The First Month

Well, it has been a month since my surgery, and what an interesting month it has been.

I have really had to learn a new way of eating, and having tasted the "green zone", I am really keen to get back into it.

The first week was bliss. I could really feel the band doing its stuff. I could feel the sensation known as satiety - the opposite of hunger (no interest in food). After only a small amount of food, I felt the the sensation of satiation (feeling satisfaction after a small amount of food). I found it very difficult to handle any lumps in my food at all. I thought the liquid diet was going to be hard, but I found it quite easy. The amazing thing was I felt freed from my preoccupation with food. I was able to actually enjoy my TV without being distracted by a constant battle with the part of me wanting junk food - that "demon" was blissfully silent. I felt so free.

However, by the initial weekend, I was wanting to try eating some solids. I made the mistake of trying some McDonalds. I only managed to get through half of it before giving up, because I threw up three times. This was due to an extremely uncomfortable (verging on painful) sensation in my stomach that would not subside. Vomitting seemed to be the only way to relieve it.

I got quite a bit of a telling off on Facebook because of it LOL

I experienced some more throwing up, as I experimented with some more foods.

Over the last couple of weeks, however, I have no doubt that I am in the "yellow zone". The "demons" are back, and binging just like I did before the surgery.

I have started Tony Ferguson as my core diet, and I believe that has stopped me from gaining weight as a result of my binging. I am looking forward to it really working, and doing away with these annoying urges.

Here is a quick explanation of the zones:

• Green Zone
  
  • this is where the surgeons want us to be - it's where the band is working properly
  • experiences satiety and early satiation
  • weight loss is steady and good
• Yellow Zone
  
  • this is where the band is not tight enough
    
  • old eating patterns and urges return
  • eat larger meals
    
  • start hunting for food between meals
    
  • weight loss is slowed or reversed


• Red Zone
  
  • this is where the band is too tight
    
  • may experience any of the following:
    
    • difficulty swallowing
      
    • reflux
      
    • night coughs
      
    • heart burn
      
  • weight loss slowed or reversed due to reverting to "slippery" foods (e.g. icecream, chocolate, etc)

I am very much looking forward to tomorrow's adjustment. This is where the surgeon injects some saline through the port attached to the abdominal wall to tighten the band.

I am really looking forward to getting back into the green zone.

The Surgery

I was getting more and more excited about the surgery the closer the day came. It was pretty much the only thing I could think about. I was surprisingly not neervous - just excited.

The only thing that made me a bit nervous was the fact that I had strayed from my Optifast diet (even had some pizza and pasta the day before the op). Due to my fatty liver, my liver could have been too large to have been able to have achieved the operation laproscopically. If that had been the case, the operation would have been a lot more extensive (i.e. I would have had to have been cut open so that they could remove the organs out of the way). Optifast is a Very Low Calorie Diet (VLCD), and has the effect of shrinking the liver.

Thankfully, I must have been good enough, as it was apparently a very straight forward operation.

I had to be at the hospital at 6am, so taxi was the only way to get there (thanks to the annoying public transport). Everybody there seemed to be in good spirits, and I got two pleasant surprises - not only was there no excess being charged by my health insurance, but I got my own private room!!!

After I was all checked in, I set everything up, and used the spare time to restore my iPhone, and chatted to some work colleagues in NZ. I remember being given the stuff I had to wear during the op, and even had to wear some disposable undies.

At around 9-9:30 I got wheeled into the Operating Area. It was quite amusing as there was quite the queue of beds in that area. I started off by the door button, and was the honorary doorman for a while. I think it was about 30-45 mins before I was wheeled into the actual Operating Theatre.

After some jokes from the anesthetist and nurse, they took some blood (for some research I gave consent for)...they knocked me out not long after that.

I woke up feeling very drowsy - although I wasn't overly concerned. I remember what it was like from previous ops, and was expecting a rapid recovery. I remember the nurse saying to another nurse that it was was standard operation. I also remember being drenched in sweat, and heard that I my blood pressure had gone quite high during the op, but was ok. By the time I got to my room, I remember being quite achy, and was asking for some painkillers (wasn't able to have any though because it was too soon since my last dose). My throat was also a bit sore from the breathing tube.

