. . . by that I mean BY a beginner, for other beginners. I had my first fill today. I found other descriptive posts very helpful in answering my questions and allaying my fears, so I thought I'd post a little step-by-step guide of my own, in case it helps any other readers who wonder what a fill involves and feels like.

First of all, I should mention that I was banded in Mexico and am getting aftercare in the US. This was made relatively easy because (1) I live in a big city, and (2) one of my surgeon's former students has a large, well-established Lap-Band practice here, and this doctor agreed to do my fills for a fraction of what he usually charges other docs' patients ($250 vs. $1000).

My surgeon, Dr. Rumbaut, had told me that I'd probably want a fill after six weeks; no matter what, he said, I shouldn't get one any earlier, and I may not need one until later. The day after my six-week anniversary I started feeling hungrier, and was able to pack away more food than before. I figured I should at least get checked out.

My appointment was at 2 pm today. I arrived at Dr. Horgan's posh Michigan Avenue office 15 minutes early, completed a new-patient info form and a questionnaire about obesity-related health problems and whether I'd noticed a change since banding, and just after 2 pm I was shown to an examination room where an assistant, Michelle, weighed me on a body-composition scale (photo #2 below) and took my pulse and blood pressure. I was asked to change into a giant hospital gown. (I should mention that both the gowns and many of the waiting room chairs are sized to accommodate very large people. Someone was thinking ahead.)

I asked Michelle if I could take pictures, and after an initial hesitation she said yes, and suggested that I ask for a duplicate copy of my fluoroscope image. She then led me to the room holding the machine (photo #1). In a few minutes Dr. Horgan and a male technician came in and briefly explained the procedure. I should mention that, except for the gown replacing my blouse, I was wearing all my clothes. Dr. H asked me to lower my trousers so that he could get access to the port, which in my case is a few inches above my left hipbone. He guided me into position in front of the fluoro machine. I remained standing the entire time, and never actually touched the equipment. To my disappointment I realized that I would not be facing the image of my belly, which (weirdo that I am) I was kind of looking forward to. So far, easy as could be, no discomfort of any kind.

Next, Dr. H sprayed a "freezing agent" near my port; I forgot to ask what it was. The freezing agent really did feel cold, and it looked as if a half-dollar-size spot on my belly had been in the back of a refrigerator that needed defrosting, little ice crystals and all! Still no discomfort. He asked me to take a swig of a thick white barium drink. It wasn't as bad as I expected (the technician joked that Starbucks was selling it, but that's pushing it) -- just a little chalky, with a slight vanilla scent and taste. The barium makes its way down the esophagus to the stomach (and, later, beyond) and allows the technician to see a rough outline of the patient's insides.

At this point I noticed Dr. H preparing a big hypodermic needle. Yikes! After adjusting my position, he aimed right for the port. I won't lie -- I definitely felt it. I know many other bandsters don't even notice the needle go in, but not me. However, it wasn't bad, and I think if I hadn't expected the entire procedure to be a total breeze, it probably wouldn't have bothered me at all.

Unfortunately I couldn't take a picture of the needle going into my belly, because I had to hold my arms straight down at my side -- and I sure didn't want to ask the doc to drop that giant needle and pick up my camera!

I think it was at this point that I took another swig of the barium drink so they could monitor the response of the band and my body. That needle was definitely in, and the doc injected some saline. I blithely thought I'd get 1.5 cc, since that seems to be average, and so far I'm your average bandster. Nope! First I was injected with 1.4 cc, then as the two guys watched the fluoro, Dr. Horgan said, "Oh, that's too much. Let's take out .2." So he did. So here I am with 1.2 cc of saline in my Inamed band, which Dr. H said should give me good restriction.

I did get a copy of my fluoroscope picture (#3). Hey, I've had less flattering photos! By the way, the small bit highlighted by the ink rectangle in the left image is my band, and the dark hairy-looking bit is the barium drifting through my stomach. I had to ask.

Well, I'm on liquids for 48 hours, then onto the real bandster eating routine. Dr. Horgan said I should lose two pounds a week. When I said I didn't mind losing more slowly, he was adamant, and said if I didn't lose those two pounds every week I should give him a call. He wants me to see him in another two months -- sooner if I have trouble. And in case this initial fill is too tight or too loose, I can have it readjusted for free as long as I do so within a week.

