How the Lap-Band actually works, fills and refills

[StrangeDz 1]

Barneygirl,

I think I can answer this! I have had more than 5 fills and been banded 4 months.

So i want to suggest that your band still is not tight enough. I believe the band should be tight enough that even really well chewed food should be a little restricted and fill the "stoma".

I had the EXACT symptoms you described 2 fills leading up to my last one. I felt good restriction but could easily "eat around" the band by chewing.

This last fill was like magic..at first i was scared it was too tight and it took a few days..but now im dialed in by going tighter.

I can even describe how it feels, if I drink a cold thick Protein Shake I can feel the band..not pain but I feel the drink pass through. That was the magic tighness for me because at that point well chewed NON liquid food backs up a little.

To be clear..it doesnt get stuck but it takes a while to go down.

Here is another way I identify being "dialed in"... Say I eat a couple ounces of well chewed chicken. If I take a swig of Water I will burp up all the water and the food along with it. Why? Because the food is still trying to go down and water has no where to go so it gets bletched up.

My guess is you dont have this experince. You probably either get stuck..or it goes down.

Soooo, my infinate wisdom is tighten that sucker up!

No doubt someone will reply back and explain why everything I said is wrong - just ignore them.

:huh2:

AMEN BROTHER! ...and Bahahaha @ "No doubt someone will reply back and explain why everything I said is wrong - just ignore them."

[Southern Leo 0]

This may help you in understanding the restrictive mechanism of a Lap-Band.

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 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 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.

That's great info, Wendell, thanks. I am preparing for surgery and like to be ready for all the procedures to come! I like your idea of "goal size" instead of weight!

[Cita_Debi 0]

thank u for the great information. I am 7 1/2 weeks post suegery and recd 1st fill of 3.5cc at 6 wk appt. I have lost almost 30 lbs so far. I have been measuring foods and making sure I get the 3 - 4 oz Protein at each meal. I try to walk at least 30 min each day. This journey is not easy. I have to remember that the band is a tool but that ultimately it is my own mindset that has to change in order for this to work.

[no_average_woman 1]

Thanks Wendall...this is the best explanation I have heard.

[muffin56 0]

i am getting my first fill tomorrow ,,,,,,,,,,mon jan 24th.....i am a little nervous but i have some other questions for the dr......well i am feeeling good otherwise and i have lost 26 lbs post op so i am pretty pleased but this post was very goood and it helped somewhat....keep this up on top ...great reading.....

[katbabie34 0]

Thank you so much for this post. So many people have asked me about this and I just printed it out so I can show it to them. I have been having so much trouble with fills it has been driving me crazy. Thanks again.

I use a goal size, not a goal weight.

My goal size is 38-inch slacks and a man's extra-large shirt.

[Amanda1982 142]

Thanks for the info this should be a required read!

[Deecuban 0]

Thank you very much for the information,I just got aprove today from my insurrance,I'm not sure if I'm going to get it done or not but now I understand what is this all about,thank you again.

[Sid77 0]

Thank you for this info. I have been getting discouraged since I got banded. I lost 6 lbs and have come to a halt after I started eating somewhat normal food. I am counting all my calories however, the scale is not budging. I feel very little restriction and feel I have went through all this for nothing. I have been looking for someone who at least knows a little more about lap band so I can ask questions. I think you summed it up in one post. I guess I will see how it goes after my first fill.

[mominoc 11]

Haven't had a fill yet. Realized until I do I have to make good choices with food. liquids were so easy. solid food can be challenging right now. I'm about 4 + weeks post op, so still new. I do feel restriction, but if I also wasn't making good food choices I wouldn't be losing wt. I didn't want to not keep losing weight, so acting as if until first fill. Having the band does make a difference for me. I can feel it, touch it and I'm trying to respect it. It does work and I am so glad I got banded. I couldn't stop eating before. Now I can. I feel like I have a little friend in my band.

[queensd242011 1]

thank you... this will be helpful when I get my lapband. Take care!

Opinions differ about how gastric banding actually works.

My opinion is based on the fact that stretching the stomach wall shuts down the appetite hormones. When your stomach size is reduced from a football to a golf ball you are going to get stomach wall stretch and appetite hormone diminution on much fewer calories.

Also, the food takes a while to empty through the restriction so the full feeling lasts longer. Some patients will forget to eat dinner because they are still full from lunch.

We know about some of the appetite hormones floating around but we know that there are many more and that the way the stomach and the brain communicate is very complicated. The drive to eat is a very powerful biological drive. If the brain thinks for an instant that you're trying to starve yourself it will take drastic measures.

The small stomach pouch above the band fools the brain into thinking you've just eaten a Thanksgiving meal.

In some patients the appetite suppression is very powerful and some patients say they are never hungry after band surgery. Some patients deal with lots of "head hunger" which is a complex process and not easy to deal with sometimes.

As you lose weight, the stomach tissue inside the band loses weight and that is why you need additional fills as you lose your weight. At your goal weight, the stomach tissue thickness stabilizes and the need for fills diminishes quite a bit.

I read a lot of posts where patients do not have their bands perfectly adjusted.

Here's my version:

Perfectly adjusted - full on small meals, not hungry between meals, easy to lose 1-2 pounds per week, amorous feelings toward your surgeon and staff, send them a Christmas card that will bring tears to your eyes

Too loose - hungry, can eat large amounts of food, hard to lose weight, feels just like you are on a diet.

Too tight - everything wants to come back up including liquids, hurts to eat or drink, bad heartburn especially at night (when you lay down), the only thing that wants to go down is Cheetos and ice cream (bad stuff)

I think if you don't fit the "perfectly adjusted" description you should call your band surgeon to make it perfect with an adjustment.

Also keep in mind that each patient's band journey is very individual.

Hope that helps

brad

[queensd242011 1]

Wow I am impressed with your success! I can't wait and thanks for the info. Take care!

AMEN BROTHER! ...and Bahahaha @ "No doubt someone will reply back and explain why everything I said is wrong - just ignore them."

[Alex1921 0]

Just had fill number 3 and still no weight loss. at the same weight for 2 months. So discouraging. has anyone else had this problem? Beinging to wonder if the lapband will even work. When I talk to my doctor about this he says I need to go on a the Atkins diet. If I have to do atkins why get the lapband?

[sherry092571 0]

Wendall,

I don't have the LP as of yet I have my consult next week but I have been spending many hours reading up on how the lapband works. I want to thank you for putting up that post I have a much better understand of how it works now

sherry

[My5dollys 0]

Just had fill number 3 and still no weight loss. at the same weight for 2 months. So discouraging. has anyone else had this problem? Beinging to wonder if the lapband will even work. When I talk to my doctor about this he says I need to go on a the Atkins diet. If I have to do atkins why get the lapband?