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Is it possible to shrink your pouch if you think you've stretched it out?



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I'm seriously thinking I may have stretched my pouch out. I had surgery six months ago and have lost 37 pounds, but I've been at a total stand still for two months. I notice that I get a full/uncomfortable feeling after a few bites, but if I wait 2-3 minutes I can usually eat my full meal, which is usually 1 to 1 1/2 cups, which I know is too much. I have a 10 cc band, which should have about 4 cc in it right now and the doctor said I should be just about full. I'm extremely struggling with the head hunger lately too. My old eating habits are creeping and I'm wanting to eat a lot. I'm going to go back to giving up sugar to see if that helps with the cravings. The holiday season really threw me for a loop since I wasn't prepared for all the goodies being around all the time. I've also been drinking about 1/2 of a 20 ounce bottle of diet Coke each day, maybe a whole bottle though some days. I never have pains from the soda though. I'm thinking I can eat too much because I stretched out my pouch. Is it too late to save myself from me?:help:

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it too late to save myself from me?:help:

I think you should consider getting your band recalibrated- I jsut had all my Fluid removed and redeposited and I feel much bettger restriction- I was in the same boat- I have also lost about 37 pounds and I had thought that I had stretched out mine as well- but I jsut needed the recalibration and now i'm back on track!

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In my case, I was absolutely convinced I had totally stretched out my stomach, I broke every rule in the book, sodas, drinking with my meals, eating too much, you name it I did it. Now after almost 6 years, I can say with absolute certainty, that I did indeed stretch it a bit, but not enough to matter. I had a gastroscopy done as well as a barium swallow. Doctor says, there is only very minor dilation of the stomach.

This tends to make me believe that it must really be a whole lot more difficult to stretch the old stomach than I thought.

Cindy

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I have a 10 cc band, which should have about 4 cc in it right now and the doctor said I should be just about full.

Are you saying that your doctor said your band is almost full?

I also have a 10cc band and I have 5cc in it right now. I do have some restriction but not as much as I would like. I've heard some people say that they have about 6-7 cc in their band before they get to their "sweet spot".

Have you asked your doctor about this and what did heshe say?

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I have 6cc in my 10cc band and I am just now feeling some restriction. I go for another fill on Wednesday. Sounds like you need a fill to me??????

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Drinking soda/eating too much/drinking with meals can stretch the pouch????

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A while back I was asking them how big my band was and he said it was 10 cc and I think he said it was by Inamed. He told me that typically they hold about 4 cc, unless maybe I misunderstood him. I do know when I went three weeks ago for a fill, which I think put me right around 3-4 cc, he said I should just about be where I need to be as far as fills.

Is is normal to have to wait a few minutes after the first few bites before you can finish your meal? I think I've heard this called first bite syndrome.

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Stretching your pouch is serious business because that can lead to a slip.

I think you'd have to have a barium swallow to determine if you truly stretched your pouch. Most doctors do a complete un-fill for a period of time (2-6 weeks?) to let everything calm down and shrink back down. You might have to do liquids for a period of that time.

Most likely you have not stretched your pouch. It sounds like you need a fill.

I think there are 2 sizes of the 4cc band - 9.75cm and 10cm. (referring to the length) When you get close to "full" or your "sweet spot" even a tiny tweak can make a big difference. (.1 or .2 cc's) I've also heard that the 4cc band can be over filled to almost 5cc's. It sounds like you have plenty of room for adjustment still.

If you search first bite syndrome you'll find a few threads about it. I don't know that much but that may be what is going on. You should analyze your exercise routine and what (solid Protein, veggies, Water, etc) & how (chew chew chew) you are eating and talk to your doctor about your concerns.

A plateau of 2 months is not uncommon but I know it would drive me crazy! Good luck

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It is my understanding that it is hard to stretch the pouch. A post I read earlier from a 1998 bander (very informative) explained that usually what happens is actually that the esophagus stretches at the bottom since the band is place at a non-elastic place on the stomach...I'll try to find the thread and post it here. It was great.

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THIS IS THE POST BY WENDELL

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.< /span>

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.

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ThinnerTimes: Lap-Band®- Complications - Slippage

b_trans.gifLap-Band®: Complications - Slippage

From time to time the stomach wall can slip up through the band. Slippage causes an hourglass effect with a bulge above the band and extra stomach tissue with in the band.

Slippage may be mild and intermittent, or it may be severe and may not resolve. Symptoms are nausea and vomiting and a decrease in the ability to take foods or liquids.

Slippage requiring reoperation or removal of the band occurs in less than 5 percent of patients when the currently accepted surgical technique known as the pars flacida technique is used to implant the band. Care is taken as well to make the pouch above the band very small.

Normal Location of the Lap-Band®

Anatomic%20location%20of%20band.jpgThere is a small amount of stomach above the band. Note the diagonal orientation of the band.

Slip with Dilation

LAGB_Dilation.jpgHere the back wall of the stomach has slipped up through the band causing dilation of the pouch above the band. Note how the band is now turned upward.

Slippage and dilation will cause nausea and vomiting. In extreme cases the stomach within or above the band may die and need to be removed.

Diagnosis

  • Symptoms of acute nausea and vomiting and inability to take liquids or foods
  • Upper GI series X-ray.

Treatment

  • Mild slip: Deflate the band, reinflate in one to two weeks
  • Moderate slip: Deflate the band, operate to reposition band
  • Severe slip: Deflate band and operate to remove band

Prevention

  • Appropriate band placement by surgeon
  • Careful progression of diet by patient. No solids for 4 weeks
  • Wait at least 6 weeks for first adjustment

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