One last thing I can't resist adding: Dr. H asked me why I had surgery in Mexico. "Financial concerns," I said. "What kind?" he asked. I was taken aback. "Well, it's a lot cheaper in Mexico," I shrugged. He didn't have a response to that!

Good luck to everyone getting their first fill -- it's not bad, and the whole thing, including paperwork and tests, took about 45 minutes.

Thanks for the post Zoe, Monday I have my first fill and I am very nervous but very ready. This helped so much.

Thanks

Kathy - Try not to worry too much. For whatever reason I was SO nervous when I got my first fill that I felt silly after. It's really not that big of a deal

Kathy, you'll do fine with the fill. It's hard not to be nervous with any medical procedure -- but the fill itself takes just a few seconds. Most of my time was spent filling out forms, putting on the gown, and waiting. Good luck, and let us know how everything goes.

Zoe, thank you so much!!! I really didn't know what to expect when getting a fill. You explained the process beautifully. I am sure there are many of us who will be thinking back to this thread when we go for our first fill!

Kathy, don't eat 2 hours prior to your fill. But it's o.k. to drink up until then. You'll do fine!

Thanks for sharing with us zoe. I just got a fill and they didnt use a machine like that at all. They just felt around found the port then filled me. It cost me 500 for consult with dr. felding. Dr rumbaut recommened him to me. and 100 for the fill. from now on it will be 100. but the nurse did the fill i was surprised. but i have 1.4 and feel great. love my fill!

Thanks Zoe!!! For the play-by-play of the fill. It will definitely help me go through my first!

Nancy*

Update: Well, that first fill really didn't give me much restriction. I knew I was in trouble when I could eat a full order of Peanut Sauce Lover with a giant pile of rice at my local Thai restaurant. From what I understand, it's not unusual for bandsters to require two or three fills before real restriction kicks in. My second fill on Jan. 21 did the trick, and now I'm losing weight again. You might have to be patient; it's frustrating, but it pays off in the end.

I had my surgery done by Dr. Horgan, and will get my first fill in two weeks at University of Illinois in Chicago. In the standard patient packet it says fills are $250.00. Maybe they charge more for the clients who are self-pay? My insurance is covering the fills at the UIC office, and the nurse told me all HMO clients must have fills done at UIC and not at Michigan Ave. location.

Your post with pics was VERY helpful..I appreciate it!

Thanks so much for the step by step! I'm scheduled for my first fill in 2 1/2 weeks. This was definitely very helpful for me.

Mercy

Dr. Waldrep

Roseville, CA

432/408/392/200

Hi Joanie -- You're right about the higher fee for self-pay clients of Dr. H. I pay $250 too because of the courtesy discount I receive as a Rumbaut alumna. I go to the Michigan Avenue office. It's very posh; if I'm lucky I can find a parking space at a nearby meter, otherwise it's the steep Bloomingdale's garage rates. You and Mercy are going to be fill sisters, getting "topped off" the same week. Good luck and congrats to you both!

That was a good idea to do a play by play. My doctor does his a little different. You don't have to change into anything. You just lift up your shirt. My port sounds like it is in a different place than yours. It is in the middle of my stomach (about 5 inches above my belly button). The machine looks different too. You lay on it and then they raise the machine into a vertical position. You have the needle put it as your vertical. Because the port is right under my skin, it really doesn't hurt, they put a numbing solution on it, but, no jelly. He gives you barium to see the insides, and it really isn't that bad just as zoe said. Word of advice, don't drink much of the barium before the fill, if they tighten it a little tight, it will make you extremely nautious(sp) Another thing........it sounds gross, but want to give you a heads up..........your poop the next time will be white and rather hard!!!

Last time I had my fill taken out, they asked me to bring a piece of chicken and they could see how it moved through on the camera. This made a world of difference for me, and I recommend it to anyone who has a hard time getting the fill correct.

hmmmm I am scheduled for my first fill on 3.17.05.

If my insurance covered the surgery do they usually cover

the fills as well?

Thanks

Carey

I don't know; contact your insurer for details. Good luck.

Dr.Horgan is by far the best lap band surgeon in the Chicago area.

Pat

Banded 2/13/2003

-100#