Help....Question About Fills & Unfills

[fotogurl 0]

Hello everyone...I'm pretty new here...but I am learning so much! I have been on my lapband journey since December, and I have one more appt. (nutritionist) and hopefully I'll have my date by summer!

Anyway, I thought I knew all there was to know, boy was I wrong. I have learned more from this forum over the past few days than all the seminars or dr.'s visits. But, I do have a question about the fills that I'm confused about.

Okay, I completely understand the fills, and sort of understand the unfills. So, do you get an "unfill" when you are losing too much or feel too restricted right? But, I've also read where some people are getting an unfill and then a fill on the same day, I don't understand that at all. Is each fill like starting all over again? You have to take it out before you put any back in?? I've done research to try to find the answer before posting, but I can't find anything about that. Please...could someone "fill" me in??

[luzin susan 0]

If I am understanding your question right ,,,when I get my fills and unfills, they put the needle in and take out all the fill to be sure that I am at the same level that was there last time. Hence they know if there is a leak or ? Then they put back in the fill amount they decided on with extra or less depending upon what the need is! Is that what you are asking? So it is a unfill and fill in one day so to speak!

Hope that helps

Susan

[shortgal 5]

My Dr.s office does the same thing, they take out all the current fill ( to check the amount) and then replace it all plus the additional new amount.

Some times a person might be too tight and then a slight unfill is done. That might happen in the same day. Pateint gets fill in the a.m and by aft. realizes it's too tight.

[fotogurl 0]

Thank you luzin susan & shortgal for your help, that does answer my question. That makes sense too that they would unfill you to check the amount for leaks & stuff.

Has anyone ever had them miss your port? That scares me a little.

Thanks again for your help! This forum is awesome! :biggrin:

[shortgal 5]

Most times they hit my port first time, once they had a little trouble. It's really not that bad and the whole thing is over fairly quickly. I was kind of nervous about the fills also, but ended up to be not so big a deal and worth any little discomfort.

[VegasGrace 1]

Straight from the manual:

INSTRUCTIONS FOR USE: BAND ADJUSTMENT

Postoperatively, the surgeon may adjust the stoma size percutaneously by injecting or aspirating saline with the access port needle via the self-sealing access port.

The following are general guidelines for LAP-BAND System adjustments:

1. The initial postoperative adjustment should occur 4-6 weeks after the operation. In most cases, you will add 1-2 cc of saline to the 9.75 and 10 cm LAP-BAND, 2-3 cc to the VG LAP-BAND, and 4 cc to the 11 cm LAP-BAND.

2. The patient should be reviewed regularly (every 4-6 weeks) and weight and clinical status measured. If the weight loss has averaged less than 1 lb per week over the period and the patient indicates there is not excessive restriction to eating, a further increment of Fluid should be added (usually 0.3 - 0.5 ml)

3. Where the average weight loss between visits has been greater than 2 lbs per week, normally no additional Fluid would be added.

4. If the weight loss has averaged between 1 and 2 lbs per week, additional fluid would be indicated if the patient feels he/she can eat too freely or finds difficulty in complying with the dietary rules.

5. Fluid would be removed from the system if there were symptoms of excessive restriction or obstruction, including excessive sense of fullness, heartburn, regurgitation and vomiting. If symptoms are not relieved by removal of the fluid, barium meal should be used to evaluate the anatomy.

Prior to doing an adjustment to decrease the stoma, review the patient's chart for total band volume and recent adjustments. If recent adjustments have not been compliant with nutritional guidelines, the patient my have a leaking band system, or may have a pouch enlargement or esophageal dilation due to stomal obstruction, band slippage or over-restriction.

Band system patency can be conformed by injecting saline into the band system, then immediately withdrawing it. An absence or decrease in fluid volume indicates a leak in the system may exist. The band may be evaluated for a leak using a radiopaque solution, such as Hypaque or Conray-43, flushing it from the band system after the evaluation. If pouch enlargement or band/stomach slippage is suspected, a limited upper GI with a samll amount of barium or gastrograffin can be used to evaluate the size of the pouch, the gastric stoma and the position of the band.

CAUTION: Insufficient weight loss may be a symptom of inadequate restriction (band too loose). Or, it may be a symptom of pouch or esohpageal enlargement, and may be accompanied by other symptoms, such as heartburn, regurgitation or vomiting. If this is the case, inflation of the band would not be appropriate.

The band internal diameter may be decreased approximately 0.5mm by adding an additional 0.4 cc of sterile saline. Excessive restriction may result in a closed stoma. Because of the possible complications that can occur with excessive restriction, a doctor familiar with the adjustment procedure must be available for several days post-adjustment to adjust the stoma in case of emergency.

Deflation (an increase in stoma size) is considered if the patient experiences frequent episodes of vomiting, is unable to swallow liquids or appropriate foods, or if there are medical indications for increasing nutrient intake. the internal diameter of the band can be increased approximatley 0.5mm by withdrawing 0.4 cc of the fluid. Elective deflation of the band is advisable in the following situations:

Pregnancy

Significant concurrent illness

General anesthesia

Remote Travel

Travel to areas where food or Water contamination is endemic.