A Goal Without A Plan is Just a Wish

5668513 goal pictureOnce a month or so I make the trek to The Big City to accommodate our downtown area patients.  This means the country mouse actually has to put some thought into her attire and wear her ‘big girl shoes’…ugh.  As I was standing on the train platform this morning, sweltering in the heat in my long-sleeved sweater and pants, I thought to check the weather forecast…I mean its mid-September why is it so freaking hot ??!!  34 degrees today.  Unbelievable.  Yesterday it was 19.  As sweat trickled down my back and my bone straight hair actually started to frizz I realized I should have been a bit more prepared and perhaps checked the weather last night.

This thought set my mind to wandering as I waited for the train and I recalled how I blasted my son last Friday.  I was in the middle of creating a meringue masterpiece for a dinner party and I got a panicked call that he needed his football cleats IMMEDIATELY for his big game.  Now all you bakers out there know that 1. you can’t bake a meringue on a humid day, and 2. you can’t leave one 1/2 whipped!!!  “WHY WASN’T HE MORE PREPARED?!?!”  I screamed (no not silently the way the good mothers do, into the phone).   Then I remembered the trip I made to the school on Monday to deliver my other son a lock for his gym locker.  “You are going to have to think ahead and be more prepared if you want to succeed in high school let alone life!!!”  Yes a bit dramatic perhaps but honestly…what does he think I do all day??  Finally it’s my daughter who is going to university in the states.   We skyped the other night…“I have NOOOO money”!!  (school has been in session 10 days..what the h#@* is she doing over there…and “why aren’t you more prepared”??) Turns out she forgot to pick up her last cheque from her summer job…who does that?!  Were they all raised by wolves? (wait a minute…)  How are they ever going to be successful and succeed if they aren’t prepared???

So what I’m getting at is this:  to be successful we need to be prepared.  Yes we all have little slip ups that throw a monkey wrench into our days, but with the bigger things in life,  we really do need to think ahead.  We need to set goals and then think of a plan.  Write that plan down.  “A Goal Without a Plan is Just a Wish”.  A very cool friend sent that to me and I’ve put it in my phone as a reminder.  Not only that but anything worth having usually requires some effort on our part doesn’t it? 

A patient came in today, I will call her Nichelle (because that’s her name and she said I could talk about her :)).  Nichelle is incredible.  She had her surgery in September 2009 weighing in at 299.8 lbs.  She has always been a committed patient, coming  regularly for follow-up visits.  She desperately wanted this weight loss thing to work, yet despite our education and encouragement  for nearly 4 years Nichelle couldn’t break the 280 mark.   Until February 2013 when something in Nichelle seemed to ‘click’.  She said that all of a sudden she realized that she had to make some serious changes to her lifestyle if she wanted to get the weight off and get healthy…no one else could do this for her.  All of our education and support was great but she had to take responsibility for her life and her actions and BE PREPAREDSo she made a plan.  She set goals.  She prepared daily.  Today she said she never goes out of the house without thinking about what she is going to feed her body.  She feels one of  the key factors to succeeding in weight loss is preparation.

Let me ask you a question:  How many people out there, banded or not, can drive through a drive through at 5:30 pm, starving because you haven’t eaten in 5 hours, and order a yogurt with limp berries??  You’d need to have super powers!!!  Not so however if you were prepared and had enjoyed a healthy protein/fiber snack at that four-hour mark or had a dozen or so raw almonds and a cheese string handy.  Being prepared, having a healthy snack in your briefcase, at your desk, in the fridge, can prevent you from giving into those cravings and help to keep you on track.   PLAN your meals and snacks.  MAKE A SHOPPING LIST and shop when you are not hungry.  AVOID the junk aisle.  PREPARE for the week.

Today Nichelle  is down to 232 and just going down, down, down.  She is radiant.  Her skin is glowing and she walks with confidence.  She just got back from ziplining (200 feet up in the rainforest!!) in Costa Rica.  Went ATV’ing through the jungle!!  Would she have done that a year ago I asked her?  Not a chance!!  And although she veered off her regular routine and sampled and enjoyed the delicacies of the resort, she still came back having lost 5 lbs.  Why?  Because she has GOALS.  She has a PLAN.  And she is PREPARED.  Exercise has become a part of her daily routine.  Yes there are days when she doesn’t feel like climbing those stairs on her lunch hour but she plugs in her music and does it because the rewards are priceless…health, wellness, longevity, happiness…all the things that go hand in hand with loving yourself and feeling good.

Now, if you haven’t already done this I encourage you to go grab a pen and 3 pieces of paper.  On the first piece of paper write down : Top 3 Reasons I Had Lapband Surgery.  On the second write :  Top 3 Goals I Want to Achieve (and don’t write down a weight…write down REAL reasons…reasons that will change your life)  and on the third piece of paper start writing a plan.

