Patient Stories

My Lap Banding Experience - The First Two Months

Jane Bryant | PDF Version

“Get off me, you fat lump”, the scales screamed as I weighed myself again this morning. Here I was struggling with my weight for the 24th year straight. I am 47 and the thought of turning 50 as grossly obese is just frightening. I had a back injury when I was younger and now my back is so painful that every time I bend down, the thought of having to straighten up again is frightening. The heavier I get, the more painful it becomes. My husband says “Bend your knees, not your back”. You should hear what my knees yell, it would make the scales blush!!!

Whenever I discuss weight with friends I usually joke and say that I am still recovering from my last pregnancy. It’s true! The trouble is that my youngest daughter is now 23 years old and has children of her own. Whenever I think of milestones in my life, I always have a weight associated with them. For example, when I was a teenager in the 1970’s my weight was a constant 57kg. When I married in 1978, it changed to 59-60kg. My first daughter was born after I had gained 21kg throughout my pregnancy. I lost about 12kg before I was pregnant ten months later with my second daughter. I put on another 7kg during that pregnancy and lost 6kg the day I gave birth. And so the weight loss and gain roundabout began…

I hate going into a clothes shop and trying on a size 18, knowing that if that doesn’t fit, there isn’t a bigger option unless I start buying from a “big girl’s” shop. I found a few that carry items up to a size 20, which makes it less confronting when you haven’t bought the biggest outfit available. Sizing is so different depending on the shop you go to. A size 18 in one place is nice and wide across the shoulders and hips, while the same size in another shop won’t even stretch over my backside.

I have known people over the years who have had surgery to assist them to lose weight and look fantastic. On the television lately there have been programs about groups of grossly overweight people, so big that they have to have walls of their house knocked down to get them out and how they have managed to lose weight with surgical intervention and lots of medical support. I know I’m not that big, but it’s pretty squeezy sitting in an aeroplane seat these days Worst of all, is the lack of energy and the constant pain in my back. I joined a gym and have been going most weeks but my motivation has always been a problem. “Its easy”, said my dad, after he had been in pain with a gall bladder problem for a few months. “Just don’t eat fatty foods”. His motivation was that every time he ate anything with fat in it he ended up in excruciating pain. However, after the gall bladder was removed, he gained weight. Ongoing health issues soon put his eating back on the straight and narrow.

My mother has been watching her weight almost as long as I can remember. I have photos of her when she was younger where she has a beautiful trim athletic figure. She played tennis in her thirties and was always fit and healthy. When she moved to the country in her forties, her lifestyle changed and her weight started to increase. I suppose the same has happened to me but a bit earlier in life. It’s surprising how a slow weight gain of half a kilo a month soon adds up over the years. If you look at it in those terms, you only need to put on half a kilo a month over three years and you have added eighteen kilos to your body. When you change a dress size between each year, you don’t seem to notice it as much. All the warm weather clothes that haven’t been worn for six months may have been getting a bit snug at the end of the season but the following year you can fool yourself that you need a new summer wardrobe. You convince yourself that going from a size twelve to a size fourteen will only be temporary anyway! It’s also really easy to say that year after year until all of a sudden there are no clothes in “normal” shops that fit you any more. It’s only then that you start to realise that not only have you lost your trim figure, you have also lost a lot of your energy and along the way, some of your self esteem.

After a particularly bad few months with my back and watching more medical programs about morbidly obese people, I decided that a trip to the doctor’s was the next step. After all, what could they possibly say, “No Jane, you are far too thin to even consider losing weight?” In my dreams…

So there I was, in my doctor’s rooms, tentatively posing the question about surgical intervention for weight loss. I was pleasantly surprised that my doctor had, in fact, seen a few patients that had undergone surgery with really positive results. He even said that he had heard of patients undergoing surgery to lose weight in preparation for a knee operation. In some cases, the operation became unnecessary because the knee problem was resolved once the excess weight was gone. I left the consultation with a prescription for anti-inflammatory medication for my back and a referral to a surgeon to see about gastric banding.

