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.

tweety63 I really feel for you. In that year you could have lost all or much of the weight you need to lose. Crazy thing is with the weight off you will be much healthier and save them money in the long run.

My insurance HMO did something that was really bad for me. I was taking Benicar, A high blood pressure medicine that worked fine for me. I got on the HMO and they said that they would not pay for the Benicar, that I had to take an ACE inhibitor and Cozaar instead. My doc was really upset with this. While taking the ACE & Cozaar my asthema got worse, I had constant diareaa and woke up one morning with my upper lip swollen like a bag of water!! It traveled to the bottom lip and into my mouth. It was angioedema (an extreme allergic reaction to the drugs) and doc said I was lucky to be alive. The doc kept my Benicar supply up with free trials. We worked fo 4 months to get the HMO to approve the benicar!!!!!!!!!! At times I was calling them daily.

Now out of nowhere I have chronic kidney disease stage 3 out of a 5 stage scale. I cannot wonder if those medicines did this? Am still in the testing phase, had a ultra sound today.

Because of this I did not even try the HMO for Band coverage. Just went to MX. and self paid.

Dr. Watkins:

I also have joined this band wagon as stated below:

I (personally) was banded 3/1/07 and have no restriction. I am at 4.20 in a band with a capacity of 4.0.

What would you do, if one of your patients experienced this?

I am going to "hang in there, till Jan/Feb and I am thinking of going to your Seattle office.

Can you give us any "insight"?

Pam banded 3/01

thanks every one for the tips and info.. does anyone experience what i have.. banded in may,, 3 fills under fluoro, and i have been told the band is totally full up. and my restriction isn't very much.. its seems that if teh band is full up.. that it !! the band has nothing left to offer me

regards

paula

I am in your boat and I don't know what to do either. I have had 4 fills and am totyally full. I never felt the first restriction until the fourth fill. I feel like to have enough restriction to lose weight properly I would need one more fill and that doesn't exist. My nurse acts like I am the only person that the lap band doesn't work on properly. She tries to find excuses of why it is my fault that it isn't working. I know what restriction is and I don't have enough of it. I had my surgery in Aug. and I have lost a total of 7 pounds.

I am in your boat and I don't know what to do either. I have had 4 fills and am totyally full. I never felt the first restriction until the fourth fill. I feel like to have enough restriction to lose weight properly I would need one more fill and that doesn't exist. My nurse acts like I am the only person that the lap band doesn't work on properly. She tries to find excuses of why it is my fault that it isn't working. I know what restriction is and I don't have enough of it. I had my surgery in Aug. and I have lost a total of 7 pounds.

Pamela

Typically you can get any band pretty tight.

I would recommend a Fluid check to make sure it has in it what they think is in it and also a fluoro to check the restriction it creates.

hope that helps

brad

Sunshine were'nt you scared going to Mexico for the operation??

Sunshine were'nt you scared going to Mexico for the operation??

It was the first time I was in Mexico, but I wasn't afraid because of the way my surgeon handles it. After you land at the SanDiego airport Laura, one of the doctors wife, picked me up and drove me everywhere. If I had to do that on my own, I'd have been terrified and lost.

Also I was a bit desperate. My health is going whacko on me cause of the excess weight and I had just received just enough money ,from a settlement with ex, for a MX lapband. A USA one was out of the picture for me.

Opinions differ about how gastric banding actually works.

My opinion is based on the fact that stretching the stomach wall shuts down the appetite hormones. When your stomach size is reduced from a football to a golf ball you are going to get stomach wall stretch and appetite hormone diminution on much fewer calories.

Also, the food takes a while to empty through the restriction so the full feeling lasts longer. Some patients will forget to eat dinner because they are still full from lunch.

We know about some of the appetite hormones floating around but we know that there are many more and that the way the stomach and the brain communicate is very complicated. The drive to eat is a very powerful biological drive. If the brain thinks for an instant that you're trying to starve yourself it will take drastic measures.

The small stomach pouch above the band fools the brain into thinking you've just eaten a Thanksgiving meal.

In some patients the appetite suppression is very powerful and some patients say they are never hungry after band surgery. Some patients deal with lots of "head hunger" which is a complex process and not easy to deal with sometimes.

As you lose weight, the stomach tissue inside the band loses weight and that is why you need additional fills as you lose your weight. At your goal weight, the stomach tissue thickness stabilizes and the need for fills diminishes quite a bit.

I read a lot of posts where patients do not have their bands perfectly adjusted.

Here's my version:

Perfectly adjusted - full on small meals, not hungry between meals, easy to lose 1-2 pounds per week, amorous feelings toward your surgeon and staff, send them a Christmas card that will bring tears to your eyes

Too loose - hungry, can eat large amounts of food, hard to lose weight, feels just like you are on a diet.

