Re: What is a soft stop ?? What is a hard stop ??

[Guest guest]

that has shown me that for a long time possibly over 2 years my band has been to

tight. so because it was too difficult to eat a proper meal i began just small

snacks whlch remained small but not nourishing then when really hungry would be

at the hard stop before i knew it.constant barfing[am i right in thinking this

means vomiting] has ended me in trouble.how i wish i had the internet and wasnt

so isolated and thinking the band was to make you stop eating.when i get over my

oesophagitis i hope to have a small fill and start to enjoy food again.had small

portion of oats for breakfast,fish with sauce for lunch and high fibre crackers

with light soft cheese for tea.that is the most i have eaten for months.

boy did i enjoy. thanks for the introduction to kate have been in contact.

sheila

What is a " soft stop " ?? What is a " hard stop " ??

What is a " soft stop " ?? What is a " hard stop " ??

These are one of the most basic of Bandster concepts, and very

essential to learn and heed. These signs apply mostly to those who

have reached a fairly good fill. Most people do not feel them before

that, but some may feel them briefly in the few days right after Band

surgery.

Not learning and heeding them gets many people into trouble -

discomfort, real misery, embarassment, and occcasionally a very

urgent situation needing quick medical intervention.

First, a little physiology. The band is placed just below the

junction of the esophagus and stomach, creating a pouch about the

size of a golf ball, AFTER a good fill is reached. (Before a decent

fill, there is very little pouch at all)

The pouch is in the CENTER of the chest, about 2 inches below

the " notch " in the lower neck. Many people think it's much lower.

This pouch expands safely to hold the ideal bandster meal of 1-1.5

cups of food. If we cannot eat this much, we are too tight for

stomach/pouch safety and are not getting enough nutrition.

The pouch is right next to the diaphragm, which is very sensitive and

full of nerve endings. When we overeat, or otherwise irritate the

stoma or pouch, it also irritates the diaphragm. The irritated

diaphragm sends signals to several different areas of the body, via

common nerve pathways. These signals are the " soft stop " or 'hard

stop " signs.

Right after surgery or right after a new fill, the stoma/pouch is

also irritated, and can send signals like the common left shoulder

pain. This is not from " gas " , but from an irritated disphragm caused

by the stretching of the internal organs BY the CO2 gas inserted at

surgery. The gas itself dissipates at the end of surgery, when the

instruments delivering it are opened and removed.

If we DO NOT feel and heed our " soft stop " signs and stop eating

(even spitting out a bite that may already be in our mouth) , we then

proceed to a " hard stop " which is sliming, a small to large pb, or

real barfing. Since these are all dangerous, we want to avoid them as

best as we possibly can.

THESE are the " soft stop " signs that mean STOP EATING ! you have had

enough to be satisfied! and more will cause trouble

1. a single burp or hiccup

2. ongoing hiccups (which are always diaphragm irritation)

3. a sudden sneeze

4. a sudden runny nose

5. left shoulder pain

6. pressure in the middle of the chest (where the overfull pouch is)

7. low back pain

8. a facial or eye tic

9. a few other much less common signs

Our own particular signs can be any one of these, and may change

depending on the situation. With practice, you will learn what YOURS

are. It's important to learn them, and then learn good Bandster

quantities, since , as time goes on, the esophagus gets much less

sensitive to a full pouch, and the stop signs are not reliably sent,

or we have learned to ignore them.

We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

our pouches. As time goes on, we will be able to rely on the band

less and less, and will then need to rely on our own improved food

choice and eating habits much more.

One of the reasons we must eat slowly and carefully is to be able to

feel our bodies and pick up the first of these subtle signs. If we're

eating fast and without thought, we blow right past the soft stop

signs and suddently we are in pain or barfing - the " hard stop " .

These all takes practice to pick up, and to heed. We have to eat

mindfully, and pay attention. This means no TV, no distractions, and

ideally eating alone for at least a week or so after a fill. It also

helps to put a 3x5 index card on tyhe table in front of usfor awhile,

to remind us of the Bandster eating techniques - " pea sized

bites " " chew 15x " " eat slowly " etc.

Most of the barfing or embarassment episodes when we are out with

friends come from not paying attention, gabbing with people, and

forgetting the eating rules. It takes about 3 weeks of consistent

work to adopt a new habit like better eating techniques, and I

suggest we put in this 3 week period very early on.

Along with all this is the importance of understanding

that " satisfied " with a small band portion is quite different

than " FULL " . " Full " was usually stuffed to the gills, uncomfortable,

and way too much. I don't like it much when people say we will

be " Full " with a small band porton. I think this sets up unreasonable

expectations that lead to misunderstandings. SATISFIED, not FULL is

the goal of the band.

With the band, " satisfied " is more like " Ok, no longer really hungry.

This is all need. I COULD eat more, but no need to becuase I want to

lose weight " It's a common mistake to think that the band will MAKE

us stop eating. It is meant to give us early signs of being stisfied

(the soft-stop signs) so we don't need to get to the point of HARD

stops where the band revels and we get sick. It is meant as a subtle

reminder, not a hammer over the head.

This also means that we must learn the difference between real,

physiological hunger and what we call " HEAD and HEART hunger " . Most

of us eat for emotional reasons that have nothing to do with being

truly HUNGRY. We eat from boredom, depression, anxiety, fear, worry,

and habit - just becuase we " always " eat in front of the TV,

or " always " stop at that fast junk food place when we drive past it.

this is not real hunger, and we have to work hard on developng better

behaviors. Instead of automatically heading to the fridge when we are

bored or depressed, we CAN choose to go for a walk, do other physical

activity, call a friend for support, etc.

Sadly, the band does little if anything for emotional hunger, which

is why it's so important to work on the emotional eating and food

issues most of us have. These psychological areas are rarely

discussed, especially pre-op, yet are extremely important. I'm a very

strong advocate for therapy, starting well before surgry if possible,

and I also personally fund great help with Guided Imagery, which is

well-proven and uesed extensively with just the type of lifestyle

changes required by the Band .

all comments and questions encouraged, as always!

sandy r

------------------------------------

[Guest guest]

I'm glad Kate got in touch - she was very happy to do so.

I'm also glad you can get in some decent nutrition again and start to

catch up a bit. Your choices were excellent today !

how long did your doctor suggest for the unfill and healing period?

How far away is the surgeon who did your band surgery? Is he the one

who diagnosed your reflux and esiphagus problems. I'm feeling you may

still need to see him, before eventually starting fills again.

Sandy r

>

> that has shown me that for a long time possibly over 2 years my

band has been to tight. so because it was too difficult to eat a

proper meal i began just small snacks whlch remained small but not

nourishing then when really hungry would be at the hard stop before i

knew it.constant barfing[am i right in thinking this means vomiting]

has ended me in trouble.how i wish i had the internet and wasnt so

isolated and thinking the band was to make you stop eating.when i get

over my oesophagitis i hope to have a small fill and start to enjoy

food again.had small portion of oats for breakfast,fish with sauce

for lunch and high fibre crackers with light soft cheese for tea.that

is the most i have eaten for months.

> boy did i enjoy. thanks for the introduction to kate have been in

contact.

> sheila

>

> What is a " soft stop " ?? What is

a " hard stop " ??

>

> What is a " soft stop " ?? What is a " hard stop " ??

