NoWorry

Hi Roger, Where are you having your port moved to? More details, please.

I must admit you've done a truly exceptional job adjusting to all the variances you've experienced. I get the impression that you believe that your experience is normal. Is that right?

Are you sure about this? As it was explained to me, immediately following a fill, the stomach gets a little inflamed which results in a fill feeling a little more restrictive than it really is. Within 2-3 days, the inflammation goes down which actually slightly reduces the restriction. Is there any reason for believing that the restriction increases after 2 weeks?

Had my third fill this past weekend with the local FillCentersUSA provider. It required a couple of tweaks, but I think I might actually be at my sweet spot! I'm a happy camper.

This makes perfect sense. (And I'm sorry to hear that you're struggling so much with finding the optimal fill for yourself. I would not have guessed that you were having so many problems.) Rather than trying to answer the question "What's the right fill amount?" I'm trying to answer the question "What's the best strategy for fills and weight loss with the band?" I found both Nita's and Roger's information quite invaluable in trying to develop this strategy.

Thanks so much for your feedback, Nita. It's terrific that you've done your homework through your support groups and are generously sharing them here. Now that I'm 're-setting' my expectations based on this new information, a fill every 20-25 lbs doesn't sound too bad. I have only 70 lbs to lose, so that means about 3 fills to get there. Of course, first I have to get to that elusive sweet spot and actually start losing weight. I'm keeping my fingers crossed and hoping that the local FillCenters doctor can do an adequate fill. That should make the remaining journey manageable.

I was simply not aware of this. Now that I'm learning this is true, I'm changing my plans and expectations accordingly. The tough part so far has been actually figuring out what I needed to do. I'm now preparing myself for multiple additional fills. I've started the process of making an appointment with FillCentersUSA for a fill next week. The Dr is very new and I'll be his 9th patient. :gulp: But I guess that even Ortiz and Romero had to have a 9th before they got to their thousands.

It looks like you've been very diligent about getting a fill almost exactly every 4 weeks. Did you get them all at OCC? I'm researching FillCentersUSA which has just opened an office locally. They have a package that includes 4 fills and 8 office consults for $1228. It sounds like a pretty good deal.

Wow! Thanks, Roger. That's the most detailed and valuable information I've found on this subject since I started looking. I really appreciate you sharing it. I had formed the impression that I should wait a minimum of 2 weeks between fills and was concerned that even that might not be long enough, but I'm dramatically revising that threshold on the basis of the information you've provided. I think my preference is also for a fill more on the snug side of the acceptable range. I have no problem with a protein shake diet, especially if the band is going to help enforce it. The general opinion on this forum of non-OCC fill centers seems mixed, with a leaning towards the negative side. I gather that your experience at your local fill center has been positive?

I'm very glad for you that you're having a smooth journey.

Where are you getting your fills? Please do post your results. Since our starting weights are very similar, I think I'm heading in the same direction as you, and your experience may give me some idea of where I'm headed. Congratulations on keeping your weight in check in the meantime. I'm managing to tread water, too. I'll keep my fingers crossed that this will be the one that gets you to the sweet spot. Good luck.

You are a real class act, Danielle. =D>

Yeah, me too! But there are still a lot of decisions to made to get through the maze. At the present time, I need to make the following decisions: 1. When should I schedule my next fill? 2. What results can I reasonably expect from that fill? 3. Where should I have my next fill? How are you making out with these questions? Is there any guidance you can provide me with?

In your place, I would get a measurement of the fat percentage of my body. The best method for doing this is underwater weighing which is not easily accessible to most people. (I am a member of my local Fitness 19 gym and they bring a mobile lab around once every 3 or 4 months with the equipment.) In the alternative, you can do a measure of fat percentage using calipers and a fat percentage chart. Most weight loss physicians provide this service (it's very difficult to do on yourself). I'm not sure, but I think you can have it done at a Jenny Craig center, as well. Finally, there is a chart that plots your weight against your wrist measurement and waist measurement for a fairly accurate measurement of body fat percentage. It's not as accurate as the first two methods, but it's adequate for most practical purposes. I think you already know that you are losing fat, but any one of these methods will show you exactly how much and that should really motivate you to lose more!

