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How the Lap-Band actually works, fills and refills



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Thank you for the info! but question, is getting fills painful? is any type of anesthesia used??

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IT DOESNT HURT. Very similar to a small injection or pin prick. If the doc / nurse is experienced you wont feel anything!

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I was so impressed that my fill did not hurt ONE BIT!!! A needle in the arm hurts 10x more!!!

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Excellent post, and very informative!

I had my second fill last Thursday, and am down 5lbs since then. I lost close to 50lbs in the six months before my surgery, but gained 4lbs back in the month between the surgery and my first fill--very nervewracking and discouraging! I honestly didn't notice a ton of restriction with the first fill, but lost a few pounds...so it must have been doing something. I'm REALLY feeling the restriction from this fill, though--having to figure out what exactly I can and can't eat all over again, and having to be extra careful that I chew properly. My portion sizes are noticeably smaller as well. I was a little nervous the first couple of days that the band was too tight, but I think it's okay now. I'd just gotten lazy about chewing and had slipped back into eating convenience foods that were not ideal for me, and this fill snapped me out of it. Looking forward to great things in the months to come!

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Can someone point me to more information on this: "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."

I have had my band for 2 years but only had 2 fills--both this year. I think I may be experiencing this delayed reaction. How does that work? Why does it happen?

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Can someone point me to more information on this: "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."

I have had my band for 2 years but only had 2 fills--both this year. I think I may be experiencing this delayed reaction. How does that work? Why does it happen?

I've had a delayed reaction as I felt the restriction - a little at first - then about 2 weeks out I felt greater restriction to the point of throwing up to relieve the pain and the frothing after eating to the point it was happening after just drinking liquids - even water! I ended up having to have them take out saline for relief! I think once you start throwing up it irritates the stomach and band area to the point of swelling making the problem worse! Now I know after a fill to follow a liquid diet for a couple days just to be sure not to irritate it further. Sometimes a stomach bug will have the same effect on us but at least if we follow a very soft liquid diet until we recover it tends to minimize that effect. Good luck! Linda

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I read somewhere since posting that it may take time for the saline to work its way around the band. This is the only thing I have found so far that attempts to explain the phenomena. Is the saline solution thick? Why would it take 2 weeks to work its way around? I guess I am looking for why there is a delay. I realize that there is one in some folks and know how to work with it as well as swelling from PBs and stress changes. Im just curious about why.

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I read somewhere since posting that it may take time for the saline to work its way around the band. This is the only thing I have found so far that attempts to explain the phenomena. Is the saline solution thick? Why would it take 2 weeks to work its way around? I guess I am looking for why there is a delay. I realize that there is one in some folks and know how to work with it as well as swelling from PBs and stress changes. Im just curious about why.

The saline isn't thick - it's just a saline solution that way if it leaks out the body can handle it...they pull out the solution to measure how much you have in the band so that irritates the stomach anyway...then after they measure it decide how much more to add to it....at least my doctor does. I wonder if I had a bug about 2 weeks out and that's what caused my problem. I've had problems with too much of a restriction that didn't occur until a couple days later - but at that time I hadn't had too many fills yet so I let a slight overfill go - and paid dearly for it, causing reflux for 3 months to heal! I could swallow so I thought I was OK - now I know how I should feel after the fill plus they only added .5 cc last time and it's been fine since then. Good luck trying to find out more...I've been curious since as many fills as I've had I really haven't had too many problems. Linda

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Wendell this is good info. I am at 11 cc started yesterday. Each time or each fill I fell like a newbie.

I am losing my clothes size slowly and I have to be patient with Myself after each fill.

I am seeking people who are like Me at this fill

stage. Thank you again for the info!

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Hi I just had my surgery on the 14th in Mexico. I live in Vancouver WA. Need help finding a place to fill in Washington. My experience so far has been great. My surgery didn't hurt at all and was up enjoying Mexico the next day. Any info would be great. Thanks

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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.

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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.

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YES...this is just the info I needed to read today. Although I am only a month postop and haven't even had a fill yet, I find myself getting frustrated...already...because I don't feel any "different." I guess I have to just keep remembering, as others have said, that the weight didn't go on in a day and certainly will not be coming off in one! (It's hard to convince an "I-want-results-and-I-want-them-NOW" kinda gal to be patient :o )

Thank you, Wendell, for your very informative post and reference tool.

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Thanks for posting. I shared it with my husband and he said it helped him understand my process better.

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