NaNa

Take pea size bites, it could be swelling, if after a week and you are still burping, ALOT...you are too tight and need to go back and get a little out before you damage your band, sometimes if you remove 0.1cc it could keep you out of the red zone. Good luck

This letter is totally uncalled for and inappropriate. This woman has NO idea why these "obese" children are obese. It could be a medical condition, or some other issue that that child is dealing with. I can't believe the thought of some people, I am SURE those kids know they are overweight, they don't need a stranger to tell them that. Let those children enjoy Halloween like other children, I guess this woman feels that Overweight children don't "deserve" treats... Also if they are fat today, does not mean they will be fat in the future, how dare she...this woman would not last in some neighborhoods...LOL.

HotButterfly, Thank you for posting this, unfortunately this happens ALL THE TIME and is NOT RARE. I would say 90 percent of lap band complications, happen like this. I've actually heard a LOT WORSE. This is why I am so cynical on these boards, newbies IGNORE you when you warn them, they think..Oh...it will happen to 'others'.... This girl is telling her story to hopefully help others, but she REALLY abused her band... The lap band is NOT about misery,vomiting, and constant burping up foam and reflux. I honestly can't believe so many live with the lap band this way. This will HAPPEN TO EVERYONE that keeps their bands too tight, NO ONE IS IMMUNE. I am going on 9 years post op and I've seen and heard a lot worse, I've had friends that bands slipped so bad until it strangled most of their stomach and they had to get a force "Sleeve, removal of most of the stomach" . Some think they can get a NEW band or it fixed after a slip....NOPE...once the band has slipped so bad or the esophagus gets dilated from being so tight so long, you can NO LONGER GET A LAP BAND. Many think 'vomiting' is NORMAL...IT'S NOT..NO VOMITING WITH THE BAND IS NORMAL AT ALL. Even if you PB and throw up food, every now and then...--THAT IS ALSO A PROBLEM...ANY FREQUENT VOMITING with the band WILL CAUSE IT TO EVENTUALLY SLIP. -- VOMITING SHOULD BE VERY RARE, like ONCE A YEAR OR SIX MONTHS. And if someone is vomiting daily --- they are in BIG TROUBLE, sometimes it takes a few years before SEVERE slippage occurs where it gets life threatening. Since I've had my new band placed, I have not vomited once and I hope and pray to keep it that way....Vomiting with the band is like "lap band suicide" and SADLY -- MANY THINK it's NORMAL to vomit and purge daily --- This is why MANY SURGEONS are NO LONGER DOING BANDS....DUE TO LAP BAND ABUSE FROM PATIENTS... In Australia...lap band complications are not as common as in the US, they don't tend to abuse their bands as much as Americans do, their slippage rate is low compared to US band patients....MOST of the lap band complications ARE preventable. -- sadly. I hope many on this board listen to this girl....BUT SADLY --- she is among MANY that have lap band complications. Anyway thank you for sharing this important video -- hopefully it will touch others.

Actually I may Ping Alex to have that very important article as a pinned article because it is very critical to any one seeking a band and all lap banders, this information was not available to me over 8 years ago when i first got my band. Newbies today are lucky they have this information. I will paste a link again to it, in the event someone missed it. http://www.lapbandta...-zone-in-fills/

If you are getting food stuck with an 'empty band' you really need to see your surgeon ASAP....this IS different than someone WITH saline in their band.

A good reference is that if you don't chew your food properly and get food "stuck: frequently and vomit often, this behavior will eventually cause band slippage. If you did not read this VERY important post that I posted today on how the band works, it is good reading as a newbie, and is critical to your band's health long and short term. http://www.lapbandtalk.com/topic/177913-must-read-how-the-lap-band-should-work-green-zone-in-fills/

Wow, that sounds horrific, sorry you experienced this. Complications from ANY weight loss surgery whether it be band, bypass, sleeve or ds can be horrible. Also, they can get very expensive too, again sorry this happened to you.

I posted a MUST read article today on how the lap band works, you should really read it, it will help give you some perspective on to live with your band and if you are in the green zone. http://www.lapbandtalk.com/topic/177913-must-read-how-the-lap-band-should-work-green-zone-in-fills/

