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.

I too have the 14cc band. I have been getting fills between 1 and 2 cc at a time. The last time, I only wanted 1/2 cc as I was getting restriction. I have somewhere between 3 and 4 cc only in my band.

With the reading I've been doing, I've come to the conclusion that everyone is different. I'm anticipating that as I lose weight, I will have to get the band filled more. I also find that in the morning I have more restriction than later in the day (after my Water pill).

I've seen the advice in other posts to not focus so much on numbers , like the scale, the number of cc's in the band, etc. and focus more on how you feel, how your clothes fit, are you more active. These actually are better positive reinforcers than the numbers on a scale.

I had gained 8 pounds at my last visit, still haveing restriction in the band, but was eating around the band (junk food). Going back to old habits and not working with the band (duh).

Last night, I went to the YMCA and got on a treadmill for hte first time in my life. I'd been resisting thinking I couldn't do more than 5 minutes. Well, I did 20 minutes and 0.6 miles! And then another 10 minutes on a recumbant bike. I was thrilled. So, back to the Y again tonight.

I'm still battling my eating habit and craving demons. I guess I always will.

Hang in there, this isn't magic but it sure is easier than dieting!

Sue Stenzel

I was just talking to my Dr.s office and found out that I have a 14CC band. AND that they should have been giving me larger fills. I had 2cc the first time and 1.5 the second time making 3.5 No wonder I didn't have restriction. This is the first time I have heard of a 14cc band. Has anyone else?? :pray2:

Wendell do you know why they gave me a larger one? I was wondering if it was because I had previous WL surgery in 1972?

Band sizes are kind of like shoe sizes in the sense that all of us have different sizes of stomach tissue. Men have thicker stomach tissue; patients with diabetes have thicker tissue; BMI>45 have thicker tissue, etc. It is also common to use bigger bands over previous surgery/scar tissue.

The new REALIZE band is one size, it's a big band and has a 9cc capacity.

Thanks everyone for your replies. Sue you are right I do feel much better and last summer couldn't do 5 minutes on my treadmill. Now can do 30 and I do it 5 to 7 times a week.

Dr. Watkins I have ordered the Urbsan rbounder (small trampoline like excerciser) My friend suggested this would not be a good exerciser for me because of the band. I really like it and it gives me a great workout but I have stopped using it. In your oppinion could using the rebounder hurt or dislodge my band. I would really apprecaite your response. Thanks Nance

Thanks everyone for your replies. Sue you are right I do feel much better and last summer couldn't do 5 minutes on my treadmill. Now can do 30 and I do it 5 to 7 times a week.

Dr. Watkins I have ordered the Urbsan rbounder (small trampoline like excerciser) My friend suggested this would not be a good exerciser for me because of the band. I really like it and it gives me a great workout but I have stopped using it. In your oppinion could using the rebounder hurt or dislodge my band. I would really apprecaite your response. Thanks Nance

In my opinion jumping on an Urban Rebounder would not be contraindicated after band surgery. I wouldn't do it in the first 2 weeks after surgery, but once everything heals, this should not create a problem and jumping burns a lot of calories. I think the funnest calorie burn for an individual is the most successful.

Wendall, you're a treasure. I have excellent medical providers, but none of them has ever given me the practical, helpful info you do. You keep things in perspective for me. I've had four or five fills and I can still eat pretty much anything I want as long as I take small bites and chew well. I'm going on seven months post-op. I sometimes think the band isn't working, but I'm losing about a pound a week, so I guess I'm within the average. I read your comments for a reality check. There are a lot of self help/how to books on gastric bypass, but not many on lap band. You ought to consider doing something. Thanks again.

Thank you so much Dr watkins I am now happiloy bouncing away. Nance

Wendell, question (it may have been asked before, but I missed it): Why can't we drink an hour before and an hour after we eat? I've never been given a straight answer on this one.

Wendell, question (it may have been asked before, but I missed it): Why can't we drink an hour before and an hour after we eat? I've never been given a straight answer on this one.

I can tell you why we can't drink for awhile AFTER we eat: one, because the Fluid can increase the chance of food getting stuck, and, two, because the liquid will move the food out of the pouch more quickly so that we get hungry sooner. We want the food to stay in the pouch awhile to help create the sensation of satisfaction.

