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 had my surgery on 11 Sept and have become discouraged on the amount of weight I've lost. I am getting my first fill on Monday and hope it helps. I am starting to be able to eat more and more but I'm trying not too.

I got my 4th fill today. I already had 4 ccs in an 8 cc band and it had been 3 weeks since my last fill. My weight loss has been up and down (some up due to Hurricane Ike and having stayed away in San Antonio for a week until the power returned).

Anyway, my 3rd fill 3 weeks ago was just a few days after my return from San Antonio when I was still carrying a couple of extra Water weight/salt weight lbs. Today, when I went to get my fill, it showed a 7 lb loss in the last 3 weeks so the nurse didn’t want to give me another fill. I told her that the loss was deceptive since most of it was weight I had gained while in San Antonio and quickly dropped when returning to normal schedule/diet. I told her I ate too much at one sitting and was hungry just 2 to 3 hours after a meal. So she reluctantly gave me another .5 cc which is all I really wanted anyway. The troubling part is that on previous fills they had always taken the old fill out to make sure that the amount that came out was the same amount as listed in the chart. This time, she specifically said she wasn’t going to do that and just gave me .5 cc on top of what was already there. I don’t think I have a leak because the Dr. checked me for a leak at the last fill; I just hate it when the medical professionals take short cuts.

I guess I’ll try this out for size for the next couple of weeks. I’m so desperately chasing that elusive “sweet spot!” :laugh:

Edited October 14, 200817 yr by Dionna113
clarification

Hi, I have ben banded since September 2007 and i had to be un filled twice due to swelling around the band after a fill. I have a 10 cc band a small one so I ahve ben told. I had 5 1/4 cc's fill however I had to lose 1/2 cc today for I was too tight and could not eat nor drink since last Sunday, all i was doing was vomiting and having reflux like symptoms. I was told not to have any solids for another few days and by Monday I should be alright to eat normal food again. This could become very dangerious if you get too tight in tehre and start vomiting you could asperate into your lungs with the bacteria laden vomit and get a seroius infection. So be careful out there.

I lost another 9 pounds since this past Sunday, yes all good but I was so sick from not being able to eat nor swallow food or liquid.

Gone from 279 to 173 from size 24-26 jeans to a size 10-12 depending on how they are cut and from a size 3x to a size Medium-Large depending on the way that is made. My diabetes and BP is all resolved but my Vit-B12 is very low and in need of a shot and some oral medications for the Vitamin B-5 no shot for that right at the moment.

Reading of everyone's experiences is very informative. The only comment I would make is that each person is so different and one should really speak with their personal medical support system to figure out why they are having or not having success. I have not yet been banded, but look forward to receiving a surgery date. One of the biggest aids received from the facility I am using (UMASS Medical Weight Center) as well as research sites, is the fact that for many people there is no weight loss prior to the first fill. Not to say that nobody does, but it is not unusual not to have loss. The point of the interval between the surgery and the first fill is for the healing process (swelling reduction, as well as your body to recover from being "invaded" - which is what surgery is, an invasion of sorts). The first fill is to find that place (I believe some of you call it your "sweet spot") where there is sufficiency for nourishment to be taken in, but a limit as to how much. Again, this is what I gather from all the research, conversations with the medical staff as well as successful patients. This link is a great one to me because of all the variety, but as I am certain any successful WLS patient would say, it all has to be balanced with what your docs say. Thanks so much for all of the information. I will be thrilled when I too have my aid to weight loss success!

Have a great day and remain on the road to Healthy4Life.:thumbup:

I cant tell you how helpful that info was for me. I feel like I cant get any correct info about this. I was baned on Oct 16th, havent been filled yet. You have answered my questionsa bout the fill, but cna you answer this on? Whe I get filled and it acutally kicks in, am I going to feel full on less food or am I gonna feel like I have indigestion and have pain? I would rather get full quickly. Please xplain this restriction or fullness that I can expect. Thanks for your help.

