VG Band Question

[CalKev]

Hi Band Fans! I am curious when I had my VG Band procedure I neglected to ask Dr. Ortiz what the initial fill amount is for the VG Band. Specifically when it is placed how much saline is in the band? Is it standardized or does it vary per individual? Also once I receive my first fill I hear rumors I will need at least a 2nd fill to feel restriction. What is the schedule for receiving subsequent fills? Six weeks as for first fill? Thanks in advance for any info you can provide. Kevin

[RogerF]

I was banded 9/8 with the VG. As far as I know it is empty when placed. I had my first fill on 10/27 and they put 4.6cc's in. I could tell pretty quickly that I wasn't feeling any restriction. I went back yesterday 11/7 for another check. They could only retreive 2cc's from my band. They refilled to 4.2cc's as 4.6 closed off too tight on the fluro.

The local office I used here said they have seen this before, but I of course am concerned if there could be a leak. I do think, and pray that, it takes some fluid to replace the air in these bigger bands. I'm still on liquids today, but I hope this will help as I haven't felt any restriction and have been able to eat way too much.

I don't know if the air in the port/tube theory holds true for many, but I think it would be a benefit and service to partially fill these VG bands 1-2 cc's at surgery. I had planned to go back to TJ for my first fill, but if the same thing would have happened I would have been disappointed. I think these bands can take several fills to find the right spot anyway, but I was hoping for a faster start. I am planning to go to TJ in Jan, but I'll see how this fill holds to see if I want to get another locally before that.

I'm a little discouraged at this point. I've done OK on my own, but I was hoping for more help from my band by now. I'm hoping this fill will hold and it isn't a leak or something else.

Roger

[CalKev]

I was banded 9/8 with the VG. As far as I know it is empty when placed. I had my first fill on 10/27 and they put 4.6cc's in. I could tell pretty quickly that I wasn't feeling any restriction. I went back yesterday 11/7 for another check. They could only retreive 2cc's from my band. They refilled to 4.2cc's as 4.6 closed off too tight on the fluro.

The local office I used here said they have seen this before, but I of course am concerned if there could be a leak. I do think, and pray that, it takes some fluid to replace the air in these bigger bands. I'm still on liquids today, but I hope this will help as I haven't felt any restriction and have been able to eat way too much.

I don't know if the air in the port/tube theory holds true for many, but I think it would be a benefit and service to partially fill these VG bands 1-2 cc's at surgery. I had planned to go back to TJ for my first fill, but if the same thing would have happened I would have been disappointed. I think these bands can take several fills to find the right spot anyway, but I was hoping for a faster start. I am planning to go to TJ in Jan, but I'll see how this fill holds to see if I want to get another locally before that.

I'm a little discouraged at this point. I've done OK on my own, but I was hoping for more help from my band by now. I'm hoping this fill will hold and it isn't a leak or something else.

Roger

Roger, Thank you so much for your reply. I get no restriction in fact I have stayed on a liquid diet just so I can continue to lose until restriction is in place. You would think the VG would be engineered so air was not an issue when it is time to fill. Rupturing the diaphragm inside the band would make it impossible to hold restriction and they would all fail. How often is your local office seeing the loss of saline I wonder. As you say replacing air in a band with fluid should just displace the air and not cause it to leak out. So in theory the air and fluid should both stay in the band and commingle.

Best of luck on keeping restriction. I am going to do some research and see if I can find out more on the subject. Appreciate the reply Roger! Kevin

[nita57]

Kev and Roger(HIHIHI)

I have heard it from everyone that the bands do somehow lose saline at first. It is normal and not a leak.