>

> These are one of the most basic of Bandster concepts, and very

> essential to learn and heed. These signs apply mostly to those who

> have reached a fairly good fill. Most people do not feel them

before

> that, but some may feel them briefly in the few days right after

Band

> surgery.

>

> Not learning and heeding them gets many people into trouble -

> discomfort, real misery, embarassment, and occcasionally a very

> urgent situation needing quick medical intervention.

>

> First, a little physiology. The band is placed just below the

> junction of the esophagus and stomach, creating a pouch about the

> size of a golf ball, AFTER a good fill is reached. (Before a decent

> fill, there is very little pouch at all)

> The pouch is in the CENTER of the chest, about 2 inches below

> the " notch " in the lower neck. Many people think it's much lower.

>

> This pouch expands safely to hold the ideal bandster meal of 1-1.5

> cups of food. If we cannot eat this much, we are too tight for

> stomach/pouch safety and are not getting enough nutrition.

>

> The pouch is right next to the diaphragm, which is very sensitive

and

> full of nerve endings. When we overeat, or otherwise irritate the

> stoma or pouch, it also irritates the diaphragm. The irritated

> diaphragm sends signals to several different areas of the body, via

> common nerve pathways. These signals are the " soft stop " or 'hard

> stop " signs.

>

> Right after surgery or right after a new fill, the stoma/pouch is

> also irritated, and can send signals like the common left shoulder

> pain. This is not from " gas " , but from an irritated disphragm

caused

> by the stretching of the internal organs BY the CO2 gas inserted at

> surgery. The gas itself dissipates at the end of surgery, when the

> instruments delivering it are opened and removed.

>

> If we DO NOT feel and heed our " soft stop " signs and stop eating

> (even spitting out a bite that may already be in our mouth) , we

then

> proceed to a " hard stop " which is sliming, a small to large pb, or

> real barfing. Since these are all dangerous, we want to avoid them

as

> best as we possibly can.

>

> THESE are the " soft stop " signs that mean STOP EATING ! you have

had

> enough to be satisfied! and more will cause trouble

>

> 1. a single burp or hiccup

> 2. ongoing hiccups (which are always diaphragm irritation)

> 3. a sudden sneeze

> 4. a sudden runny nose

> 5. left shoulder pain

> 6. pressure in the middle of the chest (where the overfull pouch is)

> 7. low back pain

> 8. a facial or eye tic

> 9. a few other much less common signs

>

> Our own particular signs can be any one of these, and may change

> depending on the situation. With practice, you will learn what

YOURS

> are. It's important to learn them, and then learn good Bandster

> quantities, since , as time goes on, the esophagus gets much less

> sensitive to a full pouch, and the stop signs are not reliably

sent,

> or we have learned to ignore them.

>

> We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

> our pouches. As time goes on, we will be able to rely on the band

> less and less, and will then need to rely on our own improved food

> choice and eating habits much more.

>

> One of the reasons we must eat slowly and carefully is to be able

to

> feel our bodies and pick up the first of these subtle signs. If

we're

> eating fast and without thought, we blow right past the soft stop

> signs and suddently we are in pain or barfing - the " hard stop " .

>

> These all takes practice to pick up, and to heed. We have to eat

> mindfully, and pay attention. This means no TV, no distractions,

and

> ideally eating alone for at least a week or so after a fill. It

also

> helps to put a 3x5 index card on tyhe table in front of usfor

awhile,

> to remind us of the Bandster eating techniques - " pea sized

> bites " " chew 15x " " eat slowly " etc.

>

> Most of the barfing or embarassment episodes when we are out with

> friends come from not paying attention, gabbing with people, and

> forgetting the eating rules. It takes about 3 weeks of consistent

> work to adopt a new habit like better eating techniques, and I

> suggest we put in this 3 week period very early on.

>

> Along with all this is the importance of understanding

> that " satisfied " with a small band portion is quite different

> than " FULL " . " Full " was usually stuffed to the gills,

uncomfortable,

> and way too much. I don't like it much when people say we will

> be " Full " with a small band porton. I think this sets up

unreasonable

> expectations that lead to misunderstandings. SATISFIED, not FULL is

> the goal of the band.

>

> With the band, " satisfied " is more like " Ok, no longer really

hungry.

> This is all need. I COULD eat more, but no need to becuase I want

to

> lose weight " It's a common mistake to think that the band will MAKE

> us stop eating. It is meant to give us early signs of being

stisfied

> (the soft-stop signs) so we don't need to get to the point of HARD

> stops where the band revels and we get sick. It is meant as a

subtle

> reminder, not a hammer over the head.

>

> This also means that we must learn the difference between real,

> physiological hunger and what we call " HEAD and HEART hunger " . Most

> of us eat for emotional reasons that have nothing to do with being

> truly HUNGRY. We eat from boredom, depression, anxiety, fear,

worry,

> and habit - just becuase we " always " eat in front of the TV,

> or " always " stop at that fast junk food place when we drive past

it.

> this is not real hunger, and we have to work hard on developng

better

> behaviors. Instead of automatically heading to the fridge when we

are

> bored or depressed, we CAN choose to go for a walk, do other

physical

> activity, call a friend for support, etc.

>

> Sadly, the band does little if anything for emotional hunger, which

> is why it's so important to work on the emotional eating and food

> issues most of us have. These psychological areas are rarely

> discussed, especially pre-op, yet are extremely important. I'm a

very

> strong advocate for therapy, starting well before surgry if

possible,

> and I also personally fund great help with Guided Imagery, which is

> well-proven and uesed extensively with just the type of lifestyle

> changes required by the Band .

>

> all comments and questions encouraged, as always!

>

> sandy r

>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Sandy,

My surgery is scheduled for August 21st..  I have been taking classes at

Geisinger Medical Center in Danville, PA and they have been very educating. 

This email that I just read from you is very helpful and you said some things

that will be of great help. 

Thanks,

Jimmy

What is a " soft stop " ?? What is a " hard stop " ??

What is a " soft stop " ?? What is a " hard stop " ??

These are one of the most basic of Bandster concepts, and very

essential to learn and heed. These signs apply mostly to those who

have reached a fairly good fill. Most people do not feel them before

that, but some may feel them briefly in the few days right after Band

surgery..

Not learning and heeding them gets many people into trouble -

discomfort, real misery, embarassment, and occcasionally a very

urgent situation needing quick medical intervention.

First, a little physiology.. The band is placed just below the

junction of the esophagus and stomach, creating a pouch about the

size of a golf ball, AFTER a good fill is reached. (Before a decent

fill, there is very little pouch at all)

The pouch is in the CENTER of the chest, about 2 inches below

the " notch " in the lower neck. Many people think it's much lower.

This pouch expands safely to hold the ideal bandster meal of 1-1.5

cups of food. If we cannot eat this much, we are too tight for

stomach/pouch safety and are not getting enough nutrition.

The pouch is right next to the diaphragm, which is very sensitive and

full of nerve endings. When we overeat, or otherwise irritate the

stoma or pouch, it also irritates the diaphragm.. The irritated

diaphragm sends signals to several different areas of the body, via

common nerve pathways. These signals are the " soft stop " or 'hard

stop " signs.

