezing of the muscles of the esophagus. This can prevent food from reaching the stomach, leaving it stuck in the esophagus.
• THIS IS IMPORTANT TO UNDERSTAND because many banded people think that their food is stuck due to not chewing well or they think they ate too fast.
•  
• Nutcracker esophagus. This type of spasm squeezes the esophagus in a coordinated way, the same way food is moved down the esophagus normally. But the squeezing is very strong. These contractions move food through the esophagus but can cause severe pain.
• Again, this is often explained away by band surgeons and banded patients as eating to fast and/or not chewing well enough.

You can have both types of esophageal spasms.

Check out this link and then see if your surgeon or PCP can order you this test.There is a lot of really useful links here.

What is achalasia?

www.medicinenet.com/achalasia/article.htm#tocb

Esophageal manometry

Another test, esophageal manometry, can demonstrate specifically the abnormalities of muscle function that are characteristic of achalasia, that is, the failure of the muscle of the esophageal body to contract with swallowing and the failure of the lower esophageal sphincter to relax. For manometry, a thin tube that measures the pressure generated by the contracting esophageal muscle is passed through the nose, down the back of the throat and into the esophagus. In a patient with achalasia, no peristaltic waves are seen in the lower half of the esophagus after swallows, and the pressure within the contracted lower esophageal sphincter does not fall with the swallow. In patients with vigorous achalasia, a strong simultaneous contraction of the muscle may be seen in the lower esophageal body. An advantage of manometry is that it can diagnose achalasia early in its course at a time at which the video-esophagram may be normal.

Esophagus

After food is chewed into a bolus, it is swallowed and moved through the esophagus. Smooth muscles contract behind the bolus to prevent it from being squeezed back into the mouth. Then rhythmic, unidirectional waves of contractions will work to rapidly force the food into the stomach. This process works in one direction only and its sole purpose is to move food from the mouth into the stomach.^[2]

In the esophagus, two types of peristalsis occur.

A simplified image showing peristalsis

• First, there is a primary peristaltic wave which occurs when the bolus enters the esophagus during swallowing. The primary peristaltic wave forces the bolus down the esophagus and into the stomach in a wave lasting about 8–9 seconds. The wave travels down to the stomach even if the bolus of food descends at a greater rate than the wave itself, and will continue even if for some reason the bolus gets stuck further up the esophagus.
• In the event that the bolus gets stuck or moves slower than the primary peristaltic wave (as can happen when it is poorly lubricated), stretch receptors in the esophageal lining are stimulated and a local reflex response causes a secondary peristaltic wave around the bolus, forcing it further down the esophagus, and these secondary waves will continue indefinitely until the bolus enters the stomach.

Esophageal peristalsis is typically assessed by performing an esophageal motility study.

If you are vomiting that is not normal for a bandster, I'll go over some of the basics of "chewing" 1. take bites the size of a pea 2. chew until liquidy 3. don't take another bite until this one is swallowed and you feel it go down. I start my meal by cutting everything before I start eating that way I don't forget and take too big a bite. As far as what to eat, always start with dense protein like a soft meat (chicken can be difficult for some, esp. white meat if dry) make sure meats are well lubed with a sauce, then eat your low carb veggie and then IF there is still room a healthy carb. Usually tho the protein is filling enough with a few veggies. Also pre measure your serving before eating so you aren't tempted to take too much. If I can help with other things feel free to PM me I'll gladly help.

 Since you are having issues, the dietary question goes to the back burner.  You need an Esophogram ASAP, perhaps an unfill and then a consult with your nutritionist to get back on track.

* What foods should I be eating to lose weight?
Do high protein/lower carb, sugar and fat

* Has anyone had issues with vomiting after eating? How did you correct this, or are you still struggling with it?
I have that occasionally. I have not had it frequently like some bandsters. I have been lucky in that respect.

* Are you satisfied with your surgery?
Oh hell no! It never worked. After 19 fills anf 4 partial unfills there was never any "green zone". It has been a complete waste of time and money!!!

Now as far as you not chewing adequately............some of the clueless Dr.s will use that as an excuse to explain the getting stuck and vomiting. That is generally NOT the case. That will happen a few times initially, then you learn to chew longer. After that you may have an occasional incident where something is not chewed enough, and you immediately notice it as you swallow it, so no, I do not think that want is happening to you is b/c you are not chewing enough.

Also as Steph mentioned............please go get checked. You may just need a partial unfill, or it could be something more serious. There are LOTS of bansters out there with failed bands! Please know that you are not alone!

Hi! I had this same problem...I would vomit at least daily. I saw my doc, who set me back on track and told me I wasn't eating right. First of all, stop eating any breads or pasta. These will almost always make you vomit.
Once you get "that feeling" even after 2 bites of something, just stop. don't eat any more after that. You are full. It sounds weird and your mind wants you to eat more, but you just have to stop, otherwise you will vomit.
I limited my carbs to about 20-25 per day. So I am eating mostly meat, cheese, tuna, salad, other veggies. Try the lowcarbfriends.com website for great recipes. Start drinking a ton! crystal light and water.
Since doing this, I have lost about 20 lbs in the past 2 months. I just needed a kick in the pants from my doc, which really helped! Good luck! You can do it!