Dr. Martinez told me to wait 6 weeks after my first fill before I try again. I got a 4.4cc fill 2 weeks ago. I also have NO restriction. I am maintaining my weight loss with great struggle but hanging in there. I think some US Drs. will fill sooner so if you are filling here then check around. And Kev, as far as I know, Dr. Ortiz always places the bands empty. If you are returning to TJ for fills, Dr. Martinez will try to get you to the sweet spot as quickly as possible so don't give up. Good Luck, hope to be seeing much less of you around here....(get it?) Nita

[JFleming56]

I had the VG placed in July. When I began to eat solids again 3 weeks post-op, I felt NO restriction. I went back to TJ at the 6 week mark for my first fill (3.2cc). Still NO restriction whatsoever, returned to TJ for second fill of 4.2. They allowed me to go eat, to see how much restriction I felt. I returned to the center the next morning and had another .4cc topped off. So, I left TJ with about 4.6cc. I felt a little restriction at first (very little, but some) but after a week or so, I could eat/drink whatever I pleased--PBing only under certain circumstances (eating too large of bites too quickly, for instance).

**Let me pause for a second to say this...when I went in for the operation, I was under the impression that I could very well find my sweet spot during the very first fill (as were many other patients I've spoken with) and that the center in TJ would be much more aggressive in their fills than here in the US. I found this NOT to be the case...read on...

So, about 1 1/2 weeks ago, I went to Dr. Curry in Cincinnati (I live in Ohio) for my 4th fill. I was very discouraged and disheartened when I went. He gave me 2cc (no fluoro) and had me walk around the shopping center for a few hours sipping water, to see if I PB'd any of the liquids, so I could return if it was too tight. I didn't PB, thus didn't return. I was on liquids then soft foods for 3 days, and am now eating solids. I should say, trying to eat solids. I'm having difficulty NOW because it's like I'm starting from scratch, trying to figure out how to eat with the band! I have lost 8 lbs since this last fill!

I know that the center in TJ really, really stressed using the fluoro for your fills...but honestly, it didn't get me tight any faster than the blind fill did...so, I question that logic a bit...but, I'm no doctor of course!

Jodie

[CalKev]

Kev and Roger(HIHIHI)

I have heard it from everyone that the bands do somehow lose saline at first. It is normal and not a leak.

Dr. Martinez told me to wait 6 weeks after my first fill before I try again. I got a 4.4cc fill 2 weeks ago. I also have NO restriction. I am maintaining my weight loss with great struggle but hanging in there. I think some US Drs. will fill sooner so if you are filling here then check around. And Kev, as far as I know, Dr. Ortiz always places the bands empty. If you are returning to TJ for fills, Dr. Martinez will try to get you to the sweet spot as quickly as possible so don't give up. Good Luck, hope to be seeing much less of you around here....(get it?) Nita

Nita, Thank you for your reply and the info enclosed. I hope that we see less of each other in future! Like you I am hanging in there with the slow weight loss. Yesterday I increased my exercise to 2 X 30 min sessions (morning and evening) on my redundant bike from just one. My hope is this will kick up my metabolism a notch and burn, burn, burn those calories. Also staying on a liquid diet only is physically and mentally taxing as I will have been on it for 2 months on the 12th. But I am not going to put any weight on. I am getting regular blood test to monitor my organs. I'm determined to act like I am banded calorie wise until the fills give me restriction so I can move to solid food. I go to TJ on the Nov. 27th for first fill. I will talk to Dr. Martinez about getting to the sweet spot sooner than later.Best wishes to you on a successful weight loss.

[CalKev]

I had the VG placed in July. When I began to eat solids again 3 weeks post-op, I felt NO restriction. I went back to TJ at the 6 week mark for my first fill (3.2cc). Still NO restriction whatsoever, returned to TJ for second fill of 4.2. They allowed me to go eat, to see how much restriction I felt. I returned to the center the next morning and had another .4cc topped off. So, I left TJ with about 4.6cc. I felt a little restriction at first (very little, but some) but after a week or so, I could eat/drink whatever I pleased--PBing only under certain circumstances (eating too large of bites too quickly, for instance).

**Let me pause for a second to say this...when I went in for the operation, I was under the impression that I could very well find my sweet spot during the very first fill (as were many other patients I've spoken with) and that the center in TJ would be much more aggressive in their fills than here in the US. I found this NOT to be the case...read on...