If you want something badly enough you can get it…but you have to put some effort in.  YOU have to want it for yourself more than ANYONE else does.  Remember to plan ahead and be prepared.  A Goal Without a Plan is just a Wish.  You KNOW you can do this!!!

Yours in Health and Wellness,


Posted in education, motivation and support, obesity | Tagged , , , , , | 15 Comments

How do you spell “SUCCESS”?

imagesCA3GO55BDoes the name: Arvind Mahankali mean anything to anyone?  What about the word ‘knaidel‘?  Well if anyone has been reading the news lately (and by the way Kim Kardashian apparently had COSMETIC SURGERY while PREGNANT) they will know that Arvind Mahankali is the 13-year-old from New York who won the Scripps national spelling bee for correctly spelling the word ‘knaidel’…a small ball of leavened dough. 

Now…I’ve noticed an extremely interesting but very DISTURBING fact from working so closely with banded patients.  What I’ve noticed is that although  many lapband patients are incredibly talented in so many ways…they are terrible spellers.  A STRANGE phenomenon you have to admit!!  What is even more strange??  The one word that many seem to have particular difficulty with…“Success”.  Yup,  not a real difficult one if you ask me and I’m sure young Arvind could bang that one out in his sleep. 

Just this morning a woman came in with a long face apologizing, because she wasn’t really a ‘success story’.  So this woman has gone from 190 lbs to 137 lbs.  Good numbers right?  But even better…she is no longer classified as ‘diabetic’ and is no longer taking hypertensive meds.  Does that spell ‘success’ to you?  It does to me and I’m sure Arvind the spelling boy-wonder would agree.  This womans’ complaint was that it has taken three years, and she can’t get down to her initial goal of 120 lbs.  Forgive me and don’t judge me but… I WANTED TO SHAKE HER!!!!

The dictionary meaning of success is as follows: “The attainment of wealth, position, honours or the like”.  Now I’m not a rebel by nature and certainly not one to routinely question authority (despite what my mom might say), but I’m not really impressed with that description of the word.  It’s cold, impersonal, narrow and seems to apply mainly to the ‘Bay Street Boys’ or those who are busy climbing the corporate ladder. 

“Success” to me as a nurse and in particular a ‘lapband nurse’ is soooo much more than the description above.  I see success every single day in my job and it has absolutely nothing to do with ‘wealth, position, honours’.  Maybe it has more to do with the ‘or the like’ part tacked onto the end of that definition. 

Success is not measured by the scale alone!!!  In fact the scale is really a very small piece of equipment in all of this and sometimes I would honestly like to throw it out the window.  I know many people find it is a good way to stay on track, but more and more we (being health care specialists in the field bariatrics) are moving away from looking at the scale as ‘the’ measurement of success.

Here follows MY definition of “SUCCESS” (and pay attention there may be a quiz later):

Success is getting your blood pressure down to normal and not having a stroke or heart attack because of that.  Success is getting off your diabetic meds and avoiding all the horrible complications that can go along with that disease.  Success is avoiding that hip or knee replacement that the Dr. says is right around the corner.  Success is going for a bike ride on a summer day and getting down in the grass and playing with your grandkids.  Success is riding on the rollercoaster at Canada’s Wonderland.  Success is not vomiting afterwards (ok so that has nothing to do with the band).  Success is doing up your bra and crossing your legs, it’s fitting into theatre seats and riding on airplanes without the seatbelt extender.  Success is our patient who climbed the CN tower…(and the thing that got her to the top of the tower?  Her kids chearing her on? (no) Spirit of her dead grandma? (no) Hot fire-fighters on each floor? (bingo:)).

YOU lapband reader are success.  Success is not just the number on the scale.  It is all these ‘little’ things that you are achieving and changing in your life that are really not ‘little’ at all..the things that improve your quality of life everyday and mean so much more than being able to  say “Hey I’m XXX lbs”.   But YOU have to recognize this and accept this and celebrate these victories both big and small because these are the things that keep you going and make this journey so worthwhile.

This is getting a little long but I want to include below something that we have posted at our clinic and for which I take no credit (just in case the author is out there and thinking ‘wait a minute sister…’) which I think sums up this blog:

~The scale can ONLY give you a numerical reflection of your relationship with gravity…


It cannot measure success, beauty, talent, purpose, health, strength, passion or determination ~

Yours in health, wellness and good spelling (Arvind made a cool 30 grand on that little gem)


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Words of Advice…whether you want them or not :)

bigstock-The-words-Need-Some-Advice-in--26511743Advice….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…


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Parental Guidance….

DSC01151One of my favorite patients came in for a visit yesterday.  Yes I am admitting it…like every nurse, doctor, teacher, esthetician, hairdresser, mechanic, escort (I didn’t say that) we all have our ‘favorites’.  This woman is bright, interesting, engaging, caring, successful, introspective, thoughtful…everything we all would like to be described as.  She has been coming to see me every 6-8 weeks for around 6 years.  I always book extra time as we end up doing lots of talking and conclude the visit with good feelings (at least on my part) and I think having learned something from each other.