Right after surgery or right after a new fill, the stoma/pouch is

also irritated, and can send signals like the common left shoulder

pain. This is not from " gas " , but from an irritated disphragm caused

by the stretching of the internal organs BY the CO2 gas inserted at

surgery. The gas itself dissipates at the end of surgery, when the

instruments delivering it are opened and removed.

If we DO NOT feel and heed our " soft stop " signs and stop eating

(even spitting out a bite that may already be in our mouth) , we then

proceed to a " hard stop " which is sliming, a small to large pb, or

real barfing. Since these are all dangerous, we want to avoid them as

best as we possibly can.

THESE are the " soft stop " signs that mean STOP EATING ! you have had

enough to be satisfied! and more will cause trouble

1. a single burp or hiccup

2. ongoing hiccups (which are always diaphragm irritation)

3. a sudden sneeze

4. a sudden runny nose

5. left shoulder pain

6. pressure in the middle of the chest (where the overfull pouch is)

7. low back pain

8. a facial or eye tic

9. a few other much less common signs

Our own particular signs can be any one of these, and may change

depending on the situation. With practice, you will learn what YOURS

are. It's important to learn them, and then learn good Bandster

quantities, since , as time goes on, the esophagus gets much less

sensitive to a full pouch, and the stop signs are not reliably sent,

or we have learned to ignore them.

We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

our pouches. As time goes on, we will be able to rely on the band

less and less, and will then need to rely on our own improved food

choice and eating habits much more.

One of the reasons we must eat slowly and carefully is to be able to

feel our bodies and pick up the first of these subtle signs. If we're

eating fast and without thought, we blow right past the soft stop

signs and suddently we are in pain or barfing - the " hard stop " .

These all takes practice to pick up, and to heed. We have to eat

mindfully, and pay attention. This means no TV, no distractions, and

ideally eating alone for at least a week or so after a fill. It also

helps to put a 3x5 index card on tyhe table in front of usfor awhile,

to remind us of the Bandster eating techniques - " pea sized

bites " " chew 15x " " eat slowly " etc.

Most of the barfing or embarassment episodes when we are out with

friends come from not paying attention, gabbing with people, and

forgetting the eating rules. It takes about 3 weeks of consistent

work to adopt a new habit like better eating techniques, and I

suggest we put in this 3 week period very early on.

Along with all this is the importance of understanding

that " satisfied " with a small band portion is quite different

than " FULL " . " Full " was usually stuffed to the gills, uncomfortable,

and way too much. I don't like it much when people say we will

be " Full " with a small band porton. I think this sets up unreasonable

expectations that lead to misunderstandings. SATISFIED, not FULL is

the goal of the band.

With the band, " satisfied " is more like " Ok, no longer really hungry.

This is all need. I COULD eat more, but no need to becuase I want to

lose weight " It's a common mistake to think that the band will MAKE

us stop eating. It is meant to give us early signs of being stisfied

(the soft-stop signs) so we don't need to get to the point of HARD

stops where the band revels and we get sick. It is meant as a subtle

reminder, not a hammer over the head.

This also means that we must learn the difference between real,

physiological hunger and what we call " HEAD and HEART hunger " . Most

of us eat for emotional reasons that have nothing to do with being

truly HUNGRY. We eat from boredom, depression, anxiety, fear, worry,

and habit - just becuase we " always " eat in front of the TV,

or " always " stop at that fast junk food place when we drive past it.

this is not real hunger, and we have to work hard on developng better

behaviors. Instead of automatically heading to the fridge when we are

bored or depressed, we CAN choose to go for a walk, do other physical

activity, call a friend for support, etc..

Sadly, the band does little if anything for emotional hunger, which

is why it's so important to work on the emotional eating and food

issues most of us have. These psychological areas are rarely

discussed, especially pre-op, yet are extremely important. I'm a very

strong advocate for therapy, starting well before surgry if possible,

and I also personally fund great help with Guided Imagery, which is

well-proven and uesed extensively with just the type of lifestyle

changes required by the Band .

all comments and questions encouraged, as always!

sandy r

[Guest guest]

doctor who did operation from sweden but comes over to england to private

hospital every so often so havent seen him since day of operation.the doctor who

did endoscopy is in our local hospital and because it is run by the national

health service they dont know anything about lapbanding which is still quite new

in this country.i see him again in july do you think i should wait until then?i

am worried bout gaining weight and using food as a crutch.the fish in sauce i

blended fine do you think i should make it moresolid..hope i dont take up to

much of your time but feel i have learned more from you in such a short time

sheila

What is a " soft stop " ?? What is

a " hard stop " ??

>

> What is a " soft stop " ?? What is a " hard stop " ??

>

> These are one of the most basic of Bandster concepts, and very

> essential to learn and heed. These signs apply mostly to those who

> have reached a fairly good fill. Most people do not feel them

before

> that, but some may feel them briefly in the few days right after

Band

> surgery.

>

> Not learning and heeding them gets many people into trouble -

> discomfort, real misery, embarassment, and occcasionally a very

> urgent situation needing quick medical intervention.

>

> First, a little physiology. The band is placed just below the

> junction of the esophagus and stomach, creating a pouch about the

> size of a golf ball, AFTER a good fill is reached. (Before a decent

> fill, there is very little pouch at all)

> The pouch is in the CENTER of the chest, about 2 inches below

> the " notch " in the lower neck. Many people think it's much lower.

>

> This pouch expands safely to hold the ideal bandster meal of 1-1.5

> cups of food. If we cannot eat this much, we are too tight for

> stomach/pouch safety and are not getting enough nutrition.

>

> The pouch is right next to the diaphragm, which is very sensitive

and

> full of nerve endings. When we overeat, or otherwise irritate the

> stoma or pouch, it also irritates the diaphragm. The irritated

> diaphragm sends signals to several different areas of the body, via

> common nerve pathways. These signals are the " soft stop " or 'hard

> stop " signs.

>

> Right after surgery or right after a new fill, the stoma/pouch is

> also irritated, and can send signals like the common left shoulder

> pain. This is not from " gas " , but from an irritated disphragm

caused

> by the stretching of the internal organs BY the CO2 gas inserted at

> surgery. The gas itself dissipates at the end of surgery, when the

> instruments delivering it are opened and removed.

>

> If we DO NOT feel and heed our " soft stop " signs and stop eating

> (even spitting out a bite that may already be in our mouth) , we

then

> proceed to a " hard stop " which is sliming, a small to large pb, or

> real barfing. Since these are all dangerous, we want to avoid them

as

> best as we possibly can.

>

> THESE are the " soft stop " signs that mean STOP EATING ! you have

had

> enough to be satisfied! and more will cause trouble

>

> 1. a single burp or hiccup

> 2. ongoing hiccups (which are always diaphragm irritation)

> 3. a sudden sneeze

> 4. a sudden runny nose

> 5. left shoulder pain

> 6. pressure in the middle of the chest (where the overfull pouch is)

> 7. low back pain

> 8. a facial or eye tic

> 9. a few other much less common signs

>

> Our own particular signs can be any one of these, and may change

> depending on the situation.. With practice, you will learn what

YOURS

> are. It's important to learn them, and then learn good Bandster

> quantities, since , as time goes on, the esophagus gets much less

> sensitive to a full pouch, and the stop signs are not reliably

sent,

> or we have learned to ignore them.

