Advice….seems like everyone is dying to give it these days but we don’t always like to get it am I right? Aside from all those horrible reality shows that are out there (my fav: “I Didn’t Know I Was Pregnant”…oh really…that’s some bad gas) the next most popular are the advice shows.
I think we can all think of the advice that was offered up to us at some point in our lives which we DIDN’T heed and which may have negatively impacted our lives in some way….
‘”I reeeally think you should check out that stock called ‘lululemon‘ “(me to my husband…no he didn’t check it out and no I never bring it up).
“Never stick your tongue on a cold fence in the winter” (to my youngest son years before I got the call from the school office saying he had ‘ripped off the top layer of his tongue’…I swear on my childrens lives I am not joking…takes after his Dads side obviously).
“Maybe you should get more sleep, drink less coffee and eat more fiber so you wouldn’t be so grouchy all the time” (ok fine but WHO didn’t buy the lululemon stock I ask you???)
If I could get on my soapbox for one minute here, and offer my readers only one absolutely vital piece of advice it would be this: SLOW DOWN. Nothing complicated or earth shattering, this isn’t Gandhi or Dr. Oz talking (no I don’t put them on the same pedestal…nowhere even close believe me :)).
The number one cause of problems I see is usually the result of patients eating too quickly. When you have a band, and you’ve had an adjustment or two or three, you all have likely noticed that it is imperative to EAT SLOWLY. What happens when you don’t? It hurts like h#ll for starters. Then you get that nasty ‘sliming’ thing going on. And quite often the culprit (big wad of unchewed food) has to come up…and as fate will have it quite often that will be in a social setting such as a restaurant or wedding…
Here follows two other very good reasons to “Eat a Small Amount of Good Food Slowly” (Dr. O’Briens…and now my…8 word mantra).
One: Eating slowly with a properly adjusted band will lead to greater satiety. And this is what allows you to go for greater lengths of time between meals without hunger (the goal of a properly adjusted band). It’s all about stretch receptors and brain trickery. When you chew a small bolus of food well and swallow it your esophagus makes a series of squeezes which moves that bolus of food down the esophagus and across the band, thereby triggering the stretch receptors in the upper part of your stomach, that makes your brain think you have eaten more food than you have. This gives you that ‘I’m not hungry’ feeling or satiety….not the ‘ugh I’m full’ feeling. So that’s the first good reason for eating slowly.
Two: If you eat slowly, taking that 30-45 seconds (minimum!) between bites, you will never have to worry about that dreaded thing called “POUCH DILATATION“….I wish I had a “scary” font for that but I don’t so I write that in big red capitals because it warrants big red capitals.
POUCH DILATATION SUCKS. It is an avenue you really really don’t want to go down.
So what exactly is POUCH DILATATION?
Well, you have approximately 1 cm of stomach above your band which we refer to as a ‘pouch’. When you eat a bolus of food it takes about 30-45 seconds to make its way down to the pouch and across the band to the stomach where it is digested normally. IF YOU CONSISTENTLY EAT TOO QUICKLY, PARTICULARLY AFTER A FEW ADJUSTMENTS YOU HAVE THE ABILITY TO DILATE THIS POUCH. What happens is that it mushrooms out from a little pouch into a muffin-top. What people start to notice is that they may have new or persistent heartburn and no sense of satiety.
To diagnose pouch dilatation we typically do a simple test called a barium swallow (you swallow a yucky chalky ‘milkshake’ and have some x-rays taken) and based on the results and the degree of severity of the dilatation we remove some or all of the fluid in the band…for a period of 4 to 6 weeks. During this time we hope that the pouch comes back to normal size. Following the waiting period we very slowly start to refill the band hoping the symptoms don’t return. As you can see this can be a very traumatizing event for people and sets them back a great deal in their journey. Hunger increases and weight goes up. What’s even worse is that sometimes the band needs to be repositioned with further surgery….so you can see why you don’t want to do this and why I’m using all the CAPS and colours and italics to hold your attention.
It’s a really crappy thing to go through and one that can easily be avoided by SLOWING DOWN.
It’s crazy how busy we all are….work, family, extra-curricular activities. Used to be we sat down to a “lunch HOUR” and a “dinner TIME”. I wonder how many people reading this get 20 minutes for lunch let alone an hour, and how often we actually sit down for a ‘dinner time’ which was a time to relax, converse, enjoy, savouring both our meals and our companions. It would be great if this could change but for many of us this may be unlikely. But to get the most ‘bang for your buck’ with your band, and to avoid complications this is a ‘non-negotiable’ issue…kind of like driving without your seatbelt or riding a bike without your helmet. You may be ok for a while but eventually something baaaaad is going to happen.
My ADVICE (here I go!) is to slow down the best you can, taking at least 30-45 seconds between bites. Sometimes you may need to opt for an ‘easier’ food at lunch if you don’t get sufficient time to consume a healthy solid meal. In those instances continue to make the best choices possible. Incorporate protein/fiber/healthy choices, but perhaps in the form of a shake or healthy soup that you can get down in the time that you have. IF you find that you never have time to eat solid foods without issues, and that your weight loss goals are not progressing, then you may actually consider having some fluid removed from your band (I hear the collective gasp)…”Too Tight is Not Right”.
That’s it, I’ve run out of colours and this is getting a little long (I can hear the advice coming at me…”shut up already” “you’ve made your point” “quit beating that dead horse”…).
Yours in Health and Fitness…and please slow down…and wear your bike helmet…and don’t stick anything warm on a cold fence in winter time…