Considering Dr. Kirshenbaum

Need some opinions, please.

I had a fill 5 days ago. I can drink fine and eat things like yogurt, cottage cheese without a problem. BUT, when I move up to something a little more solid I, without fail, slime and PB. I'm thinking that my problem is with not eating slow, small bites. If I'm honest I have to admit that I've never gotten the hang of taking 30 minutes for a meal. And up until now I don't think I've had restriction enough to force me to do it. But here I am. Tell me your tricks, oh ye band veterans. Aren't the Dr. K guidelines to consume 1 cup of solids three times per day, with a protein shake and 2 small snacks? What works for you? I can see myself so easily sliding into only eating soft food (read: high calorie foods, like ice cream) because I can do it quickly and I can't afford to go there! Do you think I need to call Natalie or our nutritionist for a consult/meal plan?

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ShelbiCallie: Dr. Kirshenbaum 9/19/07 APS
1st fill: 10/29/07 3cc;2nd 11/26/07 4.6cc; 3rd 4/21/08 5.6 cc
4th 8/1/08 6.1 cc

Shelbi, I don't have that much experience yet, but I do remember Paula's rules as being 3 meals, no snacks and 2 protein drinks. I remember distinctly Dr. K telling me IF I was not hungry, I was not to eat anything. And the goal was to only eat 3 meals -- when I was hungry. I have to admit I haven't done that because when I did, I was only getting 600 cals a day. And when I added the protein shakes between the meals, I wasn't hungry and found myself not eating anything. Somedays, I'd have my breakfast 2 or 3 hours later as instructed, I'd have my protein shake and then I'd be full until 4 in the afternoon, I'd eat my lunch and 2 or 3 hours later it was time to drink my protein shake but by then it was time for bed and I didn't want to drink or eat anything that close to bedtime for fear of having problems. I had to change the way I was doing things because my weight stalled and I felt weak most of the time. Now I eat my three solid protein/veggie/whole grain carb meals - approx. one cup at a time, then between meals, I will eat a very small or half a piece of fruit. This helps me keep things regular and I feel I am eating more balanced and healthy. I'm getting in about 80grams of protein, because I log everything in Free Diet Plans at SparkPeople.

Okay, I know that does help your PB'g problem now that you've had a fill. Sorry, but do you think you want to try to chew things more and eat them slower? I read where it takes 9 seconds for your food to get to the stomach once you've swallowed it. (I read that on the discovery channel's website in reference to speed eaters.) I think I could have easily been a speed eater. I didn't chew, I shoved food in my mouth and inhaled it. I'm surprised I didn't go the way of others who have choked to death. Maybe Shelbi, if you can start fresh with the rules of taking smaller bites, chewing to liquid form and then waiting 9 seconds until you take your next bite, maybe you'll be able to consume more solid proteins.

I admit, I'm not perfect with the chewing 30 times and waiting. But I want to be -- it's a very difficult concept for me. I have to completely pay attention to my meal. I haven't slimed yet, but I had a little stuck episode one night on a piece of chicken. My second bite and it was over. I didn't want anything else and I certainly wasn't going to force myself.

Also, have you tried something hot to drink just prior to eating, so you can relax and open up a little?

You can do it -- take those tiny bites!

I'm rooting for you!
dee~

Shelbi, if smaller bites, chewing more and waiting doesn't help, then maybe you need a slight unfill. Are you having any coughing at night or reflux issues? AND lastly, you can always call Natalie and Paula... use us as support and ideas, but they are always there!

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Oh the agony of it all!
Surgery January 29, 2008 - Dr. G. Kirshenbaum, Aurora Colorado

Hi

In regards to the BBQ what exactly would we they be serving? My husband thought it was so funny a bunch of lapbanded people trying to enjoy a BBQ. Seriously though I know its more about getting together than eating.

Have a good day!

