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 wish i had found this yesterday! I blogged about my 3rd fill last night after my dr. appointment here:

http://www.debbieposton.com/3rd-fill-in-my-lap-band/

but it would have been nice knowing how it all worked before going in...I was really stressing over the fact that I was having no restriction. I have been on liquids for 24 hrs so not sure if this new fill will help but I am hopeful!

Let me know what you think of my post if you get time to read it...

I have been reading the post and I was wondering what everyone thinks. I have 8cc's and can still eat anything and have no restriction. Doctor says that can't be possible. I'm stress eating but I tell you I am hungry all the time and can eat anything.

I can assure you...it's not only possible....IT HAPPENED to ME. Does your doctor use Fluoro for adjustments and to check your restriction level?

Just got back from having my third fill. I have all my fills done under Fluoro, and I'm thankful for that.

I knew I needed a fill (my last was done on August 28, 2013) as I was getting hungry way too fast after eating. It really brought back memories of how my life was pre-band. I was starting to search for food, I was thinking way too longingly about certain foods, and (most importantly) I was starting to slip into a dieter's mindset. By this I mean I was looking at sugary foods and saying to myself that I could not trust myself with just one little bite, as I knew it would lead to overeating that food.

When my band is properly adjusted, I don't have that dieter's mindset and I can, indeed, stop at one little bite.

I'm SO glad I get my fills under Fluoro, because I would not have been able to see what I got to see this morning: the radiologist had me drink the contrast solution BEFORE the fill, so he could see how my band was acting at my current fill level. And we both saw that I'd lost so much fat (and weight) that I had no restriction left whatsoever. The barium just flowed through the band without backing up into my pouch...right into my stomach as if I had no band. Yay for weight loss and yay for being able to adjust the lapband!

No wonder I'd been feeling like a pre-bandster! (So glad I am this tuned into my body!!!)

I thought I'd only get 1 cc but (again, thanks to Fluoro) as the radiologist filled to 6 ccs, the xray showed I still had no restriction. So he pushed in some more saline, and gave me a total of 7 ccs, but (again, thanks to Fluoro) that gave me too much restriction, so he pulled out 0.5 ccs.

My takeaway is this: Listen to your band and your body. I am always reluctant to get a fill. I'm very squeamish and I prefer to keep my band on the loose side to avoid stuck episodes. But with my weight loss, the band had become way too loose and my body was screaming for an adjustment. There was no need to keep on with my Dieter's mentality when I had/have this wonderful life-enhancing tool right there, and that tool was ready to be re-set to help me continue on to my goals.

And, as many have said on this forum, Fluoro really is very important to get an accurate picture of what the band is doing (or not doing). If you can opt for a Fluoro-fill, don't hesitate. It's like getting a custom-tailored outfit vs buying off the rack.

Edited December 27, 201312 yr by parisshel

I have been reading the post and I was wondering what everyone thinks. I have 8cc's and can still eat anything and have no restriction. Doctor says that can't be possible. I'm stress eating but I tell you I am hungry all the time and can eat anything.

Nice blog Debbie -- I have no doubt you will get to just the right fill. Thanks for posting -- and so glad to find this old thread. What great information! I am also at three fills now. Going back after the first of the year to assess. Best wishes -- we are on our way and just think what 2014 is going to bring!

Just got back from having my third fill. I have all my fills done under Fluoro, and I'm thankful for that.

I knew I needed a fill (my last was done on August 28, 2013) as I was getting hungry way too fast after eating. It really brought back memories of how my life was pre-band. I was starting to search for food, I was thinking way too longingly about certain foods, and (most importantly) I was starting to slip into a dieter's mindset. By this I mean I was looking at sugary foods and saying to myself that I could not trust myself with just one little bite, as I knew it would lead to overeating that food.

When my band is properly adjusted, I don't have that dieter's mindset and I can, indeed, stop at one little bite.

I'm SO glad I get my fills under Fluoro, because I would not have been able to see what I got to see this morning: the radiologist had me drink the contrast solution BEFORE the fill, so he could see how my band was acting at my current fill level. And we both saw that I'd lost so much fat (and weight) that I had no restriction left whatsoever. The barium just flowed through the band without backing up into my pouch...right into my stomach as if I had no band. Yay for weight loss and yay for being able to adjust the lapband!

No wonder I'd been feeling like a pre-bandster! (So glad I am this tuned into my body!!!)

I thought I'd only get 1 cc but (again, thanks to Fluoro) as the radiologist filled to 6 ccs, the xray showed I still had no restriction. So he pushed in some more saline, and gave me a total of 7 ccs, but (again, thanks to Fluoro) that gave me too much restriction, so he pulled out 0.5 ccs.

My takeaway is this: Listen to your band and your body. I am always reluctant to get a fill. I'm very squeamish and I prefer to keep my band on the loose side to avoid stuck episodes. But with my weight loss, the band had become way too loose and my body was screaming for an adjustment. There was no need to keep on with my Dieter's mentality when I had/have this wonderful life-enhancing tool right there, and that tool was ready to be re-set to help me continue on to my goals.

And, as many have said on this forum, Fluoro really is very important to get an accurate picture of what the band is doing (or not doing). If you can opt for a Fluoro-fill, don't hesitate. It's like getting a custom-tailored outfit vs buying off the rack.

You describe the dieter's mindset so well -- that is something for me to look out for as I try to assess where I am. I have definitely glimpsed the world of disinterest in foods that usually call my name, so I have an idea of what it will be like to have a properly adjusted band. And now I understand this can be a moving target over time as weight is lost (yippee for that and for adjustability of the band). I will ask my surgeon about fluoroscopy -- this has not been presented as an option so far but I will definitely inquire. What an advantage to be able to see what's going on!

I'm not sure of all the lapband lingo, but my practitioner said I was 5 last injection. I still throw up a lot with the first few bites of food... no fun, especially when you are so very hungry and now have to go on liquids for a while after vomiting. When I vomit it's mostly phlem, not too much food and it looks chewed well. Not sure what to do. I'm gaining weight because if I get very slow I can eat quite a bit. (A whole chicken breast, plus veggies.) My question is how much more can they infect? And, if I get injected again will it make the first bite syndrome worse? I have to do something, I've gained 8 lbs.

I've never been offered a Fluoro-fill but from the above post, I think it would be extremely helpful for me. I'll ask next visit.

I've never been offered a Fluoro-fill but from the above post, I think it would be extremely helpful for me. I'll ask next visit.

I had my non beneficial band removed 4 days ago. Want a useless tool.