>

> We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

> our pouches. As time goes on, we will be able to rely on the band

> less and less, and will then need to rely on our own improved food

> choice and eating habits much more.

>

> One of the reasons we must eat slowly and carefully is to be able

to

> feel our bodies and pick up the first of these subtle signs. If

we're

> eating fast and without thought, we blow right past the soft stop

> signs and suddently we are in pain or barfing - the " hard stop " .

>

> These all takes practice to pick up, and to heed. We have to eat

> mindfully, and pay attention. This means no TV, no distractions,

and

> ideally eating alone for at least a week or so after a fill. It

also

> helps to put a 3x5 index card on tyhe table in front of usfor

awhile,

> to remind us of the Bandster eating techniques - " pea sized

> bites " " chew 15x " " eat slowly " etc.

>

> Most of the barfing or embarassment episodes when we are out with

> friends come from not paying attention, gabbing with people, and

> forgetting the eating rules. It takes about 3 weeks of consistent

> work to adopt a new habit like better eating techniques, and I

> suggest we put in this 3 week period very early on.

>

> Along with all this is the importance of understanding

> that " satisfied " with a small band portion is quite different

> than " FULL " . " Full " was usually stuffed to the gills,

uncomfortable,

> and way too much. I don't like it much when people say we will

> be " Full " with a small band porton. I think this sets up

unreasonable

> expectations that lead to misunderstandings. SATISFIED, not FULL is

> the goal of the band.

>

> With the band, " satisfied " is more like " Ok, no longer really

hungry.

> This is all need. I COULD eat more, but no need to becuase I want

to

> lose weight " It's a common mistake to think that the band will MAKE

> us stop eating. It is meant to give us early signs of being

stisfied

> (the soft-stop signs) so we don't need to get to the point of HARD

> stops where the band revels and we get sick. It is meant as a

subtle

> reminder, not a hammer over the head.

>

> This also means that we must learn the difference between real,

> physiological hunger and what we call " HEAD and HEART hunger " . Most

> of us eat for emotional reasons that have nothing to do with being

> truly HUNGRY. We eat from boredom, depression, anxiety, fear,

worry,

> and habit - just becuase we " always " eat in front of the TV,

> or " always " stop at that fast junk food place when we drive past

it.

> this is not real hunger, and we have to work hard on developng

better

> behaviors. Instead of automatically heading to the fridge when we

are

> bored or depressed, we CAN choose to go for a walk, do other

physical

> activity, call a friend for support, etc.

>

> Sadly, the band does little if anything for emotional hunger, which

> is why it's so important to work on the emotional eating and food

> issues most of us have. These psychological areas are rarely

> discussed, especially pre-op, yet are extremely important. I'm a

very

> strong advocate for therapy, starting well before surgry if

possible,

> and I also personally fund great help with Guided Imagery, which is

> well-proven and uesed extensively with just the type of lifestyle

> changes required by the Band .

>

> all comments and questions encouraged, as always!

>

> sandy r

>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Weldome, jimmy! I'm delighted to hear your doc has pre-op classes. Be

sure, though, that they are teaching BAND needs, and not bypasss

needs. some docs combine do both bypass and band surgery, and combine

classes. some things are the same (the need for better food choices,

better activity and exercise, better lifestyle, etc) but there are

many other things very different for the band - like band foods,

eating techniques, nutrition, no supplements needed other than a

geneal chewable mutli-vit, etc.

I prefer separate classes and education for band patients but i know

this is not always possible.

There are lots of great people here to help us all learn from each

other. glad you're with us!

Sandy

>

> Sandy,

> My surgery is scheduled for August 21st..  I have been taking

classes at Geisinger Medical Center in Danville, PA and they have

been very educating.  This email that I just read from you is very

helpful and you said some things that will be of great help. 

> Thanks,

> Jimmy

>

>

>

> What is a " soft stop " ?? What is

a " hard stop " ??

>

>

> What is a " soft stop " ?? What is a " hard stop " ??

>

> These are one of the most basic of Bandster concepts, and very

> essential to learn and heed. These signs apply mostly to those who

> have reached a fairly good fill. Most people do not feel them

before

> that, but some may feel them briefly in the few days right after

Band

> surgery..

>

> Not learning and heeding them gets many people into trouble -

> discomfort, real misery, embarassment, and occcasionally a very

> urgent situation needing quick medical intervention.

>

> First, a little physiology.. The band is placed just below the

> junction of the esophagus and stomach, creating a pouch about the

> size of a golf ball, AFTER a good fill is reached. (Before a decent

> fill, there is very little pouch at all)

> The pouch is in the CENTER of the chest, about 2 inches below

> the " notch " in the lower neck. Many people think it's much lower.

>

> This pouch expands safely to hold the ideal bandster meal of 1-1.5

> cups of food. If we cannot eat this much, we are too tight for

> stomach/pouch safety and are not getting enough nutrition.

>

> The pouch is right next to the diaphragm, which is very sensitive

and

> full of nerve endings. When we overeat, or otherwise irritate the

> stoma or pouch, it also irritates the diaphragm.. The irritated

> diaphragm sends signals to several different areas of the body, via

> common nerve pathways. These signals are the " soft stop " or 'hard

> stop " signs.

>

> Right after surgery or right after a new fill, the stoma/pouch is

> also irritated, and can send signals like the common left shoulder

> pain. This is not from " gas " , but from an irritated disphragm

caused

> by the stretching of the internal organs BY the CO2 gas inserted at

> surgery. The gas itself dissipates at the end of surgery, when the

> instruments delivering it are opened and removed.

>

> If we DO NOT feel and heed our " soft stop " signs and stop eating

> (even spitting out a bite that may already be in our mouth) , we

then

> proceed to a " hard stop " which is sliming, a small to large pb, or

> real barfing. Since these are all dangerous, we want to avoid them

as

> best as we possibly can.

>

> THESE are the " soft stop " signs that mean STOP EATING ! you have

had

> enough to be satisfied! and more will cause trouble

>

> 1. a single burp or hiccup

> 2. ongoing hiccups (which are always diaphragm irritation)

> 3. a sudden sneeze

> 4. a sudden runny nose

> 5. left shoulder pain

> 6. pressure in the middle of the chest (where the overfull pouch is)

> 7. low back pain

> 8. a facial or eye tic

> 9. a few other much less common signs

>

> Our own particular signs can be any one of these, and may change

> depending on the situation. With practice, you will learn what

YOURS

> are. It's important to learn them, and then learn good Bandster

> quantities, since , as time goes on, the esophagus gets much less

> sensitive to a full pouch, and the stop signs are not reliably

sent,

> or we have learned to ignore them.

>

> We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

> our pouches. As time goes on, we will be able to rely on the band

> less and less, and will then need to rely on our own improved food

> choice and eating habits much more.

>

> One of the reasons we must eat slowly and carefully is to be able

to

> feel our bodies and pick up the first of these subtle signs. If

we're

> eating fast and without thought, we blow right past the soft stop

> signs and suddently we are in pain or barfing - the " hard stop " .

>

> These all takes practice to pick up, and to heed. We have to eat

> mindfully, and pay attention. This means no TV, no distractions,

and

> ideally eating alone for at least a week or so after a fill. It

also

> helps to put a 3x5 index card on tyhe table in front of usfor

awhile,

> to remind us of the Bandster eating techniques - " pea sized

> bites " " chew 15x " " eat slowly " etc.

