Although doctors and fill providers make every effort to give their patients a perfect fill level every time, it is not always possible to predict how a patient will respond after receiving a fill adjustment. There are however, certain things that can be done to increase your chances of getting a good fill the first time.
Determining if you are ready for a fill
First fills and all subsequent fills are not given on a routine basis. Instead, they are given according to patient’s individual needs. In no case should a fill be given before 6 weeks post band surgery. Please check the files for information regarding when a fill is needed to determine if you are ready for a fill.
When to avoid receiving another fill
It is a common mistake to think that a really tight fill will improve your chances at weight loss. That is simply not the case. There is no advantage gained by having a too tight fill, and in many cases can cause many problems and disappointment in your results. If you are having any trouble with your current fill such as; regular pain, frequent vomiting episodes, reflux problems, not able to drink fluids, eat soft or solid foods without problems, you are not a good candidate for a fill at this time. Rather you should consider needing a un-fill to improve any of these problems.
How to prepare for a fill adjustment
As a banded patient, keeping yourself well hydrated is always important, especially when you are going to receive a fill. Keeping hydrated will help prevent your stoma from swelling and improve the accuracy of your fill.
Start several days before your appointment, making sure you are taking in 64 to 80 ounces of fluids daily. If you engage in strenuous work or exercise, make sure you replace fluids with extra water. Avoid alcohol, coffee, tea and soups or foods with excessive amounts of sodium, as these beverages and foods can have a dehydrating effect on the body. Stick with no-calorie, non-carbonated beverages or just plain water.
If you are traveling by plane you may want to keep a bottle of water in your carryon luggage or purchase water on the plane, as a plane flight can also dehydrate your body somewhat. Take little sips up to and throughout your flight. You may want to choose a seat near the bathroom or select an aisle seat when making your reservation if you have a choice.
Eating before a fill
To receive a good fill requires that your pouch is empty. For this reason you should not eat solid or soft foods 6-8 hours before your fill. Full liquids are fine in small amounts, but discontinue 2 hours before your fill appointment.
Avoid eating a heavy, spicy or a late meal the night before. Avoid eating anything that may cause you to have a PB episode. You want your stomach to be as peaceful as possible.
Relax and get a good nights rest, there is nothing to worry about. Receiving a fill is very routine. It is similar to getting your blood drawn. We want you to be calm and relaxed for your fill. Stress can cause a false tightening of your stoma, and can make it harder to get a good fill.
Ladies check your calendar
Ladies avoid scheduling a fill during your menstrual period or several days before, as you may be retaining water at that time. This may reduce your chance for a good fill.
Hot and cold beverages
Avoid drinking either hot or ice cold beverages for one hour before your appointment. Hot drinks can over relax and open your stoma, and cold drinks will cause your stoma to close. Either hot or cold can give a false reading, and you can end up too tight or not tight enough.
Recovering from a Fill adjustment
The first 24-48 hours following a fill should be considered a period of recovery. The stomach as a rule can be a very grumpy organ, any small change and the stomach will react with swelling.
Your results from your fill may not be apparent for a couple of weeks. It can take 1-2 weeks for your stomach to return to a more settled condition. It is important not to force food through the smaller opening. Any irritation will delay your recovery. You may also end up needing a un-fill if you continue to irritate your stomach.
It is important to remember that your latest fill adjustment changed the size of the opening through the stoma. Many of the foods you were able to eat easily may now give you some trouble. A slow approach is recommended and taking small bites and chewing your food thoroughly becomes more important then ever.
This is a good time to refer back to the post-op diet you were given when you first had your surgery. Pay close attention to the sections on full liquids, soft foods and introduction to solid foods. You may also want to take this time to remind yourself of the 10 Lap Band rules.
Keep yourself hydrated
Keeping yourself properly hydrated after your fill is important to the recovery phase. It is also a good indicator of how your new fill feels. After your fill you should be able to drink room temperature water with no problem. If you can’t get water down you may need a un- fill. It is recommended that you stay in the lobby for awhile after your fill to make sure you can tolerate your new fill level. You don’t want to be traveling home before you realize you are too tight and need to return.
If you have traveled some distance to receive your fill, you may consider staying the night and leave the next day. This will give you a chance to test your new fill level with some full liquids and possibly a bite or two of soft foods, before you get on a plane or start a long drive back home. This will save you the inconvenience of having to return for an un-fill.
24 – 48 hr. recovery diet
Just like after your surgery you are going to ease back to solid food again. Except this time you will complete it in 2 days.
Stay on full liquids for the first 24 hours if you can. Full liquids are liquids that can easily go through a straw. If you did fine with full liquids you can move on to soft foods. Soft foods are foods you could eat if you had no teeth. Use good judgment; if you have had no trouble at this point you can slowly introduce soft cooked solid foods again.
Testing your new fill level
If you have completed your 48 hour recovery diet, and have had no problems, you should start to test your new fill level by eating a typical Bandster type meal. A typical Bandster meal will consist of 2-4 ounces of soft-cooked solid protein followed by a 1/2 cup of vegetables. This meal should be able to keep you satisfied for 3-4 hours.
If you cannot eat moist solid protein, and can only eat soft foods or liquids then you may be too tight. If this is the case, don’t make the mistake of eating “easy foods” to get by. You will find that “easy foods” can easily be over eaten defeating the purpose of the band. Patients that go this route will train themselves to “eat around the band” and actually gain weight, leading to disappointing results.
The slow approach is better
Your approach to receiving your fills should be slow and gradual. Although patients vary as to how many fills they may require. The key is to gradually introduce some pressure and restriction to give the patient time to adjust their eating habits and promote a perfect fill level for sustained weight loss.
If this is your first fill experience, or one of many you may have had, good preparation before and a little maintenance after your fill will greatly improve your chances for a successful fill.