Fast or gradual?

[Elisabethsew 50]

In one of the posts I read, Julie from NYC mentioned that she went for three fills in three weeks to get to a good level of restriction quickly. My surgeon takes a different approach and works patients up to a proper level of restriction.

Having been banded for 5 months and not feeling ANY restriction at all until fill #3, I wondered what other peoples' experiences were with getting to an acceptable level of restriction. At this point in my post operative course, I would have liked the process to move along at a faster rate as I think I still need a small fill to get to where I will be at MY optimal level.

Please share your thoughts.

Thank you,

[*susan* 1,709]

I wanted to get to maximum restriction as quickly as possible. My doctor gave me 1.5 my first fill and that didn't seem to do a whole lot for me. However, he makes you wait four weeks between fills. And even then, once you go in to see him you are not guaranteed another fill. He asks a lot of questions, checks your weight, etc. He wants to keep the weightloss at 1-2 pounds per week. With all that said, he took me up to 2.0 last time and it is working wonderfully for me. I understand what restriction is now.

[ralheit 0]

My doctor does them every 4 to 6 weeks. I have had 4 and this last one really gave me restriction, so now he is waiting for 2 months to check me again.

[LindaV 0]

My doctor will do fills every 2 weeks until proper restriction is reached. He tends to do more conservative fills because he would rather his patients come back again in 2 weeks rather than come back sooner because they are over-filled. I should mention that he does not do fills under fluro.

Once a good level of restriction is reached the next fill is different for every individual depending on how quickly their restriction diminishes.

[Jachut 487]

Mine has been gradual and I'm happy with that. I really think for your health its best to keep your fill at the level where you can eat as much as possible whilst still losing, and my doc has been happy with a loss of as little as 2lb in a month. I wasnt though - I wanted more fill at that point.

I do worry about long term health and the band, when you're eating less than 1200 calories a day very long term, its very hard to get in adequate nutrition even when you're faultless in your food choices. So to me, the looser you can be and still get away with it, the better.

[Elisabethsew 50]

Interesting responses. Perhaps I wish my surgeon would have been a bit more aggressive with the first 2 fills. I'm anxious but nervous about going to my Sept. appt. As I get closer to optimal restriction, I worry about PBs.

[Nana~ 4]

I prefer to go SLOW, because I'm prone to getting overly tight very easily. a .4cc can close me off well it has before so I go slow .1cc or .2 cc at most

Nana~

[jgandg 0]

Elisabeth, I am so glad you asked this question. I asked something similar, but not worded half as eloquently as yours. I am trying to get my mind around when I can expect the band to "work", as it seems to be pretty soon for some, and months after surgery for others. The replies here are interesting.

[NimbleBean 2]

I've just started the medically supervised diet, hoping that my insurance will approve me for surgery sometime in February. In the meantime, I'm reading all I can here, and attending support group sessions at my doc's office.

Earlier in this thread, I came across something I'd never heard before. Linda V mentioned that her doctor "does not do fills under fluro." Can someone tell me what fluro is.

Thanks to all of you for the great info and for being so inspirational!

[Stitchy 0]

I waited about 10 weeks to get my first fill. The doc said that they would do them every week or two, but I prefer to wait at least a month between. I have heard that sometimes the restriction takes a couple of weeks to settle in. I really don't want to be too tight too soon.

I have been on a plateau for about a month. I think I will schedule my 3rd fill for a couple of weeks from now.

[Elisabethsew 50]

I've just started the medically supervised diet, hoping that my insurance will approve me for surgery sometime in February. In the meantime, I'm reading all I can here, and attending support group sessions at my doc's office.

Earlier in this thread, I came across something I'd never heard before. Linda V mentioned that her doctor "does not do fills under fluro." Can someone tell me what fluro is.

Thanks to all of you for the great info and for being so inspirational!

Fluroscopy means having a fill under x-ray. The MD will give you a fill and then have you drink some barium and watch on the x-ray as the barium goes down. From what I have read, most surgeons don't routinely use fluroscopy (mine included). You will experience this "test" after you are banded to make sure all is OK before you're permitted to drink anything.

[Tired_Old_Man 1]

Interesting responses. Perhaps I wish my surgeon would have been a bit more aggressive with the first 2 fills. I'm anxious but nervous about going to my Sept. appt. As I get closer to optimal restriction, I worry about PBs.

I think the less aggressive a surgeon is with fills and the slower he creeps up to the optimum fill point, the less chance you will have for PB's. That is assuming that you tailer your eating to the restriction level each time.

I was doing fine until my second fill. Then PB's like mad. The surgeon added more Fluid to solve the problem. I argued with him that a partial de-fill would have been a better solution, but he said he had experience. He was wrong. The PB's got worse.

When I moved from Brooklyn to Florida and changed doctors, the new doctor gave me more saline and my PB's continued to get worse. Finally after one more add, they had to empty my band because I could hold nothing down except clear fluids.

I have been unrestricted now for about 4 months.

So, Elisabeth, please do not worry about PB's following you next fill, because I think your doctor is going about it the right way.

[babyjane 0]

i had my first fil 3 months after surgery and he put in 2cc in a 4cc capacity band. brother, did i have to adjust to

the restriction!!:biggrin1:

[JulieNYC 4]

My opinion is that I don't think there's a such thing as "the right way." Each patient is different and each doctor is different. It has to be a combination of what you are both comfortable with.

For me, what Jacqui said is exactly perfect for me -- "So to me, the looser you can be and still get away with it, the better." My doctor does allow multiple fills within as short as a week if the patient feels that the level of restriction isn't right in either direction. That's not to say that he pushes fills on any patient. I had the 3 fills in a row early on and I have great restriction, which to me means that my hunger is turned off for 4-5 hours by eating reasonable portions. I can still eat any type of food and I can still eat a larger portion than I think is reasonable if I choose to. It's just that with my restriction, I can usually choose not to! My fills were all in early June and I haven't needed one since.

This is a great approach for me, though I completely understand why a slower approach would be good for a different doctor and a different patient. For me, I wanted to feel like I was finally in control of the food, and I didn't want to wait to get there.

[Tired_Old_Man 1]

My opinion is that I don't think there's a such thing as "the right way." Each patient is different and each doctor is different. It has to be a combination of what you are both comfortable with.

For me, what Jacqui said is exactly perfect for me -- "So to me, the looser you can be and still get away with it, the better." My doctor does allow multiple fills within as short as a week if the patient feels that the level of restriction isn't right in either direction. That's not to say that he pushes fills on any patient. I had the 3 fills in a row early on and I have great restriction, which to me means that my hunger is turned off for 4-5 hours by eating reasonable portions. I can still eat any type of food and I can still eat a larger portion than I think is reasonable if I choose to. It's just that with my restriction, I can usually choose not to! My fills were all in early June and I haven't needed one since.

This is a great approach for me, though I completely understand why a slower approach would be good for a different doctor and a different patient. For me, I wanted to feel like I was finally in control of the food, and I didn't want to wait to get there.

I wish my combination of head hunger and biological hunger were as controllable as your fill regiment seems to have made it for you. I envy you. Keep up the good work.