You sound very sanguine and patient. I envy you. I've had 2 fills (5.6 cc total), and also have no restriction. My experiences are almost identical to yours. Bread is perhaps the only thing that I can't easily eat. It gets stuck usually with the first or second bite. If I rapidly take three sips or more of liquids, I also have a brief period of restriction. I feel tiny air bubbles being released through the band as the liquid goes down. It usually passes in about 10 minutes. And it's always more pronounced in the morning. What was your starting weight and BMI and how has that changed since your surgery? Considering that you're almost at the max for the band, have you and your fill doctor discussed whether the VG band was right for you in the first place?

That's very valuable information, Teri. Thanks. What's the shortest period of time you would wait between fills (to give your stomach enough time for the swelling to go down)?

That's over-simplistic and under-informed. As with most bariatric surgeons in the US, they will not fill patients from other surgeons, especially those banded in Mexico. Good for you. Apparently the distinction of who is making the appointment is lost on you. I find it hard to believe that you do not see that this clinic's approach represents a higher level of after care, where the physician takes the lead in ensuring success and the physician initiates regular communication even when there is no issue.

Does anyone have any practical knowledge or experience that might help other patients decide when to get a fill?

I believe that LoriBecky had posted on another thread that she takes NSAIDs for a back problem. I'm not sure whether it was she or another user who quoted a doctor as saying that it is no longer believed that NSAIDs cause problems with the band. You could message Lori directly for more information. I have been taking Ibuprofen and Aleve regularly since being banded, but I don't put to much emphasis on that, since I have virtually no restriction.

I think that every single one of your emotions and thoughts are perfectly justified. And I am really sorry that this happened to you. I know that in your place, I would be feeling exactly the same. I'll just state the obvious, which I'm sure you already know: You are the patient. At the end of the day, you must feel totally comfortable and only you can decide exactly what this means to you. Don't short change yourself for someone else's convenience. And if you're not happy with the information from the co-ordinator (just an email? really?), I would get on the phone with Ortiz. They have created a problem and have handed you the task of resolving it. That's not fair. Give them your facts and have them find the solution. And if it means that the doctors have to come in on a day they would otherwise get off, then so be it. And if the change doesn't work for you, then just tell them it doesn't work for you. Not having read the email they sent, are they offering you an option or is it a fait accompli? Would you please let me know how this gets resolved one way or the other? PM me if you need the name of another, extremely well qualified bariatric surgeon in Tijuana. He might still be able to fit you in on your desired date. P.S. It's not disingenuous, it's dishonest.

Thanks, Nita. I really appreciate your comments. While you struggled with your decisions (too tight, right level) did you consult with anyone at OCC at all, or did you have to make all your decisions on your own?

Thank you. The support here has been very enlightening. Let me see if I've followed: 1. Just sit back and relax. (Because everyone knows that that's the most successful weight loss technique.) 2. If I would like advice on when to get my next fill, the LapBand isn't for me. (Now that's really helpful support! Was a time when people didn't know the answer to a question, they simply let the question pass. Now it seems appropriate to pipe up and say that since they don't know, it can only possibly be because absolutely no one knows - after all, migraines and bariatric surgery are almost exactly the same thing, aren't they?) Not for nothing, a buddy who was banded 3 weeks before me in the US has regular, scheduled appointments with his fill doctor every 4 weeks where he discusses his progress, his current level of restriction and together they decide whether another fill is needed (yes, surprise, his fill doctor actually knows when another fill is needed). While he's there, he's weighed and a record of his weight loss is kept in his chart. And each time as he leaves, his doctor schedules another appointment in another 4 weeks. Anyone been weighed at OCC during a fill trip? On the flip side, when I try to contact Ortiz, my inquiry gets shuttled to the fill doctors who don't respond at all. Boy, am I glad I saved all that money going to Mexico! After all, if I'm going to have surgery that isn't for me, I might as well get a bargain!

Does that mean that I shouldn't get another fill? Wait a few weeks and get another fill? Wait a few months and get another fill? If patience is needed, I'm prepared to be patient. However, it would help to know exactly how patient I need to be and when I cross the line and become irresponsible or unresponsive.

I have now had two fills and still have no restriction at all. I think at some point I have to come to the conclusion that the VG band is highly inefficient.

I would never dream of including you with the rah-rah sisters, Teri. I find your thoughts, opinions and comments extremely valuable, helpful, open-minded and reality-based. Heck, even your wrath is welcome.