I got home, made an appointment for the following week to see Dr Sabine and logged on to the internet to find out as much as I could about the procedure. It seems as though it is a fairly radical solution to my problem. The day of my consultation arrived and I left work early and fronted up to the clinic. I was one of two people in the waiting room which was shared by a plastic surgeon and the obesity clinic. Dr Sabine called my into his office and we sat down and discussed the procedure. He told me about the risks and showed me a model of a stomach and the gastric band. He demonstrated how it was placed around the top of the stomach and inflated to make the opening to the stomach smaller. I was really nervous and quite pleased when Dr Sabine gave me a folder full of literature and asked me to go away, have a good read and if I wanted to go ahead with the procedure, to make another appointment. There was no pressure to go through with the procedure, but a great deal of optimism on his part about how successful it could potentially be for me.

I weighed 92.5 kilos with a BMI of 33.7. This was below the recommended criteria for the procedure under normal circumstances but fitted in with the guidelines if weight loss was to be achieved for other medical reasons, for example joint problems aggravated by excessive weight. Before I left the clinic I made another appointment for the following week, having almost decided to go ahead with the procedure regardless. I figured I could always cancel the appointment if I changed my mind.

Over the next three days I read and reread the literature I had been given. I fluctuated between “good grief, how can I survive with all these restrictions”, to “well if I don’t make some modifications to my life now, I could end up being overweight, overtired and unfit for the rest of my life!”. After some soul searching, I decided to go ahead with my appointment with Dr Sabine.
“Well”, he said, “What did you decide?”
“Let’s go for it”, I replied. He asked me if I had any questions and went through the risks again before I got on the scales to reveal a weight gain of nearly half a kilo. The next step was to see “The Boss”, Dr Paul Anderson. I made an appointment for the following week and went home and read the information yet again. Occasionally I had moments of weakness and wondered if I was doing the right thing, but the fleeting moment of panic was replaced with steely determination once I thought about the positive change in lifestyle that this operation would give me.

Once again I find myself sitting in the clinic waiting to be seen. Fridays when Dr Anderson consults are totally different than the other two days I was here. Accustomed to waiting by myself with only one or two patients waiting, it was a bit of a shock to see the waiting room full. There were about eight people in the room, some of whom were obviously patients and others who had come to support them.
My husband Jeff and I had planned to be away camping for the next five weeks but we had postponed the trip by a week so I could make this appointment and even cut the holiday short by a week so I could get my surgery done before I had to go back to work. Jeff came with me to this appointment which was great support for me.

Finally after a long wait, we followed Dr Anderson into his office. He asked me what I knew about the surgery, went through the risks again. He talked about changing shopping and eating habits and when I told him that my husband did the grocery shopping, (born to shop, my husband!) he started talking directly to him. He told him he is as much a part of the solution as me. He advised him not to buy snacks, chocolate and other unhealthy tempting foods and that if he wants to eat them, he has to lock them away and leave the room when he wants to eat them. Luckily I have a bit of a savoury tooth and my husband has a sweet one so that has never been too much of a problem. He also told him to choose low fat alternatives where possible.
He told me something that I hadn’t realised before which was that I would struggle to eat red meat, unless it was minced. Mental note to follow that up with the dietician after my operation.

I left the clinic with two boxes of Optifast shake mixes and instructions on what to do for my hospital admittance. There were more forms to fill in and instructions on making the one off payment which was then $1,800, no later than a week prior to the surgery date. With my private hospital cover of $400, it will cost me about $2,200. When you equate that to the thirty kilos I need to lose, it works out to nearly $74 a kilo. About the same as lobster in high season! According to the literature I was given, if you have no private health cover you could expect to pay about $15,000. Still what price do you put on avoiding Type 2 diabetes, and joint replacements? However, even $1,800 will be out of a lot of people’s reach.

The next day we set off on our holiday with great expectations of lots of exercise and minimal food. We didn’t do too badly as we made sure that we bought only food we expected to eat for meals and didn’t buy many snacks. I drank less alcohol while we were away, although I always find that if my back is sore, alcohol seems to relax me and deaden the pain a bit. This is probably mind over matter given that I would only normally have one, maybe two glasses of wine or a nip of spirits with a diet coke or diet dry ginger. I think pain killers probably do just as good a job.

A week into our holiday and I started using the shakes. Skim milk or water the instructions said and if you need some variety you can have chicken, fish, salad, vegetables (no pumpkin or potato), low fat soup and a piece of fruit. Calorie free drinks are also fine.