>

> Most of the barfing or embarassment episodes when we are out with

> friends come from not paying attention, gabbing with people, and

> forgetting the eating rules. It takes about 3 weeks of consistent

> work to adopt a new habit like better eating techniques, and I

> suggest we put in this 3 week period very early on.

>

> Along with all this is the importance of understanding

> that " satisfied " with a small band portion is quite different

> than " FULL " . " Full " was usually stuffed to the gills,

uncomfortable,

> and way too much. I don't like it much when people say we will

> be " Full " with a small band porton. I think this sets up

unreasonable

> expectations that lead to misunderstandings. SATISFIED, not FULL is

> the goal of the band.

>

> With the band, " satisfied " is more like " Ok, no longer really

hungry.

> This is all need. I COULD eat more, but no need to becuase I want

to

> lose weight " It's a common mistake to think that the band will MAKE

> us stop eating. It is meant to give us early signs of being

stisfied

> (the soft-stop signs) so we don't need to get to the point of HARD

> stops where the band revels and we get sick. It is meant as a

subtle

> reminder, not a hammer over the head.

>

> This also means that we must learn the difference between real,

> physiological hunger and what we call " HEAD and HEART hunger " . Most

> of us eat for emotional reasons that have nothing to do with being

> truly HUNGRY. We eat from boredom, depression, anxiety, fear,

worry,

> and habit - just becuase we " always " eat in front of the TV,

> or " always " stop at that fast junk food place when we drive past

it.

> this is not real hunger, and we have to work hard on developng

better

> behaviors. Instead of automatically heading to the fridge when we

are

> bored or depressed, we CAN choose to go for a walk, do other

physical

> activity, call a friend for support, etc..

>

> Sadly, the band does little if anything for emotional hunger, which

> is why it's so important to work on the emotional eating and food

> issues most of us have. These psychological areas are rarely

> discussed, especially pre-op, yet are extremely important. I'm a

very

> strong advocate for therapy, starting well before surgry if

possible,

> and I also personally fund great help with Guided Imagery, which is

> well-proven and uesed extensively with just the type of lifestyle

> changes required by the Band .

>

> all comments and questions encouraged, as always!

>

> sandy r

>

>

>

>

>

>

>

[Guest guest]

Can you tell me if this is a " soft " or " hard " stop sign?

I've just started eating regular foods. I have not had a fill yet. I

notice that I get a pain that I can only describe a cramp all the way up and

down my spine and in my sides. I'm assuming this is a sign that I've either

taken too large a bite or need to stop eating. Does this sound like

anything that anyone else has had happen?

Jen

" 'For I know the plans I have for you' declares the Lord, 'plans to prosper

you and not to harm you. Plans to give you hope and a future.' "

29:11

From:

[mailto: ] On Behalf Of moonshadow.sandy

Sent: Wednesday, June 04, 2008 3:01 PM

Subject: What is a " soft stop " ?? What is a " hard stop "

??

What is a " soft stop " ?? What is a " hard stop " ??

These are one of the most basic of Bandster concepts, and very

essential to learn and heed. These signs apply mostly to those who

have reached a fairly good fill. Most people do not feel them before

that, but some may feel them briefly in the few days right after Band

surgery.

Not learning and heeding them gets many people into trouble -

discomfort, real misery, embarassment, and occcasionally a very

urgent situation needing quick medical intervention.

First, a little physiology. The band is placed just below the

junction of the esophagus and stomach, creating a pouch about the

size of a golf ball, AFTER a good fill is reached. (Before a decent

fill, there is very little pouch at all)

The pouch is in the CENTER of the chest, about 2 inches below

the " notch " in the lower neck. Many people think it's much lower.

This pouch expands safely to hold the ideal bandster meal of 1-1.5

cups of food. If we cannot eat this much, we are too tight for

stomach/pouch safety and are not getting enough nutrition.

The pouch is right next to the diaphragm, which is very sensitive and

full of nerve endings. When we overeat, or otherwise irritate the

stoma or pouch, it also irritates the diaphragm. The irritated

diaphragm sends signals to several different areas of the body, via

common nerve pathways. These signals are the " soft stop " or 'hard

stop " signs.

Right after surgery or right after a new fill, the stoma/pouch is

also irritated, and can send signals like the common left shoulder

pain. This is not from " gas " , but from an irritated disphragm caused

by the stretching of the internal organs BY the CO2 gas inserted at

surgery. The gas itself dissipates at the end of surgery, when the

instruments delivering it are opened and removed.

If we DO NOT feel and heed our " soft stop " signs and stop eating

(even spitting out a bite that may already be in our mouth) , we then

proceed to a " hard stop " which is sliming, a small to large pb, or

real barfing. Since these are all dangerous, we want to avoid them as

best as we possibly can.

THESE are the " soft stop " signs that mean STOP EATING ! you have had

enough to be satisfied! and more will cause trouble

1. a single burp or hiccup

2. ongoing hiccups (which are always diaphragm irritation)

3. a sudden sneeze

4. a sudden runny nose

5. left shoulder pain

6. pressure in the middle of the chest (where the overfull pouch is)

7. low back pain

8. a facial or eye tic

9. a few other much less common signs

Our own particular signs can be any one of these, and may change

depending on the situation. With practice, you will learn what YOURS

are. It's important to learn them, and then learn good Bandster

quantities, since , as time goes on, the esophagus gets much less

sensitive to a full pouch, and the stop signs are not reliably sent,

or we have learned to ignore them.

We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

our pouches. As time goes on, we will be able to rely on the band

less and less, and will then need to rely on our own improved food

choice and eating habits much more.

One of the reasons we must eat slowly and carefully is to be able to

feel our bodies and pick up the first of these subtle signs. If we're

eating fast and without thought, we blow right past the soft stop

signs and suddently we are in pain or barfing - the " hard stop " .

These all takes practice to pick up, and to heed. We have to eat

mindfully, and pay attention. This means no TV, no distractions, and

ideally eating alone for at least a week or so after a fill. It also

helps to put a 3x5 index card on tyhe table in front of usfor awhile,

to remind us of the Bandster eating techniques - " pea sized

bites " " chew 15x " " eat slowly " etc.

Most of the barfing or embarassment episodes when we are out with

friends come from not paying attention, gabbing with people, and

forgetting the eating rules. It takes about 3 weeks of consistent

work to adopt a new habit like better eating techniques, and I

suggest we put in this 3 week period very early on.

Along with all this is the importance of understanding

that " satisfied " with a small band portion is quite different

than " FULL " . " Full " was usually stuffed to the gills, uncomfortable,

and way too much. I don't like it much when people say we will

be " Full " with a small band porton. I think this sets up unreasonable

expectations that lead to misunderstandings. SATISFIED, not FULL is

the goal of the band.

With the band, " satisfied " is more like " Ok, no longer really hungry.

This is all need. I COULD eat more, but no need to becuase I want to

lose weight " It's a common mistake to think that the band will MAKE

us stop eating. It is meant to give us early signs of being stisfied

(the soft-stop signs) so we don't need to get to the point of HARD

stops where the band revels and we get sick. It is meant as a subtle

reminder, not a hammer over the head.

