Well, today I clearly needed a refresher course in Lap Band basics, and I got it courtesy of my doc's PA (who handles our fills). Here's what happened... N.B. I'm writing this mostly for my own benefit so I can refer back to it, but if it helps anyone else along the way, great!
Ever since returning to real food after my last fill over 2 weeks ago, I've been having not quite daily (and mostly minor) PB issues. At first, I thought I was eating too fast or forgetting to chew enough, but then I really paid attention to those things. Then I thought stress? Overfill? NAH, it can't be an overfill -- I'm way too hungry and when I don't PB, I can eat way too much. Finally, last night, I had some really violent retching and a complete return of my delicious soft-shell crab dinner. This was no mere PB -- my esophagus still hurts today!
So, I went in -- I was originally scheduled for a fill today, but by now I was thinking UNfill! They did a barium swallow to determine if I was either overfilled or had my lower stomach slip up through the band from the incident. Fortunately, neither was a problem. Phew. We then reviewed how I've been eating, and found that I had forgotten two really basic things:
1) The size of the bite that I put in my mouth should be no bigger than the clear part of the nail on my pinky finger! Using a tiny fork wasn't doing the trick. I completely forgot myself on this one.
I should look at my fingernail often while focusing on eating. No matter how much chewing you do, if it's too much at once, it may cause problems.
2) If you do have a PB, there is always going to be some associated swelling, and the maximum swelling doesn't occur until 24-48 hours after the incident. THIS IS WHY I NEED TO DO LIQUIDS FOR 48 HRS AFTERWARD!!!
(Yes, I'm yelling at myself now!) Instead, I was having a shake or two for the next 12 hours, but the next day I just merrily went back to food, forgetting the repercussions of the day before. This is why every day or two, I further exacerbated the problem with another PB. The swelling became cumulative till yesterday's disaster. In addition to 48 hours of liquids, this should be followed by 48 hours of soft foods, working your way back to solid, hard proteins slowly.
Had I not been experiencing these problems, he would've given me a fill today. So, I'm hoping I've learned my lessons well and do not ever want to repeat this cycle. I hope no one else is going through this either.
On the plus side, I lost 4 more pounds since my last visit!
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