This trend has been going on for the last 3-4 years, it's not new. MANY surgeons are moving away from the band, NOT because the band is a bad procedure, but because they just do NOT like the AFTERCARE that the band REQUIRES. Surgeons are 'cutters' and lap band aftercare has become a "hassle" for many US lap band surgeons. It's just that simple. Many have been pushing the Sleeve for the last few years, even if the patient REALLY wants the band. Part of it is IGNORANCE from the patient, of not knowing how to live with their bands, and surgeons got tired of lap band 'complications, many patients keep their bands too tight, never follow up and only return to their surgeons when their bands has slipped, so many surgeons were removing more bands than what they were putting in. You have newbies here IGNORE how the band works, they really don't care, all they want is the "tightest fill possible" so this TREND WILL CONTINUE...UNTIL more and more surgeons get sick and tired of removing bands. Part of it is surgeons NOT educating patients on how the BAND REALLY works, and being honest UPFRONT with patient on what it takes to be successful and complication free. Also, with the Sleeve and Bypass once the surgery is DONE, they really don't have to see the patient AGAIN...FOREVER...most patients with the Bypass and Sleeve probably only need to see their surgeon for a few times after surgery and that's it. It does NOT mean Sleeve and Bypass patients don't have complications, because they have MANY..the thing is Sleeve and Bypass patients gets dumped off to their PCP's. internist, hematologists, and other specialists to 'deal' with their long term complications, Vitamin deficiencies, and other aliments. But with the lap band ONLY lap band surgeons can deal with reflux and other lap band long term problems, with filling/unfilling the band, and reading Upper Gi's , endocospies...etc, or removing the band. Also you CANNOT convince MANY lap band patients that a "tighter" band is not better, so unfortunately after a few years, MANY have to get their bands removed... Also MANY do not care if their bands are too tight, they just deal with it until their bands eventually slips...and I guess many surgeons are getting tired of removing bands. I think what will eventually happen is that ALL compliant people and those who keep moderate fills will be the only people to remain with bands, and ALL others will eventually get them removed...I guess you can think of it as a "weeding out process". The lap band will ALWAYS be available on the market, (probably in large urban areas, and decline in small rural areas) for those who can afford good aftercare and followups, but the trend of surgeons performing bands will continue to decline -- sadly due to bad surgeons and bad patients.

I agree with Missy, it depends on the condition of your stomach and the level of complication you have and how experienced your surgeon plays a role as well. Having a band removed and Sleeved in one surgery requires a highly skilled revision surgeon. Leaks are at a greater risk with Band to Sleeve revisions moreso than with virgin Sleeves. Also, BE AWARE that Band to Sleeve revisions have a LOWER success rate than virgin Sleeves, so before you remove your stomach for nothing, make SURE you research the Sleeve in its entirety before you get it done and once you get your stomach removed you can't turn back regardless if you like it or not.

I guess it depends on the surgeon, however my port is a low profile port, very small and not visible at all and it is located a few inches to the right above my belly button and I would not want to have it anywhere else. I have never had port pain, right after surgery I made sure I did not lift anything over 5-10 pound for about 2 months post op and I did not anything touch or hit my port area and I wore loose cloths for about 3 months after surgery.

Yes it does happen to MANY lap banders, we traveled to Lake Tahoe, California a few months ago and I could feel my band tighten as we traveled up the mountain. However, I've had my band tighten during plane flights, but not always, I guess it depends on the ebb flow of the band.

Congrats!! Your success is a job well done,you look great!!