I remember it was around 12ish when I got to my room, and managed to drift off for a few hours off. When I woke up (around 2pm), I remember needing to go to the toilet, and needed to be disconnected from my saline drip. I was allowed to get changed into my own clothes, so used the opportunity to check the wounds on my stomach - was very relieved that there wasn't a big slash up my stomach, and everything was just taped together.

I found that, although I hadn't eaten all day, I wasn't hungry, and was working my way very slowly through a cup of ice while watching TV. The nurses seemed to come in many many times to check my blood pressure and oxygen levels (I do remember being asked to take a few deep breaths at the beginning). By "dinner" time, I was feeling woosy (but not hungry). I got a meal of chicken broth, apple juice, and tea (no milk).

Because I wasn't feeling hungry, it took a very long time to work my way through the meal.

The surgeons like the patients to start moving around ASAP after the operation (e.g. a short walk), so, when I had some visitors, I requested that we go for a walk downstairs. We went to a cafe, and was bought a cup of tea. I wasn't even able to have much of that.

I eventually found that I was setting myself up for bed (around 11pm), and slept quite well (only got woken up once at 2am for some pain meds and my vitals taken).

At around 7:30am the next day, I got woken up by the nurse and my surgeon coming in to check up on me, and was told that everything was all good.

My breakfast was exactly the same as my dinner (with the exception that I had an additional lemon cordial). I found that I had to stop for about 5-10 mins after just the broth and the apple sauce.

I found the achiness was gone, and needed no additional painkillers - even though I asked for some panadene to take home.

I found I was able to catch the tram home (with assistance from my flatmate), and spent the day in front of the TV

How the Lapband Works

A lot of people have asked how the lap band works.

I thought it'd be a good idea to post something that explains it.

A great link for more information is: http://en.wikipedia.org/wiki/Adjustable_gastric_band


What is a lap-band

As extracted from the wiki link above:



"A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity"

It is the least invasive of all of the obesity surgeries, and is completely reversible.

How the band works is by compressing the stomach, while stimulating the nerves that create satiety (the lack of interest in food) and, at mealtimes, early satiation (i.e. being satisifed with less food).

My surgeon, Professor Paul O'Brien, has posted a very good Youtube video that explains this process quite well. He also explains the surgery itself.

Finally, what makes this system most appealing is the relationship doesn't stop with the surgery. After a month of recovery, the patient is expected to attend regular checkups with the surgeon to have the band adjusted (as necessary), and there is plenty of post-operative support - even years after the surgery. So, I am not left alone.

Due to my fatty liver, I have had to do Optifast (a special Very Low Calorie Diet [VLCD] which has the effect of shrinking the liver) for the two weeks leading up to the surgery - otherwise, the surgeon would not have been able to do the operation laproscopically (he would have had to have made a large incision to move the enlarged liver out of the way).


After The Surgery

After the surgery, there is a four week recovery period before my first adjustment, and the beginning of my new way of eating:

• Week 1 - Liquids Only - this is to allow everything to settle back into place. The band is unlikely to be able to provide the restriction that it needs in the first week, and needs this time to "adhere" itself to the stomach. Having liquids only provides the relief the band needs while settling in. This is the only time that you will be allowed to consume calorie containing liquids without guilt. However, the strong satiety should enable easy transition through this week


• Weeks 2 & 3 - Transition Phase - this where some bulk can be added to the liquids, but the lumps need to be kept small, so as not to "block" the smaller stomach opening. It is important that, over this fortnight, the transition from lumpy liquids to more solid, but soft, foods


• Week 4 - Solids Phase - by this time, you should be effectively on the diet you can expect to have for the rest of the time

Here are a couple of helpful links that explain the lap-band diet:

• A surgeon's perspective


• A patient's perspective

Why I Decided to do the Lapband

All through my adult life, I have had issues with my weight. While I was going to school, I was fairly active, and that kept the excess weight at bay. At 19, as my exercise reduced, I started noticing that my weight wasn't staying off like it did.

Once my weight crept above 80kg, this when I started yo-yo dieting. I didn't realise that I had begun a highly addictive pattern of eating that all the diets and exercise weren't helping me get off that train. After each failure, I gained back any weight I'd lost, and then some.

By the time I was 23, I was over 100kg.



