This post is really from me to me, to remind me of some lapband issues I’ve encountered recently, and to record a status update.
1. Hiccups mean that my pouch is full. When they happen while eating, stop and put down the fork/spoon and put the rest of the meal away for a later meal or snack. Be sure to wait for 30 minutes to start liquids again or hiccups can pop up if you start drinking too quickly.
2. First Bite Syndrome is something I’ve just learned about but recognized as an explanation for the throwing up I’ve been doing lately. I’ve written before about productive burping before and this is sort of a variation on it. It’s been happening several times a week lately, almost always on a weekday.
Here is a great explanation of what’s happening and how I should handle it:
First bite syndrome is not uncommon. For some reason the esophagus, and therefore our pouch will sometimes spasm, and tighten up when we take the first bite. When it does this, then anything added after will only hurt and cause you to PB.
What is suggested for issues with first bite syndrome is to begin the meal with a couple of sips of a very warm liquid—water, tea, coffee—small sips of it hot! Then take the tiniest bite imaginable—chew well, and wait. Let it hit your pouch and allow the pouch to accept it, after a couple of minutes—serious minutes, as in 120 seconds—not just a few seconds—try another tiny bite. Then wait again.
If after a few bites, you still feel good, then proceed as usual with your meal. If it feels stuck–just stop! Then in a half an hour or so, try some fluid, and stick with fluids for a few hours minimally before you try again. Anytime you end up PB’ing, the best thing for your stomach is to go onto liquids for a period of time, allowing your stomach to settle without causing further swelling.
I don’t have FBS problems on weekends because I wake up more leisurely (post 5:30 most days) and start the day with a cup of coffee, putting off breakfast (usually yogurt with a little bit of fruit) for at least an hour. My esophagus/tummy have time to relax. And I can spread out my breakfast time when I’m not watching the clock to be sure I’m dressed and ready to leave for work no later than 7:20am.
Tomorrow is my first visit with my surgeon in 2 months, and I haven’t had a fill in three months. He did take some out before that because I really was PB’ing a lot because it was too full. The band is small (mine holds 10cc) and we haven’t found my “sweet spot” yet. I’m hungry a lot, which is a sign that I don’t have enough restriction in the band.
I needed to understand the difference between PBs and First Bite Syndrome to be sure I’m ready for another fill, and know how to adjust to make things work better.
I know the nurses (one in particularly is very harsh) will give me grief for having my weight loss slow down during this period even though I did lose 8 lbs. I’ve been eating more carbs than they would like (they want me at about 40 and I’m eating more like 80-90) but it’s still well below what is considered normal for a balanced diet – and I feel better when I eat some. Not prepared sweets so much as beans, strawberries, and dairy. I’m not giving them up.
Status Report:
1. Nutrition: I’m eating between 1000-1150 calories/day, with approx. 80-90 gms carbs, 40 gms fat, 70-85 gms protein. Fiber is too low because I’m not eating enough vegetables even though I want them (they don’t stay down well yet). Cholesterol intake is under 100.
2. Weight status: 204 lbs down from 310 lbs for 106 lost. 44 lbs to go to my goal of 160.
3. Exercise status: still low but have started working out with a personal trainer in the pool and on the weight equipment.
Random Thoughts of a Disordered Mind 
I’m catching up — I loved the webby hands too when I took water aerobics. You also feel more “sportsman”-like. I might pass along your notes to a co-worker — she’s just had lap-band surgery too.
I’m really SO PROUD of you. You’ve done fantastic! Not just with the body but with the mind. *hugs*
The nurses being hard on you doesn’t make much sense to me — after all, your weight loss has been good and you are still finding the right comfort zone with the band and your eating. Some people are just crabby, though.
Hope you get things sorted out and are feeling more comfortable with your food.
Jen, there are 2 nurses who work there on “lapband follow up day”. One is motherly, supportive, and practical. The other is mostly nasty. I asked the nice one why the other one was so mean, and she said that Nurse #2 had gastric bypass surgery herself and their regimen is incredibly strict, particularly with carbs. She sometimes treats all the patients as though they are bypass patients, while lapbanders (aka bandits) have more flexibility. You can imagine which one I pray is there when I come. And if she’s not, I try not to let Mean Nurse make me too annoyed.
I wonder what would happen if you just said something to Mean Nurse — nothing really bad but just asked her to repeat herself and ask if she meant to say what she said. I’ve found if I can summon up the courage and wits to say something (again, not mean) to a bully like that — most of the time, they back down. And if she doesn’t — well, at least you tried. I’d definitely say something if you get asked for any evaluation of the group (we get questionnaires all the time at UVA), etc.
I found your blog when I googled “hiccups and lapband”. I am so glad I found your blog. I have had the surgery around a year ago and I am just now really experiencing the hiccups and the first bit syndrome. I didn’t know that either were common. I thought that I was the only one that had experienced it. I have not had an adjustment in several months because it is hard to tell if I need one or not. I am like you in that I am hungry more than I feel I should be but I can’t see that I could handle an adjustment because I am having so many issues with the hiccups, pb and the first bit syndrome. It made me feel a little better knowing that I am not the only one who has experienced this. I don’t know if I should make an appt to see the doctor or not.
Jill – if you had the surgery just a year ago, you should definitely make an appt with the doctor. I still go 3-4 times a year even at 3-years out. Ask the doc or the nurses what they recommend about the hiccups. You may be ready for another fill or just need to talk about what’s going on that has you concerned. You are definitely NOT alone with the hiccups, first bite syndrome, etc. We’re all in this together. Good luck, and let me know how things turn out.
Thank you so much for replying. I am feeling so much better the past couple of days since I read the part of your article in reference to drinking hot coffee or tea in the morning. I so appreciate your post. I have felt like I needed to make an appointment since I haven’t been for an adjustment in about 6 months but I didn’t know if I should even think about another fill with some of the issues that I have had. However, I will make an appointment just to touch base and discuss some of it with them. I believe some of it is probably from my own mistakes. It is a conscience effort for me to eat slow and sometimes I forget to pay attention to it.
As far as the sweet spot — I am not sure that I would even recognize it. I think I am at 6cc’s right now. I sometimes can eat very little and sometimes can eat a-lot of food. However, when I do stop eating it is not necessarily because I “feel full”; it is because my stomach will not tolerate anymore. Do you find that your hunger is still there or did you ever hit the “sweet spot”?
Thank God I googled this problem after a year .I had no idea that hiccups and PB was happening to anyone else. I am relieved to know and will follow the above guidelines. Thnk you all so much. why didn’t the doctor tell me that this could happen
It’s good to read all of these comments. I have been banded for 2 years and find I still am making eating adjustments to learn to live with my band. I have had hiccups and stomach acid problems but generally have not had anything to severe.
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