First Fill \o/

[parisshel 1,892]

8 weeks post op today, 18 pounds down since my surgery. My band was placed unfilled but still I respected all postop directives and I'm pleased with my loss and my level of restriction felt by the band alone. I went to get my fill reluctantly, because I'm quite fearful of getting stuck or having PB/vomiting issues and frankly, I'm fine with a slow loss.

My fills are down under fluoscopy and I told the radiologist that I didn't want a dramatic fill, something small, particularly because I travel a lot internationally and do not want to have to find myself seeking an unfill in a place where I have no insurance coverage.

He told me something that I found interesting; when you get a fill of, say, 4 ccs, it doesn't mean that you have 4 ccs of saline in your band. Some of that saline is in the tubing, and tubing lengths are different. If you have more tubing, some of that 4 ccs will be in the tube and not in your band. So you just can't "order up" 4 ccs because someone you know found their green zone with 4 ccs. This is why filling under fluoscopy is so important...the radiologist can see how the liquid flows and judges a fill "adequate" based on speed that it exits the pouch, and no reflux occuring.

On the summary, he noted that 4 ccs was done per my request and that ideally he would have put in 5 ccs. I'm glad he didn't do what he wanted and listened to my needs.

So now I'm home, spooning down some applesauce VERY SLOWLY and seeing how that goes down. It can't be any thicker than that cursed barium, right?

Wishing everyone good success with their band!

[Jean McMillan 2,973]

Your surgeon's comments are very interesting, and explain a bit more about the phenomenon of how microscopically different fills in the same size band in different patients can have such different effects on the patient.

I have to say, for the sake of bandsters reading this thread whose surgeons do not routinely do fills under fluoroscopy, that while fluoro fills can help ensure a tolerable and effective fill level, they don't guarantee it. I have never had a fill under fluoro and don't feel that my band's effectiveness was compromised because of that. Fluoro gives the radiologist or surgeon a snapshot of your esophagus, band and stomach at one point in time. A few hours or days or weeks later, the effect of that fill can feel quite different because of perfectly ordinary physiological events and processes, including hydration, hormones, time of day, allergies, medications, etc. etc.

Often bandsters get what seems to be a "perfect" fill under fluoro and a few weeks later feel as if they didn't get a fill at all. The stomach expands and contracts to aid digestion by breaking food down into pieces that can be absorbed properly by the intestines, and that necessary movement can affect the position of the band enough to affect the patient's experience of restriction. Also, as you lose weight, the visceral fat clinging to the stomach shrinks, so that your band feels looser and you need more fill. And finally, a new fill can feel extra tight in the first few days but feel less tight as the patient learns to adjust their eating skills to accommodate the new fill level.

Also, bandsters can get what seems to be a perfect fill and hours or days later find themselves struggling even to drink liquids. That can be because the fill itself, and the newly increased pressure of the band against the stomach, can cause enough irritation to cause the patient discomfort. Eventually the band settles more comfortably against the stomach, everything calms down, and life goes on.

Jean

[parisshel 1,892]

Your surgeon's comments are very interesting, and explain a bit more about the phenomenon of how microscopically different fills in the same size band in different patients can have such different effects on the patient.

I have to say, for the sake of bandsters reading this thread whose surgeons do not routinely do fills under fluoroscopy, that while fluoro fills can help ensure a tolerable and effective fill level, they don't guarantee it. I have never had a fill under fluoro and don't feel that my band's effectiveness was compromised because of that. Fluoro gives the radiologist or surgeon a snapshot of your esophagus, band and stomach at one point in time. A few hours or days or weeks later, the effect of that fill can feel quite different because of perfectly ordinary physiological events and processes, including hydration, hormones, time of day, allergies, medications, etc. etc.

Often bandsters get what seems to be a "perfect" fill under fluoro and a few weeks later feel as if they didn't get a fill at all. The stomach expands and contracts to aid digestion by breaking food down into pieces that can be absorbed properly by the intestines, and that necessary movement can affect the position of the band enough to affect the patient's experience of restriction. Also, as you lose weight, the visceral fat clinging to the stomach shrinks, so that your band feels looser and you need more fill. And finally, a new fill can feel extra tight in the first few days but feel less tight as the patient learns to adjust their eating skills to accommodate the new fill level.

Also, bandsters can get what seems to be a perfect fill and hours or days later find themselves struggling even to drink liquids. That can be because the fill itself, and the newly increased pressure of the band against the stomach, can cause enough irritation to cause the patient discomfort. Eventually the band settles more comfortably against the stomach, everything calms down, and life goes on.

Jean

Thanks, Jean, for this thorough response. I also think that given the radiation does one incurs with fluoroscopy, it is perhaps not a good idea to do more than one fill/year this way.

I'm particularly grateful to read your last paragraph, as today I'm quite uncomforable with this fill (I sense I've very sensitive to restriction). I can drink fine, but trying to get mushies down is just not happening. I will wait a few days to see if the band / stomach settles in, if not...back to the radiologist to get some saline withdrawn.

[Kai-shek 230]

Your surgeon's comments are very interesting' date=' and explain a bit more about the phenomenon of how microscopically different fills in the same size band in different patients can have such different effects on the patient.

I have to say, for the sake of bandsters reading this thread whose surgeons do not routinely do fills under fluoroscopy, that while fluoro fills can help ensure a tolerable and effective fill level, they don't guarantee it. I have never had a fill under fluoro and don't feel that my band's effectiveness was compromised because of that. Fluoro gives the radiologist or surgeon a snapshot of your esophagus, band and stomach at one point in time. A few hours or days or weeks later, the effect of that fill can feel quite different because of perfectly ordinary physiological events and processes, including hydration, hormones, time of day, allergies, medications, etc. etc.

Often bandsters get what seems to be a "perfect" fill under fluoro and a few weeks later feel as if they didn't get a fill at all. The stomach expands and contracts to aid digestion by breaking food down into pieces that can be absorbed properly by the intestines, and that necessary movement can affect the position of the band enough to affect the patient's experience of restriction. Also, as you lose weight, the visceral fat clinging to the stomach shrinks, so that your band feels looser and you need more fill. And finally, a new fill can feel extra tight in the first few days but feel less tight as the patient learns to adjust their eating skills to accommodate the new fill level.

Also, bandsters can get what seems to be a perfect fill and hours or days later find themselves struggling even to drink liquids. That can be because the fill itself, and the newly increased pressure of the band against the stomach, can cause enough irritation to cause the patient discomfort. Eventually the band settles more comfortably against the stomach, everything calms down, and life goes on.

Jean[/quote']

Thank you so much Jean for this post, my doctor does the fill in his rooms, and before reading your post I always felt sort of cheated, but now I don't feel it is so bad.

[brianb 81]

He told me something that I found interesting; when you get a fill of, say, 4 ccs, it doesn't mean that you have 4 ccs of saline in your band. Some of that saline is in the tubing, and tubing lengths are different

I never thought of that! Thanks so much for posting that info.