Hello... I thought I would post this must read article by the surgeon who invented the "Green Zone" and how the band should "ideally work".... http://bariatrictime...1/#comment-2133 Gastric Banding and the Fine Art of Eating BT Online Editor | September 22, 2011 by Paul O’Brien, MD Dr. O’Brien is from the Centre for Obesity Research and Education (CORE), Monash University, Melbourne, Australia. Bariatric Times. 2011;8(9):18–21 Funding: No funding was received for the preparation of this article. Financial Disclosure: Dr. Paul O’Brien is the Emeritus Director of the Centre for Obesity Research and Education (CORE) at Monash University, which receives a grant from Allergan for research support. The grant is not tied to any specified research projects and Allergan has no control of the protocol, analysis and reporting of any studies. CORE also receives a grant from Applied Medical toward educational programs. Dr. O’Brien has written a patient information book entitled The Lap-Band Solution: A Partnership for Weight Loss, which is given to patients without charge, but some are sold to surgeons and others for which he receives a royalty. Dr. O’Brien is employed as the National Medical Director for the American Institute of Gastric Banding, a multicenter facility, based in Dallas, Texas, that treats obesity predominantly by gastric banding. Abstract The author reviews the physiology of eating and what the adjustable gastric band does to the function of the distal esophagus and upper stomach of the patient. The author also provides the “Eight Golden Rules” on proper eating habits for patients of laparoscopic adjustable gastric banding, including what, when, and how they should eat, in order to achieve optimal weight loss results. Introduction Laparoscopic adjustable gastric banding (LAGB) has been shown to enable patients with obesity to achieve substantial, durable, and safe weight loss,[1,2] which can help reduce or resolve multiple diseases,[3] improve quality of life, and prolong survival in patients with obesity.[4] LAGB is a weight loss surgical procedure performed solely for the purpose of affecting a key physiological function in weight loss, appetite control. In 2005, we conducted a randomized, blinded, crossover trial that showed that the LAGB controls the appetite.[5] However, if the LAGB is not placed properly or if the patient does not eat properly, it will not perform at an optimal level. For example, if the band is placed too loosely, then it will not provide the proper level of reduced satiety and appetite, and likely will have little effect on the patient’s weight and health. If the band is placed too tightly or if patient eats too fast or takes large bites of food, slips and enlargements can occur, leading to reflux, heartburn, vomiting, and sometimes the need for revision. Optimally, the band should be adjusted so that it squeezes the stomach at just the right pressure. If the patient eats correctly and the band is placed correctly, the LAGB should adequately control the patient’s appetite, resulting in optimal weight loss. The Physiology of LAGB Dr. Paul Burton, a bariatric surgeon at the Centre for Obesity Research and Education, Melbourne Australia, has studied the physiology and the pathophysiology of the LAGB closely. He used high-resolution video manometry, isotope transit studies, endoscopy, and contrast imaging to understand what happens during eating in normal controls, eating in patients who are doing well after LAGB, and eating in patients who have symptoms of reflux, heartburn, and/or vomiting after LAGB.[7–15] In Burton’s series of articles, he concluded that in LAGB, it is not the band that fails, but rather the patients who receive the band and, more importantly, the doctors who care for them. Many years ago at the Centre for Obesity Research and Education (CORE), my colleagues and I developed the Green Zone chart, a conceptual way of identifying the optimal level of band restriction (Figure 1). When a patient is in the yellow zone, it is an indication that the band is too loose. When in the yellow zone, a patient may be eating too easily, feeling hungry, and not losing weight. When a patient is in the green zone, he or she does not feel hungry, is satisfied with small amounts of food, and is achieving weight loss or maintaining a satisfactory level of reduced weight. When a patient is in the the red zone, it is an indication that the band is too tight. The patient experiences reflux, heartburn, and vomiting. The range of food the patient in the red zone can eat after undergoing LAGB is limited and he or she may start to eat abnormally (so-called maladaptive eating), favoring softer, smoother foods like ice cream and chocolate. While in the red zone, patients will not lose weight as effectively and they may even gain weight. Burton measured the pressure within the upper stomach beneath the band in numerous patients when they were in the green zone. He found the optimal pressure was typically 25 to 30mmHg. The art of adjustment is to find the level of Fluid in the band that achieves that pressure range. That level of pressure generates a background sense of satiety that persists throughout the day. The patient, when correctly adjusted, normally will not feel hungry upon waking in the morning, and throughout the day should feel much less hungry than he or she did before band placement. In my experience, it is common for LAGB patients to have no feeling of hunger in the morning. Then, during the day, a modest level of hunger will develop, which a small meal should satisfy. One of the key lessons learned from Burton’s studies was that each bite of food should pass across the band completely before another bite is swallowed. There is no pouch or small stomach above the band and there should never be food sitting there waiting. The esophagus is a powerful muscular organ that typically generates pressures of 100 to 150mmHg, but it is capable of generating pressures above 200mmHg. Esophageal peristalsis squeezes the bite of food down toward the band and then progressively squeezes that bite across the band. Each bite must be squeezed across the band before the next bite starts to arrive. Figure 2 shows a bite in transit across the band. A single bite of food, chewed well until it is mush, will move down the esophagus by peristalsis. At the level of the band, the esophageal peristalsis will squeeze that bolus of food across the band. It takes multiple squeezes (usually 2–6 squeezes or peristaltic waves) to get that bite of food across in a patient with a well-adjusted band (Figure 2). Those squeezes generate a feeling of not being hungry and stimulate a message that passes to the hypothalamus to indicate that no more food is needed. If a single bite of food is able to generate between two and six waves of signal, a meal of 20 bites may generate 100 or more signals. This is enough to satisfy a person and is enough to signal him or her to stop eating. We recognize two terms for appetite control, satiety and satiation. Satiety refers to the background control of hunger that is present throughout the day regardless of eating. In the LAGB patient, satiety is generated by the band exerting a constant compression on the cardia. Satiation is the early control of hunger that comes with eating. In the LAGB patient, satiation is generated by the squeezing of the bolus of food across the band during a meal. Each squeeze adds to the satiation signal. There are sensors in the cardia of the stomach that detect this squeezing. The exact nature of these sensors is still to be confirmed but they must be either hormonal or neural. We know that satiety and satiation are not mediated by one of the hormones currently known to arise from the upper stomach.