This also means that we must learn the difference between real,

physiological hunger and what we call " HEAD and HEART hunger " . Most

of us eat for emotional reasons that have nothing to do with being

truly HUNGRY. We eat from boredom, depression, anxiety, fear, worry,

and habit - just becuase we " always " eat in front of the TV,

or " always " stop at that fast junk food place when we drive past it.

this is not real hunger, and we have to work hard on developng better

behaviors. Instead of automatically heading to the fridge when we are

bored or depressed, we CAN choose to go for a walk, do other physical

activity, call a friend for support, etc.

Sadly, the band does little if anything for emotional hunger, which

is why it's so important to work on the emotional eating and food

issues most of us have. These psychological areas are rarely

discussed, especially pre-op, yet are extremely important. I'm a very

strong advocate for therapy, starting well before surgry if possible,

and I also personally fund great help with Guided Imagery, which is

well-proven and uesed extensively with just the type of lifestyle

changes required by the Band .

all comments and questions encouraged, as always!

sandy r

[Guest guest]

Jen, this sounds like a soft stop to me. the HARD ones involve big

pain (sometimes mimicing a heart attack and truly miserable,

thankfully pretty rare), real barfing, etc. these " soft stop " signs

are just " reminders " , and not dangerous. they are part of the

important 'behavior mod' aspect of the band : " Ick ! that hurt! I

don't want to do THAT again! "

Be sure you're learning and following the band eating rules re food

choices and eating technique. Good choices, quality foods, nicely-

prpared (not dry and hard), pea-sized bites, chewing 15x per bite,

slow eating, no liquids with meals, etc. please see the Band Guide in

the files for more on all this.

If you're having a few of these signs even before a fill, that tells

me that you have a fair restriction even with no fill. that is a good

thing, and means you may not need a fill for a good while longer than

about 6 weeks out, when they CAN start - but only if needed.

you're in the steep learning curve time, and we all make some small

goofs along the way. not to worry! Just carry on and keep learning!

We all have many years of scsarfing and olfing food, without much

chewing or thought, and it takes time to improve.

sandy r

>

> Can you tell me if this is a " soft " or " hard " stop sign?

>

>

>

> I've just started eating regular foods. I have not had a fill

yet. I

> notice that I get a pain that I can only describe a cramp all the

way up and

> down my spine and in my sides. I'm assuming this is a sign that

I've either

> taken too large a bite or need to stop eating. Does this sound like

> anything that anyone else has had happen?

>

>

>

> Jen

>

> " 'For I know the plans I have for you' declares the Lord, 'plans to

prosper

> you and not to harm you. Plans to give you hope and a future.' "

> 29:11

>

>

>

> From:

> [mailto: ] On Behalf Of

moonshadow.sandy

> Sent: Wednesday, June 04, 2008 3:01 PM

>

> Subject: What is a " soft stop " ?? What is

a " hard stop "

> ??

>

>

>

> What is a " soft stop " ?? What is a " hard stop " ??

>

> These are one of the most basic of Bandster concepts, and very

> essential to learn and heed. These signs apply mostly to those who

> have reached a fairly good fill. Most people do not feel them

before

> that, but some may feel them briefly in the few days right after

Band

> surgery.

>

> Not learning and heeding them gets many people into trouble -

> discomfort, real misery, embarassment, and occcasionally a very

> urgent situation needing quick medical intervention.

>

> First, a little physiology. The band is placed just below the

> junction of the esophagus and stomach, creating a pouch about the

> size of a golf ball, AFTER a good fill is reached. (Before a decent

> fill, there is very little pouch at all)

> The pouch is in the CENTER of the chest, about 2 inches below

> the " notch " in the lower neck. Many people think it's much lower.

>

> This pouch expands safely to hold the ideal bandster meal of 1-1.5

> cups of food. If we cannot eat this much, we are too tight for

> stomach/pouch safety and are not getting enough nutrition.

>

> The pouch is right next to the diaphragm, which is very sensitive

and

> full of nerve endings. When we overeat, or otherwise irritate the

> stoma or pouch, it also irritates the diaphragm. The irritated

> diaphragm sends signals to several different areas of the body, via

> common nerve pathways. These signals are the " soft stop " or 'hard

> stop " signs.

>

> Right after surgery or right after a new fill, the stoma/pouch is

> also irritated, and can send signals like the common left shoulder

> pain. This is not from " gas " , but from an irritated disphragm

caused

> by the stretching of the internal organs BY the CO2 gas inserted at

> surgery. The gas itself dissipates at the end of surgery, when the

> instruments delivering it are opened and removed.

>

> If we DO NOT feel and heed our " soft stop " signs and stop eating

> (even spitting out a bite that may already be in our mouth) , we

then

> proceed to a " hard stop " which is sliming, a small to large pb, or

> real barfing. Since these are all dangerous, we want to avoid them

as

> best as we possibly can.

>

> THESE are the " soft stop " signs that mean STOP EATING ! you have

had

> enough to be satisfied! and more will cause trouble

>

> 1. a single burp or hiccup

> 2. ongoing hiccups (which are always diaphragm irritation)

> 3. a sudden sneeze

> 4. a sudden runny nose

> 5. left shoulder pain

> 6. pressure in the middle of the chest (where the overfull pouch is)

> 7. low back pain

> 8. a facial or eye tic

> 9. a few other much less common signs

>

> Our own particular signs can be any one of these, and may change

> depending on the situation. With practice, you will learn what

YOURS

> are. It's important to learn them, and then learn good Bandster

> quantities, since , as time goes on, the esophagus gets much less

> sensitive to a full pouch, and the stop signs are not reliably

sent,

> or we have learned to ignore them.

>

> We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

> our pouches. As time goes on, we will be able to rely on the band

> less and less, and will then need to rely on our own improved food

> choice and eating habits much more.

>

> One of the reasons we must eat slowly and carefully is to be able

to

> feel our bodies and pick up the first of these subtle signs. If

we're

> eating fast and without thought, we blow right past the soft stop

> signs and suddently we are in pain or barfing - the " hard stop " .

>

> These all takes practice to pick up, and to heed. We have to eat

> mindfully, and pay attention. This means no TV, no distractions,

and

> ideally eating alone for at least a week or so after a fill. It

also

> helps to put a 3x5 index card on tyhe table in front of usfor

awhile,

> to remind us of the Bandster eating techniques - " pea sized

> bites " " chew 15x " " eat slowly " etc.

>

> Most of the barfing or embarassment episodes when we are out with

> friends come from not paying attention, gabbing with people, and

> forgetting the eating rules. It takes about 3 weeks of consistent

> work to adopt a new habit like better eating techniques, and I

> suggest we put in this 3 week period very early on.

>

> Along with all this is the importance of understanding

> that " satisfied " with a small band portion is quite different

> than " FULL " . " Full " was usually stuffed to the gills,

uncomfortable,

> and way too much. I don't like it much when people say we will

> be " Full " with a small band porton. I think this sets up

unreasonable

> expectations that lead to misunderstandings. SATISFIED, not FULL is

> the goal of the band.

>

> With the band, " satisfied " is more like " Ok, no longer really

hungry.

> This is all need. I COULD eat more, but no need to becuase I want

to

> lose weight " It's a common mistake to think that the band will MAKE

> us stop eating. It is meant to give us early signs of being

stisfied

> (the soft-stop signs) so we don't need to get to the point of HARD

> stops where the band revels and we get sick. It is meant as a

subtle

> reminder, not a hammer over the head.