Yesterday, she came in apologizing.  She said she had nearly cancelled her appointment as she felt that she was letting me down.  I had no idea what she was talking about.  She expanded to say that she felt she was wasting my time as she really hasn’t, in the last little while, been making much progress with her weight loss journey.  I was literally gob-smacked.  She was letting ME down??  So I asked her…who exactly are you doing this for?As you can imagine, this lead to quite a discussion that veered off into a great many directions.

It got me thinking though (which is a good thing, because as you can see from my lack of blogs lately I have been in a bit of a hibernation mode)…I wonder how many patients out there are trying to achieve weight loss goals to make someone else happy.  To make a spouse love them more say, or a partner be more attracted to them.  To make their parents who paid for the band proud of them.  To make their boss or colleagues show more respect.

I think we are all motivated to do things for a wide variety of reasons.  Sometimes the reasons are altruistic, other times self-serving.  Sometimes it’s to gain love, respect or recognition.  I don’t think there is anything wrong with this, this keeps us learning, contributing, achieving…living.  When it comes to ones own health however, your primary motivation to succeed must be for yourselfYOU have to want this for yourself more than anyone else does.  Doing this, and by ‘this’ I mean improving your life by way of living a healthy lifestyle…eating well, moving more, losing weight…for someone else, from what I have witnessed results in limited, temporary success.  It doesn’t last. This has to be for you.  If you are feeling unmotivated…suffering from the mid-winter ‘blahs’ (and who isn’t) think of…no …write down… all the reasons why you want to make a lifestyle change.  Not ‘I want to get down to xxx lbs.’  but REAL, TANGIBLE things that you want to achieve.   Think of what is important to YOU and not anyone else.  Here are some of the goals my patients have shared with me:

“I am doing this because” :

  • I don’t want to remain/become diabetic
  • I want to lower my cholesterol and get off my medications
  • I don’t want to hurt anymore
  • I want to be able to ride in amusement park rides with my kids
  • I want to be able to fly in an airplane without having to ask for the seat belt extender
  • I want to be able to sit cross-legged on the grass with my children
  • I want to be able to go to the theatre and sit comfortably in the seats
  • I want to be able to do up my bra
  • I want to fit into those clothes at the back of my closet
  • I want to hold my grandchildren on my lap

THESE are reasons to work everyday at getting healthy (and it is work).  These are reasons to STICK WITH IT  and not give up!!  Who gives a @#!! about everyone else???? You are doing this for YOU.

We only go around this life once and as I get older I realize that this ride goes really, really quickly.  I can’t write this blog tonight without mentioning my father.  My Dad was a really wonderful fellow who passed away quite recently (another reason for my hibernation).  He is on my mind 24/7.  I think just as you can’t really know what it is like to BE a parent until you become one…you can’t really understand what it is like to lose a parent until you have lost one.  Even though the time may be ‘right’ for them, if you were blessed with wonderful parents it will never be ‘right’ for you.  My Dad was a man who lived life to the fullest and encouraged his three daughters to do the same.  He didn’t sit back and wait for life to happen to him.  While being a great Dad (most of the time…I blame him completely for my spider phobia) he lived his life both for his family but also for himself.  And he didn’t wait for life to happen TO him.  One of his pearls of wisdom?… “sh*t or get off the pot” :).  That’s an oldie but a goldie isn’t it?…

IF YOU WANT SOMETHING MAKE IT HAPPEN.   I firmly believe we can do anything we put our minds to if we are doing it for the right reasons.  And I can’t think of a better reason than good health, because we have nothing if we don’t have this.

Yours in health and fitness,


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Christmas Gifts, Bucket Lists and John Lennon

images john lennonI’ve been banished up to the office by my kids.  I can’t believe it.  Here I have spent the last 6 weeks….no make that probably 8, shopping, planning, cooking, baking, organizing and orchestrating what I think was a stellar holiday…only to have the little effers banish me… and very harshly I might add.  And for what you ask?  Because I can’t get John Lennon’s “And So This is Christmas” song out of my head.  I sing it incessantly, in my head and out loud, in the car, and at the check-out at Loblaws (hopefully not too loud there). It is driving me insane…and I guess everyone else too.  Part of the problem, besides having very little musical talent, is that I don’t know the words.  I fill in with a whole lot of ‘la la’s’.  So I went on-line and looked up the lyrics and boy…what a moving song it is and what a great lyricist John Lennon was.

