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

I have a 10cc band with 6 cc in it (after 5 fills). My question is.....how do you know when the fill is set correctly? I was originally told you would only be able to eat not more than 1/2 cup at a time and feel full without drinking before/during/after meals like we were taught. I can feel the food "plopping" right through the band and can still eat 1 cup or so of food. :wink2: My last fill the surgeon wouldn't add more saline because he said it felt too tight.

I realize I still need to exercise more and that I'm eating too much on occasion, but I end up famished by dinner time. That spells disaster for keeping portion size in check. Even though I had blood clots after the surgery that slowed me down, restricted my exercise time, and kept me from getting fills right away, I wish I were further along with my weight loss.

Any thoughts or ideas are very appreciated.

Banded 6/27/07 - Dr. Erbella and Dr. Bunch, Bradenton, FL

Current weight 261, loss of 34 lbs.

Hi Pam

Your will know when your filled properly for you will not even feel hungry or too hungry. I eat just a few bites of food at a time and I can drink about 1/2 cup of soup etc. I still have masshed potatoes however it might be a spoonful or two but that is it.

I had my forst fill yesterday and i liquids all day yesterday. Today i tried soft food and it got stuck once it was unstuck i tried swallowing my pills and it is still stuck. Help! Does this mean i need an unfill or do i need to give my stomach swelling more time to down?

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

Adjustments

Penni, Thanks for this site!!!!!!!!

I have printed it out and placed it in 17 different locations around the house.

This is useful info. The band is a tool, so much of our results are related to the diet, and exercise routine.

It took me 52 years to get fat, and losing 1 to 2 pounds per week is the correct way.

Aga:thumbup:in thanks.

dave

Hi guys--

New to the site--I am almost 6 weeks post-op, and need some help. I found out this morning that all the Fill Centers, USA in CA do not offer Flouro with your fills. How important is it? Is it safe to have it done without flouro?

Also, does anyone know a good fill doctor in southern CA who does do fills with flouro? I am willing to go to TJ since I live in San Diego. I just want someone reliable and safe.

Please help!

Carol

P.S. I read in one of the posts that there was a list of CA fill doctors out there somewhere. Does someone have that that they can email to me?

I HAD MY FIRST FILL UNDER FLURO AND IT WAS A LONG DRAWN OUT PROCESS OF GOING TO THE OR. AFTER THAT FILLS WERE DONE IN THE DOCTORS OFFICE AND IT TOOK A WHOLE 5 MINUTES--VERY SIMPLE AND QUICK..GOOD LUCK TO YOU-----IRISH:thumbs_up:

I was wondering when you go in for a fill and let's say you get 5cc of saline. Does that 5cc of saline stay there for the rest of your life or does it eventually absorb out into your body so when you go back in for another fill you don't have 5cc anymore?

If not, does that mean when I have 5cc put in then next time I go in for a fill and get 1cc then I will have 6cc forever?

I understand when you lose weight you need to sometimes go in for a fill, but your stomach in that area doesn't really shrink so why is it being refilled if it is not being absorbed out in some way?

I was wondering when you go in for a fill and let's say you get 5cc of saline. Does that 5cc of saline stay there for the rest of your life or does it eventually absorb out into your body so when you go back in for another fill you don't have 5cc anymore?

If not, does that mean when I have 5cc put in then next time I go in for a fill and get 1cc then I will have 6cc forever?

I understand when you lose weight you need to sometimes go in for a fill, but your stomach in that area doesn't really shrink so why is it being refilled if it is not being absorbed out in some way?

Ok, I think you need to look at a video of how they place the band. There is no way the saline can be "absorbed" into your system The saline goes into a tube which goes into the band to inflate it. It stays there until you are deflated. Yes for the rest of your life if that is the way you want it.

Did you not research this before you got the surgery? You will grt a fill with small additions to the quantity already added each time you go. So lets say you get 4cc the first time you go the next time you might only get 1 cc or less depending on your reported restriction. It is really up to you to decide based on your hunger. Got it!!

sharon:)

Here is the video site

Lapband.com - LAP-BAND® System Procedure - Watch Video

Usually, unless you have a leak, which is not a good thing, it is my understanding that is there for good. The reason you have additional fills is to get you to your sweet spot. The place where you can eat comfortably but just not very much. I had surgery in April and had 3 fills. I feel very comfortable at the spot I am at now and don't expect to have another fill unless I stop loosing and start gaining. It's like a teetertotter, just finding the place of balance. For some people it takes longer than others. Good luck on the playground.

