My first fill at OCC

[NoWorry]

First Fill (Part I)

I fly back to San Diego on June 23rd for my first fill. This time I'm taking care of my own travel and logistics and I'm pleased that things run very smoothly. I fly in, pick up my rental and drive to the border. I park at the first parking lot I find and it's $9 for the day. (On my way back I discover a parking lot near the USA exit which is $4 and make a mental note for the next time - turn left after the freeway exit to the parking area.)

I walk across the border without incident. I have plenty of time and since I haven't done my treadmill today, I decide to walk. My walking instructions to the clinic are vague at best, but I'm armed with a map of Tijuana that is a bit of help. The key is to stay to my right after I cross over and pass the taxi stand. In the distance I can see an arch similar to the St. Louis arch and I remember seeing it on my last trip to Revolution Ave and it makes an excellent visual landmark to get me over the bridge across the sewage canal.

I need to consult my map a number of times before I stumble onto the only visual reference that I have - the Costco store. From there, finding the clinic is a breeze. I arrive at OCC almost exactly on time, but a little sweaty from the walk in the hot sun.

Only minutes after filling the paperwork and forking over my $100 fee, Dr. Romero comes out to escort me to the fill room. It is supposed to be Dr. Acosta's turn in the rotation to do fills this week, but I have requested that Dr. Romero do it, since - with over 6000 fills - he has far more experience.

Dr. Martinez comes in for a brief examination. He looks over the scars and tells me that they are healing well. The swelling around the main incision is still a little pronounced, but only about half the size it was the day after surgery and he tells me that it will be gone in another month or two.

After Dr. M leaves, Dr. R makes me comfortable on the bed, and turns on the fluorscope. The image is grey and muddy and I can't make out a thing. Dr. R points out my pouch, the band and my stomach, but it's all a visual blur to my eyes. He hands me a styrofoam cup of barium and I sip it through a straw. He points out the barium going down on the monitor but I can still barely make it out.

He locates the port, and injects the needle into my stomach. It's a brief sting, only mildly painful and then another slight sensation as he inserts the needle into the port. He drapes the needle with a piece of gauze so that I can't see the needle where it enters my skin and then adjusts the bed to a semi-reclining position. The long syringe wavew wildly with every movement.

While Dr. R is flushing the air from my band, I feel a very unpleasant sensation of gas building in my chest, most likely from sipping the barium through the straw. Now comes into play the one problem I've been dreading - I've never learned to burp. I can feel the gas uncomfortably bloating my esophagus, but I can't get it out. My situation might not be as unique as I think it is, because Dr. R takes it in stride.

He injects saline into my band and closes it off my stoma completely. He hands me a bottle of water and instructs me to drink a few sips rapidly. The congestion in my chest is extremely uncomfortable now. Dr. R nods approvingly and eases off the band and settles on a 4 cc fill. He removes the syringe, wipes the disinfectant off my stomach and I am done. The entire procedure has taken around 15 minutes and much later I wonder if Dr. R rushed a little since it was not his turn on the rotation. But I have no way of knowing. What I do observe later is that Dr. Acosta never takes less than 30 minutes with each patient, but that might be explained by levels of experience. Still, I have a nagging feeling that I shouldn't have asked for Dr. R.

I am supposed to stay on liquids for three days, but I'm not heading back until I know that the band is working. I head over to the restaurant around the corner and order lunch. Some fish, rice and salad. But the discomfort of the gas in my chest is so pronounced that I can't feel anything else. I eat about a third of my lunch and I think I feel full, but I really can't tell where the sensation of gas ends and the feeling of fullness begins. I reluctantly accept that I have to assume that all is well and I walk back to the border.

The lineup at US Immigration seems very long. There is a young man in the line directly in front of me and he tells me that it only looks bad, and we should be through in about 30 minutes. It's closer to 50, but I'm in no rush and the time passes uneventfully. Immigration waves me through and I am back in the US only a little more than 2 hours after I left.

It's a bit of a maze on the US side and I need to walk around a little before I get my bearings and find the parking lot where I parked my car. I pay the fee and hit the highway back to San Diego.