I think this particular time of year…when the rush of Christmas is over and the needles are starting to fall off the tree…can be a little depressing if you let it.  Most of us have probably come down with varying degrees of the ‘Christmas Flu’  that brings with it that overall feeling of lethargy and tiredness which is directly related to the over consumption of decadent foods, extra alcohol and incredible amounts of Toblerone chocolate.  (If I were a conspiracy theorist I would believe that the Swiss impregnate those bars with some sort of addictive drug akin to heroin.  Or maybe they put a micro chip in there that when swallowed makes you crave more…hmmm….maybe its not so crazy a thought…I could see the Swiss doing that…).

Well its time to get off our butts and kick the Christmas Flu to the curb.

I hear so many incredible stories from my patients.  I have met the most remarkable people from all walks of life thanks to my job and I am so very thankful for that.  One of the things that will often be brought up in our conversations is that notion of the ‘Bucket List‘, made famous by Morgan Freeman and Jack Nicholson.

Personally I think Bucket Lists are great motivating tools.  Something that bothers me however is that more often than not when I ask patients what they have on their Bucket List “to lose weight” or “to get down to xxx lbs” is in the top 3 .   Success is not just measured by the number on the scale.  How about adding to the top of your Bucket List something along the lines of “to be healthier”, “to be able to go sledding with my kids”, “to feel strong enough to help at the food bank”…all of these things will in the end result in a healthier body and a happier you.

Now look back at this past year and ask yourself ‘what have I done’?  Have I been actively working towards attaining these goals or have I allowed myself to just coast along day-to-day?  If you are coasting and not reaching your goals ask yourself why and do something about it. Write down the reasons.  Analyze what you need to do to get things working again.  No one but you is going to do this for you.  You have this great tool that can HELP you, but you know that YOU are the one who has to make it happen.  If you feel your band is not functioning properly contact your clinic.  You should NEVER be afraid or ashamed to contact your clinic. If you are not feeling well physically or mentally/emotionally seek some help.  Start this new year off right.  Be good to yourself.

Honestly as Canadians we have to agree that we have SO much to be thankful for.  The older I get the more proud I am to be able to call myself Canadian.  We have a health care system that is accessible by all regardless of socioeconomic status.  We have a financial system that is the envy of all countries.  We have gun control…we can send our kids to school knowing that they will come home to us at the end of the day.  WE ARE SO FREAKING FORTUNATE.

I look under that shedding tree and I see so much STUFF.  It’s not as much stuff as some households but its a whole lot more than others.  It’s all relative.  And I think…(and sing, oiy here I go again) “and so this is Christmas.  And what have you done?  Another year over, a new one just begun”.  I can’t help but sing those words and feel very small.  John Lennon sang for world peace, for love among all the races and he asks us, another year is over…what have we done?  Personally my bucket list always includes trying to live a healthy lifestyle.  Without our health we have nothing.  And I’m sure as heck no saint but like all of you I do try to lead a good life.  But I promise you I’m going to try harder (if I put it in writing I have to do it!).  I think its important to have Bucket Lists but I think it’s equally important to think outside of ourselves as well.

And so I wish to all of you….

A very Merry Christmas and a Happy New Year,

Lets hope its a good one

Without any fear.  ~John Lennon

Yours in Health and Wellness,

Sue (Happy 2013)

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Flip Flops vs Stilettos…The Importance of Informed Decisions

Here is a news flash that is going to astound you, shock you, turn your world upside down…are you ready?…The gastric band may NOT be for everyone.  I can literally hear that pin drop.  I know…you are stunned aren’t you?  Here comes another shocker and you’d better sit down for this one:  living with the band can take some effort.

So what am I getting at?

I recently had the opportunity to attend an excellent weight management conference.  The topics were fresh and noteworthy and the information applicable to our daily practise.  There were people from all over the province from all disciplines: doctors, nurses, dieticians.  Some were very familiar with the gastric band and some not at all.  The speakers were for the most part terrific, the location beautiful and the lunch deeeelish! :).  Only one thing however really irked me about this day.  One of the speakers chose to use his hour as a platform to promote his favorite surgical weight loss method while misrepresenting other methods, the gastric band in particular.

Now I am all for freedom of speech but I generally get really annoyed when someone, particularly someone who is perhaps by some considered to be an ‘expert witness’, takes advantage of a situation to not only self-promote, but to shamelessly bash something that they are clearly for whatever reason either biased against, or are not properly educated on (and I believe that this fellow fit  quite nicely into both of these categories).

Anyone who is fully immersed in the field of bariatrics, who is ‘up on’ current literature and who is open-minded, has to realize that: there is no “one size fits all” when it comes to choosing a surgery to treat this chronic disease.  Just as some of us choose flip-flops over stilettos (sorry honey), some people will choose one weight loss surgery over another.  The important thing, in my mind, is to be properly educated on all your choices.

To be very honest, when I first started in this field I was completely biased against gastric bypass.  My sister briefly considered it and I dissuaded her 100% (which I don’t regret, nor does she..it was not for her).  The idea of her taking such a risk, of permanently altering her body, of adopting a lifestyle where she would be so limited in what she could eat, and so dependant on life long supplementation was abhorrent to me.  Today however I believe that for some people this is a reasonable weight management choice and the ‘right’ choice.

