Getting Stuck with the Gastric Band

Question Below Submitted By:  

Lonicera The Bandit (a patient from Bristol, United Kingdom)

You would think by now that there would be clinical studies set up to gather up the many different ways a gastric band user has stuck episodes’, and by pooling the information arrive at a consensus on the way to deal with these things according to their category. However I have yet to find it, or hear about it from the doctors when you speak to them about it most of them trot out the usual this is an art, not a science.

Most bandits accept that it comes with the territory, but I think we all put up with far more discomfort on this issue than we need to. Call it productive burping if you want, or any other euphemism that takes your fancy, but the fact is you’re being sick on a far more regular basis than you probably did in your whole life up to now. On your disgust scale it probably scores 5 out of 10 in comparison to the real thing when you’re ill but it’s still horrible and miserable. Minimise it by applying this magic formula: self-knowledge + patience.

Our organs all slot together differently according to our overall size and shape, the amount of exercise we do, how we stand, sit and lie, and so on. We have this plastic ring positioned at the top of our stomachs, and the tenth which remains the other side of it, known as the pouch, which is now our stomach, will vary in size and position according to what we’re doing or what and how much – we’re eating or drinking. I suspect the amount of scar tissue which may have developed after the procedure also has a lot to do with it, but I’m no clinician.

Imagine a loosely filled bean bag. You pick it up and in your hand (the band’) you have the pouch’, with the stomach’ slumped below. The beans have flowed through to the bottom without difficulty. Then pick it up again retaining a handful of beans in the top part by holding tightly. Put it back down carefully folding over the top and those beans will never get through because there’s now a kink where you folded it.

This is an over-simplification I know, but it’s roughly what happens when you eat or drink and you get a stuck episode. It’s complicated by all the factors named above, including time of day, any inflammations present from previous stuck episodes, and most importantly, the degree of tightness of the band. If you read blogs written by gastric band users, you’ll learn all that makes them get stuck, and how they resolve it. Let me add an anecdote of my own on what happened to me last May 2010:

SUNDAY: Out to lunch with friends, had a salad with sweetcorn and haricot beans, among other ingredients.
MONDAY: fine, nothing to report
TUESDAY: fine, nothing to report
WEDNESDAY: Had a quarter of a cc fill at the hospital, felt the restriction. Sloppy polenta in the evening.
THURSDAY: Optifast and soup feeling virtuous.
FRIDAY: Fine, nothing to report
SATURDAY: Cornflakes in the morning, I felt slightly stuck, but ignored it. Light meal in the evening, OK.
SUNDAY: Ate lightly, still feeling slightly stuck, put it down to the increased restriction and the hot weather (but then why was I fine on Friday?). Went swimming in the afternoon, and then to a tapas bar in the evening. Ate two tiny fried whitebait, had stuck episode, had to leave the table three times. Was getting concerned because I couldn’t drink much either.
MONDAY: Very uncomfortable at work all day, worried about the drinking, wondered if I should get an unfill, but reluctant. Soup in the evening. Slept badly, kept waking up drowning’.
TUESDAY: 5 a.m., awakened by a coughing fit which produced something so odd that I had to jump out of bed and look at it in the bright light of the bathroom. There in the palm of my hand was a whole haricot bean, intact and almost dry in fact it was shiny. I rewound my week’s eating in my head to remember when I had had this bean, and stopped at the Sunday before last. EIGHT DAYS earlier!

The following morning another couple followed, and that was the end of feeling stuck.

Conclusions: The fill may have trapped the beans in my pouch, but I had no idea they could stay there for even 3 days, let alone 8. More importantly, if you eat beans or sweetcorn which are big enough to get you stuck, don’t assume that chewing your mouthful quite a lot’ is enough. By the law of averages there’s going to be the odd one that slips through. Unless you have the patience to turn your food to sludge, don’t eat the items which will try your patience and your hunger – too far.

So, to keep regurgitation and discomfort to a minimum:

All food must be reduced to sludge before swallowing. Consider your own level of patience if the idea of chewing steak to a sludge sounds like it’s going to take too long, then don’t have it.

The first bites are the hardest you’re hungry, the food smells good, etc. Tell yourself it won’t run away, it’ll stay on your plate till your band is ready for it. Tell yourself also that if you eat too fast and get stuck, the other consequence is that your food will get stone cold while you wait for your pouch to calm down.

If you’re recovering from a previous stuck episode and can’t understand why it keeps happening’ it’s because the inflammation and soreness caused by the heaving action can take up to a day or two to subside, and you’re just aggravating it. You risk being unable to drink, and therefore requiring an unfill… and a week later you’ll be wondering why you paid for an unfill when you now need a re-fill again.

From now on, you need to think about everything you’re putting in your mouth, and the circumstances around you if you’re surrounded by friends at a restaurant for example, by all means take as long as you like over your bit of juicy steak, and your nice friends will understand… but don’t expect to join in with the conversation if your mouthful was too ambitious. You might enjoy the food less if you have very small mouthfuls, or fish instead, say, but you will certainly enjoy the occasion more.

Remember you could be stuck because you have a ‘kink in the link’. Stretch, jump up and down – they work sometimes.

There’s a lifetime of habits which inexorably has to change before you see a lovely new you emerging. Trust in the gastric band because it works, if you’re patient. It will take a while to get the adjustment you need, just be patient.

Every time you feel stuck, think about it, what caused it, how different is it from last time, what should you avoid next time. Be patient. It took you a long time to get into this mess, don’t expect it to be solved overnight. Be patient.

See you next time.

Lonicera The Bandit

Related: Bariatric Eating (how you eat), Bariatric Diet (what you eat), Bariatric Recipes

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Patient Responses to the Question Above

Thank you

by: Trisha

I've been banded eight weeks, sadly without realizing I had a blockage within weeks. Gastric crew assumed like me, it was swelling. I could not eat, and was putting my fingers down my throat day after day, a lump of something looking like a white alien came up.

I was jubilant. Five days later 'now' I've done it again. Your article was very informative, thank you.

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