Hi,

I am a week out and not filled yet, but wanted to share what my surgeon said about fills. He said, "I fill you until you have complete restriction, and can't even get water down, then I back off just a little bit." He said that this is full proof way and doesn't waste the patients time in finding the "sweet spot". In all my time here at LBT, I have never heard of this approach.

Does anyone else have a surgeon/doctor who fills this way?

Any thoughts?

I haven't seen that philosophy in all of my research, either.

My surgeon' practice uses the little bits at a time philosophy. If you are losing 1-2lbs per week and are not hungry, you don't need a fill. But if you are ether not losing 1-2lbs per week, or if you are truly hungry (not head hunger), then you need a fill.

Since I'm not a band surgeon, I can't speak to whether this is dangerous or not, but it seems like a very uncomfortable way to do a fill. I suppose it could also be dangerous since in order to test if you can even drink Water, that will cause you to throw it back up. And every time you do that, you are at the very least irritating your pouch.

I hope Dr. C wanders through this thread. If not, wll you go to his site and ask him? He encourages questions over there if he isn't around here. www.thebanddoctor.com

My doctors philosphy is filling slowly. Truthfully, I wish he was a bit more agressive with his fills. It took me forever to get to my sweet spot. 8 months. Julie

My doc was agressive with the first fill gave 1.5cc...2nd fill he only took out .5 so he gave me another 1cc...so there is either 2.5 in there or 1.5...it's a tough thing to really track. depends on how much air is in the tubing etc.

Hi Kity,

Although I had never heard of this either, my doctor did the same thing on the second fill that I had. He told me that when I could not swallow, I was at maximum capacity. He then decided how much to put in me, based on his experience, and the way it felt. He did admit that he would not know how it was for a few days though. This fill has been good, but it does change. The first few days, I could not eat certain foods then I could, but appetite was controlled, and just starting yesterday (4 weeks after fill) I am quite restricted again. I know that people say this can happen near the start of menstrual cycle, but this is not the case for me. Strange stuff, this band.

That wouldn't work for me because I can swallow fine at the office and then my fills dont kick in fully for up to 5 weeks so I would be in a mess and getting a slight unfill. If it works for you then go for it.

Hey, everybody!

I got my first fill on Friday. It was 1.0 cc's. I still am not feeling any restriction. Will it take time to kick in, I wonder? I don't want to have to wait until my next appointment on 6/1/07 to try again. Sheesh. I don't mean to sound so impatient, but .....I'm impatient!

Thanks for any info you can provide! BJ

Hi,

I am a week out and not filled yet, but wanted to share what my surgeon said about fills. He said, "I fill you until you have complete restriction, and can't even get Water down, then I back off just a little bit." He said that this is full proof way and doesn't waste the patients time in finding the "sweet spot". In all my time here at LBT, I have never heard of this approach.

Does anyone else have a surgeon/doctor who fills this way?

Any thoughts?

This is essentially the way my surgeon's office does it. Dr. Bertha does it under fluoroscopy and will fill the band tightly to close it off completely, so that the patient gets to feel what this is like. Then he'll back off a bit, and a bit more, watching the fluoroscope as the patient drinks barium so he can see when he's reached the right level of restriction.

I guess filling you to the point where you have no opening and then backing off a bit is a time saver, but I hear that your stomach swells after being tightened. Couldn't that cause a complete obstruction? It sounds kind of scary. Have you guys had problems with needing un- fills or band slippage or obstruction, or anything else bad? Plus, so many people seem to have that "delayed restriction/varied restriction" stuff happening.

I'm frustrated that I am having to go so slowly to get enough restriction. I guess we all have to determine what we consider to be the lesser of the two evils.

Just keep close watch... Being overfilled can cause pouch dilation. And being a new bandster, you won't have a learning curve during which to make mistakes. You'll have to be dead on with your behaviors and choices.

This method by no means automatically means you'll be overfilled, not at all. It is just another way of approaching the actual mechanics of a fill. Closing it off entirely for a moment can be very instructive; that way the patient gets and idea what too tight feels like, so she can recognize it if it happens again.

Once the doctor pulls out Fluid there is nothing different than if he'd never done the tightening thing at all. It's only for a moment, and (at least in my doc's case) watching the fluoro is really the way he's judging the final restriction, not by the amount of fluid he's put in or taken out.

My doctor must be conservative because I only had a 3 cc fill today (first one) and my band holds up to 10 ccs. I can't imagine that many doctors would think over-filling is a good thing. The down side to lap band is that it involves a fair amount of tinkering over time.

I heard from a nurse in my surgeon's office that the 10cm band is the same as a 4cc band. Am I wrong? Did I hear incorrectly?

Bjlang, nope you are right...a ten cm band holds four ccs. I ran into the same thing. For the first month i thought i had a ten cc band, because i misheard, and only when i was having a conversation with my surgeon during this last fill did he correct me. I found im actually half way full when i thought we had lots and lots of ways to go.

Bjlang, nope you are right...a ten cm band holds four ccs. I ran into the same thing. For the first month i thought i had a ten cc band, because i misheard, and only when i was having a conversation with my surgeon during this last fill did he correct me. I found im actually half way full when i thought we had lots and lots of ways to go.

Glad to hear that! I don't want to have to get 8 more fills at 1cc each, in order to get restriction that's effective! LOL I also was having a hard time imagining how big the band must be to hold 10 cc's.

I guess this means that Syrah's doc is NOT conservative! Good for you, Syrah! You should be feeling pretty full!

Hmmm. I have read around here a bit and many first-time fills for VG bands are 4 to 4.6 ccs. Even then, people are saying they haven’t felt much restriction.

Either I am confused, or you guys are. LOL! The Vanguard band holds a max fill of 10 cc. Of that, I have 3 cc. The VG holds a max of about 10 cc of saline.

The 9.75 and 10 cm bands can hold a maximum of about 4cc of saline.

The 4cc band is the 10cm band. The larger, VG band, holds 10cc's

I believe the VG used to be used for high BMI patients, but my surgeon told me he uses them routinely now. I can’t remember why but he prefers the VG band.

Someone correct me if I’m wrong!