I have also asked why we can't drink BEFORE we eat and no one has come up with an answer so I'm looking forward to the responses!

Sunshine weren't you scared going to Mexico for the operation??

I went to Mexico and yes I was scared. But it was the right choice. Never had better care -- I have never experience this great a care in an American hospital. It cost 7,000 ALL INCLUSIVE. No extras for hosp, tests, anesthesiologist, ect. If you are up for a fight with your insurance company go to Gastric Bypass Surgery | Weight Loss Surgery | Obesity Surgery-Support you can get books and information on how to successfully fight and win the battle with your insurance company. I was just not willing to put in the time.

I really would like to know if the only reason for not drinking with meals is so we won't get hungry. I am going to see my dad soon and he doesn't know I am banded. I find if I take a sip of Water while eating, I don't get stuck as often. I am normally very good about not drinking anything for an hour, but around my dad, I definitely don't want to get stuck.

I have heard drinking even a sip while eating will stretch the pouch, and I need to know if that is true.

I went to Mexico and yes I was scared. But it was the right choice. Never had better care -- I have never experience this great a care in an American hospital. It cost 7,000 ALL INCLUSIVE. No extras for hosp, tests, anesthesiologist, ect. If you are up for a fight with your insurance company go to Gastric Bypass Surgery | Weight Loss Surgery | Obesity Surgery-Support you can get books and information on how to successfully fight and win the battle with your insurance company. I was just not willing to put in the time.

I'm with you. This is why I went to Mexico for banding. Also I wanted the banding done right away and not wait a year for my insurance to reject me.

I really would like to know if the only reason for not drinking with meals is so we won't get hungry.

I have heard drinking even a sip while eating will stretch the pouch, and I need to know if that is true.

I understood that the reason for not drinking during or after the meal is to keep the food from leaving the pouch. This thing about Water causing the pouch to stretch is scary. I have drank right after a meal at times. I don't want a stretched pouch!!!!

The not drinking before a meal is a real mystery to me.

Thank you so much for the information. It has been a while since I visited the forum and was having concerns over being hungry with little restriction 4 weeks after 2nd fill so I am somewhat relieved after reading your info.

I just had my first fill this past monday and have experienced 3 pb's so far- not chewing enough!!!!! Very not fun!

but I also don't have a sense of a smaller stomach, in that if I chew well I can still eat a good amount of food- almost as much as before the band. I have 2.5 ccs in a 4cc /10cm inamed band. My weight loss has stalled since I went onto solids.

I didn't do well with my first fill and felt like you do. I have a 10cAP band and took 6.5 cc;s in first fill. Then last month I went in for a 2ed fill and WOW what a difference. Stomach is definally reestricted. I pb/throw-up/slime, all or one, when I don't chew/chew/chew or when I eat too much. I can take a lot of liquids and creamy stuff in. I'm trying to stick to regular food and am losing weight slowly.

Thank goodness for this post. I didn't think support groups were needed, but now I see the light!

Banded 9/29/07, first fill 7 weeks ago. NADA. No more restriction. Just had a second fill last Tuesday. Boy, I couldn't hold down Soup for three days. On the fourth day, better, by 7 days later, (now) I can eat just like I did before the second fill. This had me worried. Heck, tonight I had a full plate of Nachos!

From reading this entire post, it seems like I had some sort of post-fill swelling. The cool thing about this swelling, I didn't get hungry at all! Sure I had a bit of the physiological hunger aspect, but that was easily defeated by occupying myself with something. No stomach hurting hunger pains, no severe mood swings (the wifes happy!) just the occasional mouth watering when I see a good food commercial.

I am not a religious man, but I am PRAYING for that sweet spot!

My Dr. out of San Bernardino California is a bit, shall I say oh... unhelpful. If my appointment is at 10:00, I usually don't get to see him until noon or 1:00p. I fear asking questions because his retort is less than positive. It reminds me somewhat of a assembly line. Boy what I would do for a Dr. Watkins out this way.

Anyway, sorry for the rant folks, it does seem like I am on the right track. Questions were answered, negative thoughts turned positive. Thanks Everyone!

Groovielou

You are right, when you gain weight the band gets tighter and you have more restriction. Nice for me! It works better than not fitting in your clothes, because you really have to think about losing weight, doing exercise, etc... cannot leave it for tomorrow.