At Dr. Martinez's suggestion - made at the time of my surgery - I'm staying overnight in the area so that I can test out my fill and be close to the clinic if any adjustments are needed. I'm booked at the Holiday Inn and it's pleasant enough. My room is on the 10th floor with a lovely view of the ocean. I unpack, make a few phone calls and decide to take a nap. When I wake up, thankfully the discomfort from the gas is almost gone. I had originally planned to spend the evening exploring the city, but I'm simply not in the mood and a part of me wishes that I hadn't scheduled an overnight stay.

That evening, I stock up on protein drinks for the next day, but then decide to test out my fill. I'm looking for something soft and mushy that doesn't require a lot of chewing, but substantial enough to be restricted by the band. I settle on a chicken and rice bowl at El Pollo Loco. It has been recommended that I eat the meal in private in the event of any unexpected results so I carry the meal back to my hotel room.

I start on the bowl, eating slowly and methodically, chewing my food well before swallowing. I keep waiting for this feeling of 'restriction' I've heard so much about but have never yet experienced and it never comes. I finish the entire bowl and have discerned no feeling different from before. Fearful of just such an event, I have also ordered a few extras but my chicken quesadilla and then a pollo taco carbonara also go down without any fuss. This is pretty much what I used to have for dinner before being banded and on some level I'm simply destroyed that, after two months of anticipation, I'm back at square one.

[NoWorry]

First Fill (Part II)

The next morning, I call Claudia at OCC and inform her that I'm heading back for another adjustment. I'm not much in the mood for walking this time, so I call the car rental company and purchase insurance for driving in Mexico. It costs $26, but subtract the $9 for parking and the $5 for a cab each way and it feels perfectly reasonable.

I drive to the border again and, this time, just drive across. It takes only a few minutes to get to OCC. I drive into the underground parking garage and ask the security guard where I can park. She tells me that there is no guest parking, but then asks how long I'm going to be. I guess that I'll be there for about half an hour and she graciously allows me to park.

Claudia has already informed me that Dr. Romero is off that day, and my appointment is with Dr. Acosta. The waiting room is already quite crowded and most of the patients are there for fills or consultations, since there are no surgeries on Saturdays. Around 10 minutes after I arrive, Dr. Acosta comes out and takes me into the fill room. He goes through his procedures and turns on the fluoroscope. This time, the image is clearly defined and I can easily make out all the organs and the band. As far as I can tell, Dr. Romero prefers to keep the fluoro on continuously at a low intensity, while Dr. Acosta prefers a much sharper intensity, but turns on the fluoro for only brief periods of time.

This time I pass on the straw and sip the barium directly from the cup. I can see the barium going down clearly this time and although it creates the hurricane image passing through the stoma, it flows through fairly quickly. Dr. A plays with the adjustment while I drink water and then adjusts me to 4.6 cc. Dr. Martinez comes in briefly. I have the sense that he has a busy day scheduled, but that he wants to make sure that all his patients are well looked after. He tells me that he has done around 8000 fills, but that was before the advent of the VG band, and even with their lower numbers, both Dr. R and Dr. A are now much more proficient and experienced than him.

He wants to be sure that I am properly adjusted this time and wants me to take the toast test. I sit in the waiting room until a nurse brings me two slices of dry whole wheat toast and I take small bites and chew thoroughly before swallowing. All four wedges of toast go down without any restriction at all. The waiting room is packed now and Claudia tells me that this has been a strange day since there were very few early appointments and many patients showed up a little late, so the schedule is fairly jammed now.

Around 20 minutes later, Dr. A takes me into the fill room again. Once again we go through the preparation routine. This time when the needle goes in, the pain is significantly elevated. After all, it is being inserted into almost precisely the same tissue that has already been injected twice before. Dr. M pops in again and he is very gracious even though he is now clearly very pressed for time. Under the fluoro, it is clear that all the toast has already passed through the stoma. In spite of the increased fill, there is still virtually no restriction. The two doctors decide to bump me up by a full cc to 5.6.

I've already been considerably longer than my guess to the security guard, so I'm not surprised when I return to the parking garage that my car is trapped behind another vehicle. It takes 15 minutes to get my vehicle untrapped, and then I am on the road. While I'm driving around looking for the route back, I feel a terribly strange sensation. As much as I swallow, I can't seem to get my saliva down. The back of my mouth seems permanently awash in liquid. This can't be good. Reluctantly, I make my way back to the clinic. I park on the street this time and head upstairs.

