Several Questions

[Mellie 0]

I have been banded since June of 07. I have had 2 small fills since then. My doctor is not very agressive and I have 1.5 ccs in right now.

I have lost 31 pounds since June but haven't lost anything in the last 3 months. I am very discouraged and wonder what restriction is supposed to feel like. I feel a little discomfort when eating meat but that's it and it passes quickly. I feel like a failure. I've been bouncing 4 pounds back and forth for about 2 months now. I can eat pretty much what I want but I am trying to watch what I eat but it's really hard especially this time of year. I'm not sure what I'm supposed to eat and what I'm not anymore. My surgeon was excellent pre op but I haven't seen him since. My visits are with the PA. They gave us information before the surgery but it was geared more for the gastric bypass patient because that is the majority of his clients right now. I thought by now that I would be alot further than I am.

Can anybody give any advice on what I should eat and what are the signals to look for in restriction. I don't want to give up.

[tonya66 13]

I thought this was good advice:

Think you need a fill again by Nikki Johnson

Do you remember that feeling you had when you first had your band placed? For a while, everything was great. You didn't experience hunger, you felt satisfied with a small portion of good food, you had more energy, and you were thrilled with your initial weight loss progress.[/color][/size][/font]

If you are like most people, your experience changed over time, Some of those feelings of hunger returned, and you stopped losing weight. You knew you needed something, so you went to your surgeon's office and asked for a "fill" right? If so, you might be surprised to learn that it is your thinking about your band, and not the band itself, that needs adjusting.

The LAP-BAND Bad Word

Paul O'Brien, MD, FRACS, is a skillful, compassionate surgeon and a foremost expert on the LAP-BAND System. he was involved in its design in the early 1990's and placed the first band in Australia in 1994. Since then, he has treated thousands of patients and is recognized worldwide for his expertise. When his patients utter that worst of four-letter words, "fill," in his office, they are asked to throw a dollar in the Red Cross donation bucket--a reminder that, according to Dr. O'Brien, thinking about a "fill" is just wrong thinking.

How can a concept that we hear about so constantly be so very wrong? Dr. O'Brien's answer is simple: "Any adjustment to the band is something that only takes place in the context of clinical consultation--part of a relationship of trust, honesty and communication between patient and surgeon--that is much more key to the success of the patient than the precise number of milliliters of Fluid in the band. This concept of partnership is the central theme of Dr. O'Brien's new book, The Lap-Band Solution--A Partnership of Weight Loss.

Patty's Note: Available on Amazon.com ISBN#9780522854121

Like many people, you might assume that weight gain or a sustained plateau means an incorrectly adjusted band; in fact, you may be right. But you may be surprised to learn that weight gain sometimes results from a band that is too tight. This is part of the reason why the "fill" concept is so misleading. If your surgeon determines that you are not losing weight as you should, then discovering why that is happening is crucial. Sometimes adding Fluid to the band will only make matters worse.

Life in the "GREEN ZONE"

Most people who have the LAP-BAND operation will have an amazing feeling of disinterest in food for the first week after surgery, before any adjustments are even made to the fluid in the band. According to Dr. O'Brien, that lack of interest in food is referred to as satiety. A related but different feeling is satiation, or the feeling you get as you are eating, precisely at the point that you don't need any more food to eat but you do not have an uncomfortable feeling of fullness. These two feelings--satiety and satiation--are what the properly adjusted band helps you achieve, allowing you to maintain your new healthier eating habits.

Your careful observation and truthful sharing of your feelings and eating behaviors, combined with the expert care and training of your surgeon and his or her staff, can make the very individual determination of whether your band is properly adjusted much more accurate. In order to help create the most effective partnership between themselves and their patients, Dr. O'Brien and his colleagues at the Australian Centre for Obesity Research and Education have developed a concept they refer to as the "Green Zone". When patients are in the green zone, they experience satiety, satiation after properly-sized small meals, and satisfactory weight loss or maintenance.