[16] Ghrelin is a hormone that stimulates appetite. A number of hormones that can be derived from the cardia of the stomach are known to reduce appetite. None of these hormones are found to be raised in the basal state after gastric banding and none can be shown to rise significantly after each meal.[16] Vagal afferents are plentiful in the cardia, and one group of afferents has a particular structure that lends itself to recognizing the compression of the gastric wall associated with squeezing of the bite of food across the band. In my opinion, the intraganglionic laminar endings, better known as IGLEs, are the most likely candidate as mediator of the background of satiety throughout the day and the early satiation after a meal. The IGLEs lie attached to the sheath of the myenteric ganglia and are known to detect tension within the wall of the stomach. They are low-threshold and slowly adapting sensors and therefore are optimal for detecting continued compression of cardia of the stomach over a 24-hour period. The several squeezes that go with the transit of each bite stimulate the IGLEs further. The signal passes to the arcuate nucleus of the hypothalamus and the drive to eat is reduced. The lower esophageal contractile segment. Burton developed the concept of the lower esophageal contractile segment (LECS). It is made up of four parts: the esophagus, the lower esophageal sphincter, the proximal stomach (including the 1cm or so above the band and the 2cm of stomach behind the band), and the band itself (Figure 3). As the esophagus squeezes the bolus of food down toward the band, the lower esophageal sphincter relaxes as this peristaltic wave approaches. It then generates an after-contraction, which can maintain some of the pressure of the peristaltic wave as a part of the food bolus is squeezed into that small segment of upper stomach. The upper stomach, including the area under the band, is sensitive to these pressures. It generates signals to the hypothalamus. These signals may be hormonal but are more likely to be neural. A correctly adjusted band will generate a basal intraluminal pressure of 25 to 30mmHg, providing a resistance to flow. The segment of the bolus that is squeezed through generates more signals from that area. Keeping the LECS intact is a key requirement for success with the gastric band. Bad eating habits (e.g., insufficient chewing, eating too quickly, taking bites that are too large) hurt the LECS. If those bad habits go on for long enough, stretching occurs and the power of peristalsis is lost, leading to the return of hunger (Figure 4).[11,12] The Fine Art of Eating A quality aftercare program is essential to successful weight loss in patients after LAGB. Before making the decision to proceed with LAGB in patients, I promise my patients three things: 1) to place the band in the optimal position safely and securely, 2) that they will have permanent access to a skilled aftercare program, and 3) that I will give them the information they need to obtain the best possible weight loss from the band. In return, I ask for three commitments from my patients: 1) that they follow the rules regarding eating after undergoing the procedure, 2) that they follow the rules regarding exercise and activity, and 3) that they always come back for follow up no matter how many years have passed.[6] The “Eight Golden Rules.” At my facility, we summarized guidelines for eating after LAGB into what we call the “Eight Golden Rules” (Table 1). These rules are included in a book and DVD given to every patient who undergoes LAGB at the facility.[6] The rules are also posted on www.lapbandaustralia.com.au and are reinforced at most aftercare visits. These eight golden rules must become part of each patient’s life. The effect of the LAGB procedure on hunger facilitates a patient’s adherence to the rules, making it more likely that he or she will follow them. However, achieving positive results with LAGB requires a working partnership between the physician and patient. Adhering to these rules is the patient’s part of the partnership, and he or she ultimately is responsible for the success or failure of weight loss following LAGB. What to eat. After undergoing LAGB, patients should eat small amounts of “good food,” meaning food that is Protein rich, of high quality, and in solid form. Each meal should consist of 125mL or 125g (i.e., about half of a cup of food). This measure of “half a cup” is a concept rather than a real measure of food, as some foods, such as vegetables and fruit, are composed largely of Water and this has to be allowed for in some way. Thus, I allow exceeding the “half a cup” limit a little for vegetables and fruit. We instruct patients to put each meal on a small plate and to use a small fork or spoon. The patient should not expect to finish all of the food on the plate, but rather he or she should plan to stop when he or she is no longer hungry. Any food left on the plate should be discarded. Protein-rich foods. Protein is the most important macronutrient in the food a LAGB patient eats. At our clinic, we recommend that our patients consume approximately 50g of protein per day. We have measured protein intake of our patients (Table 2) and have monitored their blood levels. We have not seen any protein malnutrition after LAGB, indicating that a daily intake of about 50g a day is sufficient. Table 2 shows the energy and macronutrient intake of 129 consecutive patients measured before and at one year after LAGB. Note the mean energy intake is reduced by approximately 1500kcals.[17] The best source of protein is meat; however, red meats, such as beef and lamb, tend to be difficult to break up with chewing in order to be sufficiently turned into mush. It is much easier to break up fish with chewing, and many fish are high in protein, including shellfish. chicken, duck, quail, and other birds can also be cooked to be easily chewed to mush before being swallowed. eggs and dairy, including cheese and yogurt, are also excellent protein sources. For nonanimal sources of protein, a patient should consider lentils, chickpeas, and Beans. Half of the “half a cup” allotment per meal should comprise protein-rich food. The other half should be made up of vegetables and/or fruits. I recommend to my patients that they eat more vegetables than fruit because vegetables have less sugar. Any space left in the “half a cup” can be used for the starches, (e.g., bread, Pasta, rice, cereals, potatoes), though I recommend to my patients that they eat a minimal amount from this group of foods as they tend to provide no important nutritional benefit. High-quality foods. High-quality food are foods that are minimally processed, natural, and whole. We encourage our patients to look for quality over quantity—for example, they might try