Standard protocol for fills

[Penni60 45]

Does anyone out there know the standard protocol for fills? I have heard anything from being filled 2 weeks post op to every 4 weeks post op to every 6 weeks post op. Is there a protocol for each doctor or is there a standard and then it is adjusted per patient? Anyone know?

Anyone given literature or instruction on how their fills would be managed pre or post op?

Curious as there seems to be this haphazard approach from some doctors and they are making up their own protocols as they go.

There should be a standard and then adjust per patient as needed.

[donali 57]

I believe the Inamed literature says 6 weeks, but I wouldn't swear to that...

[Penni60 45]

I have an email out to them asking about their recommendations to surgeons on fills.

[Penni60 45]

Below is the response I received from Don Mills at Inamed regarding protocols on fills.

________________________________________

Hello Penni,

I received both of your e-mails.

The answer to your question is that band adjustments (fills) are not based on a specific schedule and the frequency is left up to the surgeon depending on the patient and doctor's approach to patient management.

Here are some general thoughts. The first fill should occur after the swelling and edema from the surgery has gone down. Obviously this can vary from one patient to another and varies from 4 weeks to 8 weeks. Some surgeons believe that frequent small fills are more effective that larger fills with more time between fills. Both approaches can be correct. Surgeon decide for themselves the best course for patient management.

We do recommend that adjustments occur when they are needed not according to a preset interval. When a patients weight plateaus for a period of time (how long depends on the surgeon) then that is a good indication that an adjustment is needed. If a patient finds that they are able to eat more than previously, then that might be an indication for a fill. Naturally if a patient is unable to eat a normal band diet or seems to be over restricted that might mean that a looser adjustment is needed (there are other reasons too).

Rarely, a patient will not ever need a fill. As long as the patient is losing weight then a fill would seem to be unnecessary. If you are losing weight after two months and have not had a fill, ask your surgeon when or if you need a fill. It is likely that you will not need a fill until you stop losing weight for a period of time. However, your surgeon and you will be the best judge of this.

Best wishes for success with your band.

Regards,

Don Mills

INAMED Health

_______________________________________________

[Abundant 0]

I have a question what does 1cc fill mean? I had my first fill yesterday but does that mean how much saline was filled or that is the size of my stomach? I read on this forum that someone is having thier lapband removed from erosion how did that happen? Is that dangerous?

Magnolia

[GeezerSue 7]

Originally posted by Abundant

I have a question what does 1cc fill mean? I had my first fill yesterday but does that mean how much saline was filled or that is the size of my stomach? I read on this forum that someone is having thier lapband removed from erosion how did that happen? Is that dangerous?

Magnolia

It means how much saline is in the reservoir in the band. NOW, how much is that? A teaspoon is 5cc's. So If you take a teaspoon of Water and pour out 4/5ths f it (80% of it) what's left in the spoon is 1cc. (WAAAAAAAAY too tiny for a stomach.)

[newlapper 0]

I had my first fill at 6 wks and it was .8cc. He didn't want to ruin my vacation and wanted to go small. However, yesterday, which was one week later. He filled me an extra 1.2cc's. I felt a difference, because when I drank for him. I heard a gurgly soulds as it was going down slowere. I feel that i will experence moer redtriction now, I'm excited. But, we are are different. Just go by how your fill during adjustments.

[donali 57]

Magnolia -

This is everything I know about erosion:

http://lapbandtalk.com/forum/showth...=&threadid=2250

http://lapbandtalk.com/forum/showth...=&threadid=2256

http://lapbandtalk.com/forum/showth...=&threadid=2274

Is it dangerous? It can be, if not treated. Generally speaking, most erosions are found and corrected before they cause severe problems.