Lizzieann

It worked. Tonight for supper I had about 1 cup with protein/veggie/carb of varying textures. I took a tiny bite, chewed 30 times, swallowed then counted to 10 before I took another bite. No PB, no slime, no discomfort -- I feel satisfied with what I had to eat. It worked! Thank you, thank you -- I just needed a refresher, I guess. I am(I mean was) such a speed eater, volume eater, and non-planner. Old habits die such a slow and painful death with me. But I'm taking it one meal at a time now; I have to. Question -- are you doing 2 protein shakes, 3 meals, and 2 small fruits daily or no protein shakes any more? Also, have you been able to find chewable Biotin (I thought I remembered your posting at some point that you take Biotin; maybe I'm wrong:confused2:) I'm taking a chewable multivtiamin, chewable Omega-3 but I couldn't find any chewable Biotin or Chewable calcium citrate (lots of chewable calcium carbonate, though) so I just chewed up the Biotin and calcium citrate that I have -- disgusting, but doable. Have you found anything better?
Thanks again for your help, Dee.

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ShelbiCallie: Dr. Kirshenbaum 9/19/07 APS
1st fill: 10/29/07 3cc;2nd 11/26/07 4.6cc; 3rd 4/21/08 5.6 cc
4th 8/1/08 6.1 cc

Hi Lizzieann,
I think a BBQ is a perfect meal for a Lap Bander. I eat a lot of BBQ now. I don't eat the Potatoe Salad, Mac Salad or Beans, but the meat is perfect for me. There is a BBQ place in Parker close to the hospital and the Similac Rep brings us food all the time. He knows I can eat their BBQ chicken. It's very very very tender. It almost melts in my mouth. (but I don't allow it to, Shelbi!) I don't eat pork of any kind, so I don't know how that would work, but Brisket is good too.
Are you not able to eat really tender meats?

Anyway, I agree, I think it's not so much about the food and more about socializing!
Hope you can come!

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Oh the agony of it all!
Surgery January 29, 2008 - Dr. G. Kirshenbaum, Aurora Colorado

Yeah Shelbi!!!

You made my evening!! I'm so happy to hear it worked! Wow! I know I have a friend who lives in Littleton and she was banded by a different doctor, but she has trouble everytime she gets a new fill. She tends to eat really fast and not chew things well. It takes about a week to get back to the slow eating routine!
My meals are pretty funny looking, actually. Trying to get all of my different foods in there on one tiny plate. Like breakfast this morning was pretty cute. I had one Morningstar Farm Veggie Sausage (10grams of protein in one patty), 1/4 piece of Dakota bread (1gram of protein), toasted with 1/3 Less fat cream cheese and one egg soft scrambled with milk (6grams of protein).
I have stopped drinking the protein drinks because I really don't have room for them, if I'm eating my fruit and I don't need the protein. I do admit that I drink 5oz of a MIX1 drink every morning with my crushed pills before riding my bike. (7 grams of protein in half) I feel I need to get them to the lower stomach so they can start working and I don't want them down there with just water. So I drink my MIX1 drink. They come in 11oz servings and I drink 1/2 of one. They aren't thick at all and come in fruity flavors and are filled with all kinds of good vitamins, including calcuim and vitamin D. I get them at Whole Foods for $1.50 (on sale) so if I drink half, one serving for me is 0.75cents.
I haven't found a chewable Biotin, but I read some where that someone did. I'll see if I can find that post and I'll repost it here. I take the tiny tiny ones from Walmart. They taste okay - I just chew them really fast and then chase them with my MIX1 drink in the am. I also take the GNC Chewable Calcium. It's Calcium Carbonate. But it tastes okay. My chewable Multivit has some Calcium Citrate in it, actually, the one I'm taking now has 100% required. I just finished a chewable that was really good. I got it at Vitamin Cottage. Now I'm using the one from a tiny health food store in Albuquerque. The next one will be the one Brandy turned me on to from GNC. I have tasted more Multivits in the last three months than in my entire life. One day at Vitamin Cottage, I sampled about 5 different ones. I guess, it didn't click in my head that I shouldn't be eating so many vitamins, but I was searching for the one that tasted the best. They have one container open and you can sample them. I bought a chewable Calcium, Magnesium, Zinc, Vit D combo and it is absolutely horrible!

Well, I better get going now! Hugs! AND I'm thrilled that you were able to eat a good meal. I'm so anal, that I write down the time I finish eating so I can see how long before I get hungry again! I know! I'm a nerd! I started doing that a year ago when I was checking my blood sugars two hours after my meals. I was obsessed with that too! My doctor said he'd never seen anyone like me! Oh well... Life goes on...