sashimi-grade tuna, smoked salmon, duck breast, lobster, or even a simple poached egg. It is also important to remind your patients that there is no limit to the amount of herbs and spices that can be used to enhance the flavors of their foods. Solid foods. The patient should choose solid foods over liquids whenever possible. Liquids pass too quickly across the palate and, more importantly, too quickly across the band. There is no need for the esophagus to squeeze liquid, and without the squeeze, there is no stimulation of the IGLEs and no induction of satiety; therefore, eating calorie-containing liquids may negatively impact a patient’s weight loss. When to eat. After undergoing LAGB, a patient should eat three or less times per day. If the patient is in the green zone, meaning that the band is adjusted correctly, there should be no need for him or her to eat between meals. In fact, even three meals a day may be more than needed for satiety. In my experience, patients have little interest in eating in the morning. By late morning or early afternoon, patients may start to notice some hunger, which indicates that it is time to have a first small meal. In the evening, patients may have another meal. Most importantly, patients should be instructed that a meal missed is not to be replaced later on. The typical human body is satisfied with a maximum of three meals per day but often is happy to accept two or even one meal per day. Patients should be reminded that there should be no snacking between meals. If a patient finds that he or she is hungry by late afternoon, encourage him or her to eat something small and of high quality, such as a piece of fruit or some vegetables, just to tide him or her over until the evening meal. The patient should then visit the clinic to check whether or not he or she is in the Green Zone. It is important that the patient adhere to the aftercare program to monitor whether or not he or she is in the green zone. If not in the green zone, the patient will need to have fluid in the band increased or decreased. How to eat. Take a small bite and chew well. The “half a cup” of food should be placed on a small plate. The patient should use a small fork or a small spoon to eat. A single bite of food should be chewed carefully for 20 seconds. This provides the opportunity to reduce that bite of food to mush. It also provides the important opportunity for the patient to actually enjoy the taste, the texture, and the flavor of the food. Encourage your patients to enjoy eating more than they ever have. After chewing the food until it is mush, the patient should swallow that bite. Swallow, then wait a minute. The patient must wait for that bite to go completely across the band before swallowing another bite. Normally, it will take between two and six peristaltic waves passing down the esophagus, which can take up to one minute. This is probably the biggest challenge of educating the patient who has undergone LAGB. You must instruct the patient to eat slowly—chew well, swallow, and then wait one minute. A meal should not go on for more than 20 minutes. At one bite per minute, that is just 20 small bites. The patient probably will not finish the “half a cup” of food in this time. In this case, the patient should throw away the rest of the food. After undergoing LAGB, the patient should always expect to throw away food and to never eat everything on the plate. If it takes between two and six squeezes to get a single bite of food across the band and each squeeze generates satiety signals, then 20 bites should be generating 40 to 120 signals. The actual number will depend on the consistency of the food, the tightness of the band, and the power of the esophagus. With good eating practices and optimal band adjustments, the patient should not be hungry after 20 bites or less. As soon as the patient is no longer hungry, he or she should stop eating. After undergoing LAGB, the patient should never expect to feel full. Feeling full means stasis of food above the band and distension of that important part of the LECS above the band. This destroys the LECS, the mechanism that enables optimal eating behavior and appetite control. A patient should always keep this process in mind. If the patient finds that after eating the “half a cup” of food he or she is still hungry, he or she should review his or her eating practices, correct the errors, and consider the need for further adjustment of the band. If this is occurring, it is usually an indication that the patient is not in the green zone. Eat a small amount of good food slowly. These eight words are the key to success. Small amount refers to small bites, the small fork (e.g., oyster fork), and a total meal size of half a cup. Good food refers to protein-rich, high-quality, and solid food. Slowly refers to chewing well, swallowing, and waiting a minute. Try to repeat these eight words to every patient every time you see them. Get them to repeat it at every meal. The failure of the gastric band can almost always be traced to failure of this process. Addressing the Challenges The two principal challenges after LAGB are weight loss failure and the need for revisional surgery due to proximal enlargements above the band. Weight loss failure will occur if the band is not placed or adjusted correctly or if the patient does not adhere to the guidelines of proper eating and exercise. When a patient is not achieving results after his or her LAGB operation, the doctor should check to ensure that the band is correctly and safely placed. The most common reason for weight loss failure is poor eating behavior, which leads to enlargement above the band. There are three common eating errors: 1. The patient is not chewing the food adequately. Food must be reduced to mush before swallowing. If it cannot be reduced to mush, it is better for the patient to spit it out (discreetly) than to swallow it. 2. The patient is eating too quickly. Each bite of food should be completely squeezed across the band before the second bite arrives. 3. The patient is taking bites that are too big to pass through the band. Each of these errors leads to a build up of food above the band where there is no existing space to accommodate it (Figure 4). Space is then created by enlargement of the small section of stomach or by enlargement of the distal esophagus, both of which can compromise the elegant structure of the LECS. If the LECS is stretched, it cannot squeeze. Without the squeezing, satiation is not induced. When satiation is not induced, hunger persists, more eating occurs, and stretching continues. If our patient continues this each day for a year, it is inevitable that chronic enlargement will occur, the physiological basis for satiety and satiation is harmed, and stasis, reflux, heartburn, and vomiting supervene. The doctor should continually review the Eight Golden Rules for proper eating and exercise with each patient. For optimal weight loss following LAGB, the patient should have access to a comprehensive long-term aftercare program for clinical support and optimal band adjustments and he or she must follow the guidelines regarding eating and exercising for the rest of his or her life. “Eat a small amount of good food slowly” is the key to optimizing the gastric band.