Hello there. Love your user name! Well, let's see if I can help. The idea of the fill is just that, to cause you to feel full with less foods AND be at a comfortable amount so that you are not feeling sick. That is apparently why it sometimes takes a variety of fills. Since each person is different their satiety levels will vary. Yes, I do get you about wanting to be fuller more quickly and it will come. But, I would say as with anything, be patient. Give your body a chance to register. That is why with the program I attend they truly stress the behavior involved. A couple of doctors swear by the saying that it is "10% surgery and 90% behavior". I do believe that. The behavior encompasses our mental being. What our relationship in the past has been with food. Whether just based upon or our views or how others' have impacted us. It seems that many times, not ALWAYS of course, that the indigestion, etc. comes from not eating slowly enough so that you are not able to give your body and mind enough time to get in sync with one another, so that your brain tells you that you have had enough. Does that make sense to you? I hope so. If you need anything else leave me private message and it will notify me more quickly and I will be certain to response as soon as I get on line! Best of success to us all.

What is PB?

pb stands for productive burp. It's basically throwing up.

Everyone must be careful about being too tight. I was too tight and didn't even know it. I never had any problems in the day time. I thought all my food was going down fine. I never felt food get stuck and I never pbed or threw up in the day time.

My problem was in the middle of the night. I haven't had a fill since last dec. but last couple of months, I would throw up in my sleep. I had the barium swallow and the barium would not go into my stomach, it stayed in my esophagus. That is so dangerous. I had 1 cc taken out.

I never thought I had a problem and I thought I was at my sweet spot. I got full on the right amount of food and stayed full for 3-4 hours. All this time, the food must have been staying in my esophagus instead of going down.

The band is not intended to do all the work. Even if we are banded, we still have to to do our part . Having a tight fill is really bad and dangerous.

Thanks AthinnerDenise,

I've had a few of those, mostly when I swallowed too quickly and it feels like the food is sitting over top of a big bubble. Last time it happened in the airport restaurant and I had to turn aside to get it out - explosive actually. Luckily I had some napkins. Fortunately there was hardly anyone there. I have the esophagus problem too, so I thought it was the esophageal problem happening. Anyway, I have taken to carrying an airline sick bag in my purse just in case I can't make it to a bathroom.

The esophageal problem is the result of a condition called intermittent achalasia, something I'd had many years before getting banded. While I did also have a sliding hiatus hernia repaired at the same time as banding, I forgot to mention to the doctor about the achalasia. When we did fluoroscopy prior to a band adjustment, we could see that I had mega esophagus -so I have to be very careful, because if I eat too much, it just sits there and the pouch gets bigger. I will probably have to get it repaired at some point but for the moment it just adds to the complexity of having the band.

To clarify, intermittent achalasia is when the lower esophageal sphincter only opens intermittently into the stomach. So even water won't go through sometimes, which makes it really hard to gage eating. It opens "intermittently" so food sometimes has to sit in the esophagus above the stomach. Food sitting there causes the lower esophagus to form a pouch. If you sleep lying flat, the food will back up and that is when it gets dangerous.

Anyhow, I go for another fluoroscopic exam with barium prior to a likely band adjustment today.

Geranium, I hope all goes well for you today.

i am anxious to see my doctor next week. He will explain the results of my esophagram. I hope I don't have a dialated pouch. I asked the x ray tech and he said it was, but only slightly. Somebody told me I should be on a liquid diet for this but I called my doctor's office and asked, and they said only for 24 hours.

My band holds 9 cc. Realize Band, My doctor said this fill should help me not eat as much, He was wrong. How long do I have to wait after a fill to feel the restriction from it.

My band holds 9 cc. Realize Band, My doctor said this fill should help me not eat as much, He was wrong. How long do I have to wait after a fill to feel the restriction from it.

Andrea, I grew up in Radcliff and graduated from NHHS in '86. Did you grow up in E-town or are you a transplant there?

Thanks- great info...I wondered why people had so many fill visits!

I am like many of you who have not felt restriction after several fills. I went for my 4th fill this week. It does feel a little different, but I thought so last time, as well. I'm still on liquids, so I won't know anything just yet.

What is everyone else’s post fill diet like? I have to be on clear liquids two days, full liquids two days, soft foods for two days, and then to a regular diet. I half think that's the only reason I am losing any weight at all.

At least I have been walking. I have been walking 5 days/ week for 45 min-an hour. Still, I've only lost 26 pounds since I was banded in July.

I have a normal appetite and I can pretty much eat everything on my plate, although I try not to.

When I eat less, I am hungry a couple of hours later. I am worried this will happen when I get restriction. Someone asked about how it felt and I am wondering the same thing. Will I feel SATISFIED, or just uncomfortable?