It takes around 25 minutes before Dr. A can see me again. Even as we go through the now-familiar routine, it is clear that I'm over-filled. Dr. A and Dr. M consulted shortly after I left and decided that the toast test is simply not an accurate gauge. They're going to find an alternate test. This time when the needle goes in it really hurts. The skin above the port is tender and inflamed from the barrage of syringe pricks.

Dr. A wants to take out .6 cc, but I am reluctant to give up that much. We negotiate and I convince him to take out only .2 cc. When I leave the clinic this time, I am filled with 5.4 cc of saline. I bump into Francisco in the waiting room and he gives me directions to the border. I climb into my car and head off again.

Turns out the Avenue Heroes is closed each weekend and becomes a long lineup of cars backed up from the border crossing 1-1/2 miles away. From the clinic, I have to drive away from the border, turn left at the McDonald's, drive over the bridge and then return to join the back of the queue. From there, it can take anywhere from 1 to 2 hours to cross the border. As the line of cars inches forward, I start to feel the sensation of liquid backing up into my mouth again. I try and ignore it. I make a few phone calls to friends, I listen to music, but the sensation will not pass. I have been in the lineup for 40 minutes when I begin to approach the last exit before the border. And the sensation is still there. It's decision time. Also hanging in the balance is the knowledge that this is my last chance for making my 5:00 p.m. flight. If I return to the clinic now, I will almost certainly miss my departure. As I creep past the exit I know that I can't take the chance and I reluctantly pull out of line and head back.

Back at the clinic, the last patient is in with Dr. A and the waiting room is empty. It is already just past the OCC's 2 p.m. closing time. While I'm waiting, I ask Claudia's permission to use the clinic's computer to try and find another flight home. Before I can finish doing that, Dr. A is ready for me.

This time the pain of the syringe going in brings a tear to my eyes. For days later I can see a cluster of tiny inflamed red dots where the needles went in. The image on the fluoro is a jumbled mess; there are clustered pools of barium everywhere. Dr. A recommends a significant unfill back to 4.6. I think that 5.0 might be better. We split the difference and he adjusts me to 4.8. What he hints at, and what I realize is true, is that it's all guesswork at this point. The stoma is probably rather inflamed and swollen by the constant barrage of tightening and loosening and it will take some time to return to a normal state.

We all leave the clinic together. The front exit is locked, so we leave through the garage. I drive to the back of the line to the border and it hasn't moved much, but at least I'm now a pro at getting there. It takes a little under 2 hours to cross to the US it keeps me close to the glimmer of actually making my flight. But by the time I return my rental vehicle and take the shuttle to the airport, my flight has already departed.

While I'm waiting 3 hours at the airport for my new flight that will take my home through an absurd series of connections, I decide to have a cup of hot tea with lemon to soothe my insides. Twenty minutes later my mouth is once again awash in liquid. I call my bandster buddy and ask for her recommendation. She recommends that I continue home. If the problem persists until Monday, I can always make another trip down. She tells me that when she is severely restricted she has an ice cold drink and it usually un-restricts her. This is contrary to my sense of logic that tells me that heat soothes, but I'll try anything now.

It's past midnight when I get home and the first thing I do is grab a popsicle from the freezer. Ten minutes later, I feel completely un-restricted and at least able to sleep. In retrospect, I would guess that the hot tea further inflamed the already senstive lining of the stoma and the swelling closed it entirely. The time lapse, further assisted by the cold of the popsicle, eased the inflammation and opened the stoma again.

Dr. A and Dr. M had both recommended that I go on liquids for 5 days - instead of the usual 3 - to allow the stomach to heal. I started immediately upon my return, and sure enough, everything went swimmingly well. I had no need of returning to the clinic the following Monday as I had worried about at the airport.

[NoWorry]

First Fill (Conclusions)

Since my first fill, I have discovered the conditions of sliming (which, it turns out, was what I was experiencing in TJ) and PB'ing, another thoroughly unpleasant experience. I have found that turkey and chicken are the most frequent causes of PB'ing for me while fish and red meat go down fairly easily and smoothly. This is almost the opposite of most of what I've read, but I'm beginning to realize that this procedure is in its infancy and there are simply no absolutes, just a long series of educated guesses.

Clearly the surgery is an exact medical science and OCC has perfected it. As best as I can tell through my research and experience, the procedure of fills and adjustments is much closer to an art than a science. And the results each individual encounters are fairly hit or miss, in spite of the fill doctors' high level of competence and skill.

