Sorry to ask such a silly question, but I honestly can't find any instructions anywhere regarding my first fill in my paperwork. So should I stop eating a certain amount of hours before the fill? I did have a couple very small things to eat this morning (2 slices of wheat toast for Breakfast, some pureed bananas for lunch around 11:00 when I was feeding my baby and a couple chocolate-covered strawberries left over from Valentine's Day). It's 11:40am now and my fill is at 4:00pm so I'm not going to eat anymore. How about fluids? Can I drink anything and should I stop drinking beforehand? How long before the fill should I stop drinking? I'm really thirsty right now.

Thanks so much...:wub:

Hi,

I just had my first fill today. I was banded on January 7. I did have something to drink before the fill, but no food. Since the doctor did not recommend that you fast before the fill...I think you should be ok. So far, so good. No pain at all during the fill, just pressure. Keep me updated.

I asked my MD the same question but he said there are no dietary restrictions before a fill, though I think I will put myself on liquids the morning of. Due for my first fill this Friday (2/22). I'm really nervous about the effects afterwards. I was so swollen after surgery I could not keep anything down. I have just gotten used to feeling somewhat normal again.

Not sure where I got this from.. somewhere that I was doing research on.. but thought it might be useful for this thread.

Increase Your Chances of a Good Fill

The following suggestions are good rules of thumb and will greatly increase your chances of getting a good fill.

1. Be sure you are very well hydrated when you come in for your fill appointment. That means at least 6 to 8 full glasses of liquid every day for at least several days before the fill.

(Remember, Water is your friend).

Drink especially well the morning of the fill. If you're flying in, it can be much harder to stay hydrated, so take an empty drink bottle and fill it after you pass airport security. TSA rules state you can bring an empty water bottle past the TSA security check point. Bring some of those "to-go" packs of Crystal Light, they’re ideal! Ask the flight attendants for a refill of your water bottle, pop one in, and then you will have plenty to drink.

(Hint - If you flying in for a fill, while you're on the plane, grab a couple of those white barf bags.

It’s good to keep one in your purse or car, for "emergencies".)

2. Do not to have any solid foods for at least 6 hours before the fill. Don't eat a huge or late dinner the night before. If you're having any trouble (reflux, possible slip, etc)

please have nothing but fluids after dinner the night before.

In some cases, food can still be in the pouch for 12 or more hours.

ANY food in the pouch will make it impossible to give a good fill, or get a good fluoro

3. Don't drink COLD fluids for an hour before the fill. That will shrink your stoma and give a false fluoro reading, and a poor fill. Room temp fluids are fine. Let the ice in your drink melt and hour before a fill,

and then you'll have room-temp fluids to drink right up to the fill time.

4. Avoid getting a fill during a menstrual period or a few days before an expected one. During this time, girls are usually retaining water, and the fluoro will not be as accurate, and the fill will not be either.

5. If at all possible, hang around for at least a few hours after a fill. Don't run right back home or to the plane. It takes the normal swelling after a fill 1-2 hours to develop, and by that time you might be too tight and need to come right back.

6. If you fly in, If at all possible, stay overnight and catch a plane out the following late afternoon or evening. If you are too tight, this will allow time to get a small unfill before you leave. This is not very convenient, but sure beats having to possibly return to TJ in a few days, on short notice, in pain, and at high last-minute plane fares! This is "prevention!" Overfills are not common, but they DO happen, even under the best of conditions. Be prepared, and think about this overnight stay. Test your fill the next day before you leave.

7. After a fill, please have liquids only for at least 24 hrs. This allows the stoma to rest and heal. Then, a day of soft foods, then back to regular foods. Full liquids are fine, no need for clears. Remember, if you staying over night test your fill before you fly out.

8. Review the eating and food guidelines again before every fill. You’ll need to refine your eating more and more with higher fill levels, and there will be less and less room for goofs. As you reach a higher fill level, you'll no longer be able to "get away" with things you might have before!

9. Please don't get a fill if you are having ANY trouble with the current level of fill. This means ANY regular pain, PB or barfing more than maybe once a week at the VERY most, not able to get enough

calories in, not able to drink enough, able to eat only soft foods or fluids.

More fill will NOT help, and will make things worse. Discuss all this carefully with your doctor. You may even need an UNFILL, to keep your band and stomach safe.

10. First fills are routinely given at 6-8 weeks after surgery, but only as you need them. Many people do, some do not. Your doctor will help you decide if you need a fill, just ask. There is no rush for fills. Too much can very easily get you in trouble, and you end up further "behind" than if you had gone slower with fills.

11. Give a fill at least 2-3 weeks to test it. Some fills don't "settle in" for a week or two, and sometimes more. Your weight loss is what determines how a fill is - not any feeling of restriction, necessarily.

