Lap Band Fills: Too Loose, Too Tight or Just Right?

by gloria on May 2, 2010

I’ve had emails and comments from some of you asking about fills.  How do I know when I have a good fill?  What will it feel like?  How many fills does it take?  What fill volume?  I’ve also heard from several members of the Banded Living community who are either feeling too tight, or worried about slips and are having trouble eating good quality foods.  I’m convinced that a good fill is as much of an art as it is a science.  I also know that we are all so different when it comes to fills.

It took me many fills to get to just the right place, where I’m satisfied with a small amount of good quality food, and not obsessing about my next “fix” between meals.

When it comes to assessing where I am, I’ve also found that I need to remember that it’s the trend that matters.  What I mean by that is that some days, I feel looser, and some days I feel tighter, and some days I feel just right!  I’ve come to accept those variations as normal, and I can usually adjust my food choices accordingly.  I’ve also learned that if I have an episode of being stuck, I can be irritated for days.  If I don’t go back to liquids and give myself a chance to allow any irritation to subside, I can get irritated and swollen and end up feeling too tight.  That can take days to resolve; it can also require a small “un-fill”, but after having that experience, more than once I might add,  I’ve learned to catch it early and try to avoid the cycle of un-fill, feeling too loose then re-fill.

too loose, too tight or just right

I found that it’s super important to be able to clearly describe what I feel to my doctor.  Here are three things that I often discussed about with my doctor, during my transformation or weight loss phase:

Volume
How much plain dense protein I could I comfortably eat in one 20 minute sitting (no food lube)?  During my transformation phase, I felt best and was happy with my weight loss when I could comfortably ½ cup to 1 cup of dense protein like chicken or fish, without food lube in a 20 -30 minute sitting.

Satiety
Did I feel satisfied after eating?  I don’t mean: Did I feel stuffed or uncomfortable?  To me satisfied is a more subtle cue, like I’ve had enough and I can push away from the table and stop thinking about food.  This is not the absence of emotional or head hunger.  But I can say that finally feeling satisfied, on a small amount of food, helped me to recognize the difference between physical and emotional hunger.  For me, this feeling of satisfaction was like being set free.

Hunger Between Meals
Was I hungry between meals?  What was the intensity of my hunger between meals?  How long did the absence of hunger last?  For me, I felt best and experienced good weight loss during my transformation phase when I wasn’t hungry for at least 3-4 hours after a meal.  For me, that meant that I was comfortable and in control of my food choices, and it didn’t require unnatural acts of willpower to wait for my next meal.

Now in addition to how I felt, I know that my doctor has other criteria he considers.  For example, was I losing weight?  Where am I on my weight-loss journey?  What is my history?  That being said, I found that it was helpful to be able to clearly describe what I am feeling to my doctor so that we could work together as a well informed team. 

Please keep in mind that we really are all different.  You may even notice that I didn’t even mention fill volume.  Believe it or not I don’t know exactly how many cc’s I have in my band; I stopped focusing on that a long time ago!

 I’m hoping this answers some of your questions.  Please leave additional questions in the comments section below and I will do my best to respond.

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{ 5 comments… read them below or add one }

Rosemary May 2, 2010 at 7:11 pm

I guess my question is more about types of foods. I, also, have no real idea how much is in my band, realizing from the message boards that we all seem to have very different tolerance levels. But there are a few things that I just can’t eat without getting stuck or vomiting. Eggs, for one. Who knows why – maybe you do? And I love eggs, so I keep trying (dumbly, I guess). Yesterday I made my husband some chopped egg salad for lunch and had a few tablespoons and had a nasty burps and productive burps all afternoon. Reflux. I had the impression (before surgery) that if I chewed carefully I would be able to eat anything. That hasn’t turned out to be entirely true! Thank you so much for all your support; I gain so much from reading your posts!

gloria May 3, 2010 at 1:32 pm

Hi Rosemary,
Even though we’ve dialogued about this offline, I wanted to post my response here for others to see.

Here’s what I know, which is not very much. There are certain foods that are common problems for people, but each of us are different, I haven’t met anybody who could really explain why. Most of those common problem foods have never been a problem for me – for example white meat chicken, but tuna salad is a problem for me and I could never figure out why. What I finally accepted was that I can eat a wide variety of great foods with my band, but tuna salad just doesn’t work for me. Sandi and I talked about that in our A/V series, the 7 Things I Wish I Knew Before Lap Band surgery. Unfortunately my suggestion is to stay away from eggs, because if you keep trying to may get yourself irritated and start wondering why your band feels too tight.

Meg Gambill May 3, 2010 at 4:57 pm

Gloria,
This blog came for me at just the right time..:) I go for my first fill tomorrow and I am nervous and excited. Since being banded almost 6 weeks ago, I am learning to pay attention to my body. My body tells me when I am satisfied. For me, if I relied on my head to do that I would NEVER be satisfied. Also, since I have no fill yet…I have been getting away with eating many different foods. I am assuming that this will now change, so I need to REALLY listen to my body and stay within surgeons RULES on amounts of food!!
By reading personal journeys and posts on message boards I have found that yes, everyone is different. Now is the time to really build my relationship with my surgeon as she only knows what I tell her….She is only here to help me and the more information I can give her, the better we will work together.
I love yours and Sandi’s blogs and find you both a great resource and inspiration. Thanks you both for paying it forward!!
Meg

CA May 16, 2010 at 10:40 pm

I had lapband July 27,2007.I started at 294lbs I lost 152 lbs within about 14 months .i went from size 24- to size 8. Unfortunately i started working at a sedentary job in front of a computer 8 hours a day and have gained 30 lbs. this mainly beucase your body get so used to the little food you take in and if youarent doing all the physical activity you were doing before no matter how little youeat you will gain ,but I am still able to to better control my eating and exercise habits then if I tried to to do this by myself than without the band . People dont understand that morbidly obese people cant just exercise and get rid of it .It takes years to get rid of that kind of weight through normal healthy weightloss process.I also did not experience the severe loose skin that some people do and I am 52 years old now .My abdomen looks like any other woman who has had 3 kids . I have been nothing but pleased with my banding .Hope you have good results

Diane September 27, 2010 at 4:22 pm

Gloria I appreciate this subject and I am learning. I was banded April 2010 and have had 4 fills and 1 unfill. I just can’t seem to be in the “sweet” spot. I know this sound crazy, but when i was too tight i actually enjoyed the part of not having any appetite at all, or at least that’s what I experienced. Unfortunately I also had great discomfort. I was unfilled and since have had one small fill but fill
like i am back to square one. I don’t want to experience that again. My weight loss is slow but i have had no vomiting in over a month. I am going to find my
“sweet spot” soon I hope.

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