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

Is it easy to get fills from another Dr if I move out of state? I am working towards the band (with my insurance I have to jump through lots of hoops first, 6 months of hoops). Thanks!

If you begin eating solid foods before the 6 weeks then there is the possiblitly that the new stoma can close itself off and then you back in the hospital. I have a nice big black binder full of all kinds of band info given to me by my center. If you stay to the diet as I am now doing you will still lose some weight becasue I know that my restrictionsare starting next week is 5 meals a day and 2 snacks and your only getting 2-4 ounces per meal and if it is liquid or even semi liquid you will still lose weight at least I know this is how it has been for me. I had my band last Monday and been on straight liquids since last Sunday and my weight is coming off.

Well I have to tell everyone that I was disappointed when I went for my 4 week check up. I have lost 23 lbs and I asked my doctor when I was going to get my first fill. He said "when you quit losing weight." I told him that I am hungry and can eat a ton of food. He said "well as long as you are losing weight you don't need a fill. I am doing this on sheer will power alone. If I was going to do that why did I get the band. I was so looking forward to getting that fill. I have another appointment in 4 weeks. So do I go ahead and eat what I want and not lose or go ahead and lose and take the chance I still won't get a fill. I am sitting her right now hungry. I had a Weight Watcher "Smart One" for lunch and a bowl of oatmeal for breakfast. Any one care to make a comment?

Well I have to tell everyone that I was disappointed when I went for my 4 week check up. I have lost 23 lbs and I asked my doctor when I was going to get my first fill. He said "when you quit losing weight." I told him that I am hungry and can eat a ton of food. He said "well as long as you are losing weight you don't need a fill. I am doing this on sheer will power alone. If I was going to do that why did I get the band. I was so looking forward to getting that fill. I have another appointment in 4 weeks. So do I go ahead and eat what I want and not lose or go ahead and lose and take the chance I still won't get a fill. I am sitting her right now hungry. I had a Weight Watcher "Smart One" for lunch and a bowl of oatmeal for breakfast. Any one care to make a comment?

Congratulations on your success so far!

Of course you don't really want to throw away your success, so I would recommend contacting the doctor and telling them what you posted, that you are hungry and that you fear losing control.

See if they can be a little more reasonable with their fills, and remember that normal weight loss with a properly restricted Lap-Band is one to two pounds per week.

Many doctors will not fill if you are losing over one pound per week, because you are in the normal weight loss range.

Hi everyone I have been reading all the comments here and well i called my Dr. and asked the nurse what are my chances of not getting my fills if I am losing the weight and she told me that the Dr. has never told a patient no that he does not want for his people to be left hungry so I will get my fills and my first one will be due on October 24. I have lost 42 pounds and I was banded on September 10, 07 my weight loss began before I had my band put in and well I refuse to gain a pound of it back. I am still on my liquid diet going into the pureed part now and it is not so bad, but I do keep my ounces down and I have a good protein suppliment too, but let me tell you I have one louder than life growling tummy, but it could be gas or digestion rumbling around according to my sis the diet guru. I alos walk daily and have my own exercise program at home. I am down from a 26 to a 20 and cannot wait to see size 18 and even less in the future.

Well my surgery lasted just about two hours I had general anesthesia and stayed overnight in the hospital was on oxycodone for about three days every day I got stronger

Hi everyone, well I went for my first fill last night (live in a country town, Dr. works til late in the evening) and it didnt hurt when he put in the needle but I sure did feel it when he put too much in. He quickly took some out and when I left I felt like I had ate 12 pizzas LOL, now it is morning and has settled a bit, not hungry but am enjoying my coffee. He told me to ease into solids as I see fit. And that I can eat anything I want to. I have only lost 5 kg (12 lbs) since my surgery but he was very happy with that. As like all the other doctors seem to say "if I was loosing weight still" he wouldnt do the fill. So, if he is happy, I am as well. I look at it as AT LEAST I HAVENT GAIN 5 kg!!!! slow slow if fine by me :-) ... In my little country town (13,000) almost every fat person has had a band, so I know he has heaps of experience and the best bit is that I dont have to hide the fact that I have had it done.... anyhow, thanks for listening... best of luck to everyone and I LOVE MY BAND.:whoo::whoo:

Laural

The surgery was simple. I was totally knocked out. Myt surgery was at 7:00am and I remember waking up at about 10:00am in recovery. I stayed in a room until about 3:00pm and I went home. It was a day surgery and I haven't had any problems. It will be fine.

I Notice You Have A Vg Band At 7.5, My Vg Is Up To 9.2 And I Have For The First Time Got Some Restriction I Am Worried That I Wont Have Much More Room To Tighten It Up When I Lose Some Weight, The Vg Only Holds 10 Right?

My doc is very conservative with the fills. His office is in closer proximity to me than some of your doctors are to you.

I feel the tiny stick for the novocaine but only a little pressure from the fill itself. I do not ever feel bad afterwards and in fact, I always have the fill around 4 PM and then I go home and have dinner. I have never stuck with soft foods or liquids after a fill. I think all of this is attributed to his very conservative approach. But of course I'm only guessing.

Btw, immediately after the fill, they have me drink about 2 oz. of herbal tea just to make sure there's no problem.

I hope you all can figure out the code and stop having problems with your fills! We shouldn't be afraid to get a fill. We should look forward to it when we think we need it.

Hey BJean! I'm really glad you posted about eating solids immediately after a fill, b/c yesterday I had my second fill. After I got home I ate the rest of my leftover calzone from the night before - I wanted real food! I hope this is ok.

Lizgroover: I had read so many posts here where people said their doctors had them only eat liquids or mushies after a fill that I got worried that my doctor had forgotten to tell me about it. I went through all his literature and ... nothing! So I asked him and he said that unless you get a really large adjustment, there is no problem with eating pretty much whatever you feel like eating after a fill.

But he did say that sometimes if someone gets a large fill, or haven't had a fill for a long time, the area can get swollen and sensitive and that in those cases, we should probably take it easy for a day or so.

I was very relieved because many times, I was hungry after a fill :hungry: (often because of scheduling, I had missed lunch).

I have my appt coming up on 11/8 does everyone automatically get a fill after 6 wks? what does the Doctor consider when or often to give the patient a fill?

i was banded 6-5-2006 in Denver have not lost very much weight . I have a small band was told that the 10cc were used for men, I feel very little restriction . I just had my third fill oct24. they always have a hard time finding the port. Did you have the same problem before the band slipped

i was banded 071507 have had good results but lately am having burning pain in port area. has anyone else had this problem?

Has anyone heard of another type of liquid other than saline used for a fill. I saw something about it a while back and it decreases the time you have to have fills.