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.

Wendell, help. First time on this site. Banded 12/8. Have a 14cc Lapband Dec 2008. TEN FILLS later at 9.6 cc full. Little restriction no sweetspot. 62 years old. Feel I'm doomed to slow weight loss - can walk, no extreme exercises. Small fills each time. 50 lbs first year - 1 lb a month since - total 58 in 15 months. 40 to go at least - aiming for size 14. Frustrated. Got reflux more than .4cc fills. Kathy B

Hi had my 3rd fill on Thursday - Total 5.5 CC.

Had a tough 4 days - including not being able to drink more than a sip of water :-(.

But my perseverance paid off - Have lost 7 pounds since my fill, and have move to thicker liquids!!! (I guess I have lost some fat around the band and swallowing has become much easier).

Really excited as I had not lost weight for more than 2.5 months!!!!

I feel your pain! I got a fill last Friday (6 days ago) and I am having trouble with most liquids and am eating very very little. I have also lost 7 lbs but eating is getting frustrating!

I tried refried beans last night, and gacked up every bite! I was able to eat half a sausage link (of all things) and it stayed down great.

I am hoping I wasnt too overly zealous with my last fill of .5 ccs and am now TOO tight. I'm at 7 ccs in a 10 cc band. Before this I was only losing about 3 or 4 lbs every 6 weeks or so. Anyone have some words of wisdom about how long I should wait before becoming concerned about being TOO tight? Should I wait a couple of weeks and see if eating and drinking gets better?

Thank you so much for posting this information... I had no idea why I'd get a fill and a few weeks later need another after what I thought was "good" restriction.

My eyes are now open!

The nurse in my surgeon's office keeps talking about how a fill can "evaporate" but sounds like she is trying to describe the changing size of the fat band...is that the flap of muscle/skin/whatever that attaches the band to your stomach? If I understand that correctly. Went thru a MISERABLE 2nd fill this past Tues, couldn't even keep down my own saliva...only had 5cc in a 10cc LapBand. After 24 hrs of praying to die...and getting dehydrated & blood sugars gone crazy :smile2:...he took 1/2cc out...and got instant relief and could keep water down. This time they tested it in his office before I left...may insist on that extra precaution for future fills. So, evidently 4.5cc is a goood place for me to stay for a little while. Good luck to all...and Wendell...post when you can.

My doc recommeds 6-8 weeks. He says it takes that long for your body to adjust to the tightness...

Same here...mine waits min. of 6 weeks...had to beg them to let me fill @ 5 weeks since was going out of town for vac...so glad I moved it up & got the adjustment amount right before leaving town...or would not be able to enjoy Myrtle Beach at all. 1st vac. since sx....wish me well. Gonna concentrate on fresh seafood...not fried & leave the side dishes alone!!! Hope this plan works.

I was banded 07/21/10 and my doc put in 3cc as well. I have already lost 18lbs, but am worried about starting to eat again and will start gaining....

Thank you for your awesome message. It is so informative. I am a newly banded member and am trying to read as much as I can to be successful. I am very excited about the journey ahead and welcome the change. Thanks again for the good info and Congrats on such a significant weight loss.

Thank you for the compliment.

Yes, before I obtained effective restriction with fill number 4, which was given 24 weeks after surgery, I thought that my Lap-Band® did not work and that the entire thing was a cruel joke at my expense.

I don't know anything about the Swedish Band, but I do know that a Band that would not provide restriction when filled to capacity is exceptionally rare.

Best wishes on your journey.

Thanks for some great information...!

I was banded 07/21/10 and my doc put in 3cc as well. I have already lost 18lbs, but am worried about starting to eat again and will start gaining....

Wow that's great! I just got banded July 15 2010 and am scheduled for fill on august 30..hopefully everything goes well...

Thank you so much.. really the part about the fill not working for awhile is news to me... and I like it...

It is my second fill and I never seem to feel anything different. I have 5.5 CC s in a 14 CC band... so I have a way to go.. But it is good to know it could Kick in later ...

What is the amount of a normal fill? I have only gotten 1.5 in each fill and there was some in there to start... I feel like I could go a bit higher.. but they do not go higher on me... Bless you for your wisdom!!! Happy loosing!

Edited August 13, 201016 yr by Ninababy
miss spell

i was banded 7/12 and had my first fill 8/13. i'm just finishing my liquid diet so i'll see tomorrow how solids go down. the fill went well except that my dr's partner had to do it and he didn't tell me which band i had or how much he filled it. i definately won't be seeing him next time. i like to be well informed about what's going on. he also seemed a little frustrated while filling.........even called me a rookie , which of course i am. he had to fill and unfill a few times with me taking big gulps of water to make sure it all went down. i get my next fill in three weeks.

Wendell, thank you so much for great info - you pretty much answered all my questions that i had when coming here today...

Just one question, when you say it can take up to 4 weeks for "Delayed Action"...do you mean the swelling?

I had my second fill last week (5 days ago) and i still am having trouble with mushy food. It feels like i am still a bit swollen.

Edited August 16, 201015 yr by Seby
mistake

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 havent had surgery yet but im getting there soon =i have question about the fill ///does it really hurt? they showed me a needle they stick in your skin that goes to the insert ...oooooch that is the main thing thats scary to me

Thank you! After reading this I was right and was too tight on my last fill. I was only able to eat liquids, cheetohs (LOL) and ice cream the latter two I tried to resist, but after you can't eat anything solid for a few weeks they become tempting....after this last slight unfill though I am too loose. I need another fill! I will need to schedule one for the first of the year. One thing I am really enjoying right now with this unfill is that I am able to eat salad again....YUM I really missed it! I don't miss bread, pizza, hamburgers - just my salad greens!! Now I can eat them again, but I don't feel like I am eating as small of amounts as I should be with my LAP-BAND®...I can eat 1.5-2 cups of food at one sitting.

Renee

Cheetos are EVIL! :huh2: Since my last fill, it seems that is the only thing I CAN digest! Damn those Cheetos! I'm thinking of going in for a slight unfill next week, if things dont get better for me... I have to drive to another state, so I'm hoping they do...

Contrats on the weight loss. Could you direct me to the thread you found with the 5-day pouch diet test. (I have a lot of trouble navigating around this site.) Thanks.

Surgical Weight Loss 5 Day Pouch Test

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."