However, there are also yellow and red zones, both of which indicate that the band is not optimally adjusted. If your band is too loose, you will not have the benefits the band's hunger-controlling mechanism. If your band is too tight, you will have trouble eating properly and may actually gain weight because the foods you can eat more comfortable, that tend to be liquid and calorie-rich, like ice cream and chocolate, do not provide the proper nutrition. Learning to recognize when you have the feelings and eating behaviors that signal a problem can help you give your surgeon the information he or she needs to help you keep the band optimally adjusted.

Thinking Adjustment

Once you have eliminated the concpet of "fills" from you Lap-Band vocabulary, you will be able to let go of much of the conventional thinking connected to it. Perhaps you have heard talk about the "ideal" amount of fluid in the Lap-Band. While it may be helpful to have some idea of how much fluid is in your band, Dr. O'Brien says there is no magic number. No perfect amount of fluid will provide the best results for everyone. He says, rather, that "whatever volume of fluid is needed to achieve the [feeling of non-hunger] is the correct volume." When you notice that you are feeling hungry or are not losing weight, your body is telling you it is time to revisit your partner in weight loss -- your surgeon. your success absolutely depends on this relationship. So rather than thinking "adjustments," adjust your thinking, and, in partnership with your surgeon, find a lifetime of health!

For more information about all of the themes discussed in this article, please see Dr. O'Brien's book, The Lap-Band Solution--A Partnership for Weight Loss, which is available fro Amazon.com. We also invite you to visit LAP-BAND® System Forum - Home for more information and supportive resources.<!-- google_ad_section_end -->

[tonya66 13]

Here is a link to see the "green zone"

http://www.lapbandtalk.com/f17/you-green-zone-25523/

[tonya66 13]

One other piece of info I found on the lapband official website:

How will I know if I need an adjustment?

Your surgeon can help you decide if you need an adjustment. If you are hungry, looking for food, and not having optimal weight-loss, you probably need Fluid added to your band. If you are experiencing early and prolonged satiety (feeling full after a small portion of food for several hours), and losing one to two pounds per week, your band is working fine, and you do not need an adjustment. If you are having symptoms such as difficulty swallowing, night cough, regurgitation, acid reflux or heartburn, you might need Fluid removed.

When your band is optimally adjusted, you should feel satisfied after eating a small portion of food, and you should still be able to tolerate most foods. If you find that you are having difficulty swallowing solid foods, you might not be chewing well enough, you might be eating too fast or your band may be just too tight. Check with your surgeon if you are not sure.

[gretchens4 0]

Hello,

I have been banded since 2/23/07 and have lost 73 pounds. I barely lost anything the first 3 months. I got the right restriction after my 2nd fill and then started losing weight. It wasn't until I got that fill that I was restricted in any really way. For me, I have to be very tight to lose weight. When I say tight, I mean I can't eat after a few bites if I eat too quickly. I can not eat a whole piece of pizza or a sandwich. I will throw up if I eat too much or too quickly. For me this is the optimal restriction. It is IMPOSSIBLE for me to overeat. Some people may not like this much restriction b/c I can eat very little during the day (I can eat a little more at night which is interested). If I follow the rules and eat very slowly and not drink I am fine. I think I'm about as tight as I can get without not being able to drink.

This restriction was very obvious when I got it. It was very hard for me to "get" the band until I had it. I feel like this is the way the band should work. I don't want to diet, count calories or obsess over food anymore. I eat everything I want, but in very, very small portions. Some days are different than others as well. Some days I feel really tight, and others not as much..

I really believe that you will know when you get to the right restriction, but you are not there yet. It will happen, and then this thing will work the way it should. Good luck and feel free to send me a private message if you want more info.

Gretchen

[juliegeraci 7]

Mellie, for me good restriction is when I can only eat 1/4 - 1/2 cup of food. If you are consuming say 1 cup and not losing you need a fill. You should be losing a minimum of 1 lb per week. Good luck.

[juliegeraci 7]

If I didn't like you so much I would tell you to fuck off. Happy Holidays!