[Abundant 0]

Thanks for the info although I still dont get it does 1cc mean that it wasnt filled enough? I dont think it is since today I could easily eat a small turkey buger patty, tomatoe, smashed avocado, pickle and half an ear of corn with no problem. so what do I do now? Go back and have the doctor refill? My stomach is black and blue from the first port fill should I wait? Please help somebody, Thanks I am still trying to figure out this reply thing it took me forever to find my initial msg when i want to reply to someone how do I do it? There is only a reply at the end of all the postings...? Thanks again,,,,,,,,,,,,,,:cry

[Abundant 0]

geeeeeeeeeez I must be a dork. meant to say burger not buger LOL. also how do I stay logged on for this lapband forum? everytime I go to it to read I have to log on each time..........thanks again....also I am going on vacation end of july should I wait to have another fill until I get back? what about alcohol is it okay to have margarita on vacation?

[Alexandra 55]

Hi Magnolia,

First, as far as staying logged on to the forum, that has something to do with whether your computer uses Cookies and what your security settings are. That's a technical thing I can't really help with, but suffice to say it's on your end. You are staying logged on DURING each session, right?

This forum is organized by message "threads" within topic areas. If you want to see the just the recently active threads click on "New Posts" at the top of the home page when you arrive and after you log in. That will show you only those threads that have new posts since you were last here. The ones marked with black dots are the ones in which you have posted. Posting a reply can be done by clicking on any of the "reply" buttons, and of course we always try to stay on topic.

Next, about your 1cc fill: Every doctor approaches fills differently. There is no "right" or "normal" amount of Fluid, and in any event the effect of a certain amount varies immensely from person to person. Ask your doctor what he expects the result of this fill to be--did he expect you to be substantially restricted right off the bat, or is he approaching good restriction slowly? Once you have the answer to that question, you can evaluate whether this fill was successful or not.

a small turkey buger patty, tomatoe, smashed avocado, pickle and half an ear of corn with no problem

Did you eat all this quickly at one sitting? It sounds like a perfectly fine meal and one that I might be able to eat, but only if the burger had no bun and it would take me a while in any event. My point is that's not a whole lot of food and I'm sure it's nowhere near what you would have eaten prebanding.

There is another whole thread about alcohol. Is it OK to have a margarita? Well, sure, if you're willing to take in the empty calories and possibly compromise your sense of fullness. Many people report that even one drink is enough to get a buzz and also makes them eat more absentmindedly, which at best means more calories and at worst can mean pain. But it's up to you.

[Abundant 0]

Thanks Alexandra,

The only Cookies I am familiar with are the kind you eat....LOL. but thank you for explaining. I guess I need a come-to-jesus-talk on whether having a margarita on vacation is worth it....I will ask the doc if he is prededing cautiously as you mentioned....although yes I gotta say I have been much hungrier these past three days following my first fill than ever before! I ate the turkey burger with no bread...today I had cottage cheese, iced tea and 3 meatballs same thing going down with no golf-ball-in-your-mouth-effect.....I was banded on May 25 weighed 255 down to 244. I am doing a half hour mile on the treadmill 4 times a week. I still think I need to get another fill but I think I will wait a week first since I am black and blue from the first time fill. Is that normal? What are your thoughts? Thanks everyone else for your help it is most appreciated!

[Vera 7]

I have resently read that 1.3cc's for the first fill of an Inamed band was recomended..

I feel that the first fill should be conducted under Flouroscopy. Its the only way to read the flow/Restriction.

Having a band in it's self I can't eat what I use to.

[Alexandra 55]

Magnolia, fills can take some time to make themselves known so I would wait at least another three weeks before thinking you need another one. I had a fill on June 10 and it wasn't until last week that I really started to feel it--that's two weeks later.

Bruising at the port site is a direct result of how much troouble the doctor had getting the needle in. My first two fills, done by an experienced surgeon, resulted in no bruising at all. My third one, done by a doctor new to the practice, created a fairly large bruise because she had to feel around quite a bit before locating the right place. It's nothing to worry about.

[Abundant 0]

Alexandra,

Thanks I will wait and see what happens before I go back. It did take the surgeon several times to locate the port about 5 so maybe that is why I am so bruised does this mean next time I should have it done floro? He said it can be done at the hospital instead of his office....

Vera,

You live about 20 minutes from me!