I settled into a routine of a vanilla shake with banana for breakfast, a chocolate shake for lunch but I couldn’t cope with mixing them with water, and used the skim milk option instead. Dinner was alternating between a chocolate shake and a vanilla shake each night. I was pretty good and stuck to the recommended additions quite well. However, I still find it really difficult to give up my skim milk decaf latte when we are out. This isn’t really a problem when we are home, but it is a bit of a ritual when we travel. When we are driving, we have a break, sit down, have a coffee and watch the people walk past. People tell you a lot about a town when you have time to sit and watch them!

We ate out twice while I was on the shakes. Once I had a chicken salad and the other time I had chicken and vegetables. I had soup in the afternoon and fish or chicken and vegetables or salad on the nights that we ate in the camper. I had the shakes for ten days while we were away which wasn’t too hard to stick to, although it was a pretty boring selection. Hmmm, will I have chocolate or vanilla? What ever happened to strawberry? I still had the odd glass of wine and a couple of evenings skipped the shake altogether as I didn’t feel like it after the chicken/fish and vegetables/salad. I feel really guilty that I haven’t stuck to the Optifast diet religiously but I have given it a real good go. When we get home it should be a bit easier as I can prepare food in advance and will have a bit more selection given that I have room to store vegetables and have lots of herbs and spices that I can use to flavour up the food a bit. Camping is great but the lack of room to store food and no freezer, does make it a bit more difficult.

I feel like I have lost a bit of weight, probably not much but I feel a lot less bloated than I did when I left home. Exercise was pretty hard as my back has been so painful. A constant ached coupled with sciatica and muscle spasms have plagued me for months. Trying to walk up steps has been really painful and going through the Jenolan caves just about had me in tears by the end of the tour. I certainly hope this operation improves my mobility. I figure it won’t make it worse and any improvement whatsoever will be a bonus. I also suffer from rheumatism which has gone into remission so I haven’t been plagued with that painful condition for a few months now.

Well the holiday is over, we are home and yes, it is easier to stick to the Optifast diet. Only six days to surgery. However, a 40th birthday party for a friend and a grandson’s first birthday on the weekend were a bit of a disaster. If I had any doubts that self control could stop me from putting back any weight that I had lost, they were well and truly reinforced at this point that self control was not enough. Even with impending surgery, instructions to stick to the Optifast diet from the surgeon and all good intentions, I still couldn’t manage to avoid unsuitable food. I didn’t go absolutely overboard but I really felt as if I had let myself down badly. I managed to redeem myself from the weekend by being really strict for the next few days and finally set off for the hospital on Wednesday morning 16th May. A quick check on my scales before I left showed that I now weighed 90.5kg.

After the initial preoperative checks, questions and forms, I was prepared for theatre and was pleased to learn I was first on the list. There was really no time to be nervous. The anaesthetist told me that he had some great medication that should stop me from vomiting after surgery as I have done after every other general anaesthetic. In no time at all the room started to spin, my eyes closed and next thing I knew, it was all over. The good thing about general anaesthetic is that you feel very little pain when you wake up. Unfortunately, all those drugs that I was assured would stop the nausea did very little to stop me vomiting. After I was back in the ward I was sick again, and again, and again. Abdominal surgery and vomiting do not go very well together and I felt like a herd of angry rhinoceros had been dancing on my belly by the end of the evening. Finally after yet another drug was injected, the nausea had stopped. I was really wondering why I had decided to go down this path and was starting to regret my decision. I spoke to the nurse and asked how the other three patients were getting on. “Fine,” she said, “they are sitting up in bed eating their chicken broth.” Oh well, so maybe it wasn’t that bad after all, it was just my reaction to the anaesthetic that made me feel so ill. The dietician visited and gave me lots of really comprehensive information about what I could and should eat and the different stages of food preparation that was required.

I had a restless sleep, not because of pain or discomfort but because of the inevitable noise that always seems to amplify as soon as the lights are off in hospital. I left for home at 11 o’clock the next morning and settled in to the couch for the rest of the day. As usual, when you sleep all day it is hard to sleep at night. I had a bit of discomfort, but given that I had only had two Panadol the previous day in hospital, it was really pretty good. You definitely can’t sleep on your stomach for a few days after a gastric banding operation!

Food is quite easy, soup, milk drinks, runny custard and yoghurt for a couple of weeks. The guideline is that it should be nutritious and be able to be sucked through a straw. The following two weeks, I will eat mushy moist food, and then after that soft food before the gastric band is inflated. Red meat is out unless minced because it is too hard to break the fibres when you chew. It really seems to just soften, but not break apart. I’m sure I will have no problem mincing roast beef before putting it on my plate!

