Here is info will come in handy when thinking about fills/adjustments. Great information. I have seen this information before and it is really good.

How to Tell When You Are Perfectly Adjusted

You are losing 1-2 pounds per week.

If you are not losing 1-2 pounds per week:

A. You may need an eating adjustment

1. Are you eating 60 grams of Protein a day

2. Are you eating 25 grams of Fiber

3. Are you avoiding all liquid calories

a. Soup can be sign of “soft calorie syndrome”

b. Alcohol contains a lot of calories – 7 calories per gram

(1) It’s also a stomach irritant

c. fruit juice is just sugar Water

4. Are you making healthy food choices from a wide variety of

foods?

a. Are you avoiding soft foods

b. You can’t just eat what’s easy

c. cheese is glorified fat

5. Are you drinking 6-8 glasses of water a day between meals

6. Are you eating too much junk

a. chips, chocolate, nuts, ice cream, Cookies and other highly

processed junk foods are too calorically dense to be regular parts of a

healthy diet. But don’t avoid them completely to the point where you

feel deprived.

b. Stay out of fast food places

7. Are you getting in two servings of Calcium daily

8. Do you always eat the protein first

9. Then the vegetables or fruits

a. Five servings a day

b. Potatoes are NOT a vegetable

10. Is your portion size appropriate?

a. meat or fish

(1) 3 ounces – the size of a deck of cards

b. Vegetables

(1) ½ cup – the size of your fist

c. Starch

(1) If you eat the protein and the vegetables first you don’t need

much

(2) Avoid: rice, potatoes, Pasta

11. You might try avoiding artificial sweeteners

a. Some people think that artificial sweeteners stimulate the

appetite

b. They are HUNDREDS of times sweeter than sugar

c. They teach you to like things too sweet

d. There is no evidence that people who use them are any thinner

than people who don’t

12. Avoid most diet foods

a. Real food usually tastes better

b. Real food is more satisfying than low calorie substitutes

c. When you are only eating a tiny bit the caloric savings is not

that great

(1) Use a teaspoon of real butter instead of a tablespoon of diet

margarine

(2) The body has no way to break down artificial fats

a. They may go into permanent storage

b. Some people think liposuction is the only way to remove

hydrolyzed fats from the body

B. You may need a behavior adjustment

1. Are you eating only when you are hungry?

a. If you’re not sure drink 8 ounces of water and wait.

2. Are you eating three meals a day?

a. With maybe 1 or 2 small Snacks

3. Are you sitting down to eat?

4. Are you eating consciously?

a. No distractions, turn off the TV, put the book or newspaper

away, pay attention to your food and your companions

5. Are you eating slowly?

a. Put the fork down between bites

b. Take 20 to 30 minutes to finish a meal

c. Taking longer might cause the pouch to begin emptying

6. Are you taking small bites?

a. Tiny spoon, chopsticks, cocktail fork

7. Are you chewing well?

8. Are you drinking with your meals or too soon after your meals?

a. Practice water loading between meals

b. You won’t be thirsty if you are well hydrated before the meal

9. Are you stopping at the first sign of fullness?

a. Sometimes it’s a whisper: not hungry, had enough

b. Hard stop versus soft stop

10. Do not eat between meals. Stop grazing.

11. Do not eat when you are not hungry

C. You may need an activity adjustment

1. Are you getting in 30 minutes of physical activity at least 3

times a week?

a. Over and above what you would do in the usual course of your day

b. Could you make it 4 or 5 times a week?

c. Could you make it 45 or 60 minutes?

2. Are you taking advantage of opportunities to increase your

physical activity?

a. Taking the stairs instead of the elevators or escalators

b. Walking on the escalators instead of riding

c. Parking your car further away from the entrance

d. Getting out of the car instead of using the drive through

e. Getting off the bus one stop before your destination

f. Washing you car by hand instead of the car wash

g. Playing with your kids

D. You may need an attitude adjustment

1. Are you committed to your weight loss journey?

2. Are you totally honest with yourself about how much you are

eating and exercising?

a. Log your food and activity on ww.fitday.com for 3 days

3. Are you using food inappropriately to deal with emotional

issues?

a. Have you identified what the emotions are that drive your

eating?

b. Can you think of more appropriate ways to deal with those

emotions?

c. Are you willing to seek help from a qualified counselor?

4. Are you attending and participating in support group meetings?

5. Have you drummed up some support from your family and friends?

6. Have you dealt with saboteurs realistically?

7. Do you have realistic expectations about the weight loss

journey?

8. Are you still obsessing about food, weight, dieting, eating?

a. Obsessive – compulsive thoughts

(1) Obsess about something else

b. Perfectionism

(1) All or none, black and white thinking

c. Patience with the pace of healthy weight loss

9. Are you acknowledging your successes with non-food rewards?

10. Have you learned how to take a compliment?

11. Are you giving up diet mentality?

a. Stop weighing yourself several times a day or every day

b. Stop dieting

c. Stop depriving yourself

d. Stop defining food as “good” and “bad”

e. Stop rewarding and punishing yourself with food

12. How do you feel about all the changes taking place?

E. You may need a band adjustment

1. You feel like you are making healthy food choices in appropriate

portion sizes but getting hungry between meals?

