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 don't understand how you can give up on the band BEFORE you have achieved restriction, which apparently you have not yet done. I'm not surprised. My doctor says it takes an average of six fills to get to the right spot.

Please don't give up - it took 5 fills before I felt anything - and then it was almost too tight. Be patient - it took you years to get to the size you are not - take your time and know that it WILL work. I know we all want immediate results but I think it's better for your body to take it off slowly.

I've lost 24 lbs over a period of 10 months (Mar 21,06) and there are times I wish it were more - but am grateful for it not going the other way.

Hang in there - it's worth it.

PS: as for the picture, I had to go to the site, make it look the way I wanted, then copy and paste it into this site...

regards,

Nellie

Thanks so much for all your encouragement. I had no idea that the average number of fills to get to the right restriction was 6! That's encouraging.

I admit I'm getting anxious and frustrated. But you're right.. at least I'm finally doing something and even if I gain a little, over the long haul I'll still be ahead of the game. I do want fast results and I guess that's not reasonable. The doc told me from the beginning that this is a 2 year plan. I may be guilty of thinking of this as being like the gastric bypass surgery, and it is not. It's way more healthy and takes some work on my part.

Thanks again for the reality check. I really appreciate it!

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 weight. I certainly dont have any leaks to worry about:clap2:

So know that at some point you are going to know what this PBing is all about. Hang in there and get to the sweet spot....

julier: It must be a real challenge to figure out just the right amount for our bands. I shouldn't be so impatient.

I can't help right now but be jealous that eating isn't that much fun for you. Besides, I love soup. Hmmm. Maybe I wouldn't love it if it was the only thing comfortable to eat.

Hope things settle down for you soon and you achieve that "sweet spot" that works perfectly for you. I'm headed out for my 3rd fill and I'm keeping my fingers crossed that the 3rd time is the charm for me.

keep in touch and try and get them to be a little more agresive and find out what size band you have and how much they put in.....

Julier: I'm back from the doctor and seeing the dietician. He put in .3 ccs. That takes me to 2.1 ccs total.

I am in a program where they do not use fluroscopes for the fill. They err on the side of being very cautious and very slow. They have decided that it is better for us to go slow and change our eating habits very gradually. They also don't want to have to do unfills. They will do a fill every 2 weeks until you've found the right restriction for you. We also see a dietician every 2 weeks and an exercise physiologist every 4 weeks. It's all included in the initial surgery fees. We pay about $18,000 out of pocket. He does not participate in any insurance programs. Also, once a month we have meetings with other bandsters and get tips about how to eat and exchange recipes and ideas. Also, every month there is a psychologist who lectures about some facet of regaining our physical and mental health as it relates to food.

I found out most of this info about the fills today. It explains a lot why my experience has been so different from many of the bandsters here at LBT.

The neatest thing I learned was that since my last visit - 3 weeks ago - I had not gained like I was sure I had. I came away feeling better about myself and the program. And I'm going to try to not be so impatient and I am going to not feel so bad about myself when I don't lose several pounds every week. I will be happy with 1 to 2 lbs. a week.

Your posts have been good for me and I appreciate it. You helped me get through a very hard couple of days without throwing in the towel. Thanks!

The dr. I go to in College Station, Texas charges $200 and that's with a

flouroscope and she has had the procedure too, so I trust her!

Anniemay

So, how many fills have you had from her? What size band do you have? How much have you lost? These folks that have had 3-5 fills and feel no restriction sounds strange to me. I felt little to nothing after the first fill, but my second fill has had me tight..........almost too tight. She told me I would feel this fill, and boy was she right. I am finally, after almost 6 weeks can eat a small meal with out giving half of it back to the garbage or the toilet. I just went out to eat MX food with my daughter tonight. I had a tamale and one fajita with not much more than the tortilla, some chicken a little lettuce and some green sauce on it. I had to go to the toilet twice and give back a few bites each time. So, i would say out of the entire meal, I guess I kept about half of it.........maybe. :hungry::hungry:

She told me to come back in 4-5 weeks for another fill.......but I would probably not be able to keep liquid down if I went back and got another fill.

Have a great day.

God bless

Wild...........about life:clap2::clap2:

My band is a 9.75cm. I have had 2 fills since surgery in Aug. and I have lost about 20lbs. not a whole lot but at least I'm not gaining. I didn't gain

it overnight and I have always been a slow loser. I can only eat soup and

cottage cheese and fruit out of a can, and sometimes scrambled eggs.

I have trouble keeping it down too, but I am not going to get it unfilled

because with the first fill she took some back out and 2 weeks later I

couldn't feel the restriction, I hope this one lasts a lot longer. I know

I am not hungry all the time now, but I still have the cravings. The only

thing I can't figure out is my nerves are much worse now! Have you had

that problem?

Anniemay:hungry:

DonnaGT & Bjean

I Like Both Of You Started Getting Very Frustrated. I Got My Band On 9/05/06 And Have Lost 31lbs. I Lost Most Of It In The Week Before On Full Liquid Diet And The Week After On Full Liquid. During The Month Of Noveber I Actually Gained Some Back. I Had My First Fill And It Did Nothing. I Then Went Back In 3 Weeks For Another And Can Finally Tell A Difference. I Got Very Discouraged With Weight Gain. I Do Feel Hope Again But Am Worried That I Already Have 2cc's In My 4cc Band And Have 50lbs More To Lose. All We Can Do Is Just Take One Day At A Time And Hope For The Best. Good Luck To Both Of You!

What is PB'ing? Thank you

laurigee: I have lost 31 lbs. too! And most of it just like you did. I have 2.1 ccs in my band and I have another 50 lbs. to lose too! We sure have a lot in common. Or maybe this is normal outcome for the first 3 months after getting banded. I'm trying to get back on the band wagon and after Thanksgiving, it's hard. I can't believe I made it through Halloween without any candy and then Thanksgiving threw me off.

Anyway I'm going to take one day at a time and try to not beat myself up if I goof up. My dietitician said that after about 6 months we will stop worrying so much about regaining the weight. I sure hope she's right! Best of luck to you on your journey to a slender you.

Lynn Band: Once you've been here awhile you'll see how everyone who's new asks this question.

PB stands for productive burp. It isn't your normal burp, it's one where you actually spit up something you've eaten. It is usually preceeded by a bout of "slime-ing". I've read some posts that say they actually PB'd at the dinner table without warning. I've only PB'd once. And just after a couple of very small bites of a bran muffin. I got a terrible pain, like a golf ball is stuck, went to the restroom of the restaurant, started developing lots of slime, and then PB'd. Afterwards the golf ball pain went away, but I wasn't interested in eating breakfast.

Small bites, chew thoroughly and take lots of time eating and you'll probably be able to avoid a PB episode.

I just asked my doctor today about carbonation. He said set a drink out for 4 hours first day and drink it. Then next day for 3 hours......

He said wait for my stomach to tell me when. Could you let your New Years Eve get flat first?

edie

Edie: I have already had champagne. I had not eaten at all though. But I had absolutely no problem. However I just remembered that I had very little restriction. It was practically non-existent. So that may have allowed the champagne go down easily with no repercussions. And I must say it was a very pleasant buzz. (no hangover either!)