>

> This also means that we must learn the difference between real,

> physiological hunger and what we call " HEAD and HEART hunger " . Most

> of us eat for emotional reasons that have nothing to do with being

> truly HUNGRY. We eat from boredom, depression, anxiety, fear,

worry,

> and habit - just becuase we " always " eat in front of the TV,

> or " always " stop at that fast junk food place when we drive past

it.

> this is not real hunger, and we have to work hard on developng

better

> behaviors. Instead of automatically heading to the fridge when we

are

> bored or depressed, we CAN choose to go for a walk, do other

physical

> activity, call a friend for support, etc.

>

> Sadly, the band does little if anything for emotional hunger, which

> is why it's so important to work on the emotional eating and food

> issues most of us have. These psychological areas are rarely

> discussed, especially pre-op, yet are extremely important. I'm a

very

> strong advocate for therapy, starting well before surgry if

possible,

> and I also personally fund great help with Guided Imagery, which is

> well-proven and uesed extensively with just the type of lifestyle

> changes required by the Band .

>

> all comments and questions encouraged, as always!

>

> sandy r

>

>

>

>

>

>

[Guest guest]

I don't contribute much to the board, but I do read all of the posts. This one

amazes me because I had an eye tic for MONTHS.

Since my repair surgery (April, 2007) I have been very nervous about my band.

I had something get stuck in September of last year and almost all of my fill

taken out.

From sometime in November until I had a fill in March I had daily bouts of eye

twitching that were so bad I was afraid to drive long distances by myself,

almost always the left eye, but once or twice in the right one.

It was not until I read this post that I realized since getting that fill in

March the twitch is gone! I knew I was eating too much ( I was gaining weight

after reaching my goal within 9 months of my original surgery). But only now do

I realize how out of control I must have been with no restriction.

I cannot tell you how valuable this site and everyone's input has been for me.

I only wish I had found it sooner because I probably could have avoided the slip

and the repair surgery if only my surgeon had educated me half as well as you

all have!!

Thank you for taking the time out of your busy lives to help all of us with our

issues!

Berta

What is a " soft stop " ?? What is a " hard stop " ??

What is a " soft stop " ?? What is a " hard stop " ??

These are one of the most basic of Bandster concepts, and very

essential to learn and heed. These signs apply mostly to those who

have reached a fairly good fill. Most people do not feel them before

that, but some may feel them briefly in the few days right after Band

surgery.

Not learning and heeding them gets many people into trouble -

discomfort, real misery, embarassment, and occcasionally a very

urgent situation needing quick medical intervention.

First, a little physiology. The band is placed just below the

junction of the esophagus and stomach, creating a pouch about the

size of a golf ball, AFTER a good fill is reached. (Before a decent

fill, there is very little pouch at all)

The pouch is in the CENTER of the chest, about 2 inches below

the " notch " in the lower neck. Many people think it's much lower.

This pouch expands safely to hold the ideal bandster meal of 1-1.5

cups of food. If we cannot eat this much, we are too tight for

stomach/pouch safety and are not getting enough nutrition.

The pouch is right next to the diaphragm, which is very sensitive and

full of nerve endings. When we overeat, or otherwise irritate the

stoma or pouch, it also irritates the diaphragm. The irritated

diaphragm sends signals to several different areas of the body, via

common nerve pathways. These signals are the " soft stop " or 'hard

stop " signs.

Right after surgery or right after a new fill, the stoma/pouch is

also irritated, and can send signals like the common left shoulder

pain. This is not from " gas " , but from an irritated disphragm caused

by the stretching of the internal organs BY the CO2 gas inserted at

surgery. The gas itself dissipates at the end of surgery, when the

instruments delivering it are opened and removed.

If we DO NOT feel and heed our " soft stop " signs and stop eating

(even spitting out a bite that may already be in our mouth) , we then

proceed to a " hard stop " which is sliming, a small to large pb, or

real barfing. Since these are all dangerous, we want to avoid them as

best as we possibly can.

THESE are the " soft stop " signs that mean STOP EATING ! you have had

enough to be satisfied! and more will cause trouble

1. a single burp or hiccup

2. ongoing hiccups (which are always diaphragm irritation)

3. a sudden sneeze

4. a sudden runny nose

5. left shoulder pain

6. pressure in the middle of the chest (where the overfull pouch is)

7. low back pain

8. a facial or eye tic

9. a few other much less common signs

Our own particular signs can be any one of these, and may change

depending on the situation. With practice, you will learn what YOURS

are. It's important to learn them, and then learn good Bandster

quantities, since , as time goes on, the esophagus gets much less

sensitive to a full pouch, and the stop signs are not reliably sent,

or we have learned to ignore them.

We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

our pouches. As time goes on, we will be able to rely on the band

less and less, and will then need to rely on our own improved food

choice and eating habits much more.

One of the reasons we must eat slowly and carefully is to be able to

feel our bodies and pick up the first of these subtle signs. If we're

eating fast and without thought, we blow right past the soft stop

signs and suddently we are in pain or barfing - the " hard stop " .

These all takes practice to pick up, and to heed. We have to eat

mindfully, and pay attention. This means no TV, no distractions, and

ideally eating alone for at least a week or so after a fill. It also

helps to put a 3x5 index card on tyhe table in front of usfor awhile,

to remind us of the Bandster eating techniques - " pea sized

bites " " chew 15x " " eat slowly " etc.

Most of the barfing or embarassment episodes when we are out with

friends come from not paying attention, gabbing with people, and

forgetting the eating rules. It takes about 3 weeks of consistent

work to adopt a new habit like better eating techniques, and I

suggest we put in this 3 week period very early on.

Along with all this is the importance of understanding

that " satisfied " with a small band portion is quite different

than " FULL " . " Full " was usually stuffed to the gills, uncomfortable,

and way too much. I don't like it much when people say we will

be " Full " with a small band porton. I think this sets up unreasonable

expectations that lead to misunderstandings. SATISFIED, not FULL is

the goal of the band.

With the band, " satisfied " is more like " Ok, no longer really hungry.

This is all need. I COULD eat more, but no need to becuase I want to

lose weight " It's a common mistake to think that the band will MAKE

us stop eating. It is meant to give us early signs of being stisfied

(the soft-stop signs) so we don't need to get to the point of HARD

stops where the band revels and we get sick. It is meant as a subtle

reminder, not a hammer over the head.

This also means that we must learn the difference between real,

physiological hunger and what we call " HEAD and HEART hunger " . Most

of us eat for emotional reasons that have nothing to do with being

truly HUNGRY. We eat from boredom, depression, anxiety, fear, worry,

and habit - just becuase we " always " eat in front of the TV,

or " always " stop at that fast junk food place when we drive past it.

this is not real hunger, and we have to work hard on developng better

behaviors. Instead of automatically heading to the fridge when we are

bored or depressed, we CAN choose to go for a walk, do other physical

activity, call a friend for support, etc.

Sadly, the band does little if anything for emotional hunger, which

is why it's so important to work on the emotional eating and food

issues most of us have. These psychological areas are rarely

discussed, especially pre-op, yet are extremely important. I'm a very

strong advocate for therapy, starting well before surgry if possible,

and I also personally fund great help with Guided Imagery, which is

well-proven and uesed extensively with just the type of lifestyle

changes required by the Band .

all comments and questions encouraged, as always!

sandy r

[Guest guest]

Berta, thank you for a supportive post! We'r all glad to help.

