Question for people banded for over a year

[Wendell Edwards 73]

When was the last time you had a fill? How often did you get filled at the beginning?

I had my first fill 8/6 and I am scheduled for another one 9/4. I think Iam still eating too much. I was self pay and the price includes 4 fills and after the 4 fills it costs 250$ per fill so I am hoping this next one is it and I don't haveto go back for a long long time.

Hi, the difference between an effective fill and a non-effective fill is night & day.

An effective fill is what we are all looking for. It makes the Lap-Band restrict the amount of food that we can eat, and provides the sensation of "Full", although your new "Full" feeling may not feel like your old "Full" feeling.

Some people use the term "Sweet Spot" to describe what I call "Effective Restriction".

The reason I do not use the term "Sweet Spot" is that it is easy to mistake a "Sweet Spot" for something that will last indefinitely, and an effective fill will usually NOT last indefinitely, due to the inevitable reduction of the residual fat-pad that lies between the band and the stomach wall.

The ALLERGAN protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band. Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band. Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to three weeks. A “Delayed-Action” means that the fill may not become effective for up to three weeks after the fill. That is why the ALLERGAN protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

[juliegeraci 7]

Wendell, thanks for the great post. Very informative. Julie

[Wendell Edwards 73]

Wendell, thanks for the great post. Very informative. Julie

You're very welcome!

[Susan Charmain 0]

OK I thought I'd get a clue reading the forum. What is a sweet spot and exactly what is restriction. In layman's terms, please?

[Kat817 19]

Restriction is when you are only able to eat a small amount. The flow of eaten food is restricted as it passes through the tightened down area where the band itself is placed around your stomach. When there is good restriction, it means there is plenty of saline in the band (or the band itself can provide enough for some people), and the amount you can eat is restricted. It moves through so slowly, it only allows you to eat a small amount.

Sweet spot is when you have proper restriction, so your portions are limited, but you can eat a variety of foods, including hard Proteins without any pain, or discomfort. You do not have frequent PB episodes. It is similar to a maintenance....you eat small amounts, of most any food, and are in a position of not worrying about your fill level.

Sometimes it is just easier to ask----!!!!

Welcome to LBT!

Kat

[Wendell Edwards 73]

OK I thought I'd get a clue reading the forum. What is a sweet spot and exactly what is restriction. In layman's terms, please?

Hi Susan!

Restriction means that the band has enough saline fill in it to restrict the amount of food that you can eat. In essence, that is what makes the Lap-Band work, enough saline fill to provide restriction.

I call this "Effective restriction".

Many people use the term "The sweet spot" to describe effective restriction.

The problem is that some people expect "The Sweet Spot" to last, it doesn't, and neither does "Effective Restriction".

Not until the entire residual fat-pad on the outside of the stomach muscle is melted off, and that takes TIME. (And usually MULTIPLE FILLS)

[Chickie 15]

When was the last time you had a fill? How often did you get filled at the beginning?

I had my first fill 8/6 and I am scheduled for another one 9/4. I think Iam still eating too much. I was self pay and the price includes 4 fills and after the 4 fills it costs 250$ per fill so I am hoping this next one is it and I don't haveto go back for a long long time.

I was banded 31 months ago, I went in for fills as needed, usually every 6 weeks for the first 6 months or so (I would have to find the diary that has the exact dates and fill amounts to be more exact). My last fill was February 2006. My last unfill (a total unfill) was in January 2007.