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.

:biggrin:oh my goodness I finally understand this whole thing - your residual fat pad explanation is the best explanation I have ever gotten thanks AURA114@AOL.COM

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On the water questions, my Doc told me I could drink right up to the time of my meal, just don't drink for one hour after a meal. The previous answers to the reason for not drinking after a meal is correct. It will wash away food from your pouch and won't feel full for as long. There is no reason you can't drink right up to the time you take your first bit.

lou, you look like my husband twenty years ago. He's in the same boat as you: got his second fill january 10, had restriction for a while, but now can eat a whole frozen pizza at one sitting. We're driving back to Tijuana Wednesday for another fill. By the way, we love our fill doctor there. He can get us in almost any time, and is very easy to talk to. Fills are $100 with fluoroscope so he can see exactly how the band is doing each time.

Every Doctor is different. Mine requires no water 1 hour before and 2 hours after a meal IMPOSSIBLE (at least for me)

I have had three fills now with 6 cc in my band in total. I try to eat about 1 cup of food as that is what they tell me a "meal" is. More than that could stretch my esophogas, which I don't want. And generally I am full anyway so don't need or really want (except in the head) any more.

So that's great.

My last fill was a week ago so that may change somewhat, as it has in the past. So I'll see. I have made a monthly appointment so will go in and see what their input is.

So far I have lost weight pretty consistently so I feel okay about it.

Of course like many, I want it gone tomorrow -- which tomorrow never comes -- so some day I will be there. I surely feel more confident that I will get to a decent weight for me without some crazy dieting techniques only to fail -- again.

It is so nice to be able to feel full --

Luck to all, and thanks for sharing!

PCGIRL

When you stretch your esophogas what happens? Does it heal back?

Hey, NM Sunshine: From what I understand, the Fluid has to be taken out and time is given for the esophagus to heal back to it's original size/shape.

It is really keeping me in touch with amounts to ingest at one time! I have heard of a couple folks who ate too much at their meals and had that problem.

Then the fills begin again. Not what I want to have happen for sure.

Hi. Im LindaE. I was banded on Sept.11th. I havent had any fills at all. Ive dropped around 8 to 9 lbs a month so far. My doctor doesnt want to give me any fills. Thats ok with me. Im not hungry for the most part. I really appreciate youre explanation on fills. Good luck to you on getting healthier.

Hey, NM Sunshine: From what I understand, the Fluid has to be taken out and time is given for the esophagus to heal back to it's original size/shape.

It is really keeping me in touch with amounts to ingest at one time! I have heard of a couple folks who ate too much at their meals and had that problem.

Then the fills begin again. Not what I want to have happen for sure.

WOW to go through the unfill and refills again..ugggggggggggggghhhhhhhhhh...as of now I am going to start measuring everything I eat. I've been negligent. Do you know how someone would know if their esophagus was enlarged besides getting a flouroscope??

Hi Dr. Walkins. I was banded on Sept. 11 2007. I loose around 8 to 9 lbs a month. My dr. has chosen not to give me a fill. Thats ok. with me. Does this sound reasonable to you. I see him the first Mon. of every month for the next 2 years. Thanks for youre opinion. LindaE

I have 3 1/2 ccs so far, my band is a 10 cc. I can tell I am restricted pretty good becasue I am having a time geting almost all foods down. I now can only eat 3 to 4 bites of food and I was told that this is normal and expected. When I get a fill the nurse gives me some water to drink aftrwards to see if it can go down or not, this last time I had to sip it very slow and I even burped which I have never done before. She told me that I might be at my max fill the sweet spot and to be careful from here on in because I might have to ahve some fluid removed, well no way. Ic an handle less food and I eat very slow. I use Nectar for my protein drink and I use the IDS Liguid Protein for a suppliment the 46 gram type, it is not too bad if it is real cold. My weight is coming off rel nice and I have been exercising and walking , I ran for the first time in years earlier today and it felt great. I had surgery back last September 2007. I have lost about 80 pounds so far and gone froma24 to a 16 and soon to a 14 misses, my goal has been to stop at a size 12. I have nice curves (again) I am almost 55 years old and well I do not need to be a size 10 or smaller, why? because I am not here to look like a teenager or something. I was a type 2 diabetic but no more.

I had my first fill yesterday. 3.5 cc. Onliquids for 3 days after fill. I am 6 weeks out from surgery. For the last week I could eat anything and was very frustrating. The reason for the lapband for me was to feel hungry sooner. I have control if i feel full but not much otherwise. Sharon I agree, at age 56, I want to look good and wear fun clothes but will never be like i was in my 20's. but that is ok. I am thrilled with how i feel and the energy I have.

deb

i was told that if you just cant stand not being able to drink anything at all while eating then get just a glass of ice and sip on whatever melts that way you know your not drinking to much!

Thanks Misstyln

he water thing is my biggest issue. 1 hour before and 2 hours after a meal -- and it's time to start the 1 hour before again. How do you get the water in. I'll try the ice cubes. Thanks again.

Nance