So, about 1 1/2 weeks ago, I went to Dr. Curry in Cincinnati (I live in Ohio) for my 4th fill. I was very discouraged and disheartened when I went. He gave me 2cc (no fluoro) and had me walk around the shopping center for a few hours sipping water, to see if I PB'd any of the liquids, so I could return if it was too tight. I didn't PB, thus didn't return. I was on liquids then soft foods for 3 days, and am now eating solids. I should say, trying to eat solids. I'm having difficulty NOW because it's like I'm starting from scratch, trying to figure out how to eat with the band! I have lost 8 lbs since this last fill!

I know that the center in TJ really, really stressed using the fluoro for your fills...but honestly, it didn't get me tight any faster than the blind fill did...so, I question that logic a bit...but, I'm no doctor of course!

Jodie

Jodie, Appreciate you sharing your experience. It is of much help to those of us just getting to fills for our VGs. It sounds like I need to be aggressive in requesting the maximum fill they will do for me or it may just be a matter of adjustment and they do not want to cause complications like you said I'm no doctor I live about 2 hours north of Dr. Ortiz so can get there if I need to. Getting used to eating with constriction is what I am trying to do without it and still get the nutrition I need. The only way I have found to do this is to stay liquid and try to keep my pouch small until restriction occurs. Thanks for the good info. Best of luck on your band journey. Kevin

[LoriBecky]

Don't forget - part of the reason for the floro is to make sure we hit the port with the needle and don't puncture tubing. that is the biggest reason we see people come back for a port replacement - a U.S. doc puncturing the port or tubing doing a blind fill. So be careful. This is still rare... but much more likely with a blind fill.

We are trying to be more aggressive with fills especially with the VG band, but we do like to err on the side of caution. A band that is too tight can cause a slip, it can also cause you to become malnourished because you are unable to eat.

There is no perfect fill number that fits everyone. If only it were than simple...

I believe Dr. O has started putting in a small fill with the VG band at the time of surgery. This is something he has started doing recently. It isn't in all patients, and he determinds during the surgery which patients it will benefit.

[GregNE]

I have wondered, is the "VG" just an abbreviation for Vanguard, or does it indicate something else different about the larger band?

[Phil McDonald]

I had my surgery on September 6th and got the VG band. I lost about 10 pounds during the first three weeks of the liquid phase. When I went to the solid phase I did not feel at all like I had a band. I could eat the same as I could prior to surgery. I gained back the 10 pounds from the liquid phase and was back to my surgery weight. I got my first fill on November 1st by a local US doctor. He used Fluro, but without the barium swallow. He was very agressive with the fill. He started with 5 CC and had me sit up and drink some water. I did not feel anything different. He then took it up to 8cc and had me drink some water, I noticed that right away. He then took me back down to 6cc and that is where I stayed.

Right away I felt restriction. The next morning I forgot about the fill and after just a couple of bites got something stuck. My first exerience with pbing. I did not chew enough. After that I got with the program and started chewing everything to mush. I had one more pbing episode that same week, this was from eating a bite of tough beef roast. I have been able to eat everything else, including bread with no problem. I did not show any weight loss during this first week after being filled, but was eating less. This second week I got a bit more focused and have been careful with the calorie count. So far I am down about 2 pounds.

The restriction is tigher in the morning and loose late at night. I have not been eating hardly any fast food since being banded, but had occasion to dine at Taco Bell at the request of my five year old son. It was interesting to notice that my 130 pound wife was eating more food then her 315 pound husband. Before surgery I would have had a minimum of three items, probably four at Taco Bell. This time I had one item, ate slowly, chewed to mush and was full at the end of the meal.

Like everybody, I want to have this weight gone as fast as possible, however having experienced getting something stuck and the benifits of eating correctly with restriction I am more patient today. I can handle the lifestyle change with this level of restriction and while I am not melting away the pounds, I am eating less and eventually the weight will come off.

[kym828]

Don't forget - part of the reason for the floro is to make sure we hit the port with the needle and don't puncture tubing. that is the biggest reason we see people come back for a port replacement - a U.S. doc puncturing the port or tubing doing a blind fill. So be careful. This is still rare... but much more likely with a blind fill.

We are trying to be more aggressive with fills especially with the VG band, but we do like to err on the side of caution. A band that is too tight can cause a slip, it can also cause you to become malnourished because you are unable to eat.

There is no perfect fill number that fits everyone. If only it were than simple...