Pro’s and (possibly one) Con

Obviously I am biased towards the gastric band (so maybe I am no better than that ‘expert witness’…say it isn’t so!!!).  I couldn’t be working with banded patients daily, and writing this blog if I didn’t believe in it 100%.  Yes, weight loss is generally slower with this type of surgery (that would by some considered to be the one ‘con’).  However the ‘pros’ in my opinion FAR out weigh the ‘cons’.  The surgery is minimally invasive.  The risks as well are minimal.  You are not dependant on a large number of supplements in order to meet your nutritional needs.  Post operatively, when your band is well-adjusted and you have learned how to properly eat with the band (here comes the broken record:  “small bites, chew well, eat slowly”) you can lead a happy and healthy lifestyle, enjoying a wide variety of foods, enjoying the pleasure that dining with  friends and family brings, without having to worry about being nutritionally deficient.  Yes on the occasion when you may not be paying attention, you take too big of a bite, or perhaps don’t chew enough you may ‘yak’ (that would be a term I’ve taken from my 13 year old..love it).  However, people who are successfully living with the band know that once you have ‘mastered’  Dr. O’Briens 8 Golden Rules, (and I encourage everyone with the band to review these occasionally..or read my blog ‘Demystifying the 8 Golden Rules’…and I’m NOT self-promoting here…really!!  I am not like ‘him’!!…I’m just trying to help, honest!!) the pay off is enormous.

Just an Aside…

When I refer to the one possible ‘con’ of the band, that being that weight-loss may be slower with the band than with other forms of bariatric surgery, I personally don’t see this as a true ‘con’.  To be honest, my job would be SO MUCH EASIER if the weight came off more quickly.  Patients wouldn’t get frustrated…they wouldn’t take their frustration out on poor lil’ ol’ me…and I would go home every day in a good mood!

The Tortoise and the Hare

I truly believe that the idea of the tortoise and the hare applies to the band 100%…slow and steady wins the race.  Too rapid a weight loss can have many negative side effects.  It can deprive the body of the essential nutrients it needs to be healthy and function properly.  It can result in such things as gallstones, dehydration, electrolyte imbalances, hair and muscle loss, fatigue to name a few.  One area that I think needs to be examined much more thoroughly are the psychological issues that can develop from too rapid of a loss.  (I had one patient who lost over 100 pounds with gastric bypass.  She went down to a ‘normal size’.  Yet every day when she passed a mirror she didn’t know who this person was.  She proceeded to regain all of her weight and is now losing sensibly as a banded person).

It’s a Personal Choice

In the end it comes down to personal choice and that choice has to be based on education.  What is SO important is that you are fully aware of what you are embarking upon and happy, committed and prepared to live with this decision.  You need to continue to see your choice as a method of fighting your disease and not as a weakness because of some perceived personal failing.  Obesity is a chronic disease that can be managed successfully, perhaps with a little help from a  ‘friend’.  And it is so important for individuals who are fighting this disease, and for society to recognize and support this.

Yours in Health (and non-biased freedom of speech :))


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As Steve Martin would say “EXCUUUUUUUSE ME”!!!… but what just happened??  Where did it go? Tell me did we not just put away the backpacks and crusty lunch bags and pull out the sunscreen and flip flops? (my daughter shudders every time I slip up say “where are my thongs”?).  Could someone pleeeeeease just whip out their magic wand and make that glorious summer come back???

There is no avoiding it, the cooler months are soon to be upon us.  I saw a t-shirt once that said we should combine the months of February and March and call it “Farch” and I agree with this idea 100%.  There are only two things I begrudge my parents for and they are:  #1. not buying that Tim Hortons franchise in Oakville back in the ’70’s (“Donuts Garth?? who’s going to buy donuts??” seriously…they actually had that conversation 😦 ), and #2. not raising me in southern California where I was meant to be raised.

So here it is, September and already those languid, humid days are behind us, the nights are longer, and the leaves are starting their beautiful kaleidoscope of change. Its funny (well not really but that’s always how we start these sentences), in the spring most of us either verbally or mentally say “The good weather is finally here! I’m going to get out more, get more active and eat healthier!”  It’s a time of renewal and good intentions.  Patients will opt not to come in until September because the weather is great, there are (a myriad) of better things to do and wonderful vacations to be had.

All of a sudden we turn our heads for a millisecond and BAM!…its fall.  The clinic becomes a hive of activity.  Appointments never get missed and our waiting list grows.  It’s a bit like January 1st.  Most often the chorus sounds something like “weeellll..it was summer.  There was better food, more entertaining and it was too hot to exercise”.  That’s okay though.  A couple of months hiatus is fine.  Maybe the weight stayed the same or maybe a couple of pounds went on.  No biggie. 


