How is your fill performed?

[Leila 0]

He requests nothing to eat or drink for two hours before the fill. My Dr. had me lay back on the table, fully clothed, just having my shirt raised. He palpitated my stomach for the port, he couldn't find it, had me put a pillow in the small of my back to stretch my abdomen out, palpitated it some more, still couldn't find it. He told me not to worry, that he places a low profile port quite deep and he often can't feel it. So then he prepped me with an antiseptic wipe, no numbing shot (they hurt more than the fill needle, I agree) and went in directly over the small round scar he says is the scar from where they anchor the port, he always knows if the port hasn't moved from where it was stitched it's always directly under this spot. Sure enough he says, it's exactly where it should be, no worries. When he first goes in with the needle he taps down gently with it until he encounters the port, then he pushes down into the port harder. Then depresses the plunger on the needle to add the fill. He pulls the needle out quickly, follows with another wipe and a bandaid. He has me sit up, and drink Water to assess my level of restriction. He does not use flouro, and feels from his experience he finds no advantage in it. He has used flouro in the past, but found his success rate with adjustments has been the same with or without flouro. He explained that even if flouro shows perfect levels of restriction, patients react so differently to adjustments - some with swelling that goes down and restriction leaves within the next few days up to a couple of weeks. Some the opposite, no restriction at first, and then all off a sudden in a few days or as much as a week or two later restriction kicks in. He has me drink about a styrofoam cup filled to the brim, and then refilled half way of the water. To assess that I'm not too tight. First fill he had put in 4.5cc's in the large VG band - I had the water - didn't go down easy, so he had me lay back and took .5cc's back out, tried the water again, and no problem. Second fill of .5 cc;s water went down fine. I've had just the two fills, one week apart. The restriction on the first fill was there for two days (so I had restriction right off the bat - so even without flouro he hit the nail on the head) unfortunately some of that was from swelling, and three days later, restriction gone. With the second fill I've reached good restriction again, not too tight, not too lose, just right. My further follow up fills will be done by another Dr other than my surgeon, but one that has been trained by my own Dr. via INAMED Health and authorized by INAMED (whom I assume you'll be recieving training/authorization from yourself.) I think there are some slight differences, usually around whether they use a numbing shot and/or flouro, but the majority of adjustments seem to be done very similarly. The best to you in your practice.

[CCBSTX 0]

1) Clean area w/alcohol

2) Inject lidocaine

3) Inject saline (confirms correct amount from previous fills).

4) While injecting saline, patient is sipping Water through straw (nurse holding).

5) Patient says "STOP" when the Water is no longer comfortably passing.

6) Doctor usually pulls a bit of saline out, at that point.

7) Patient sits up and comfirms passage or not.

8) If not, doctor pulls out a bit of saline.

That's my "bit."

Shawn