When ever you have a very bad stuck episode please go on liquids for a few days, and you probably need to call your surgeons office and see what they recommend. Blood can be from a tear in the esophagus, getting food stuck (obstruction) can be a horrible experience as you have seen and can last for HOURS, or sometimes require a visit to the ER -- until all the stuck food comes up, this is why I warn newbies if they are going to try to eat chicken on a tight band it has to be moist and eaten with caution.

Hello... It all depends on how bad the slippage is, will determine what your options are. If your band has truly 'slipped' you need to get it surgically fixed, removed or replaced. The Band-aid approach is to remove all saline, go on a liquid diet for a bit and slowly refill and most people are ok with this, however, it may be difficult for you to get back into the Green zone WITHOUT reflux and other issues. But this can be managed by either taking PPi's (acid reducers) and not keeping the band too tight. If things get worse, your only options are is to fix the band, your surgeon can re-position the band if it has slipped out of place,, there are several types of band slippage, Here are some information on Band slippage, hopefully it can help you out. Good luck Lapband Slippage Lap Band Slippage - Symptoms, Diagnosis, Treatment A condition in which sometimes the stomach wall can slip through the band resulting in lap band slippage. This slipping will result in a bulge above the band. Sometimes this will resolve itself, others it will be more severe and have side effects such as nausea and making it harder to eat or drink. The following pictures depict a normal and a slipped band. Normal Band Slipped Band Two common types of slippage: Anterior slippage: the front of the stomach slips past the band. To try to secure the band at the time of installation, the stomach on either side of the band is stiched together trapping the band. Posterior slippage: the rear of the stomach slides up through the band. This type of slippage was more common in the early 90's in Europe because they used the perigastric technique. Since then they've moved to the method employed in the U.S. and now commonly accepted as safe, the pars flaccida method. Diagnosis of Band Slippage: How can you tell? Usually it's fairly simple to diagnose. If a patient has had no problems for a period of time and suddenly has acid reflux or if you can eat more than before with a tight band it may mean that the small pouch has been stretched by overeating and some of the stomach has pulled through the band. An x-ray with barium easily confirms the issue. As stated earlier, nausea or difficulty eating may accompany slippage. The only sure way to tell is to visit your doctor and have a ugi series also known as an upper GI series x-ray. Treatment of Band Slippage: Mild slip: Deflate the band; reinflate in one to two weeks. Moderate slip: Deflate the band, operate to reposition band. Severe slip: Deflate band and operate to remove band. Less than five percent of patients will require removal or reoperation In extreme cases the stomach above or within the band may need to be removed. Prevention of Band Slippage: Appropriate band placement by surgeon Careful progression of diet by patient. Follow your meal plan to a "T" No solid foods for 4 weeks. Wait at least 6 weeks for first adjustment. Avoid vomiting or purging Avoid over eating and stretching the stomach pouch Chew food slowly and completely