So now its getting cooler and soon it’s going to be really cool, in fact its going to be stinking COLD (California Dreamin’).  Who wants to exercise when its that cold??  And Thanksgiving and Christmas are just around the corner with all the yummy foods, temptations and excuses for indulgence. Then of course its the chocoholics dream day Valentines.  Follow that with Easter and throw in a few weddings and birthdays along the way.  Suddenly…its spring!!!!  Yay!  “The good weather is finally here! I’m going to get out more, get more active and eat healthier!”   Hmmmm…and a full year has gone by and not much may have changed. 

What I’m getting at is, there are ALWAYS going to be reasons not to exercise (its too hot, it’s too cold, I’m too busy, I’m too tired).  There are ALWAYS going to be special occasions and opportunities to indulge (it’s this thing called ‘life’).  We can’t use these things as obstacles that are keeping us from living a healthier, happier and more satisfying LIFE. 

 Goals and Setting the Bar…

I believe having goals in life is paramount in achieving any type of success.  It worries me however when people come into the clinic post surgery and present a goal that is measured in pounds or dress sizes or months.  If you look at this journey in that manner you may be unwittingly setting yourself up for disappointment and frustration.  Because life DOES happen.  Holidays and parties and ‘slip-ups’ DO occur, and weight loss may very well come to a stall at these times.  It is so very important to look at living with this band as a making a lifestyle change.  You have this wonderful band and yes it can help you lose that weight by controlling your hunger.  In fact it can do that very, very well when used properly.  But as I have said before it won’t MAKE your life change.  It won’t MAKE your life better.  Its made of soft silicone.  It’s a device without a brain, a conscience or motivation (sounds like my son on certain days…I won’t say which one in case by some miracle they read this).  YOU however have all of these things right?!  Sometimes they all work beautifully together and sometimes…not so much right?  That’s ok.

Setting small, attainable, realistic goals is important.  Remember: don’t set that bar so high that you can’t possibly get over it.  That is just begging for disappointment and defeat and who out there wants that?  Try some reverse psychology.  Dr. Michelle May (of “Eat What You Love and Love What You Eat”) suggests setting that bar so LOW that we can’t possibly NOT get over it.

Achieving a goal and knocking it off your “bucket list” (so it doesn’t become a “@#*! list”) is INCREDIBLY motivating!!  And that just fuels the fire and makes us want to keep going.  And it is all about keeping going.  Set those small attainable goals and work towards them every day.  Make healthier choices that are going to help you get over that bar.  Eat better.  Eat properly. Move more.  And having said that…Dont forget to ENJOY LIFE ALONG THE WAY. If  it doesn’t totally derail you (and at some points it may) don’t say ‘no’ to the parties and celebrations and dinners out because you have a band or because you have a goal in mind.  These are some of the many things that make life enjoyable.  Conversely don’t use those events as excuses to consistently over-indulge or as reasons not to live a healthy lifestyle.  Life with the band is not a race.  It doesn’t end and things don’t go back to ‘normal’ when you reach your ‘goal’ whatever that may be.  Life with the band is about lifestyle change.  THIS is the ‘new normal’. 

We only go around once, and the older I get the more I realize that life is like (no Forrest not ‘a box of chocolits’…OMG thats so ‘yesterday’ :)) ‘Leviathon’ at Canada’s Wonderland….its scary, its thrilling, its exhilarating and its over waaaaay too quickly (I experienced Leviathon for the first time this summer…my next business venture will be selling ‘Depends’ at the entrance to that ride).  Don’t put life off until ‘tomorrow’.  Make your goals realistic.  Work towards them everyday by leading a healthy lifestyle.  Most importantly… Don’t give up if you slip up because we ALL do.

Yours in Health, Fitness and an AWESOME ride,


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The Importance of Education (what a dull title..but the blog isn’t)

As I sit here writing this I am preparing myself for a major life change (no, thankfully not hot flashes…yet).  My eldest and only daughter is heading off to University.  This can’t POSSIBLY be happening because I just headed off didn’t I???  I remember getting closer and closer to the University of Western Ontario and seeing the painted banner on the overpass along Hwy 401 “Fathers say Goodbye to your Daughters”, hearing his quiet sigh…and myself doing a mental fist pump.  I couldn’t WAIT to get away.  Not that I didn’t love my parents or home life, it was just the excitement of this new life awaiting me!  I had such great expectations and high hopes.  I would meet new and interesting people!  I would have wonderful adventures!  Oh yeah….and I’d get a useful education along the way (these are placed in what my order of importance was at the age of 18).

All of these things were achieved and more.  Education is one of the cornerstones of life (love is another one.  My kids will barf if they read this…it’s a bit schmaltzy I must admit but it is true).  Without education, be it formal or not, we can’t possibly function to our full potential.  We have to grasp this education wherever we can.  Everyday we are presented with new opportunities to learn and better our lives but we get so busy that we may tend to not recognize them or we just plain ignore them.