Mum and dad came for lunch today and mum bought down four soups that she made for me last night. That should just about do me for the next week and a half until I am on the mushy food. She’s such a good mum!

It’s Sunday, five days after the operation and I woke up this morning really hungry. It was a nice feeling to actually feel that you needed food, not just wanted food. There is a bit of swelling around my operation site (five incisions with staples in four of them) and I still have a bit of tenderness if I touch the skin around the wounds. It only takes 110ml of orange juice to satisfy my hunger and then I almost struggle to eat the remainder of the recommended meal. I have lost weight after four days and really feel like I have turned a corner towards recovery. I am back at work tomorrow so it’s probably just as well. I lost about two and a half kilos on the Optifast diet, and three and a half kilos since the surgery. I will leave it until the end of the week before I start to really get into the exercise as I don’t want to push it too fast given that I will be back at work full time and I imagine, pretty tired.

Yes, well… thinking that I was going to cope going back to work after just five days, was probably just a bit optimistic. I have been so tired and have a pain under my rib like a really bad stitch. It is so painful! When I get the stitch I also get an excruciating pain in my left shoulder. I know that the shoulder pain is associated with the rib pain as there are nerves that run from the diaphragm to the shoulder. Once I get the pain, I find that if I lay down for ten minutes it eases off and then disappears. If I stand or walk too long, it comes back but lying down again stops it in its tracks. On Wednesday, a week after the operation, I went back to clinic and had the staples removed. This was no surprise as I had staples used on a previous surgery and knew that they were relatively painless to have removed. Dr Sabine asked me to get on the scales and said, “So how much have you lost, three kilos?” I was pleasantly surprised when the scales showed around five kilos. Even after a week, my trousers are starting to loosen and it is a great feeling.

Well it is two weeks after surgery and I have lost 5.5kg in that time, which is a total of 8.5kg. It’s a great feeling. The liquid diet has been fairly easy to stick to but I am really starting to yearn for some real food that isn’t vitamised and served as a soup. I had one particularly uncomfortable evening when I ate some apple fruit puree. I had the most painful bout of indigestion and have not been game enough to try the puree again since so have been drinking fruit juice instead. My trousers are starting to hang off me and the button holes on my shirt are a lot less stretched than they used to be. I can even get some of my over-shirts done up, where previously the front panels had no chance of reaching each other. My bras no longer fit me but luckily mum gave me a couple of smaller pairs that she had never used. I haven’t bought any new clothes yet, as I still have some smaller clothes that I haven’t worn for a while, but I am getting to the stage that even those will be too big soon if I keep losing weight at the rate that I currently am.

I seem to be losing weight from the ends towards the middle. My face and neck, breasts, forearms and lower legs lost weight first. My thighs, bottom and upper arms have lost a bit, and my waist is finally starting to emerge from the stack of spare tyres around my middle. If my target weight is still 16 kg away, I will end up a mere shadow of my former self. My energy levels are improving all the time and I find it much easier to squat or kneel down than before. I always avoided sitting on the floor because it was uncomfortable and really quite difficult to get up. Now, if I need to wipe something up from the floor, I don’t even have to think twice about kneeling down to clean it up.

At the two week mark, any regrets I may have had about having this operation are well and truly behind me and I am over the moon about the results so far. Only two days to go and I will be able to eat mushy food, instead of liquid food.

The food I had tonight was probably the worst example of tuna mornay known to man. Normally I have no problem cooking it, but today everything that could go wrong did. It was lumpy and runny and just wasn’t very good at all. However, being able to eat it was absolutely fabulous. It was such a good feeling. I am now starting to eat dishes like mashed vegetables, minced meat casseroles, and even omelettes. It is such a nice feeling having something in my mouth to chew, even if the food is soft.

I have had really bad breath and a horrible coating on my tongue. My poor husband has to turn away, if I roll over a face him in the middle of the night. My weight is still dropping off and I have so much more energy than I did before. My belly is still a bit tender but is getting better each day and the pain in my side and shoulder is well and truly behind me.

Since I have migrated to soft food it is so much easier when you are dining with friends. Most people don’t know I have had surgery, and I really feel no need to tell them at this point in time. I can easily say that I had a big lunch or I am trying to eat less and nobody is the wiser. I just have to keep reminding myself to chew all my food thoroughly and not eat too fast.