Thanks for sharing your story, it's very inspiring! I do know one of my friends really miss her chocolate fix...she says she feels sick on any small amounts, she also gets sick if she drinks orange juice (I guess from the hypoglycemia) so from that aspect, I know she is not being totally compliant with her diet. From a medical standpoint I was told the reason behind the "dumping like syndrome" and hypoglycemia was that food empties quicker and has fast emptying in the small Sleeve stomach. However with the lap band stomach, our food empties very slow which gives us a "full feeling" really quick. I think is she is lactose intolerance now, she will get foamies if she try to eat too much food at one time, it's a bit different with us bandsters, we get the slimies...LOL

Of course complications happen with the band, it can happen with ANY weight loss surgery that you get. Those are the RISKS you take when you undergo lap band surgery. Do they happen to everyone? NO, however there are precautions to take and you may need to go to Allergan's website for a complete list of contraindications and warnings to make sure you are a candidate for the lap band, everyone's body cannot tolerate a tight band around their stomach and pressure on their esophagus for years, but many people can. Many people go through pre op testing to make sure they are a candidate for the band. Also, make sure you research your surgeon, I would feel more comfortable if my surgeon had banded over 600-1000 people, and is very experienced with aftercare that the band requires, those are your FIRST defense against complications with the band, don't worry too much about everyone else issues, because they can be from not following up with aftercare, or diagnostic testing, to keeping the band too tight, etc. What you need to focus on if are you in great hands with your surgeon, and learning about how to live with your band. Good luck!

That's great you are doing so well with your Sleeve, do you have any reflux? Can you tolerate carbs and sugar without getting sick? I know we are not supposed to eat sugar, but my friends told me the further they got out with the Sleeve, they are now experiencing more reflux and food intolerance issues. It's more like hypoglycemia than real dumping syndrome.

Congrats!! Keep up the good working your band!!!

You are correct .1cc can make a difference with being at the sweet spot with no reflux to being too tight and in misery. If he took out .5cc, you may want to go back and I would start with a .2cc fill and then wait about 4 weeks to see how that works, sometimes it takes about 2-3 weeks before a fill adjustment settles in...and if you are still hungry and can eat more than you want, then go and add about .1cc at a time and ease up on your sweet spot. I use these adjustments as examples of what I would do in this situation, you can discuss with your surgeon how you want to move forward with your fill adjustments. Good luck

Night cough = too tight, if you go back now and get a small amount out, you won't risk a damaged band. taking out as much as 0.1 to .02ccs will make a big difference in being too tight and being just right.

Hi JennyBean, 4 weeks post op is about time for most who are hungry, and I am assuming you have the 10cc band like I do. I started off with .4cc in my band, and I felt nothing with my first fill, but you may be different if you had to get some priming Fluid removed, so in that case you may want to start a littler lower and let your surgeon determine how much to give you. Good luck

Congrats on your weight loss with the Sleeve, but to say that the Sleeve WILL NOT eventually stretch out, is misleading people on a surgery that they can't reverse once it's done. Regardless of which bougie size you have it WILL stretch out eventually, you are only 2 years post op, based on my friends who have Sleeves, AND many medical published cited journals to back this up.... My friends with the Sleeve can't eat as much as pre op and they are 5 + years post Sleeve, but they can eat too much for it to be effective for weight loss without serious dieting, and they have to diet if they want to lose weight at the 5 year mark, also they have dumping syndrome, something that's not openly discussed with the Sleeve. If your Sleeve is working for you great! But many are just not willing to risk removing their stomach and end up having to diet like crazy in about 3-4 years.