Hugs! Kisses!
dee~

__________________
Oh the agony of it all!
Surgery January 29, 2008 - Dr. G. Kirshenbaum, Aurora Colorado

Oh Shelbi, I forgot to mention! My daughter says she can see me counting to 30 in my head and then she can see me counting to 9 after I've swallowed. Hey! If it keeps me on track then that's good!
I'm so happy for you! Keep counting Girlie!

How does the Omega-3 chewable taste? And is that the one from GNC? I'm about to put my order in online and I saw them.

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Oh the agony of it all!
Surgery January 29, 2008 - Dr. G. Kirshenbaum, Aurora Colorado

Hi Dee, I've got the EveryDay Omega-3 Soft Chews by Life Fitness. I bought them at CVS. "Each orange-flavored chew contains 120 mg of EPA and DHA Omega-3 fatty acids, the essential ingredients that researchers believe help maintain a healthy heart." --according to the package. They taste good, with no fishy after taste. I think it must be flax and not fish. I would rather have fish and I've heard that the Vitamin Shoppe has a lemon-lime flavored liquid that's good. But I saw these in CVS and thought I'd give them a try. I like them.

Have a great Sunday and thanks again for helping me stay the course!!

Hey Dee -- I just checked the GNC website and found

TWINLAB® Emulsified Omega-3 Fish Oil 002036
12 fluid ounce(s) Regular Price: $13.95
EPA (Eicosapentaenoic Acid) (omega-3) 1003.00 mg
DHA (Docosahexaenoic Acid)(omega-3) 669.00 mg

This is supposed to be mint flavored and seems to be a much better value than the chews, considering the amount of omega 3 per tbs.

I may give this a whirl when I'm out of the chews.

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ShelbiCallie: Dr. Kirshenbaum 9/19/07 APS
1st fill: 10/29/07 3cc;2nd 11/26/07 4.6cc; 3rd 4/21/08 5.6 cc
4th 8/1/08 6.1 cc

SheilbiC. You got some great advice here. Hope it helps you.

I'll agree with you that right now I feel extra tight. But before I think it is the band or my fill, I'm going back to me. Scientific deduction, what do I know?
I know that I have a concern with food.
I know that I have historically had a hard time eating properly AND slowly.
I know I use to drink my meals down with loads of fluids.
I know I ate too much fat to lose weight as I should have.

..when we can identify things that we know about ourselves that perhaps others don't (and really we are the #1 best source for our own food plan, habits and such ) WE have the power to better adjust the things we need to.

I'm with you on the chewing. If I don't chew well, by the third bite I'm hacking and sliming.
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Hello Banditos:

This is Sunday and as part of my plan with Paula, it is a day that I select to PLAN my food plan for the week. Sort of like jotting my planner full of the appts. I've schedule.

More to come>>>>>>>>>>>>>>>>>

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Patty in Florida

I don't look like this anymore!


Doctor Gerald Kirshenbaum, Aurora, Colorado
THE FAT GIRL'S GOIN' DOWN!

Part II

Happy Sunday everyone:

Just finished lunch. Boston Market chicken, baked, peeled the skin off, couple bites of apples and I was full. I've revamped my eating plan to an Occam's Razor Food Plan.

William of Ockham: "entia non sunt multiplicanda praeter necessitatem", or "entities should not be multiplied beyond necessity".

This entity (me) tends to flounder in the cumbersome thoughts of planning too much or trying to do too much at the same time. Simplest method works best for me. Simpliest solution is where I succeed.

In talking with Paula we came up with some simple solutions to my food plan. One I'll mention in my protein choice, liquid, Profect Protein Beverage:
Lap Band Rockies - Profect Protein Beverage 4-Pack Sampler

They look like those shots that glow served in test tubes at the bar. Yeah. So one vile is 25 grams, I mix it with water and I've started ( 3 days) doing one for lunch and splitting one for snack mid-morning with water for a BOOST inbetween meals. I figure 12 grams of protein is better than 100 calories of nothing since I know my body responds well to protein.

