Good fill vs Too much and dangerous

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Teaching Module, Orginal version written for Dr Kuri

What is a GOOD fill vs a fill that is too much and dangerous ?

It's important to know that, even with a fluoro, a good fill can be

very elusive. A fill that " looks perfect " on a fluoro can still turn

out to be way too tight in an hour, a day, a week. The usual swelling

that is common after a fill occurs in the next few-24 hrs, not

immediately. a fluoro tells ONLY that a fill is OK right at that

second, and does not predict how the fill will be later.

The only thing that matters in the end is how well and

safely you can EAT later on, not what the x-ray " shows. " It also

takes some fills 1-2 weeks to settle in, and we cannot tell how a

fill really is until then. this is why at least 4 weeks between fills

is very important, and this is addressed by the band manufacturer in

the professional literature they provide surgeons.

This is why many US docs rarely use a fluoro. They consider it

unneeded radiation (and to the ovary area in women) that does not

tell enough to justify it's use very often .

A fluoro DOES have it's place, though, in certain

circumstances.

I personally chose to get only one fluoro a year, to check band

position, pouch size, etc - never with every fill - and did just

fine.

Since a fluoro is only a clue to a good fill, WE must therefore be

responsible for knowing what a good fill is, and never trying to keep

a too-tight one. Way too many people think that if the doc says " this

fluoro looks great " and sends you home, that the fill IS always good,

and they must put up with any pain or problems.

Just not so! I wish it were that clear-cut.

With a GOOD fill, we can:

1. easily drink fluids from the start, and get the minimum 80-100 oz

a day in. this does not mean gulping, but something like sip-sip-sip-

sip, 5 second pause for it all to go thru, then sip-sip-sip-sip, etc

2. be able to eat ideal 1-1.5 cups of good bandster food per meal

most of the time. Less than this will never meet nutrition needs for

health or safe loss

3. can get in the minimum 1200-1500 cal a day required for safe loss,

and for minimum nutrition for health

4. with good bandster choices, can meet the daily (on average)

protein, fiber, calcium, good carb, and omega 3 oil needs

5. we never have pain when eating, unless we forget a band rule

6. we rarely have barfing, pb's, or sliming

7. With a good band meal, we feel satisfied (not FULL - there is an

important difference) for 3-4 hrs

8. we will be losing, averaged over 4-6 weeks, about 1-2# a week, as

long as we are ALSO being reasonable in food choices, exercise, and

fluid needs. we have to do our part too - the band is not a magic

cure.

9. hunger is generally dimmed, and we think much less about food and

eating. for me, there was a general disinterest in food. Still, we

should experience a bit of normal hunger when it's meal time, and

still must eat decent meals even if not hungry. skipping meals is

very unwise. We're never trying to eat as little as possible.

A TOO-TIGHT and dangerous fill is:

1. being unable to swallow your own saliva, and having painful burping

2. being able to eat only a few bites per meal (ask about

having " first bite syndrome " is you have pain with the first several

bites, but then can go o and eat more comfortably)

3. being scared and worried when we eat

4. not being able to eat a variety of foods

5. Struggling to meet fluid needs

6. ANY REFLUX (assuming you are following the needed anti-reflux

rules)

7. ANY regular pain or trouble, including Pb's, slimming, barfing

8. Being unable to eat the solid oid meat/chicken/fish that is the

basis of most good bandster meals.

9. Having to rely on soft foods and liquid foods like protein drinks,

soups, ice cream , etc to get enough to eat and feel satisfied (This

applies only after we are back on regular foods, of course, not in

the post-op diet phase)

10.Being unable to meet minimum calorie needs (1200-1500 cal a day)

to avoid " starvation mode "

11. a too-tight fill is harmful to the stomach, and the #1 reason for

ALL the major band problems, some requiring more expensive surgery

and even band removal.

We have to take very good care of our stomachs if

we want the band to stay safe and last inside us.

One of the hardest things we have to change is the thought that the

less we eat, the more we will lose and the better we will do. this is

very untrue, and very unsafe. when our bodies are deprived of

adequate calories, they refuse to lose well - if at all. When our

calories are too low, the metabolism " set point " is way too low, and

we VERY easily regain even we if do lose a bit - and most do not lose

much at all.

This is a big reason why we all regained plus extra

after all previous diets, and ended up here, needing band surgery.

The " starvation mode " , when we are eating too little for safety and

stop losing as a protective mechanism, is VERY real. We must eat

ENOUGH calories, but still just a bit less than we need, to lose

safely and in a way that will STAY the heck OFF this time!!

We have all lost weight before, and sometimes a lot of weight, but we

did it in an unsafe way that caused deprivation and poor health, and

all the weight plus more just came right back again.

THIS time, we need to learn and follow better ways to be successful

with the Band, maintain lost weight long term, and regain our health.

Sandy R

band educator