Too tight - everything wants to come back up including liquids, hurts to eat or drink, bad heartburn especially at night (when you lay down), the only thing that wants to go down is Cheetos and ice cream (bad stuff)

I think if you don't fit the "perfectly adjusted" description you should call your band surgeon to make it perfect with an adjustment.

Also keep in mind that each patient's band journey is very individual.

Hope that helps

brad

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 lapband...I can eat 1.5-2 cups of food at one sitting.

Renee

I am in your boat and I don't know what to do either. I have had 4 fills and am totyally full. I never felt the first restriction until the fourth fill. I feel like to have enough restriction to lose weight properly I would need one more fill and that doesn't exist. My nurse acts like I am the only person that the lap band doesn't work on properly. She tries to find excuses of why it is my fault that it isn't working. I know what restriction is and I don't have enough of it. I had my surgery in Aug. and I have lost a total of 7 pounds.

Pamela

what does your Dr. say about the fills, do you only deal with the nurse

Salad:

So many people say they can't eat salad. I LOVE salad and my fill nurse tells me NOT to eat salad because it slips through MY band too easily and causes me to overeat on salad dressing etc.

I can't eat roasted turkey!! I am totally bummed but I eat two bites and am stuck for quite sometime.

I can eat deli sliced turkey~just have to take it REAL slow....

Wonderful & helpful!! I was a 11-9 band, with a 1cc fil 4 weeks later. I feel more hunger than I expected even still. Maybe it's mental obsession!

Wonderful & helpful!! I was a 11-9 band, with a 1cc fil 4 weeks later. I feel more hunger than I expected even still. Maybe it's mental obsession!

You'll need several more fills before you feel restriction... just hang in there.. My Doc gives them at 2 wk intervals until you are losing 2 lbs per week.

neen7171

I too was discouraged initially. I gained 10 pounds after my first fill! The second fill, didn't feel any restriction until towards the last week and 1/2 before going to the doctor. I thought that was wierd, but then realized I was paying more attention to what I was eating and feeling.

The third fill, as far as I'm concerned, was the magic one. Wow! What a difference. I feel the restriction, I feel full, fast, can eat only small meals. don't know about the weight loss as I don't weigh myself (promised myself I would only get weighed at the dr. office and not be a slave to the scale.)

So, hang in there. It is a process and when we're expecting great results, like, yesterday, it's hard to be patient.

One of the things that happened with me, is that I forgot the small portions, chew, chew, chew, and no liquids. With the 3rd fill, my band doesn't let me forget those rules. It was not initially pleasant when I ate too big a bite too fast. My body learned fast to chew, chew, chew, chew, chew, chew!

Keep up the good work.

Sue Stenzel

:whoo:Sometimes it even takes more than 3 fills. It took me nearly a year to get it right. One of the reasons I am close to goal is from an overfill. I could hardly eat for a month.

I knew that was dangerous so I got an unfill. There went all of my restriction.

I got another fill at the beginning of Dec. which is nearly a year from having my surgery and I am finally at the right spot. It's very frustrating.:whoo::whoo:

neen7171

One of the things that happened with me, is that I forgot the small portions, chew, chew, chew, and no liquids. With the 3rd fill, my band doesn't let me forget those rules. It was not initially pleasant when I ate too big a bite too fast. My body learned fast to chew, chew, chew, chew, chew, chew!

Keep up the good work.

Sue Stenzel

Boy, did I find that one out big time last night. I was excited and talking as I started on my hotdog. Next thing I know it hit!!! I ran to the sink and upchucted everything. The band reminds you to chew chew chew.

I am so glad I found this thread. I read every post. The information is invaluable. I can relate to so much that has been written here. Was banded on Oct 8th. Lost during Oct and Nov. Dec was a loss. I am getting another fill on Jan 2nd. I vacationed with my Florida family for two weeks and over Christmas. Back home in Texas. Now I am ready for another (2nd) fill.

Thank you so much for this information. I wish I had found this thread a long time ago.

Wendell,

Thanks for the post - good information. I am new to this site, and this is my first post. I have a question about fills. Who determines the need for a fill? Can I go in a request a fill when I feel the need, or is this dictated by the doctor? Currently, I am pre Op, but I've been approved by Insurance. 7 Jan is the day I go in to discuss a surgery date (I guess). Also, I read on another post, that there was some "sewing" done on the stomach, attaching the band to it? I didn't think there was any sewing involved? I thought they put the band on the stomach and that was it? Anyone have any clarification to this? Thanks so much!