I made this post about 5 years ago on another site a few years ago and it was very helpful to newbies so I thought I would post it here "Disclaimer, this is from my OWN journey and also seeing thousands of other lap banders journeys over the years" 1. If you drink COLD liquids or cold things the band will tighten up. 2. If you drink hot liquids the band will loosen up. 3. Most women that have menstrual cycles tissues around the band will tighten therefore causing the band to tighten up while menstruating and then loosen up right before or after a cycle. 4. The band will tighten if you get stressed about something, always leave a little wiggle room for unexpected tightness of the band, otherwise those who are very tight may find themselves not able to swallow their spit and cause irritation. 5. For many people the band will tighten during flying or even high elevation, those who live in mountainous terrains above sea level may experience a tighter band than those who live in flatter areas. 6. The band is tighter for most in the mornings, when you lie down this cause it to tighten further, something about how the saline moves around in the band which causes it to get tighter when you lie down. 7. When you have a GOOD FILL level you will notice you can't eat as much while sitting down, so don't cheat and stand up and eat! 8. When you have a GOOD FILL level, you will NOT be able to eat and drink at the same time, trust me, this will cause PBing and vomiting and cause the food and liquid to stack up and there is no where to go but back up. (This is an update to this one, many people can eat and drink at the same time, so this may be on an individual level). 9. When you are tightly restricted avoid, grilled chicken IN PUBLIC, make sure your meat are moist, example when I eat salads I add lots of dressing in order to eat this at work without getting stuck, but salad dressing is fattening, but it' not fattening only if you are only able to eat about 5 bites of it and get full/satisfied. 10. To avoid slimming and frequent vomiting (which may cause slippage or a stretched pouch if done daily) make sure you take pea size bites and chew and wait until you feel the food go through, the food IS SUPPOSED to gently ease down your esophagus slowly without PAIN, if you are having painful eating, you are not eating properly OR you are way too tight. Also if you are in public and eating at a restaurant you may want to order a hot tea or Soup to prevent first bite syndrome, typically the first bite is the toughest. Some people disregard this and they may vomit and if this is done regularly you will be on your way to become a revision patient. 11. Eating with the band will become very easy when you learn your band and signals of how tight you might be, your restriction WILL NEVER BE THE SAME EVERY DAY, you will have some days a little bit looser than others, THIS IS WITH ANY RESTRICTIVE SURGERY INCLUDING RNY OR THE SLEEVE, but the band is a bit more finicky since it is filled with saline so you have to eat accordingly based on how tight you are, However,...restriction should NOT vary a great deal, meaning one day soup and one day 2 whole Big Macs...lol, if your restriction varies that much you got a problem and need to see your doctor to make sure you are properly restricted or if you have a stretched pouch. 12. Clearing the pouch out daily -- THIS IS VERY IMPORTANT FOR LIVING with your band in peace! this is what I do to clear my pouch out daily, I make sure I drink Water after I eat before I go to bed, also chew about 2 papaya tablet from (GNC) this also helps clear my pouch out and avoid any indigestion while I lay down at night and I have a good night’s sleep even if I eat very close to bed time. But this will NOT work if you have a slipped band or esophageal issues or band damage. 13. Some foods may irritate you more such as spicy foods, fried foods, chocolate, mints, onions, coffee, these things may cause heartburn in some and may not in others, I can tolerate them as long as I don't overdo it, but taking a pepcid or other heartburn meds will help. 14. Getting food stuck - I've been stuck several times and it is not a good feeling so I try to avoid it as much as I can, the first thing I would do if I get stuck is excuse myself in go somewhere private and raise my arms and take deep breaths and message the middle of my chest this has helped me many times to prevent vomiting and when I message my sternum between the breast this will help move the food down, the food will either slide down or you will throw it up. 15. If you are truly stuck you may have to see your surgeon for an emergency unfill, you will know if you are truly stuck, this may cause breathing problems and can be quite scary and repeated vomiting, but as soon as the food becomes unstuck, most of the time you will feel better immediately. 16. You should ALWAYS be able to eat solid food, even if it's only 5 bites at a time you should be able to eat solid food with your band, if you get a fill and you have trouble with liquids, you are too tight and this will eventually cause problems. 17. It usually takes about 3-7 fills until you reach your sweet spot safely, If you can never get a good fill level, sweet spot, meaning too tight or too looseyou may want to change surgeons and seek a band surgeon only -- your fill giver may not be filling you properly, it should not take that much time to reach your sweet spot, your sweet spot should not be painful or have nightly reflux or pain or vomiting, the sweet spot should allow you to eat a few bites of solid food and you get a signal to stop eating like a hiccup, burp, sneeze, runny nose, and you may feel like you have eaten a thanksgiving dinner on about 4-5 oz of food. 18. The band will restrict dense solid foods better than soup or liquids, you will get fuller on these foods quicker, the band is designed to restrict solid foods, if you are too tight you may not be able to eat healthy foods that are required, which may result in no weight loss. 19. How to know if you are in trouble (deep do do) with your band, Reflux is that slippery slope type issue and should ALWAYS be of concern to lap banders, any time you get a new fill and if you experience reflux that is frequent, you should see your surgeon immediately, there are two types of refux with the band that needs to be CLARIFIED. 20. If you plan on going VERY tight with your band use common sense and puree your food, because eating solids on a too tight band will be a nightmare and you will eventually slip your band, if you don't want to remove saline, puree! and drink Protein drinks and when you lose the weight you want, reduce saline, because you will surely cause band slippage if you attempt to eat "regular solid food" on a too tight band for long periods of time (but word of caution, this may not work for everyone and can be very dangerous to some). How can you tell if your band is about to slip? 1. The dangerous reflux that indicates band slippage or (pouch dilation) is when it awakes you from your sleep and vomit and nasty liquid starts to shoot up into your nose and mouth, or a constant dry cough that is not associated with a cold. THIS REFLUX REQUIRES IMMEDIATE ATTENTION from your surgeon and possible saline reduced and Upper Gi to check your band. 2. The not so dangerous reflux is when you are in the green zone and you ate too close to bedtime and you wake up with "stuff" in your mouth and have to spit it out, what I've done to correct this type of reflux is to drink water before bed along with a few Papaya enzymes (from GNC) which helps ease digestion and move food through a tight band from the upper pouch to lower stomach to clear out that food. 3. However, you should NOT get reflux often WHEN YOU ARE TRULY in the Green Zone, if your reflux is every night despite taking the precautions of clearing out your pouch and not eating too close to bedtime, you are probably in the Red Zone and need some saline out or you may have other issues that needs to be followed up by your band surgeon. What to eat and how much should be discussed with your Nutritionist, but most who have success with their bands walk or exercise DAILY, eat lean Proteins first and veggies and drink water, it's just that simple.