I have now had the opportunity to test my adjusted band fairly extensively and my early conclusion is that while I have some restriction, I am not at my optimal fill level. I would guess that my optimal fill is 5.0 cc.

The band prevents me from eating too fast, it keeps me from not chewing enough and whenever I eat too soon after drinking a lot of liquids, I can usually count on an incidence of sliming. At a normal meal, I can eat around 2/3rds of my pre-banding capacity, which is significantly less than my goal of 1/3rd, but still a definite improvement. More importantly, I am far more aware of my eating habits and patterns, more than on any recent diet, and this is contributing towards slow but continuous weight loss. I am afraid of what will happen once the novelty and attention wear off.

In an ideal world, I would head back to TJ for another adjustment sooner than later, but I must first get around a fairly busy schedule over the next 4-6 weeks and also justify the cumulative expense for what feels like a relatively tiny adjustment. And I am a little fearful of repeating my past experience.

I have mixed feelings about the repeated attempts at fine tuning my first fill, since it got me a lot closer to optimal than the first attempt. I am certain that I would be extremely unhappy if I had returned with 4.0 cc, since it provided no restriction at all. But I wonder if I wouldn

[FurEllie]

I was overfilled my first time - 1.5cc and w/in two days I couldn't keep water down. Oddly, the first day, I actually ate a lunch. I went back a week later and now have .8cc I've had that for 2 months now? What I can tell you is that some days, it's a perfect restriction, other days I can eat like a pig, and other days I PB. One day I can eat 5 shrimp, 2 days later even one will come back up.

I think the body is much too complex to be able for a "one size fits all" situation.

They are opening a Fill Center place near to me HOPEFULLY in the next 2 weeks. I'm going to give them a chance and get an additional .2cc put in knowing it won't take 2 days and a $1K+ to get it removed if it's too much

[Cat]

First Fill (Part I)

I fly back to San Diego on June 23rd for my first fill. This time I'm taking care of my own travel and logistics and I'm pleased that things run very smoothly. I fly in, pick up my rental and drive to the border. I park at the first parking lot I find and it's $9 for the day. (On my way back I discover a parking lot near the USA exit which is $4 and make a mental note for the next time - turn left after the freeway exit to the parking area.)

I walk across the border without incident. I have plenty of time and since I haven't done my treadmill today, I decide to walk. My walking instructions to the clinic are vague at best, but I'm armed with a map of Tijuana that is a bit of help. The key is to stay to my right after I cross over and pass the taxi stand. In the distance I can see an arch similar to the St. Louis arch and I remember seeing it on my last trip to Revolution Ave and it makes an excellent visual landmark to get me over the bridge across the sewage canal.

I need to consult my map a number of times before I stumble onto the only visual reference that I have - the Costco store. From there, finding the clinic is a breeze. I arrive at OCC almost exactly on time, but a little sweaty from the walk in the hot sun.

Only minutes after filling the paperwork and forking over my $100 fee, Dr. Romero comes out to escort me to the fill room. It is supposed to be Dr. Acosta's turn in the rotation to do fills this week, but I have requested that Dr. Romero do it, since - with over 6000 fills - he has far more experience.

Dr. Martinez comes in for a brief examination. He looks over the scars and tells me that they are healing well. The swelling around the main incision is still a little pronounced, but only about half the size it was the day after surgery and he tells me that it will be gone in another month or two.

After Dr. M leaves, Dr. R makes me comfortable on the bed, and turns on the fluorscope. The image is grey and muddy and I can't make out a thing. Dr. R points out my pouch, the band and my stomach, but it's all a visual blur to my eyes. He hands me a styrofoam cup of barium and I sip it through a straw. He points out the barium going down on the monitor but I can still barely make it out.

He locates the port, and injects the needle into my stomach. It's a brief sting, only mildly painful and then another slight sensation as he inserts the needle into the port. He drapes the needle with a piece of gauze so that I can't see the needle where it enters my skin and then adjusts the bed to a semi-reclining position. The long syringe wavew wildly with every movement.

While Dr. R is flushing the air from my band, I feel a very unpleasant sensation of gas building in my chest, most likely from sipping the barium through the straw. Now comes into play the one problem I've been dreading - I've never learned to burp. I can feel the gas uncomfortably bloating my esophagus, but I can't get it out. My situation might not be as unique as I think it is, because Dr. R takes it in stride.

