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

Penni,

I have a question for you. What is the signifigance of the liquid diet after a fill? Is it OK to eat lightly if you "can"?

Thank you in advance!

Hi I jst had mine done wih Dr. QUESADA he's so nice. How did he do hi fills. I'm going back to costa for my first fill. Debbie

Hi ~ I was just banded on 5/27/08 and your info has helped me tremendously. Thanks so much.

Bren649

It does not hurt to get a fill. I have had four done and have had no problems. Just the needle stings a little. Hope this helps Stacey

i just had my first fill, 1cc this week, I got banded 4/2 and am down 21 lbs.

I am bummed because I have plateaud.

part of it I think because I needed a fill, was feeling more hungry.

the other part because I got "brave" in what I found out I could eat, and need to get back on track with better choices.

I have been exercising and graduated up to jogging.

unfortunately heavy exercise seems to really stimulate my hunger.

We were told not eating for 12 hrs before fill and no liquids 1 hr before fill.

Okay I had my second fill yesterday, my first fill was 3cc's. When the pulled out the old fill I only had 2cc's. The Dr. told me that this is quite common in the first few fills, but couldn't/didn't explain to me why. Has anyone else had this experience or if anyone knows why this happens I would love to hear from you. I have called and left a message with the nurse, but never know for sure when you will hear back and I have been up all night wondering if my band is okay.

Thanks again,

Brandy

Okay I had my second fill yesterday, my first fill was 3cc's. When the pulled out the old fill I only had 2cc's. The Dr. told me that this is quite common in the first few fills, but couldn't/didn't explain to me why. Has anyone else had this experience or if anyone knows why this happens I would love to hear from you. I have called and left a message with the nurse, but never know for sure when you will hear back and I have been up all night wondering if my band is okay.

Thanks again,

Brandy

Brandy,

This doesn't make sense to me, because normally when you have a fill it doesn't go down in amount it's just when you lose weight you need more

fill to tighten your band to cause more restriction.

Anniemay:cool2:

Thanks, I know it doesn't make any sense to me either. Thats why I posted I'm still waiting to hear back from the nurse. It is very frustrating and confusing to me.

Brandy

I've been lucky. I had excellent restriction with my first adjustment in December and haven't needed one since. But in the last couple of days, I'm ravenously hungry and food is going down much easier. Can a band loosen that quickly when it's been so nicely filled for all these months?

I've been lucky. I had excellent restriction with my first adjustment in December and haven't needed one since. But in the last couple of days, I'm ravenously hungry and food is going down much easier. Can a band loosen that quickly when it's been so nicely filled for all these months?

you lose restriction when you lose weight, so to answer your question,

yes, you can, if you have lost weight!

Anniemay

When they do a 2nd fill, do they take out the liquid from the original fill? I thought that they just added to it.... It would make sense to take it all out to make sure that there is still the same amount as when they filled the first time. If there was less, it would indicate a leak perhaps?

My doctor never took out any fluid she only added to it, if it is too much restriction and you are having problems they will take some out.

Anniemay

I was banded on Feb11, had my first fill last week. So far 62 lbs down. BUT now I know what happens when you take to big a bite. I was in a restraurant with my grandkids when it happened. That was a hopeless and embaracing feeling.It got my attention , then I took a drink and that made it worse. Went away in 15 minutes. :ohmy:

I've had a lot of fills. The doc always takes out the amount that is already in the band and sees what is there. He compares it with the amount that he put in the time before by looking at my records. Then he has a good feel for how much to add. Usually it is a very small amount that he adds each time. He is always very cautious. And I have my fills included in the total amount I paid for surgery and all other related stuff, dietician, exercise physiologist, etc. Because he is so cautious, I have only had to have an unfill one time over the past 1.5 years.

Sometimes things can change internally that can make your fills seem tighter or looser. If you lose weight, your can need more fill added. If you experience other changes (some people do when they fly, among other things) the fill can seem tighter and you can need to have some fill removed.

I was banded 5/5 and had my first fill last Wednesday--the dr only put in .5cc, which he said is all he will give at a time. However, I can go back in in two weeks for another small fill if I do not feel enough restriction. The fill actually hurt more than I thought it would, and he had to press down hard on the port for a while to force the saline into the port. He said that this is not uncommon with first fills but that additional fills should be more comfortable for me (and easier for him). A co worker of mine with a band suggested that I ask the dr to use a smaller needle--that maybe that would make it a little more comfortable? Has anyone had to request this with their doctor? Also, I do notice restriction in the mornings but not so much in the evenings. This makes me wonder if I shouldn't go back in for that 2nd fill next week.