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February fills

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For those patients that will be coming to the OCC in February for your fills,, the best way to travel from the airport is to either schedule the OCC van/shuttle or take the bus/trolley. If your wanting to use the OCC van, it would be wise for you to use the forum to coordinate with other patients and share the van to help reduce your traveling expenses. Also,, get with Rene at the OCC and he'll know the van schedule for that day. For those who like the adventure and are thinking of taking the bus/trolley and walking across the border, jumping into a Mexican cab/and or walking to the clinic, use the forum and see if your coming into San Diego around the same time as other patients. Remember,, your in a new club,,, the bandster club. Once your a bandster,, you'll always have a friend. Buddy up and share the adventure.

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This article was just a general guideline. I can't remember where I got it. If the OCC says liquids for 3 days after a fill,, their the boss, but I know this sounds funny,, but how would you be able to test the fill before you left town by doing liquids for 3 days after your fill???? But,, remember,, I'm not the doctor and this article might not be what the OCC tells its patients.

Below instructions are from Northwest Fill Management, Arlington, WA http://www.northwestfills.com/education.php

I have read on obesity help forum about the 3 days liquid, some docs even say up to a week on liquids? There are other bariatric surgeon's web page where they just do the 24 hours liquid, 1 day mush.. then eat as permitted if comfortable. It varies so much that i really would like to know their reasoning. If this was the case of every fill then I definitely would not see going to OCC as cost effective any longer. The three days hotel and flight will cost more. Even if it was $500 for a fill with fluoro locally.



The Lap Band fill (adjustment) is the effect the band has on decreasing your appetite. If you are less hungry then you eat less and will lose weight. The word restriction is a misnomer. When fluid is added to the lap band it causes the food one eats to stay in a pouch for a longer time. This releases a neurotransmitter to the brain that says you are full for 4 hours. This is a fill. To feel restriction is not good and can lead to other problems, like Gastric Reflux, heartburn, PB (projectile burping) and band slippage (rare).

How much fill should I get?

It is important to understand that the tissue in you gut is like the tissue in your mouth, it is very sensitive and swells very easily. Everyone is different; a good fill for one person is too tight for another person, or not enough for the next person.

1. The initial adjustment post operatively should occur at 6 weeks or later, and 1-2cc of Normal Saline (for the 9.75 or 10 cc band). The larger band (11CM and VG) adjustment os 3-4cc.

2. Regular reviews (4-6 weeks) are recommended with weight and clinical status measured. If weight loss is 1 pound per week over the period and patient is following bandster diet guidelines then another fill of normal saline is added at .2 to .5 increments.

3. If the weight loss average between visits is 2 plus pounds per week no fill is needed.

4. If the weight loss averaged between 1-2 pounds and the person feels hungry and found it difficult to comply with the dietary guideline/portions.

5. Fluid is removed from the system if there is symptoms of excessive restriction or obstruction, including excessive sense of fullness, heartburn, regurgitation and vomiting.

6. Fluoroscopy is needed for evaluation of band placement and/or port placement.

7. It is important know that the fluid in the band never adds up, it is always give or take 1 cc because fluid hides in the tubing or in the band.

Post Fill/Adjustment Guidelines

Eat lightly the day of your fill.

After the fill is done drink liquids for 24 hours.

Day 2 go to mushy foods, continue on this until you are comfortable to progress to solid food. If you have pain in your chest, heartburn or you are unable to progress to solid foods within a day or two then please call our office and we will discuss with you if you need to have some fill removed.

If you start vomiting (PBing) at any time then stop eating for a few hours. After an episode of vomiting, the area of the band is swollen and you will not be successful in keeping anything down, give the band a few hours to rest and then eat later on.

Don’t try to force food down!

It is normal for the band to be tighter during the morning. Many people can only drink fluids, or eat yogurt or mushy foods. Work with your band and do not try to force food down. It is also normal of the band be looser in the evening, you might be able to eat more. Some women feel tighter during their period, or flying in a plane. WORK WITH YOUR BAND!

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I don't remember what the OCC guide lines are when it comes to eating before and after fills. I'm from the Midwest and I fly out of Chicago. I can say I wouldn't be leaving Tijuana not knowing how my fill is,, especially if I would be to tight and I needed to have some saline removed. The last thing I need is to have to jump back on a plane to fly back out to San Diego to have an unfill. I don't know how many patients have ever had to have some saline removed,, I have never heard of it happening at the OCC. The OCC does a pretty good job with their fills. So,, I can say,, "OFF THE RECORD" The next day, while I have plenty of time before I leave, I'm going to test my fill. Of course, this statement is "OFF THE RECORD" LOL.

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