How the Lap-Band actually works, fills and refills

[Success in lapband 0]

Pjrugby!!!

Please read!

I was banded 3/1 (go look at all my posts)

We are exactly alike. I am at FULL on my band.

I am going in on Tues and Dr. said he may give me .25, he also said there are people who never feel restriction.

I am going to make other decisions after the holidays.

~pam

[Foofy 0]

Opinions differ about how gastric banding actually works.

I read a lot of posts where patients do not have their bands perfectly adjusted.

Here's my version:

Perfectly adjusted - full on small meals, not hungry between meals, easy to lose 1-2 pounds per week, amorous feelings toward your surgeon and staff, send them a Christmas card that will bring tears to your eyes

Dr. Watson. Hahaha. That's great! I am looking forward to this reaction. I'll have to warn my surgeon. Thanks for the input. ;o)

NMsunshine. I would have to agree about the book "You on a Diet". It is a fabulous resource for understanding how complicated and deep-seated our bodies reactions to food are. I recommend it all the time.

[NM Sunshine 1]

Dr.Watson

Got that name for my band. Going to call her 'skinny'.

Foofy

It's cool to hear from someone who has read 'You on a Diet'.

Pam & pjruby

Could you have a leak in your bands??? (I think that is the same thing DrWatson said). When I had my consultation with my surgeon he showed me a band. He had me put my finger in the center of it. Then he filled it. I was shock as to how tight it became on my finger.

[DrWatkins 5]

Dr.Watson

Got that name for my band. Going to call her 'skinny'.

I love your band's name!

[DrWatkins 5]

Opinions differ about how gastric banding actually works.

I read a lot of posts where patients do not have their bands perfectly adjusted.

Here's my version:

Perfectly adjusted - full on small meals, not hungry between meals, easy to lose 1-2 pounds per week, amorous feelings toward your surgeon and staff, send them a Christmas card that will bring tears to your eyes

Dr. Watson. Hahaha. That's great! I am looking forward to this reaction. I'll have to warn my surgeon. Thanks for the input. ;o)

I can't tell you the number of times I've walked a new patient back to the waiting room and one of my patients runs up to me and plants some lipstick on my cheek. That never gets old!

[Oregondaisy 2,021]

Hi Dr. Watkins, First I would like to say how much we appreciate that you come here and are so informative and helpful. We are lucky to have you here!

I read on another post where you were talking about a leak. I am afraid I have one. I got a fill and it was too much, so my doctor said he was going to take some out and leave 2.75 cc's in a 4cc band.

I just got another one last week ( 2 months later,) and he was only able to pull out 2.0 before he did the fill. He said it does not necessarily mean I have a leak. I had great restriction the first few days after this last fill. Now, not so much. Is it because when you get a fill, there is some swelling?

Is there any way to find out if I have a leak other than the next time I go for another fill and check and see what's left in there? That is how I got overfilled to begin with. He thought I had a leak so he put me up over 3.0 and I was miserable. That was when he moved me down to 2.75. He was able to pull out all of it out that time, when he left the 2.75 in there.

Is there any other way that he is not able to pull all of it out, rather than some of it leaked out? Is it possible to not get the entire fill in the band when doing a fill?

I could really test it out and try to eat something that I can't normally eat with a good fill, but I don't want to do that and risk throwing up. __________________

banded 12-29-06 by Dr. Steven Tersini in Coos Bay Oregon

[NM Sunshine 1]

Denise

My surgeon told me that sometimes the body absorbs some of the fill. Hard for me to understand that. Perhaps DrWatson will enlighten us.

BTW wish I lived in Seatle.......I 'd have my fills there

[DrWatkins 5]

Hi Dr. Watkins, First I would like to say how much we appreciate that you come here and are so informative and helpful. We are lucky to have you here!

I read on another post where you were talking about a leak. I am afraid I have one. I got a fill and it was too much, so my doctor said he was going to take some out and leave 2.75 cc's in a 4cc band.

I just got another one last week ( 2 months later,) and he was only able to pull out 2.0 before he did the fill. He said it does not necessarily mean I have a leak. I had great restriction the first few days after this last fill. Now, not so much. Is it because when you get a fill, there is some swelling?

Is there any way to find out if I have a leak other than the next time I go for another fill and check and see what's left in there? That is how I got overfilled to begin with. He thought I had a leak so he put me up over 3.0 and I was miserable. That was when he moved me down to 2.75. He was able to pull out all of it out that time, when he left the 2.75 in there.

Is there any other way that he is not able to pull all of it out, rather than some of it leaked out? Is it possible to not get the entire fill in the band when doing a fill?