Over the period of my 20's, I fell into deep depression and anxiety, and really fell like I lost control of my life and my body. I started developing weight-related illnesses (e.g. gout, high cholesterol, sleep apnoea), and seemed to age very quickly (i.e. I was balding and I was starting to get white in my beard). It got to the point where I really didn't like what I saw in the mirror.

I went for help several times, but nobody seemed to be telling me stuff that I didn't already know. I have a background in health, and I know the underlying energy equation (energy in > energy out = increase in weight and energy in < energy out = decrease in weight), but nobody could seem to help me with my eating habits. I know how important both diet and exercise is in keeping healthy.

All everybody was doing was trying to get my weight down, and I have never found it difficult to lose the weight - it's been keeping it off that's been the issue with me.

Before I was even 30, I looked about 10 years older. Now, as a 34 year old, I feel like I look like I am in my 40's. Some unkind queens have even said to me that they know 60+ year olds who look better than me.



I completely retreated from romantic relationships. I chose to surround myself with friends, but could never bring myself to enter into a relationship. I could never believe that anybody could find me attractive, as I was highly repulsed by what I saw in the mirror. Everytime my picture is taken I always feel like crying.

I have never been in a real relationship, and it's been a very long time since I have been intimate with anybody. I constantly feel worthless and a failure.

I know I shouldn't feel this way, as I have many friends, and a lot of people who care about me, but I feel like I am falling apart, and losing myself. If I can't control what goes into my mouth, it is no surprise I am not where I want to be.

By the time I moved to Australia, I was nearly 110kg, and I have bounced between 100 and 110 since I've been here. I have also slipped into other bad habits that have destroyed my credit rating (to the point where I can't get a FlexiRent for a new computer any more), and keep sabotaging my career

It is always so frustrating to hear the "all you have to is..." advice from people who have either never had a problem with their weight, or have found the solution that has worked for them, and assumes it will work for everybody. However, I truly feel like there's a demon living inside me - wanting to destroy everything I have worked so hard to put together. This seems to affect every part of my life: health, work, and finances - all due to lack of self control.

I feel like a passenger in my own body when I am compelled to go the shop and eat that junk food. I hate it. I hate that I am driven to do this, and I hate that I can't seem to do anything to stop it. Every time I get a tool, this demon sabotages the effort.

I have been a gym donor (i.e. someone who has the membership but doesn't go) for many years, and I can usually sustain the gym thing for a short time before I lose interest and stop going. I have never really been into sports, so couldn't imagine playing one - although I do enjoy table tennis @ work (although I am not really that good).

I was on Duromine for over a year, and I got down to 94kg. I remember what it was like to not want to eat, but that wore off very fast. I enjoyed being able to eat whatever I wanted, and still lose weight. However, with Duromine being an amphetamine, I very quickly felt something wrong in my head. I felt it very difficult to concentrate, and had difficulty concentrating. I took myself off it, and I still don't feel like my though patterns have come back to normal.

I tried moving onto Tony Ferguson after the Duromine, but couldn't seem to release the bad eating habits I'd formed over the time I was on Duromine, and came off it in less than a month - this was despite doing it with my best friend.

I had bought some hypnotherapist tapes, and all I had to was listen to them, but I couldn't even bring myself to do that. I had talked to friends about this, and given myself some timelines (i.e. "if I haven't lost X amount of weight by Y amount of time, then it's surgery for me). With no relief on the horizon, I decided this year to look into the surgery.


During the initial checkups, I also discovered that, in addition to everything else, I was pre-diabetic, and beginning to become hypertensive (which was saddening, as my blood pressure had always been normal up until this point).

It had come to the point where, if I had any chance of gaining control over myself, and saving myself, I had to do the surgery. I was hoping that, even if I did end up succumbing to the binging, due to the style of eating I'd have had to achieve (slow and small mouthfuls) that the driving energy would dissipate before I ate everything. I also was pleasantly surprised to find that the band itself would create this persistent state of "satiety" (not being interested in food) and that I'd feel this thing called "satiation" in my meals (which is where a small amount satisifies).

I hope that, once I gain control over my body, and I start to look and feel better, that my self esteem will improve, and I can improve other areas of my life as well. Who knows, maybe I could even open myself up for a relationship.

I really want this to work