I have been banded for almost a year and have lost 35 pounds. I have numerous fills and unfills. When I get a fill, it begins to be too tight after 4 - 5 weeks. I have difficulty eating and drinking. During these periods, I lose weight! When I get an unfill, my doctor unfills me more than .1 or .2 cc to let my stomach relax (normally it appears too tight on the fluoroscopy). After the unfill, I can eat more and do not lose weight.

I hear so many people say that they have had only 1 or 2 fills and have lost 100+ pounds. How do you do it? When I am tight, I know I am not eating enough to be healthy. It is difficult to eat 1200 calories. I am curious how those that are successful do it. Are you very tight and live with it? I have tried doing Protein.

Also, do you have trouble with cold drinks or is it better to have Hot Drinks? When I am tight, I never know if I will be able to eat or drink in the morning. Normally, I am only able to sip small amounts of liquids. Is this how you survive.

I think that I have not found the right fill. But I have been at 1 (too lose), 1.5 (too tight), .5 (too lose), 1.4 (too tight), unfill (too lose), 1.0 (too tight) and now .5 (too lose). Do I keep trying to get it right? I do feel good about losing the 35 pounds and people say that I look good. However, I want to lose another 35 pounds and keep yoyoing with the fills.

Any suggestions?

JoAnn

235/200/165

Dr. Ortiz April 29 2004

Joann, have you tried tracking your foods on www.fitday.com? This is a good way to see what types of food and how much you are eating? Are you exercising regularly? How tall are you? Are you drinking tons of water, but not w/ your meals or 1 hour afterwards? It could be that you have less "fat" to lose than a lot of us do. Best of luck to you!

Hi Joann,

It can be very hard to find a good level of restriction when only a few tenths of a cc make such a difference. My doctor just recently told me that in fact, when people get to that "razor edge" of restriction it can seem very fussy and be hard to manage. A tiny adjustment can make a big difference at that stage.

I recently had a small unfill (-.4cc) because I was suffering from reflux. If it hadn't been for the reflux I would have been fine at that level of restriction--it was difficult to eat more than a few bites but I was never hungry, so that was OK. Warm drinks before meals eased the tightness somewhat. Since almost all of what I ate was protein-based, I didn't worry about nutrition even though my calories were probably in the 1000 neighborhood. During that two months I lost almost 20 lbs, and the only downside was the reflux.

When you were filled to 1.00 cc and felt too tight, what did too tight feel like? Sometimes any restriction feels "too tight" because it limits us from doing what we're used to doing--that is, eating with abandon. Were you having symptoms of reflux or an inability to drink fluids? Maybe, if you give it another try and take it really slowly, you'd be able to manage a fill of that level again.

You ask whether you should keep trying to get it right, and my feeling is yes, if there are no obstacles to doing so (like money, or your doctor's patience). The "sweet spot" is in the mind of the beholder and clearly you haven't reached it yet. But it's still out there for you if you have the patience to find it.

Also after a fill are you going to liquids/mushes for a few days afterwards? If not, and you are hitting the "hard" stuff right after a fill, the restriction you are feeling could be your stomach is still irritated and swollen some. It seems some get more irritated from a fill then others. Some can eat solids right after and some can't. But it seems the best route is liquids/mushes for several days after to give your stomach a rest and then move on to the solid's. This allows the swelling to go down some before the stomach is put back to work. Also several other also have noticed the same thing you mention--that a fill will "tighten" up a few weeks after you get it.

Most of all remember that your new pouch should only hold about 4 ozs. of food at a time. That is a super small amount compared to what we have grown accustomed to thinking of as normal sized. Its about 3/4 a cup or so volume wise. Keep that in mind when eating. I go for banding tomorrow and I plan on actually using a measuring cup at first to help me get accustomed to the new volumes of food that will be normal for me after surgery. Of course that will be a few weeks down the road after my liquids and mushes stage.

T

JoAnn, I am right there with you!!! I have been banded for 4 months and I am about to make an appt for my 5th fill. I have only lost 16 pounds and the majority of that came off when I was recently overfilled for 6 days. I got an unfill and now nothing has happend for the last 2 weeks. It's one of the most frustrating things I have ever been through!!! Hope we both find that sweet spot soon!

Joann did I meet you at Dr. Ortiz's office in November?

I too have had 2 fills and have only lost 7 pounds since the surgery on Dec 4th 2004 it is now March 7th 2005. I do pb a lot and I have reflux at night that wakes me up choking me. Don't want to get any thing taken out because Im not losing now so if the stoma is bigger Ill never lose this awful fat...Boy this is so frustrating....G

Gcravener, I have to say that if you're having reflux and PBing all the time you probably are too tight. It's accepted wisdom that being too tight can lead to weight gain just as easily as weight loss, because the patient stays away from the healthier (harder to eat) foods and gravitates toward softer foods.

Finding the right spot with the band is not necessarily an easy thing. You've only been banded for three months and many, many people don't get to the "sweet spot" right off the bat. I'd suggest an unfill immediately and that you then take a careful look at what you are eating. Fitday.com is a great tool to help you track your actual calories in and out, which might be enlightening all by itself.

Being too tight is NOT the way to banding success. Please consider having an unfill and getting a fresh start. Banding can't possibly work if you're fighting with it all the time, and you may even do yourself some damage along the way.

You may want to start a new thread with your experience and see what other bandsters have to offer. I'm sure there are other people in your shoes who can benefit from a discussion about it. Welcome to LBT!!

I agree with Alex

When patients are too tight they tend to fall int to the soft food syndrome, food that goes through the band quicker and does not give the satisfaction of being full hence to only eat more softer foods quicker then eating solids and letting the food sit in your pouch and fall through slowly. Not to mention Pbing often is not good for your band, it is a definite way and proven to be a factor in your band slipping and the reflux damages your esophagus, If it were me and I was experiencing these symptoms I would go in for a small unfill . Many have had your experience and would share their input, I agree again with Alex, start a thread about your experience to date, you will get lots of info