I had my first encounter with food getting stuck above the gastric band. I was at work eating a tin of sardines (in spring water, not oil) and as I was working at the same time, I must have just been shovelling the fish in and not chewing them properly. Next thing I got this massive ache above the band and felt extremely uncomfortable. It wasn’t really painful but felt like a really bad wind pain. I had to end up going to the toilet and sticking my finger down my throat to bring it up. Once it was gone the relief was immediate. I will certainly not make that mistake again in a hurry.

My trousers are now too big to wear, and what a great feeling that is! All of my shirts are very loose and I even bought a size 14 woollen coat and a size 16 pair of trousers in a brand, which has always been a very narrow fit on me. My weight is still dropping although it has slowed down. I seem to go two steps forward and one step back. I have still been having the occasional glass of wine, and I had a small cup cake today and a tiny piece of cheesecake a couple of nights ago when we went to our daughter’s for dinner. I will really have to make sure that I don’t make a habit of consuming high calorie food and drink otherwise all this hard work will have been in vain. In three days I go back to the clinic to get my band inflated for the first time. It will be interesting to see how that will change my eating habits.

Dr Sabine said my weight loss was OK. After a brief chat about how it was all going, I lay on the table ready for the inflation. The procedure wasn’t painful, just a bit of discomfort as the needle went in. The part I wasn’t expecting was how hard the needle was pushed once it had gone through the skin. I thought I was going to be pinned to the table. Of course it made sense afterward as a gentle force is needed to pierce the skin, but a lot more pressure is needed (almost a jab) to get through the membrane on the port. Dr Sabine injected a small amount of saline and told me that I may experience a funny sensation in the back of my throat, which I did after I sat up. It was similar to heartburn really.

I made my appointment for another month then had a small glass of water just to make sure that everything could pass through the band OK. Once I swallowed, I felt really uncomfortable. It was like the water was stuck just below my breastbone and was bordering on painful. I was told that maybe I took too big a swallow. After I left the clinic, I made my way to the toilet as I thought I was going to be sick, but after one gigantic belch I felt much better. I had strict instructions to take only clear fluids for three days, then soft foods for one day before returning to normal food. Of course I didn’t realise that this would be the case when my husband and I arranged to have dinner with friends at their house. The thought of fluid meals when I had just started eating solid food again was almost unbearable. I stuck to the modified diet for two days but the thought of the dinner party was just too much to turn down. It was there I discovered Turkish bread and oil does not work well with a lap band and that even though you ask for a really small serve, no-one listens to you and gives you a huge helping anyway.

The lesson I learned here is that the gastric band changes the way you socialise and that you have to be tough. If you ask for a small serve and they give you a large one, just leave it when you have had enough, with the comment “it was lovely but just far too much for me to eat”! I had rotten indigestion the rest of the evening, I had to sneak off to the toilet and vomit a few times. I should have stuck to the liquid diet! At least next time I will be prepared.

In the past month since the inflation, I have learned the following:

• If you eat too fast you will be sick.
• If you eat too much you will feel guilty and uncomfortable.
• Make a sandwich with one slice of bread, its always enough
• Eat from a small plate, and I mean a SMALL plate
• When you go out, share a meal or order an entrée
• If you have to have takeaway, e.g. McDonalds, order the smallest burger with no cheese and add extra salad
• If you are really hungry and the next meal is a going to be a while, have a drink instead (a skim milk latte usually does it for me, although I am sure there are healthier options)
• If you have to drink alcohol at home, buy a single serve bottle. It may be a more expensive way to buy it, but weight loss is not about economics, it’s about health
• Do the exercise!!! (Crunches during Ad breaks while you watch TV are always good!)

The exercise is a real bug bear for me as I can always find a good reason not to go to the gym, exercise at home, or walk. This procedure has been a really big financial and emotional investment and unless you embrace it wholeheartedly, there is really no point in having it done at all!

It is now two months since my operation and I have gone from a size 18/20 to a 14/16. It was great to try on a pair of size 16 jeans and find they were too big. Of course there was no size 14 in stock so I couldn’t even buy them! I have had a few occasions where I’ve vomited. It usually happens when I eat too fast. I need to make sure that I take small mouthfuls slowly especially at the beginning of a meal. There is still a lot to remember and hunger seems to overtake common sense, although it is happening less as time goes on.