I could really test it out and try to eat something that I can't normally eat with a good fill, but I don't want to do that and risk throwing up. __________________

banded 12-29-06 by Dr. Steven Tersini in Coos Bay Oregon

If your band held 2.0cc for 2 months it seems unlikely that you had a leak then. The question is if you have a leak now. The best way to determine if you have a leak or not is to have them do a "Fluid test" at each fill, i.e. draw back all of the Fluid and see how much is there.

Most leaks will drain all of the fluid out within 3 days. Occasionally we'll see a slow leak that takes a week, but if your band has the majority of the fluid in after a week then there's no leak (hey, that rhymes).

Also, sometimes we think we add fluid to the port but it doesn't get into the port, etc. Sometimes we think there's a leak but over time we determine that there isn't one. I've seen everything.

I would advise that if the band isn't tight enough (full on small meals, not hungry, easily lose 1-2 pounds per week) then have them add some more saline and do a fluid check. If the fluid is repeatedly at zero, have them replace the port. Replacing the port cures 99% of fluid leaks. I've seen a few patients that had needle injuries to the tubing but that's rare.

And leaks are not a problem in the sense that we use sterile saline which is the same stuff in intravenous fluid they give you in the emergency room if you're dehydrated. It doesn't hurt to have a few milliliters of saline leak out. Your body just absorbs it.

And it goes without saying that fills should always be done with a Huber non-coring needle. Regular needles can cause leaks in the system. (So can Huber needles, but much less of a chance).

hope that helps

brad

[DrWatkins 5]

Denise

My surgeon told me that sometimes the body absorbs some of the fill. Hard for me to understand that. Perhaps DrWatson will enlighten us.

BTW wish I lived in Seatle.......I 'd have my fills there

The band balloon is a permeable membrane and it will lose a tiny portion of the saline over time. The smaller the band and the tighter it is, the more saline you lose over time. A bigger band with a small amount of saline will lose very little saline over time (assuming no leak).

If the saline leaks out the body will absorb it very quickly.

Sometimes when we do a fill we're not actually in the port and the fill goes into the tissues. This creates confusion when we do a Fluid check on the next fill.

If you live anywhere near Cincinnati, I'm happy to do your fills.

hope that helps

brad

[tweety63 0]

Dr. Watkins,

Thank you for taking your time to anwser everyones questions on here. I think that is so nice of you. Most Dr.s would charge you for thier time so thanks

Colleen

[peaches9 3]

I went in for my 7th fill today in a 10 cc band. I should have had 9.75cc's in there but the Fill Nurse could only 'pull' out 4 cc's. I was banded July 11 and started with my 1st fill 6wks later.

So today she added 2.75 to my 4 remaining cc's = 6.75

She also booked me for a Fluro Xray Jan 7th to see what's up with my band.

IF I need a port replacement do they go back in thru the old scar? Can it be done under LOCAL Anesthetic??

I'd appreciate your thoughts Dr. Watkins

[NM Sunshine 1]

DrWatkins now that makes sense. I was thinking that the membrane of the ballon was impenetrable.

Unfortunately I live a long long way from Cincinnati. I live the little town of Silver City, New Mexico, in the foothills of the Gila National Forest & Wilderness (largest in the lower 48).

[Coolmikey8 0]

New to the site. Banded Sept 1. Have had two fills currently at 6.5 cc in the VG band. Have trouble getting anything but Soup and liquids down right now. But my last fill was only a few days ago. Do any of you find that even though you are losing weight that you have trouble making time to get to the gym or do any excersise at all.

[DrWatkins 5]

Dr. Watkins,

Thank you for taking your time to anwser everyones questions on here. I think that is so nice of you. Most Dr.s would charge you for thier time so thanks

Colleen

Colleen,

You're welcome.

I love band patients and am continually inspired by the amazing things they accomplish. The more information people have the more successful they are. That motivates me to spend time here.

[DrWatkins 5]

I went in for my 7th fill today in a 10 cc band. I should have had 9.75cc's in there but the Fill Nurse could only 'pull' out 4 cc's. I was banded July 11 and started with my 1st fill 6wks later.

So today she added 2.75 to my 4 remaining cc's = 6.75

She also booked me for a Fluro Xray Jan 7th to see what's up with my band.

IF I need a port replacement do they go back in thru the old scar? Can it be done under LOCAL Anesthetic??

I'd appreciate your thoughts Dr. Watkins

If the 6.75 stays in there more than a week I would doubt you have a leak. The 10cc bands (Vanguard) can be hard to withdraw the exact same amount you put in. If you are maintaining good restriction then the band is likely holding saline. If the restriction repeatedly goes away after fills then it is likely you have a leak especially if they withdraw zero saline on a repeated basis despite replacing the saline each time.

Fluoro is always a good idea if the clinical picture is confusing.

When we replace a port we always go through the same incision and it can be done under local anesthesia (with some sedation to make it more pleasant).

hope that helps

brad