This is so very true of life with the band as well.  The better educated you are on how a piece of equipment works, the more success you will have in using that piece of equipment (this is why I heeded my wise mothers advice and never learned how to use the BBQ…”its just one more thing you will be responsible for dear”).  If you start out with bad habits, these bad habits tend to get ingrained and they become more and more difficult to change.  For anyone who has ever had the sheer pleasure of watching me swing a golf club you will know that I know what I am talking about.  This is why educating yourself on how this wonderful piece of hardware you now own operates, and how YOU need to operate WITH it, is not just an asset, but an ABSOLUTE necessity.

Those of you who have been living with the band for a while likely realize that it takes some getting used to.  You need to cut your food into small pieces.  You need to avoid certain foods.  You must chew well.  You need to take your time (a minute) between bites.  You must focus on eating mindfully looking for ‘absence of hunger’ or ‘satiety’ vs ‘full’.  You must force yourself to walk away from the table before you may mentally feel ready.  Yes you need to kick up the exercise.  You need to have your head in the game.  You must be committed.  YOU need to want this for YOURSELF more than ANYONE ELSE wants this for you.

The more you understand the reasons behind these behaviours the more sense it will make (so read my blogs…thats what all this is for :)).  Anything worthwhile is worth working for and know that feeling better, being healthier, living longer and stronger and enjoying life is worth the effort.

Education, education, education, in all way shapes and forms is so important to having a fulfilling life.  Take advantage of whatever opportunities you can to learn about living properly with your band.  Make sure the information you read comes from a reliable source.  DON’T believe everything you read on the internet.   Ask questions and demand answers of your clinic (but be nice…we are human) and utilize the resources and information your clinic offers.  The better educated you are on the use of this tool the more success you will have with this tool.

And yes as we drive away without my dear Maggie I will be crying a river of tears…she will be SO far away (Kansas!…it will take more than a click of my ruby slippers to get to my baby).  She will be the only Canadian on her rowing team.  She will be all alone with a bunch of strangers in a ‘foreign’ country…..and yeah I know…I may have been born at night but it wasn’t last night… she will be doing her own mental fist pump as we pull away in the van, as she stands on the cusp of the next stage of her life!

Yours in Health and Fitness,


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Lapband Letdown?

Do you remember the ad from several years ago, I think it was for some kind of luncheon meat, where various members of a family would eagerly stick their hand into their lunch bag, pull out a less-than-satisfactory sandwich and moan “LUNCHBAG LETDOWN!!”  (and then throw an accusing glare at the mother…doesn’t go over well in my house)?

Sometimes I feel patients can experience a bit of this.  Its like waiting and anticipating and imagining a very special event, only to be mildly, or even largely disappointed.  (But wait a sec, don’t misinterpret this… ‘Appliances-for-Christmas’ warrants a good deal of self-pity and the cold shoulder treatment).

Lapband Letdown:

On occasion I have had patients who have reached a milestone, losing a large amount of weight, and instead of the hand slapping high-five elation, I may get a half-hearted shrug of the shoulders.   They seem to have a case of the Lapband Letdown.   They aren’t feeling quite how they thought they would feel.

Now this doesn’t happen all the often.  The best part of my job is celebrating the weight-loss victories.   And these victories often aren’t even related to appearance.  There is no better feeling than sharing in the elation of a patient who is no longer deemed diabetic, or  who has been taken off their blood pressure meds.  Of one who can get on that airplane and not have to ask for a seatbelt extender, or of someone who is finally pregnant…now THAT is a good day!

But sometimes I do get patients who are not feeling the way they anticipated they would feel.  Yes they feel better physically but emotionally or psychologically they are not in that  ‘hip-hip-hooray’! frame of mind.

Realistic Expectations:

What we know is that pre-band expectations need to be realistic in order to not only have weight loss success but to have the emotional success that should go with the weight loss.  Losing weight gives a person so many things:  better health, better mobility, more energy, and better quality of life to name a few.  What it won’t do however is change certain pre-band situations.   It probably won’t change the way a rotten employer treats a person.  It won’t necessarily ‘get’ someone the job they always wanted.  And it likely won’t fix a relationship that was not good to begin with.  The band is a very effective tool that when adjusted well and used properly controls the hunger a person would normally feel from eating less food.  Period.  As we always say (I know ‘over and over’), it is not a magic wand, it is a tool.  But what a wonderful tool it can be.

As a lapband nurse I want to ‘fix’ these issues.  I want these patients to be able to look at where they started and to see and celebrate where their hard work has taken them…to congratulate themselves and revel in the knowledge that they fought hard, are fighting hard and are WINNING the battle!  But I can’t do that.  That has to come from within.  Sometimes it is just a matter of time and people come around and recognize and take great pride and pleasure from what they have worked so hard to achieve.  Sometimes it takes professional help to examine what is missing, to figure out what is behind these feelings.