I believe Dr. O has started putting in a small fill with the VG band at the time of surgery. This is something he has started doing recently. It isn't in all patients, and he determinds during the surgery which patients it will benefit.

Lori,

How would i know if i got a small fill during surgery? i had surgery on nov 3rd and i have the VG band.

Thanks, kim

[RogerF]

Hi all,

Jodie and Phil, thanks for your info and I'm glad you are both getting to a point where this is working for you. I would try to hold on to as much restriction as you can now as it should get less as you continue to loose weight.

Well, its been a week now since my second fill. The good news is that I think I feel "something" now.

I can still eat a full meal of food, and I haven't had any problems eating anything yet (chicken, steak, etc.). But I generally feel full on a regular meal for about 4 hours. Seems like this would be a good level for maintenance, but not for losing. It's not even close to where Chelley had suggested.

First fill was 4.6 cc's on 10/26, second fill only 2.0 was pulled out and refilled to 4.2 on 11/7. So technically I guess I've had 6.8 pushed into my band so far.

I'm wondering if I should I make an appointment for another small adjustment at this time. Would three in a month be harmful? I wouldn't mind being able to eat through the holidays (bad boy thoughts of pie running through my head), but I'm not very patient with this. I am scheduled to go to TJ in mid Jan with my wife, but I'm not sure yet if I'll try to get another in between now and then.

The main thing is that these larger bands are a little more fickle and finding the right level will take some adjustments and time. Don't give up.

Best of luck to all. Roger

[tombourn]

Roger:

I have about the same to report. I can eat a full meal, but my full meal now is still alot less than before. Feel some restriction, but can usually eat past it. So I'm scheduled for my second fil DEc 9th. Still below surgery weight but not by much. Hope this next one does it..

Tom

[RogerF]

Hey Tom,

Hang in there. If you're feeling some restriction then I'm thinking it's close and another good fill under fluro should get close to where it needs to be.

While I can still eat a full meal if I chew well and take it slow, I did get a little stuck last night eating too fast (even had a minor pb!). At least it re-assured me it was there and the second fill helped. But I went ahead and scheduled my third fill for Nov. 30th locally. I'd really like to get where my intake is pretty limited for awhile. I'll then be in TJ in mid-Jan and can get another then. From everything I've read (thanks to all of you), I'm resolved to push on an agressive fill schedule to get it going. I figure it will loosen up as I continue to lose anyway.

Roger

[RogerF]

Well I had my third fill yesterday (over five weeks). This time they could only pull back 3.0 cc's from the 4.2 they say I had in last time. They added another 1.8 to 4.8 and I am really tight now. Even liquids are slow going through, and I'm not sure how I'll tolerate food just yet.

My concern now is if I may have a slow leak somewhere. I've actually had 8.6 cc's pushed in and only have 4.8 showing. I don't know how much extra space is in the band to account for the difference. The restriction continues to increase with each fill, so I guess I'll just try to see if I can ride this one for awhile.

While I've read that there have been similar occurances, I'm not sure if this is continuing pattern with the VG, or something to be concerned with yet.

Roger

[tombourn]

Roger

Way to go on your continued weight loss. I've been stagnate Only 5 pounds lost since banding... VEry Very sporadic restriction.. mainly if I eat too fast and of the wrong food ( bread)...I'm getting my second fill 9th so I think that is when the weight loss will really begin... When you can eat.. you do.. or I wouldnt have had to get this ..so as soon as I get get restrricted I know it 'll be different.. or at least I hope so

Tom

[RogerF]

Thanks Tom,

The last weight dip got my BMI under 35 and I can see some changes, so I'm keeping motivated. You really need another fill. My second one helped, but the third one last week really had a noticible effect. I'm pretty tight into the late afternoon, even liquids go down slow, and then loosen up a bit. I think I can make some real progress at this level so I hope my band will hold for awhile. I'm still concerned because of the noticible reduction in the saline level at each fill but I'm hoping it has settled in and this one seems to be holding for now.

I totally agree that if you can eat, you will, so keep trying to make good choices until your next fill, it will make a difference.