2. You can still eat white bread, fibrous vegetables and large

portions.

3. You are having to struggle to lose

4. You are gaining weight in spite of eating right, exercising and

having a good mind set.

F. You may need your band loosened

1. There are times when you can’t get fluids down

2. You are vomiting too much

a. How much is too much?

3. Do you have frequent reflux or heartburn at night?

a. Do not lie flat or bend over soon after eating

b. Do not eat late at night or just before bedtime

c. Rinse your pouch with a glass or water an hour before bedtime

d. Certain foods or drinks are more likely to cause reflux:

(1) Rich, spicy, fatty and fried foods

(2) Chocolate

(3) Caffeine

(4) Alcohol

(5) Some fruits and vegetables

a. Oranges, lemons, tomatoes, peppers

(6) Peppermint

a. Baking soda toothpaste

(7) Carbonated drinks

e. Eat slowly and do not eat big meals

f. If you smoke, quit smoking

g. Reduce stress

h. Exercise promotes digestion

i. Raise the head of your bed

j. Wear loose fitting clothing around your waist

k. Stress increases reflux

l. Take estrogen containing medications in the morning

m. Avoid aspirin, Aleve and ibuprofen at bedtime

(1) Tylenol is OK

n. Take an antacid (Pepcid complete) before retiring

o. Try other over-the-counter heartburn medications

p. See your health care provider

4. See your health care provider immediately (or call 911) if

a. You have a squeezing, tightness or heaviness in your chest,

especially if the discomfort spreads to your shoulder, arm or jaw or is

accompanied by shortness of breath, sweating, irregular or fast

heartbeat or nausea. These could be symptoms of a heart attack.

b. If your symptoms are triggered by exercise.

c. If your pain localizes to your right side, especially if you

also have nausea or fever

d. If you throw up vomit that looks like black sand or coffee

grounds. Or if your stool is black, deep red or looks like it has tar

in it. These are symptoms of bleeding and need immediate attention.

(Note: Pepto-Bismol or other medications with bismuth will turn your

stool black. Iron supplements can also make the stool tarry.)

e. If your pain is severe

You might try fillcenterusa.com 866-345-5872 a lot of people go there.

Thank you for the suggestion. I am in Arlington. What do you think of Dr. Dobson?

Mary Luke

I don't know yet, but he will be doing my next fill.

I know someone that went to him a couple of years ago and she liked him.

You might check www.aigb.com. American Institute of Gastric Banding operates lap-band surgery centers in Houston and Dallas. I get my fills for $150 at the Houston Physicians SurgiCenter. Check either the Surgery Center of Richardson or Specialty Surgery Center of Fort Worth.

I think you will be fine. For me i was given alot of saline very fast with my first fill. On a 4cc band my first fill was at 2.1 and then 2nd they added .4 to make a total of 2.5

I am so tight that often i choose to have Soup just for a break in swallowing. It makes eating a task not a enjoyable experience. My Doc says i will loosen up but after three + weeks i think i will but only after loosing a bit more

I had my second fill about 8 weeks ago, and I am still pretty tight. There are days I can eat quite a bit, but then, there are days that I can not eat anything solid until after 3:00-5:00 p.m. Just because I wanted to see my weight loss increase in speed, I almost went to get a third fill. I had an appointment and the day before I went in, I could not eat much of anything. I Pb'd most everything up that day. I was really hungry, but had to drink cause everything I ate, seemed to come up. I postponed my appointment until this Saturday. To be real honest, I don't think I am going to need the fill this week either. I did not eat any solids today until 5:00p.m., but once I started eating tonight, I ate more than I meant to......so, what do you think???? What should i do????? Today is a perfect example of my confusion. I have lost about 28-30 pounds in 6 months and am very discouraged. I just don't get it when I hear others say they lost 25-35 pounds the first 2 months. H E L P!!!!!!:help::help::help::help::help::help::help:

Wild.........about life.

wild_in97: You weight loss is actually a little above average according to my doctor. We are supposed to only be losing 1 to 2 lbs. per week. Those first big losses are due to things that are not all actually accumulated fat. Our fat stores are what we need to get rid of to lose the real weight and losing it over a longer period of time is what helps us get in the position to keep it off.

Having a really tight band that doesn't allow you to eat solids for an extended period of time can cause you to not get the proper nutrition and can cause you to lose weight so fast that you will eventually have a lot of cravings that will subbotage your efforts.

I'm not an expert, I'm just telling you what I've been told. It makes perfect sense. Like they say, if you keep doing the same behavior you've always done, you'll get the same results that you've always gotten. So if you are anything like me and have done diets that have been really restrictive and caused you to lose weight real quickly, but some time later you gain it all back, and more, you may be doing the same thing that you've always done. And you'll get the same results - unhealthy obesity.