I am cutting out the 100 pack snacks. I'm not going to lie to you all. Last week I had purchased the cheese flavor brand of a 100 pack snack. Thought WOW, I love these. See, that is the problem. I don't simply love a food, I loooooooove a food. So rather than a simple addition to my food plan like normal people do, I ingest something that I LOVE and suddenly it becomes FOOD PORN and I'm having an orgy. I ate four bags of the 100 over the course of the afternoon. Next morning the scale was up (high salt content) 3 pounds and now I'm busy getting off ONCE AGAIN, what I had already taken off. That crap has got to stop. I'm just gettin' too old for this. I feel like an obstanant child.

It's Sunday and I am now below the gain radar. Thank God.

Planning now for the week. It looks something like this:

Muscle Milk-Vanilla Cream (from Walgreens) 19 grams of protein
with my morning coffee.

Midmorning Protein-Profect 1/2 vile with water.

Lunch: Muscle Milk or food or wait if you aren't hungry and eat at home after work.

Dinner: Light item that fills in the gaps of the morning, greens, proteins, milk, cereal/flex to need

Late: peach tea with protein sauce. ((grins))

..............................................

time for reading and meditation.

A movie.

A book.

Ready items for work.

Bed time.

__________________
Patty in Florida

I don't look like this anymore!


Doctor Gerald Kirshenbaum, Aurora, Colorado
THE FAT GIRL'S GOIN' DOWN!

Hello all! :)

I just have a question - I'm going to Dr. K's for my first fill on May 29th. How much does he fill you? I had asked him preop how many fills a person (average!) gets a year and he said 3-4. I have to fly there and I'd hate to fly out there, spend $300 and not have ANY restriction at all!

So...that's the question. What did he fill you with the first time?

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Banded 4/16/08 in Denver with Dr. Kirshenbaum!

254/232.8/150
Progress, not perfection.
500 Minutes of Exercise in August: 305/500

Hi Nurse7263 ~ As you know, the first fill is really going to vary -- it's all about what constitutes the right level of restriction for you. I know some people get 1 cc and others get a lot more. I think that the first fill is usually the biggest, though. I left with 3.6 cc in my band. I also flew in from out of state, and he told me that he wanted to be extra careful about not overfilling because of that. I immediately felt restriction, which started to "wear off" after about two and a half weeks. Maybe it could've been more, but it was better to be cautious. I know if I hadn't had restriction, I might've felt like I "wasted" the money and time going out there. But on the other hand, I wouldn't have wanted to get home and immediately need to find someone to give me an unfill.

Dr. K also gave me a Huber needle to take home with me. Since I couldn't take it in my carry-on (I believe you can only carry on needles with a prescription) I FedEx'd it to myself. Also, he probably mentioned this, but since you are coming from out of town he prefers that you get your fill the first day you're there and then stay a day or two if you can. That way if you find it's too tight, you can go back in and get it adjusted. Good luck!

* * * * * * *

I haven't had much to say lately here; I guess in some ways the "newness" of the band has worn off. Things are becoming second nature, like not immediately grabbing the bread basket or vacuuming up my food in five minutes. I am still diligently logging my food and exercise in SparkPeople. This weekend my daily calorie intake was much higher than it's been in months -- I attended my brother's wedding. But I also know that it was still far less than I would've eaten in the past, and I made the smartest choices I could. I also hit the treadmill in the hotel fitness room -- I can't remember doing that at a hotel, well, ever -- so hopefully I won't see a gain from the rich food.

I got a lot of compliments yesterday at the reception; I wasn't always sure if it was the dress or me. And sometimes I was sure they were just being polite. Oh well, as long as the weight keeps coming off I'll keep working on my self-esteem so I can graciously accept those compliments!

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Dr. Gerald Kirshenbaum (surgery) ~ 2/14/08
Dr. William Johnson (fills & aftercare)
302 H / 295 S / 235 C / 175 G

Check out my blog!

Very good words to live by! So true, so true for me as well.

Have a wonderful week banditos!

__________________
ShelbiCallie: Dr. Kirshenbaum 9/19/07 APS
1st fill: 10/29/07 3cc;2nd 11/26/07 4.6cc; 3rd 4/21/08 5.6 cc
4th 8/1/08 6.1 cc

Hi Shelbi!
How did the rest of your weekend go? Did you continue with success? Anymore PB's or Slimes?
I've been thinking about you each time, I sit down to eat.
dee~

__________________
Oh the agony of it all!
Surgery January 29, 2008 - Dr. G. Kirshenbaum, Aurora Colorado