How the Lap-Band actually works, fills and refills

[sash 0]

I don't think you should feel anything in your throat.

When you have restriction you should feel full after eating a small amount of food.

That's the reason for chewing well and eating slowly.

It gives your body time to send those "full feeling" signals to your brain.

I've found if I don't chew well and eat quickly I'm usually very uncomfortable afterward because I feel stuffed. :laugh:

Not to mention the food doesn't go down very well!

[HappyLoser 0]

I have that feeling in my throat too. Sometimes when I am eating, I feel like my food isn't going down and I have to stop and wait for the food to go on down. I did not have this before the surgery. I have not had enough fills to get restriction yet. I don't know what is causing it. Does anyone else have the same problem?

[BANDIT GIRL 1]

Most likely the reason this is happening is you're probably eaiting too fast and or not chewing enough before you swallow. You have to remember that even though you haven't had alot of restriction yet you still have a band around your upper stomach which i'm sure causes a very little restriction and with some fills you have some restriction even though it may not be alot. I would just suggest to take smaller bites,slow down and chew,chew,chew. Good luck!

Edited May 18, 2009 by BANDIT GIRL

[svelt2009 0]

Thanks for all the info. I've heard some people are on liquids and purreed for a for a month after surgery. I was told I could start eating regular food on the 3rd week after as long as I eat slow and chew well. Someone told me that I may not be letting my band heal and that I may have trouble on my first fill. Anyone have other input to this?

[Oregondaisy 2,021]

Most doctors at least keep people on mushy foods before letting them move to solid food.

Your stomach does have to heal around the band for it to

stay properly where it's supposed to heal. It can't do that if it's digesting food. The stomach moves when it's digesting food. That's why a lot of doctors put their patients on a liquid diet post op for at least a couple of weeks then mushie food for a couple of weeks before moving to solid food.

[svelt2009 0]

Little confused, but will check again tomorrow with the nurse. Following is the feedback from the office last week. Perhaps it depends on each person or maybe things have changed since your surgery.

Hope I'm doing this right. Getting my first fill on the 28th.

"Thank you for your email. I understand your concern regarding restrictionsduring post-op when one considers the restrictive nature of the Lap-Band. It is normal for patients not feel restriction during the few weeks after surgery because you are slowly reintroducing more nutrient dense foods and consistency into your food intake. The key is to gradually introduce “solid foods” into your meal plans, and that’s where one will begin to notice the difference. The Lap-Band should allow for fluids to pass through easily, which allows for healing time. Let’s focus on getting you through the next two weeks, working towards tolerating solid foods, then we can begin to take a look at the specifics areas of healthy eating we need to address. What you have selected to eat is along the lines of “soft foods” and you are tolerating them well – so you’re definitely on track. The nurses can give you more information on band adjustments when you come in on Wednesday. In general, the patient needs to be at least one month post-op (minimum 4 weeks) and has been tolerating solid foods well. Once you’re at that stage, you can call our clinic to schedule an appointment. I hope I was able to answer all your questions. You’re doing great, keep on track!"

"

[parothwell 0]

This may help you in understanding the restrictive mechanism of a Lap-Band.

The ALLERGAN protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band.

Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band.

Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill. That is why the ALLERGAN protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.< /span>

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater.

It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

Thanks for the great post. You sound very knowledgeable about the fill process. At first I thought you were probably a surgeon, but later read you are a patient. I am 2 and a half years post op and have been having trouble getting my fills to a desirable spot. It was helpful to hear that a smaller adjustment may be what I need. Thanks so much for your input.

[svelt2009 0]

Thanks for the info. I did read Wendells post before. Heard back from the office and they said not to worry and that I will feel the restriction after the first fill. I must be all healed inside and ready to go the next step.

Thanks

[LovelyLT 0]

Hi Wendell, first i want to say you look great. I haven't had a fill since 8/08 - my question is a crazy one. Does my band still work, can i go an get a fill or is the band (broke):-). Do you think i should get checked under furo to make sure everything is okay??

[Lois Ruth 0]

Thank you for this thread!! Sooo informative and answered a lot of my questions! Wendall you look great! I applaud you!

I have been alittle concerned because I have had 2 fills so far (banded on March 23, 2009) and still don't feel much restriction. I am losing weight slowly (have lost 30 pounds since surgery) but it is only because I am watching what I eat and how much I eat, just like I would on any diet, and not because I feel full or restricted. I need that extra incentive! I am wondering how many fills it will take until I get to that point. I am somewhat encouraged by what I read here and realize that it is not unusual, so I will keep on keeping on! I see the doctor in another 2 weeks so maybe I will get another fill at that time. Thanks again.

[eyespy 1]

I go in again tomorrow for my umpteenth fill. At almost a year out, I still don't have any restriction. I am meeting with the surgeon this time. It's usually the PA who does the fills. Maybe I will get some answers as to why I don't feel any restriction. I know the band is tight because it sometimes hurts for the first couple of bites.

[Oregondaisy 2,021]

I got a revision surgery and had my band removed and got the sleeve. I got really sick of fills and unfills looking for the perfect spot.

It took me many fills to find restriction and finally when I thought it was perfect, I started throwing up in my sleep. I had a swallow test and it turned out to be too tight. I never had problems in the day time. I chewed my food well and nothing got stuck. Then in the middle of the night, it would come back up. When they removed my fill because of this, I started gaining weight back. That is why I decided I was done with the band and got the sleeve. I will never have to have another fill or unfill again.

[NiceWillSuffice 0]

Can you give some more insight to this statement...

<A fill may have a “Delayed Action” of up to 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill. >

This may help you in understanding the restrictive mechanism of a Lap-Band.

The ALLERGAN protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose...etc...

A fill may have a “Delayed Action” of up to 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill.

...etc... for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

[PangeaOne 0]

Wendall:

Thank you so much for this very detailed information regarding the process of fills. In the year of preparing and finally having my LapBand surgery in mid May of this year I have never read or heard this very valuable information and have instead been very hard on myself since I am having increasing hunger and beginning to gain weight. Your information has helped my stop being so hard on myself. What I am going through is "normal." Again, thank you.

[Theagillis7 0]

Thanks for the enlightening info. it helps alot