March Madness No, we are not talking about the basketball time - March is when most folks re-evaluate the New Year's Resolutions, and decide if what they are doing is working.
This is typically when most realize that exercise and diet alone do not work but the band does work. Now is a good time to look at what you are doing with the band and see if you can make it work better for you.
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| First Bite Syndrome 
Do you ever eat something and after the first or second bite you feel the urge to burp it out, or you find it comes out? Or do you ever eat something then your body makes a lot of mucous or "slime?"
This is called first bite syndrome, and it comes from eating too fast, taking too large a bite, or eating too much, or eating too fast.
Some think this means that the band is too tight, and yet they are not losing weight. But, often it is not the band that needs adjusting, it is the way you eat.
It probably should be called "I ate too fast" or "I ate to large a bite," because this is when it occurs.
The upper pouch has a very small amount of room, and when a bolus of food comes into it, it will attempt to push the food through to the lower stomach. If the food bolus is too large, wrong texture, or too dry it can become stuck in the stoma. When that happens your body tries to slide it through by creating more mucous (sometimes called slime) - and that mucous can back up into your mouth.
If you are too hungry, and trying to eat too fast to satisfy your hunger, you probably notice that you may burp up the first few bites.
The way to avoid this: Eat small portions slowly.
See the next article to learn more.
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You really think you know how the band works? 
Here is a simple question for you - how does the band work?
Here is what a lot of patients think -- that the food sits above the band and that the longer it sits there the less you would be hungry.
But here was the data that didn't make sense with that conclusion. People who didn't lose weight, and had a tight band. An x-ray of these folks would show a large pouch and large esophagus - they had a lot of food sitting above their band, but didn't lose weight. Here was a second bit of evidence - people who got something acutely stuck - feeling a horrible sensation at the bottom of their breastbone - some even going to the emergency room thinking they had a heart attack.
So here are two people with the band -- two different results. One person can passively expand the upper stomach and esophagus and consume a lot of calories.
Here is how the band works - in a perfectly adjusted band, with a patient who is losing weight, eating a meal that will provide appetite suppression for four hours -- the food moves past the band to into the lower stomach in less than two minutes. I
That is it. Does that blow your mind? It means, we DO NOT want the band to be too tight. Too tight is not good -- too tight leads to band slips, band erosion, and lots of other problems.
So, to do well with the band you need to follow four simple words:
Eat small portions slowly.
That's it!
Choose your food -- you have the choice of what to eat, so make your choices healthy food, and not processed types. The band will not make that choice for you, only you can make that choice.
Measure your portion -- the band will NOT tell you when to stop eating (that is your job).
Eat slowly -- if you eat too fast, you can cause the upper pouch to become irritated and dilated and it may make you vomit, or cause the band to slip (requiring another operation) or just keep dilating until you have a problem.
Too often I hear people talk about "restriction," and that is a word you will never hear in our office. Never. The band is NOT about restriction - the band works by suppressing appetite.
So -- before every meal, repeat those words:
Eat small portions slowly.
Do that, and you will be on your way to your goal.
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April Support Group is Restaurant Month 
April support groups will be held at 6:30 p.m. on Tuesday, April 14th, and Thursday, April 23rd.
The topic for April's support group meetings is eating out. We want you to bring to us your favorite menus from your restaurants -- and also brng where and what you use to eat.
We celebrate good food, and we celebrate eating out. We want to know how you changed, and what tips you might have for the new patients coming in.
We will also have tips for eating out, as well as great recommendations. For some of our patients-- who own restaurants- we hope you come and tell us about what you have to offer.
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Doctor is out! 
Probably by the time you get this I will be in Cabo San Lucas -- Mexico, for my second vacation in ten years. Don't worry, I will be back on the 30th, and have someone who will cover me should you have some issues.
But while I am gone-- please, don't eat dry chicken, eat slowly, enjoy your food.
I will be refreshed and ready. Now, if I am kidnapped - do NOT send ransom. I'll just join the revolution on the beach and ..... Ok -- there is the cartoon of me stuck on an island with a cigar.
See you soon
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| New Botox offering to our patients.
Wrinkles can disappear, and rejuvenate your face.
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New Coordinator
Jennifer Cooper is our new bariatric coordinator. Jennifer had her band two years ago and has lost over 130 pounds so far! She has served in the role as assistant coordinator for the last couple of years. Jennifer has done a great job in keeping in contact with patients, as well as helping new patients gather their materials together so they can get a band.
Christine Walt, our previous coordinator, resigned after working for us for several years, but continues to stay in touch with our office and come to support group. We wish her well.
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