Remember my post about restriction being a mind game? Well, I think I’ve got it figured out. Bear with me and I hope I can explain this.

Back in late September I started feeling a little less restriction, so I made an appointment for a fill. Because of my doctors’ schedule, that appointment was about 6 weeks away. So what happens? Restriction immediately returns. At least, that’s what it felt like.

Then over the next few weeks I became aware of not only increased restriction, but some stranger symptoms I’ve never had before: a little extra gurgling, a sensation of food hanging up in my pouch only to go through all at once later on, and one episode of nighttime waking due to Fluid in my throat. I’m starting to worry, a little, but these are not major problems so I forge ahead.

So even though I doubt very much a fill is in order, I kept my appointment because I wanted to get a look at the situation through fluoro. I know that if there is anything wrong, catching it early is key to an easy resolution. Here’s what we discovered:

My band is fine, everything is in good position, but the barium hung up a little in the pouch before going through. The doctor explains that this could be the beginning of a slippage, where the stomach creeps up a little through the band, enlarging the pouch and creating problems. I’m not there, yet, but the pouch looks a little larger than he’d like and he’s a little concerned about the way some of the barium didn’t flow through readily. So he takes out .7 cc of saline to increase the size of the stoma, and I’m to see him in a month to see where we’re at.

Looking back, I think it wasn’t the restriction that changed, it was my behavior. Making that appointment sent my subconscious a signal that I can relax, eat “normally” (meaning faster), and not worry because in a few weeks my restriction will be back. So I start overdoing it slightly, without even being aware that I am, which makes my restriction FELT. It hadn’t gone anywhere—I was just less conscious of it because my habits were such that it didn’t need to.

I’m convinced I did this to myself by eating too fast, and therefore eating too much before I realize it. BAD BAD BAD BAD BAD!!! I’m so, so thankful that I have ready access to a doctor who uses fluoro to see the band every time. My symptoms could easily have been ignored because they weren’t causing any pain or major discomfort, until such time that another surgery would be required. As it is, a minor unfill is all that's indicated, and I'm confident that what's left in my band will keep me on the straight and narrow.

My focus now is not so much on losing weight, it’s about taking care of myself and my band for the long term. This episode points up the habits that I STILL have, and that only I can control over time. Somehow I feel like the hard work is still ahead.

Can anybody explain the difference between Fluoro and an Upper GI? There's one doctor here, Dr. Teng, who will do fills on Mexican patients. When I asked if he does them under fluor, his nurse responded with, "he does them under an Upper GI." For the Upper GI, I stood up on an x-ray table and drank barium while they took pictures of my belly. What's fluoro in comparison?

I think it is almost the same..with fluoro it is almost like an x-ray machine you can see your port and your band and Ortiz has you drink barium so we both can see it trickle down to give him more of an accurate fill ammount. Gives a better guide to your restriction for example he would not go tighter then 2'cc's on my last fill by how slow the barium was going through, if it goes through faster he will fill more but slowly as he wayches it pass through until i he feels it is a good fill level for you. He was right on the money with both my fills...not too much but just enough

And once again, the guy looked good doing it! Thanks - it does sound like the same kind of equipment. Maybe fluoro is more like a live image while Upper GI is like pictures? Curious.

"Upper GI" isn't the name of a test, it's the name of a part of your body. Upper Gastro-Intestinal, or close to that. The full name of what you got, which I'm sure is the same thing as we all get, is an Upper GI *scan.* A fluoroscope--essentially an x-ray machine taking motion pictures--is the machine used to perform this type of Upper GI scan.

At least, that's what I think.

umm, actually, in the hospital, the test is called an Upper GI series. but, you're right it is indicative of the upper gastro area.

<HR align=right width="95%"> What is Upper Gastrointestinal (GI) Tract Radiography?

Also called an upper gastrointestinal (GI) series or simply an upper GI, upper gastrointestinal tract radiography is an x-ray examination of the esophagus, stomach and first part of the small intestine. However, in order for the anatomy to show up on radiographic images, the upper gastrointestinal tract must be coated or filled with a contrast material called barium, an element that appears bright white on radiographs. The barium is given to the patient to drink. This procedure is called upper gastrointestinal tract radiography when the esophagus, stomach, and duodenum are evaluated, or a barium swallow when only the pharynx and esophagus are evaluated. Additionally, some patients are asked to swallow baking-soda crystals to create gas and further improve the images; this procedure has the modified name of air-contrast or double-contrast upper GI.

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It used to be that this was done with still pictures/xrays, however, nowadays they have Flouroscopy, which basically is digital moving pictures, so that they get a more multidimensional picture. To us, it's basically a barium swallow - same procedure, more advanced equipment.

This post answers a lot of my questions. I was filled on the 25th and I sure notice a big difference. When I was banded the nutrionist had told me to chew chew. chew. Well I did pretty good I thought, until this fill. I have had to really slow down. I have found that sitting the fork down works pretty good. I still have those times when the food is in my mouth and just wants to go down. I have gaged myself a couple of times trying to catch it before the darn bite goes down.

I still don't understand why we would need more fills. Where does the fluid go? How can it be good for a period of time and then be gone? I am so confused on that.

Kathy, can you ask your doctor that question and let us know? Because I don't think the fill is supposed to go away. I know that a doctor can puncture a tube during a port fill, and maybe that would cause a leak. My doctor was looking for leaks during my Upper GI scan, so the Fluid would come out of the band if there was a leak. But other than a leak or a puncture, I think the saline stays in the band.

Thanks everyone for the information. Something really important here - during my Upper GI scan, the technician wanted to give me the gas bubbles to drink to expand my stomach. Good thing the doctor walked in and stopped her. He said people with bands should never be given the bubbles, which is something we all know already. But, if I'm laying on an examining table, and a doctor tries to do something to me, I usually trust him. Good think he walked in and stopped her, because it may have slipped my mind and I probably would have gulped it down. He told me the bubbly stuff they give would have instantly expanded my pouch and could have damaged it.

Thanks for the clarification, Leatha!!

DeLarla, oh my god!! What the hell?!? I hope that doctor reamed that tech's ass! That seems like total negligence. Didn't he have a clue as to why you were there? If not, he sure as hell shouldn't be making suggestions like that. Just do what's on the sheet and shut up. Grrrr.

As far as where the fill goes, it's not "supposed" to go anywhere. But many people report a lessening of restriction as they lose weight, which is not due to Fluid disappearing. Also, it's not unheard of for some saline to dissipate through osmosis. And in some cases some fill is removed for various reasons, and replaced later.

It's very individual, and can't be predicted. Kathy, maybe your fill will be perfect the first time and never need to be replenished!

Alex, I'm not sure it was the tech's fault. When I walked in, she had two bottles on her tray. I wonder if it was in her paperwork to give it to me. Or maybe it's just SOP for her to have them both ready? At least the doc knew. So far, in all my flipping doctor visits over my port, only that doctor and one of my surgeons is even familiar with the band. Even my local gastro knows so little about it. I can't wait for it to become more widespread so medical help is more available.