Roger

[RNR93]

I am new to this and have not yet been banded. I am going to the seminar on Thursday to get started. What can I expect as far as how much I need to lose before surgery? Also, what is this pb and slime stuff?? Any info would be great. :-?

[CalKev]

I am new to this and have not yet been banded. I am going to the seminar on Thursday to get started. What can I expect as far as how much I need to lose before surgery? Also, what is this pb and slime stuff?? Any info would be great. :-?

RNR93, Congratulations on your decision to look into banding.

When I was where you are in the process it helped me tremendously to email Lori, Patient Care Coordinator for the Obesity Control Center at lori@obesitycontrolcenter.com or call 1-866-376-7849 ext. 81.

She answered all my questions and gave me much needed insight into what I could personally expect based on my own statistics. She usually is available by eamil on the weekends which is really nice and M-F by phone. Let us know how you doing and when you schedule banding!

Best wishes, Kevin

[nita57]

YES!! He lives!! I was gettin worried about you Kev...Lookin mighty good there too...Nita =D> =D> =D>

[CalKev]

YES!! He lives!! I was gettin worried about you Kev...Lookin mighty good there too...Nita =D> =D> =D>

Nita,

I am still around mostly deleting spam. See what happens when you post to much Lori puts you to work. Working hard at losing through those crazy plateaus. Starting new job tomorrow... been in interviews for 2 weeks...... just to much. Finally I get to read the board. Yeah! Hope you are doing well and Happy New Year! Kevin :-h

[nita57]

Nita,

I am still around mostly deleting spam. See what happens when you post to much Lori puts you to work. Working hard at losing through those crazy plateaus. Starting new job tomorrow... been in interviews for 2 weeks...... just to much. Finally I get to read the board. Yeah! Hope you are doing well and Happy New Year! Kevin :-h

Good luck at the new job!! Its a whole new life eh? nita

[RogerF]

I got back yesterday from TJ yesterday after taking my wife and her friend down for banding on Friday the 12th (both are doing well). While I was there I got my 4th fill in my VG band. Dr. Romero was able to pull the 4.8cc's that I hoped to be there so my concern for a leak is gone. We discussed that that are probably 3 to 3.5 cc's just in the port and tubing that will be needed just to flush the air before counting the fill. He said that they try to work most of the air out on the first fill.

So while it took me three fills to get to a true 4.8, those of you that went back to TJ for your first probably fared a little better. Although the VG is still tougher to get right from the start.

SO now I'm really, really tight. Liquids are slow going through and for a few days I was kind of sliming/foaming on nothing. Better today but I'm afraid to try much in the way of solids. I was able to do a few bites on a Zone bar and some crackers, but I can tell my intake will be much more restricted now. It was uncomfortable, but I didn't want to get a slight unfill as long as I can get something through, so I'm going to see how this goes. If I can make this work for another 20 pounds I'll be very pleased.

Keep the faith and good luck to all. Roger

[RogerF]

I saw this on a post in the the Smarterbandsters yahoo group. It some info on the VG from the Inamed representative (from 2004).

Don Mills <don.mills@i. ..> wrote:

Subject: RE: new INAMED band

Date: Wed, 14 Apr 2004 16:22:29 -0700

From: "Don Mills"

To:

Hello Sandy,

I'm afraid that some of the confusion was created by INAMED itself

with regard to the name of this band. The Vanguard band is the old

name for the LAP-BAND VG System. Same band. "Vanguard" had some

negative implications. So our marketing dept gave the band the name

LAP-BAND VG System. Turns out that is not a very good name either

because it can be confused with the VBG procedure.

The VG band is being sold in Europe and now in Mexico too. (Note from

Sandy 8/20/054 - used in US now too )

However, the VG band is quite different from the 11 cm band that has been sold

in Europe and Mexico. The 11 cm band continues to be available in

those locations.

We don't quote the circumference for the VG band as it depends how

the band is measured. It cannot correctly be called either an 11 cm

or a 12 cm band. The band is different enough that we really do not

want to measure it in the way we measure the 9.75 cm and 10.0 cm

bands. In any case the band is longer (when open) than 12 cm. But

please do not refer to it as either an 11cm or a 12 cm band! The VG

band has been misquoted by surgeons and others as a 11 cm band. This

is incorrect and probably comes from confusion with the 11 cm band

sold internationally but not in the US.