He injects saline into my band and closes it off my stoma completely. He hands me a bottle of water and instructs me to drink a few sips rapidly. The congestion in my chest is extremely uncomfortable now. Dr. R nods approvingly and eases off the band and settles on a 4 cc fill. He removes the syringe, wipes the disinfectant off my stomach and I am done. The entire procedure has taken around 15 minutes and much later I wonder if Dr. R rushed a little since it was not his turn on the rotation. But I have no way of knowing. What I do observe later is that Dr. Acosta never takes less than 30 minutes with each patient, but that might be explained by levels of experience. Still, I have a nagging feeling that I shouldn't have asked for Dr. R.

I am supposed to stay on liquids for three days, but I'm not heading back until I know that the band is working. I head over to the restaurant around the corner and order lunch. Some fish, rice and salad. But the discomfort of the gas in my chest is so pronounced that I can't feel anything else. I eat about a third of my lunch and I think I feel full, but I really can't tell where the sensation of gas ends and the feeling of fullness begins. I reluctantly accept that I have to assume that all is well and I walk back to the border.

The lineup at US Immigration seems very long. There is a young man in the line directly in front of me and he tells me that it only looks bad, and we should be through in about 30 minutes. It's closer to 50, but I'm in no rush and the time passes uneventfully. Immigration waves me through and I am back in the US only a little more than 2 hours after I left.

It's a bit of a maze on the US side and I need to walk around a little before I get my bearings and find the parking lot where I parked my car. I pay the fee and hit the highway back to San Diego.

At Dr. Martinez's suggestion - made at the time of my surgery - I'm staying overnight in the area so that I can test out my fill and be close to the clinic if any adjustments are needed. I'm booked at the Holiday Inn and it's pleasant enough. My room is on the 10th floor with a lovely view of the ocean. I unpack, make a few phone calls and decide to take a nap. When I wake up, thankfully the discomfort from the gas is almost gone. I had originally planned to spend the evening exploring the city, but I'm simply not in the mood and a part of me wishes that I hadn't scheduled an overnight stay.

That evening, I stock up on protein drinks for the next day, but then decide to test out my fill. I'm looking for something soft and mushy that doesn't require a lot of chewing, but substantial enough to be restricted by the band. I settle on a chicken and rice bowl at El Pollo Loco. It has been recommended that I eat the meal in private in the event of any unexpected results so I carry the meal back to my hotel room.

I start on the bowl, eating slowly and methodically, chewing my food well before swallowing. I keep waiting for this feeling of 'restriction' I've heard so much about but have never yet experienced and it never comes. I finish the entire bowl and have discerned no feeling different from before. Fearful of just such an event, I have also ordered a few extras but my chicken quesadilla and then a pollo taco carbonara also go down without any fuss. This is pretty much what I used to have for dinner before being banded and on some level I'm simply destroyed that, after two months of anticipation, I'm back at square one.

[NoWorry]

They are opening a Fill Center place near to me HOPEFULLY in the next 2 weeks. I'm going to give them a chance and get an additional .2cc put in knowing it won't take 2 days and a $1K+ to get it removed if it's too much

A fill center has just opened 15 mins away from me. The doctor does not use fluoroscopy but I'm not sure that it makes that much difference. $300 on first visit, $155 each thereafter. I'm headed to TJ for my second fill tomorrow. If my results are not satisfactory, I'm leaning towards giving the local guy a try.

[FurEllie]

A fill center has just opened 15 mins away from me. The doctor does not use fluoroscopy but I'm not sure that it makes that much difference. $300 on first visit, $155 each thereafter. I'm headed to TJ for my second fill tomorrow. If my results are not satisfactory, I'm leaning towards giving the local guy a try.

TBH, from what I've heard/read, the experience in TJ is far better than the Fill Centers. I've already read one complaint and one compliment on the center here near me. I'll give it a try though. Good luck with yours

[NoWorry]

TBH, from what I've heard/read, the experience in TJ is far better than the Fill Centers. I've already read one complaint and one compliment on the center here near me. I'll give it a try though. Good luck with yours

Thanks. The last thing Romero said to me as I was leaving after my last fill was "See you in six weeks." If that's the norm (and I am now almost convinced that it is - this is the one dirty little secret about banding), and it takes a full day for a fill at OCC plus a $375 price tag all-in, it only makes sense to check out the local guy where a fill should take less than an hour and cost a lot less. So it might take an extra poke or two with the needle. I think it's a small trade off.