I agree that teaching from our docs and their teams is often very

lacking, sadly, and the result is lots of trouble that didn't have to

occur.

WE must be very pro-active in our band journeys and activley seek out

good teaching and the info we need to do well.

Sandy r

>

> I don't contribute much to the board, but I do read all of the

posts. This one amazes me because I had an eye tic for MONTHS.

>

> Since my repair surgery (April, 2007) I have been very nervous

about my band. I had something get stuck in September of last year

and almost all of my fill taken out.

>

> From sometime in November until I had a fill in March I had daily

bouts of eye twitching that were so bad I was afraid to drive long

distances by myself, almost always the left eye, but once or twice in

the right one.

>

> It was not until I read this post that I realized since getting

that fill in March the twitch is gone! I knew I was eating too much

( I was gaining weight after reaching my goal within 9 months of my

original surgery). But only now do I realize how out of control I

must have been with no restriction.

>

> I cannot tell you how valuable this site and everyone's input has

been for me. I only wish I had found it sooner because I probably

could have avoided the slip and the repair surgery if only my surgeon

had educated me half as well as you all have!!

>

> Thank you for taking the time out of your busy lives to help all of

us with our issues!

>

> Berta

>

>

>

> What is a " soft stop " ?? What is

a " hard stop " ??

>

> What is a " soft stop " ?? What is a " hard stop " ??

>

> These are one of the most basic of Bandster concepts, and very

> essential to learn and heed. These signs apply mostly to those who

> have reached a fairly good fill. Most people do not feel them

before

> that, but some may feel them briefly in the few days right after

Band

> surgery.

>

> Not learning and heeding them gets many people into trouble -

> discomfort, real misery, embarassment, and occcasionally a very

> urgent situation needing quick medical intervention.

>

> First, a little physiology. The band is placed just below the

> junction of the esophagus and stomach, creating a pouch about the

> size of a golf ball, AFTER a good fill is reached. (Before a decent

> fill, there is very little pouch at all)

> The pouch is in the CENTER of the chest, about 2 inches below

> the " notch " in the lower neck. Many people think it's much lower.

>

> This pouch expands safely to hold the ideal bandster meal of 1-1.5

> cups of food. If we cannot eat this much, we are too tight for

> stomach/pouch safety and are not getting enough nutrition.

>

> The pouch is right next to the diaphragm, which is very sensitive

and

> full of nerve endings. When we overeat, or otherwise irritate the

> stoma or pouch, it also irritates the diaphragm. The irritated

> diaphragm sends signals to several different areas of the body, via

> common nerve pathways. These signals are the " soft stop " or 'hard

> stop " signs.

>

> Right after surgery or right after a new fill, the stoma/pouch is

> also irritated, and can send signals like the common left shoulder

> pain. This is not from " gas " , but from an irritated disphragm

caused

> by the stretching of the internal organs BY the CO2 gas inserted at

> surgery. The gas itself dissipates at the end of surgery, when the

> instruments delivering it are opened and removed.

>

> If we DO NOT feel and heed our " soft stop " signs and stop eating

> (even spitting out a bite that may already be in our mouth) , we

then

> proceed to a " hard stop " which is sliming, a small to large pb, or

> real barfing. Since these are all dangerous, we want to avoid them

as

> best as we possibly can.

>

> THESE are the " soft stop " signs that mean STOP EATING ! you have

had

> enough to be satisfied! and more will cause trouble

>

> 1. a single burp or hiccup

> 2. ongoing hiccups (which are always diaphragm irritation)

> 3. a sudden sneeze

> 4. a sudden runny nose

> 5. left shoulder pain

> 6. pressure in the middle of the chest (where the overfull pouch is)

> 7. low back pain

> 8. a facial or eye tic

> 9. a few other much less common signs

>

> Our own particular signs can be any one of these, and may change

> depending on the situation. With practice, you will learn what

YOURS

> are. It's important to learn them, and then learn good Bandster

> quantities, since , as time goes on, the esophagus gets much less

> sensitive to a full pouch, and the stop signs are not reliably

sent,

> or we have learned to ignore them.

>

> We must then SELF-limit our eating to 1-1.5 cups so we don't dilate

> our pouches. As time goes on, we will be able to rely on the band

> less and less, and will then need to rely on our own improved food

> choice and eating habits much more.

>

> One of the reasons we must eat slowly and carefully is to be able

to

> feel our bodies and pick up the first of these subtle signs. If

we're

> eating fast and without thought, we blow right past the soft stop

> signs and suddently we are in pain or barfing - the " hard stop " .

>

> These all takes practice to pick up, and to heed. We have to eat

> mindfully, and pay attention. This means no TV, no distractions,

and

> ideally eating alone for at least a week or so after a fill. It

also

> helps to put a 3x5 index card on tyhe table in front of usfor

awhile,

> to remind us of the Bandster eating techniques - " pea sized

> bites " " chew 15x " " eat slowly " etc.

>

> Most of the barfing or embarassment episodes when we are out with

> friends come from not paying attention, gabbing with people, and

> forgetting the eating rules. It takes about 3 weeks of consistent

> work to adopt a new habit like better eating techniques, and I

> suggest we put in this 3 week period very early on.

>

> Along with all this is the importance of understanding

> that " satisfied " with a small band portion is quite different

> than " FULL " . " Full " was usually stuffed to the gills,

uncomfortable,

> and way too much. I don't like it much when people say we will

> be " Full " with a small band porton. I think this sets up

unreasonable

> expectations that lead to misunderstandings. SATISFIED, not FULL is

> the goal of the band.

>

> With the band, " satisfied " is more like " Ok, no longer really

hungry.

> This is all need. I COULD eat more, but no need to becuase I want

to

> lose weight " It's a common mistake to think that the band will MAKE

> us stop eating. It is meant to give us early signs of being

stisfied

> (the soft-stop signs) so we don't need to get to the point of HARD

> stops where the band revels and we get sick. It is meant as a

subtle

> reminder, not a hammer over the head.

>

> This also means that we must learn the difference between real,

> physiological hunger and what we call " HEAD and HEART hunger " . Most

> of us eat for emotional reasons that have nothing to do with being

> truly HUNGRY. We eat from boredom, depression, anxiety, fear,

worry,

> and habit - just becuase we " always " eat in front of the TV,

> or " always " stop at that fast junk food place when we drive past

it.

> this is not real hunger, and we have to work hard on developng

better

> behaviors. Instead of automatically heading to the fridge when we

are

> bored or depressed, we CAN choose to go for a walk, do other

physical

> activity, call a friend for support, etc.

>

> Sadly, the band does little if anything for emotional hunger, which

> is why it's so important to work on the emotional eating and food

> issues most of us have. These psychological areas are rarely

> discussed, especially pre-op, yet are extremely important. I'm a

very

> strong advocate for therapy, starting well before surgry if

possible,

> and I also personally fund great help with Guided Imagery, which is

> well-proven and uesed extensively with just the type of lifestyle

> changes required by the Band .

>

> all comments and questions encouraged, as always!

>

> sandy r

>