The LAP-BAND VG is available in the US to all band surgeons and also

now in Mexico. Several have already been installed in both the US and

in Mexico.

The fill capacity is 10 cc. The first 3.5 cc only fill the band and

do not increase restriction. (emphasis added by Roger)

The indications for the LAP-BAND VG are generally for patients with

BMIs larger than 45, OR patients with larger anatomy (i.e. thicker

gastric walls and/or substantial omentum), patients that may have

more fat in the immediate band area and for the pars flaccida

procedure when the additional tissues that are enclosed within the

band are larger than usual.

The surgeon will make the decision as to which band is appropriate

for a particular patient. The above indications do not mean that

patients with the 10 cm band or the 11 cm band have an incorrect

band. It also does not mean that a surgeon might choose to use the

LAP-BAND VG System when he/she could have chosen the 10 cm band.

As always, great to hear from you. We haven't spoken since the

Seattle Bash - keep in better touch! And congratulations again on

your wonderful LapBand success and dedication to the Band Boards.

You are helping to provide a very valuable service.

Don Mills

INAMED Health

[Teri]

I saw this on a post in the the Smarterbandsters yahoo group. It some info on the VG from the Inamed representative (from 2004).

Don Mills <don.mills@i. ..> wrote:

Subject: RE: new INAMED band

Date: Wed, 14 Apr 2004 16:22:29 -0700

From: "Don Mills"

To:

Hello Sandy,

I'm afraid that some of the confusion was created by INAMED itself

with regard to the name of this band. The Vanguard band is the old

name for the LAP-BAND VG System. Same band. "Vanguard" had some

negative implications. So our marketing dept gave the band the name

LAP-BAND VG System. Turns out that is not a very good name either

because it can be confused with the VBG procedure.

The VG band is being sold in Europe and now in Mexico too. (Note from

Sandy 8/20/054 - used in US now too )

However, the VG band is quite different from the 11 cm band that has been sold

in Europe and Mexico. The 11 cm band continues to be available in

those locations.

We don't quote the circumference for the VG band as it depends how

the band is measured. It cannot correctly be called either an 11 cm

or a 12 cm band. The band is different enough that we really do not

want to measure it in the way we measure the 9.75 cm and 10.0 cm

bands. In any case the band is longer (when open) than 12 cm. But

please do not refer to it as either an 11cm or a 12 cm band! The VG

band has been misquoted by surgeons and others as a 11 cm band. This

is incorrect and probably comes from confusion with the 11 cm band

sold internationally but not in the US.

The LAP-BAND VG is available in the US to all band surgeons and also

now in Mexico. Several have already been installed in both the US and

in Mexico.

The fill capacity is 10 cc. The first 3.5 cc only fill the band and

do not increase restriction. (emphasis added by Roger)

The indications for the LAP-BAND VG are generally for patients with

BMIs larger than 45, OR patients with larger anatomy (i.e. thicker

gastric walls and/or substantial omentum), patients that may have

more fat in the immediate band area and for the pars flaccida

procedure when the additional tissues that are enclosed within the

band are larger than usual.

The surgeon will make the decision as to which band is appropriate

for a particular patient. The above indications do not mean that

patients with the 10 cm band or the 11 cm band have an incorrect

band. It also does not mean that a surgeon might choose to use the

LAP-BAND VG System when he/she could have chosen the 10 cm band.

As always, great to hear from you. We haven't spoken since the

Seattle Bash - keep in better touch! And congratulations again on

your wonderful LapBand success and dedication to the Band Boards.

You are helping to provide a very valuable service.

Don Mills

INAMED Health

[/quote

WOW Roger! Great Stuff!!!!!! Very Helpful, Thanks so much!!! While I do not have the VG band, I know this will help so many people who do. After my 2nd fill of the smaller band, I am still in need of restriction as I can still eat anything. I do eat less, but still more then I should. I have been in touch with Dr. Romero and am going to schedule another fill and port check. :-? Teri