Sally

Hi guys--

New to the site--I am almost 6 weeks post-op, and need some help. I found out this morning that all the Fill Centers, USA in CA do not offer Flouro with your fills. How important is it? Is it safe to have it done without flouro?

Also, does anyone know a good fill doctor in southern CA who does do fills with flouro? I am willing to go to TJ since I live in San Diego. I just want someone reliable and safe.

Please help!

Carol

P.S. I read in one of the posts that there was a list of CA fill doctors out there somewhere. Does someone have that that they can email to me?

Hi Carol

My doctor never uses flouro to place saline in my band. It is pretty accessible and able to be palpated pretty easily. I think maybe it could be related to how obese someone is. I started out at 244 lbs and from day one they never had a problem finding it. I've had 6 fills so far. Good luck to you. I'm 8 months out and have lost 50 lbs....slow but steady

sharon:)

Hi,

Just got back from my doctor and was not allowed to get a fill today, even though it is clear I am not at my "sweet spot."

I have been having an unrelated problem called papilledema that is caused by my body, for thankfully no known reason, producing too much spinal/brain fluid. The problem is that I am at high risk for vomiting until I get my last test done this week and can then start to take medication to reduce the fluid level, so the doctor was concerned that he might actually have to take saline OUT of my band for a few weeks until my intercranial pressure comes down.

Since I have been very uncomfortable (dizzy & nauseous & have diharrea - it's been a LOVELY experience - NOT), but no vomiting, he won't unfill me for now. I go back in two weeks and will probably be able to start getting back to normal with fills and weight loss again, and will hopefully be cleared to go back to the gym, which I miss a lot.

This is a totally unrelated health glitch to the band. It happens that the ONLY possible risk factor I have is being overweight. The tests are done to rule out serious causes like meningitis or brain tumor, and so far all the test prove I don't have those. I get a spinal tap on Thursday to be sure, but have no other symptoms for cause. The condition is then called "psudotumor cerebri" which means the fluid is caused by my body THINKING I have a brain tumor, but there isn't one.

So anyway, I'm in a lousy mood and want to lose more weight. I was filled in August and have lost a whopping 17+ pounds. I haven't been allowed to work out for four weeks now and feel horrible all the time. Once I get on the medication to resolve this, which by the way is a diuretic - bonus! - I should start to feel better within a day or two. Thank goodness. This has been just awful to live with and I feel really down about having to start over again. And again. And again...

Thanks for reading my vent. I just needed to get this out.

Hang in there and get healthy again, worry about your weight loss after your feeling better. The weight will come off you just will have to wait alittle longer---good luck to you--irish

Hang in there and get healthy again, worry about your weight loss after your feeling better. The weight will come off you just will have to wait alittle longer---good luck to you--irish

Thanks, Irish. That is VERY sweet of you.

I had my surgery back in March 2008. I lost 15 lbs right off the bat but slowly started to gain weight back. I was getting fills every six months. Well Nov. 21st I got a fill with a little extra to see how that worked for me and it has been crazy. I could barely keep water down the first three days! I was definitely swollen. I am now able to eat some solid foods but what I find does not stick is very sketchy.

Here are the foods I seem to be able to eat:

cottage cheese

cucumbers

fish

cheese puffs & fritos

LOTS of soup

mashed potatos

That is pretty much it! I'm frustrated and would give anything to eat a meal without the fear of throwing up. I have not thrown up in two days, which is good for me. But I barely eat. I probably eat once a day. Today I had 1/2 a coffee, about 1/2 oz of turkey, a bite of mashed potatos, and about 1/4 cup of salad. That is it. Is this normal? After 8 months I would figure it would get easier but it has gotten harder for me. I am losing weight though. I dropped a whole size in about two weeks.

Please if anyone out there can tell me this is normal, I will feel so much better. And will it be like this for the rest of my life?

Does anyone here get small adjustments like .10cc's. My doctor only seems to do in .50 increments and I feel like I need smaller adjustments to get to my sweet spot. I'm having real trouble finding the right space.