I've been having the same struggles as you. I am trying to decide whether to have another fill too. It's a tough decision because you know that if you can't eat, you'll lose weight faster. But I have decided that I'm in this for the 2-year plan that they promised will give me better health and will not cause me to lose my hair.

I hope you continue to do as well as you have been and wish you all the success in the world!

Hi, I am considering a TJ doctor. Do you mind sharing who did yours and how much did it cost? What was your experience etc...

I had Dr. Ortiz in Tijuana. He is great. The facility is clean and modern and the staff is friendly and caring. Dr. Ortiz has done thousand of lapbands and has more experience than most U.S. doctors. The cost was $8500 and that included the hotel for 3 days and transportation from the airport and hotel to the facility. You have to pay your own airfare. The follow up fills are free unless done under fleuroscope which costs $100. If you are self-pay I would definitely recommend Dr. Ortiz. I went back to Mexico for first fill so he could check to make sure everything was going right. After that, I found a fill a great doctor in Oregon who does the fills for $150. Good luck on your surgery!!

Wild in 97

I too have the same problems you have, and I have lost about the same amount of weight in the same amount of time, but my girlfriend lost twice as much as me but she had a lot more to lose, but her skin sagged really

bad so she had to spend a lot more money getting a body lift and face

lift just to get rid of the extra skin, so I don't think it's worth it to lose

too much in a short length of time.

Anniemay

I just returned from an appt. with the exercise physiologist and the doctor because I decided I wanted a fill. I had lost 5.5 lbs. in 4 weeks. I've lost 35 lbs. and 35 inches - about the size of my granddaughter. Just think. I was carrying around my granddaughter (in fat) full time!

The doc gave me a sweet lecture. He did not think I should get an adjustment. He said that I should wait until I plateau. He says I'm being impatient and not giving myself enough credit for what I've already lost. He says that we bandsters tend to give our bands all the credit. We need to be proud of our accomplishments and take full credit. I was pretty pumped after I left. I think I just wanted even more restriction so I could lose it faster. But faster isn't better if you want to keep your health, including your hair. Plus slower gives time for our minds to adjust and really register our weight loss. He said that one day, in another 30 lbs. or so, I will come to the realization that I won't gain the weight back like I always have before.

So I hope this helps somebody else at least a tiny bit. I can't eat fast, but I don't PB a lot. Only twice in the past month. And he says that's a good thing. It means I am learning how to eat properly... with or without the band. Good point I guess.

Hello to all. Haven't been on for awhile. I had my 3rd fill today. I haven't had any restriction, don't think I will with this either. But today when she injected the saline, unlike before I felt a big rush kind of painful sensation. Is this the saline going in the tube or what? It did not do that the first or second time. Also there wasn't all the saline in the band that should of been , I think I'm supposed to have 1 1/2 or 2cc. I have the 9.75 band. It is so frustrating, cause I haven't lost any weight at all since I had this done in July 06. Then you read of poeple being tight and can't hardly eat anything. I will probably go for my next fill under flouro. Was just wondering if anybody else had this experience. Thanks

Swimswiggs: I have never heard of that happening. I never feel anything except the tiny needle for the anesthetic.

When you asked the doc about it, what did she say? I think I was supposed to have 2.1 cc in my band and when he withdrew the solution, it was 2.0 ccs. He says it amounts to a couple of drops. I asked if I had a leak and he said no way.

But feeling a rush and kind of an uncomfortable or painful sensation during the fill doesn't sound right to me. But someone else here might be able to clarify that for you.

Good luck! Please let us know what you find out.

I could feel the band tighting, It was not painfull, just strange. This happened with both of my fills. Both fill have caused a restriction and were done under flouroscope. The band was filled untill water would not go down then some of the fill was removed. A barrium drink showed that a nice flow was working. I am happy paying the extra for the flouroscope and getting resualts.

My doc doesn't believe in doing fills that way. He claims we need the time to adjust to new eating patterns, etc., plus he says some people have to have an unfill sometimes even if they use a flouro.

Frankly, I don't know if he is right. I am tired of going through several weeks of no loss. Then only getting a small fill that I don't even notice. Having holes poked in me isn't fun. And I would like to lose this stuff faster. I'm not getting any younger!

I've completely stopped losing weight since my last fill. Is it possible I'm too tight? I've had some problems getting things to go down, but I can still eat fairly large quantities of soft foods. I've been the same weight for 4 months!!! I'm ready to scream.:angry

BJean: he is your Dr. and I would listen to him. It works for me and may not for someone else. I have been told that 2-3 days after a fill it will be tighter than when first filled. This has been true for me, I have been tight for about a week. That means that if I eat solid food it must be chewed till it is soft and wet. The Dr. has offered to be avaliable 24/7 if it is too tight. As long as I do not use bad habits it goes well. I feel that the problem is that if you do not follow directions well and don't chew you will be in discomfort.

Eating is so natrual that we must fight the act of being "normal". It is our brain that we must control. I tell myself all the time, eat slow, chew, chew some more....