The Three Legged Stool:

I have always said that to have success in any weight loss endeavour you must have a well-balanced three-legged stool.  The first leg is eating the right foods in the right amount.  The second leg is incorporating daily exercise.  And the third, and often hardest leg to ‘balance’ is having ones head ‘in the game’.  If one of these legs is off, the stool will be wobbly and unbalanced and the success will be limited and short-lived.

So remember keep your stool balanced (this is starting to sound like a blog for seniors) and recognize if it is becoming unbalanced.  Live each day of this new life you are creating in this new body fully and joyfully and celebrate every single victory no matter how small it may seem!  (and for anyone who may have the luxury of someone else making their lunch… eat that ketchup and baloney sandwich with a smile on your face…).

Yours in Health and Fitness,


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Band-Aid…Is it my Band or is it Something Else?

So…you’re out on your bike enjoying a lovely ride.  The sun is shining and you are (of course covered in SPF 30 or above…thats the nurse/mother in me talking) sailing along, enjoying the scenery, feeling GREAT and looking damn good in your bike helmet when all of a sudden you start to feel a discomfort in your lower abdomen.  Hmmm…not sharp but dull and kinda nagging, moving around, up and down, left and right.  In fact it is pretty much all over the lower abdomen now and starting to spread up a bit TOWARDS THE BAND OR WHERE YOU THINK THE BAND IS and is increasing in intensity.  Now its cramping.  Abdo is a bit tight.  You ask yourself:  “Have I ever experienced this before”?  Not sure.  “Did I ever have this pre-band”?  Don’t think so.  “Could this be related to my band”?  Absolutely.  “Should I call the clinic”?  YES, ASAP, IT MUST BE A SLIP, WHERE IS MY GD PHONE??!!  Suddenly…you let one rip and the pain disappears…whew.  THIS time, thank heavens it was only the broccoli.

In general physics there are two ends of the colour spectrum and 7 colours are distinguished when white light is dispersed by a prism.  Red is at one end of the spectrum with the longest wavelength, and violet at the opposite end of the spectrum with the shortest wavelength (and that is the extent of my grade 11 physics knowledge..but admit it, you were momentarily impressed).

There tends to be two opposite ends of the band spectrum as well.  The “Red” patients relate every ache, pain, malady, wart, cramp, nosebleed, to their band (and often their family MD’s do as well).  The “Violet” patients on the other hand may be tolerating only liquids, have persistent heartburn, night-time reflux of food and/or fluids, are seeing specialist after specialist, being scoped up and scoped down to determine the source of their discomfort and have never once contacted their clinic.  These patients are at opposite ends of the band spectrum.  I have seen MANY of both at our clinic (and of course this applies to people in general NOT just banded patients).  Thankfully most people fall somewhere in between red and violet.

I’m really not trying to be impertinent here, just a bit lighthearted…and perhaps a bit cheeky.  To have something ‘foreign’ in your body can be a frightening experience, particularly in the beginning when you are not at all sure what to expect.  It is not unusual to question yourself and your symptoms and to relate them to this new piece of hardware.  (But just for the record: anything happening in the groin region or below is usually not band related…don’t be embarrassed to ask but don’t be offended if you get a slight giggle…we are only human).

In an attempt to ease some fears and provide a bit of insight, but IN NO WAY TO TAKE THE PLACE OF YOUR CLINIC OR SURGEON(I hope I made that clear) I am providing below:

“Symptoms which could Suggest that Something MAY be “up” with your Band and should have you contacting your clinic” :

  • new or persistent heartburn
  • difficulty with most solids (not just the ‘trigger foods’ such as dry meats, soft bread, rice, pasta, stringy foods, steak, pork for example)
  • difficulty with liquids
  • persistent nausea even without having eaten
  • persistent vomiting not related to ‘trigger foods’ mentioned above
  • the ability to eat ‘everything’ and never feeling the presence of the band, sometimes combined with weight gain
  • reflux of food/fluid up your throat at night (and not just when you ate/drank late and went right to bed)
  • night-time cough
  • pain/discomfort with eating
  • persistent abdominal pain/discomfort
  • redness, warmth, around port site, fever/chills

Your clinic should be THERE for you and you should never feel embarrassed to contact them should you feel that you may be experiencing a problem that is band related.   Your clinic should be your best source of information and support (not the internet).  Resist the temptation to believe everything you read on-line…the internet can be a wonderful resource and it can also be the cause of a great deal of anxiety and sleepless nights.  Your clinic should know best.  If you suspect something is seriously wrong with your band please contact your clinic/surgeon.  And rest assured that 9 times out of 10 there is nothing wrong with your band, but always better safe than sorry.

Yours in Health and Fitness,


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