12. One of the most important things in determining if a fill is good is choosing proper band foods. Soft foods, liquids, junk foods, sweets, etc, will NEVER be well-restricted, and will never tell a thing about having a good fill or not. Only solid foods give useful info.

A good test meal is 2-4 oz of solid meat or chicken - be sure it's soft and moist - and about 1/2 cup veggies. You should be able to eat about a cup of food (no less) and this should keep you satisfied (NOT "FULL", but simply "satisfied, not physically hungry". for about 3-4 hrs.

13. Plan regular meals. A good fill will keep you satisfied for 3-4 hrs, but no longer. If you are hungry 5 hrs after lunch, it is not because you have an inadequate fill! Regular meals at planned times are important for a number of reasons; including avoiding snacking, maximizing your calorie burn and normalizing metabolism, which is essential for weight maintenance later on.

14. Learn to recognize YOUR "soft stop" sign. Common ones are chest tightness or "fullness", a sudden runny nose, a single hiccup or burp, an eye twitch, back pain, left should pain. All mean the pouch is full enough and we should STOP eating, even spitting out the bite that may be already in our mouths. If you do not, you could progress to the "hard stop" - slimming, pb, barfing.

Please remember that good fills are very elusive, even with highly- experienced docs and fill people. There are just too many individual factors involved that the docs cannot control. Even the fluoro is only a clue, and not entirely accurate - for some of the reasons above.

It usually takes 3- 5 fills to slowly and safely creep up on a good level, and they can be safely given a month apart.

Trying to go faster with a bigger fill is not the solution, and the stomach rebels at big sudden fills. The goal of the first few fills is NOT to achieve a good restriction, but to gradually get your stomach used to some pressure so you can tolerate a GOOD fill later.

SLOW and GRADUAL is the key!

Going slowly with fills can be frustrating, but is well worth the wait to avoid problems.

• After a “fill” you are on a clear liquid diet for 24 hours; then, soft for 24 hours; then, regular food

o Clear – juice, water, broth, miso Soup, tea - no salty or iced drinks.

o Soft – V-8, yogurt, cottage cheese, smoothies, (no ice cream), pureed Soups, squash, apple sauce.

• Call me if you are unable to sleep lying down due to reflux to schedule a slight “unfill”. Do not talk yourself into “working through the reflux”.

• Eat Protein at every meal; eat your protein first in order to facilitate proper digestion of this complex food.

• Eat three meals daily or six small meals; do not snack – ¼ to ½ cup per meal

• Drink water instead of mindless munching (add lemon to water) between meals. DO NOT DRINK LIQUIDS 45 MINUTES BEFORE AND 60-90 MINUTES AFTER YOUR MEALS.• Make sure your bowels are moving daily with ease not effort

• Add Fiber into your diet if you are not having complete bowel movements – 1 tablespoon ground flax seed• Have some form of movement every day for 30 minutes

• Avoid white flour and white sugar products

• You are not allowed to be on an ice cream diet

• You may not lose weight if you’re not eating enough

• Eat slowly between bites; take small bites; sip your drinks.

• Chew your food slowly

• Throw out all the junk food in the house

• Don’t buy anymore junk food

• Eat organic as much as possible to avoid increasing exposure to false hormones, antibiotics, and other toxic substances

• Join a support group, Curves, or weight watchers.

• Stop eating after 7:30pm during the summer; and 6:30 in the winter

• Keep working on the mental emotional component to comfort food eating

• Schedule another fill when your portion sizes increase to “old day” sizes or you are feeling hungrier earlier then you remember.

• Journal about your feelings, keep a food diary, create a collage of what your future looks like and hang it in your room.

• Create a collage of images you want to let go of and burn the collage.

• Laugh every day

RECIPES FOR AFTER A FILL

Master Cleanse Drink (adjust lemon, ginger and cayenne to taste)

4 oz of apple juice

Pinch of cayenne pepper

¼ teaspoon fresh grated ginger

4-8 TBls of Lemon juice

4Tbls of Maple Syrup or Honey

Pinch of salt

top off the blender with filtered water

Blend till mixed

Strain and drink ½ - 1 Quart a day

SMOOTHIE: FOR DAYS WHEN YOU ARE ON SOFT FOODS AFTER A FILL OR UNFILL - A 24 HOUR REQUIREMENT FOR POST FILLS AFTER LIQUIDS.

2-4 oz of apple juice or Rice or Soy Milk

3-5 ground almonds

1-2 teaspoons of flax oil

¼ cup of frozen fruit ? berries, bananas, mangos, papaya

1-2 Tbls (or packet) Protein powder (I use a Rice Protein which is hypoallergenic and tastes pretty good)

¼ teaspoon Bee Pollen (do not add if allergic to bees or huge environmental allergies)

½ - 1 teaspoon of chlorella or spirulina