Hi everyone. This Is Linda E. I was banded on 9/11/07. I feel great and am

happy as a lark. Im down 7 lbs. Im trying to walk every day. Im eating 3 meals (1/2 cup) each and 2 snacks and as much liquids as possible everyday. Im not hungery. Soooo heres the big question for you experts out there. Do I need a fill if everything is going good?? I would appreciate any info you have. Im going to see my Dr. Dr.Eagon(St.Louis, M0) Oct. 1st. Thanks

Hi everyone. This Is Linda E. I was banded on 9/11/07. I feel great and am

happy as a lark. Im down 7 lbs. Im trying to walk every day. Im eating 3 meals (1/2 cup) each and 2 Snacks and as much liquids as possible everyday. Im not hungery. Soooo heres the big question for you experts out there. Do I need a fill if everything is going good?? I would appreciate any info you have. Im going to see my Dr. Dr.Eagon(St.Louis, M0) Oct. 1st. Thanks

This may help you in understanding the restrictive mechanism of a Lap-Band. The INAMED 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 two weeks. A “Delayed-Action” means that the fill may not become effective for up to two weeks after the fill. That is why the INAMED 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.

If you are losing at a steady rate of 1-2 pounds per week AND have good restriction, than chances are you DON'T need a fill.

I just had my 5th or 6th fill since May. I thought my first couple of weeks went really well also. Then my weight started to go up and down. I lost 8 pounds in the past 4weeks. But I told me dr. that I still am hungry in between meals. So he put in a little bit more. and I don't feel my fills generally about 2-3days after.

So, how do doctors determine when a fill is necessary and how much it should be???

So, how do doctors determine when a fill is necessary and how much it should be???

The ALLERGAN guideline says a fill is required if the patient is not losing at least 1-2 pounds per week.

Some doctors do not follow that guideline, some accept patient input.

There are no standard guidelines that I can tell.

If you are losing 1-2 lbs a week and eating only 1/2 cup of food you are perfect. If you find that you are hungry more often then you would need a fill. Sounds like you may be at your sweet spot.

I was told that there are a few people out there that do not require any fills. They hit there sweet spot right away. Unfortunately I am not one of them. I am going for my first fill on Tuesday October 2, 2007. I am not getting my hopes up that this will restrict me. We shall see.

One to one and a half cups of food per meal, three meals per day is what I was told is normal for a Lap-Band patient.