[GregNE]

Thanks. The last thing Romero said to me as I was leaving after my last fill was "See you in six weeks." If that's the norm (and I am now almost convinced that it is - this is the one dirty little secret about banding), and it takes a full day for a fill at OCC plus a $375 price tag all-in, it only makes sense to check out the local guy where a fill should take less than an hour and cost a lot less. So it might take an extra poke or two with the needle. I think it's a small trade off.

Multiple fills are indeed the norm for the VG band. The 4.0 cc bands generally require less fills. Of course there are always exceptions for both bands. Fortunately, I knew about the need for frequent fills prior to surgery.

I am extremely reluctant to even consider a fill from anywhere other than the OCC. Although I have no personal experience, the 'lost fluid syndrome' worries me. Many fill reports from the USA talk about bands leaking. It has almost become a normal expectation to some bandsters. However it is not normal. According to Dr. Romero, the bands are very unlikely to leak, and the loss of fluid is due mostly to incorrect port needle insertion or withdrawl.

And the stats correlate this. I have seen very few (if any) reports of fluid loss from OCC fills, but many from other fill providers. Dealing with fill frustration is something I can live with; worrying about incorrect fill technique is something I do not want to deal with. Not that all other fill providers are bad-- but many are.

Just my opinion.

[PAMMIE]

Multiple fills are indeed the norm for the VG band.

I HAVEN'T SEEN ANYTHING TO THE CONTRARY. I DON'T KNOW WHY NO WORRY THOUGHT OTHER WISE. aka dirty little secret

THE BAND IS A TOOL, NOT A MIRACLE WORKER

[GregNE]

I HAVEN'T SEEN ANYTHING TO THE CONTRARY. I DON'T KNOW WHY NO WORRY THOUGHT OTHER WISE. aka dirty little secret

THE BAND IS A TOOL, NOT A MIRACLE WORKER

I do not disagree with NoWorry's position that he was not informed about the need for regular fills. He read Dr. Ortiz' book (I never have) prior to being banded. He also used information published on the OCC website.

He is absolutely correct in his observation that the need for 4-5+ fills for a VG band is not discussed. And my understanding is that in the Ortiz book, it is stated 1/3 of people get restriction with no fill, 1/3 with 1 fill, and 1/3 after 2 fills. That may be the norm with the smaller bands, but not with the VG band.

I can understand the source of his frustration.

[PAMMIE]

WHEN I WAS IN MY RESEARCH STAGE, ALLERGAN AND INAMED, MAKER OF THE BANDS THE OCC USES, EMAILED ME THIS BOOKLET:

http://www.allerganandinamed.com/pdf/healt...atient_Book.pdf

Page 6: The band is adjustable

Normally, you don

[RogerF]

I have read the book, and I know it came out before the VG band did and there still isn't much info out there on it. In the past those who would have benefitted from the VG still got the shorter band. So if you think about it, they actually got squeezed down an extra inch at the time of surgery, so of course they're tighter to start off. They simply had more natural restriction, and would be included in the statistics across the board. NO lies, just the info available at the time. With the addition of the VG comes safer placement with the longer length, but the greater capacity makes it more difficult to find a good level, but really its better for those who need it in the long run.

MY OPINION - I still think Greg's right about OCC doing a better job on fills. There is 3.5cc's of air in the unfilled VG band and port (only 1 in the regular). You shouldn't really count the first amount it takes to replace the air. I've been to two different fill places locally and they just seem to push in the saline. Restriction right away is from the fill and air. But the air works its way out under pressure and you're left with a looser fill untill all of the air is displaced, which may take a couple of fills. I thought for sure I had a leak, but when I went back to OCC (for my 4th fill and thinking the worst) everything finally came together and held. I think OCC understands this and does a better job of working the air out at the beginning so there isn't as much drop off. But it's difficult to get it all at once, and your anatomy and weight loss dictate the rest. My band currently "reads" 6.2, but I've had an even 10cc's pushed in. I've also felt a need for a fill about every 20 lbs lost.

NoWorry, I really have appreciated your posts and the details you have provided. I found most of the events pretty much right on to my experiences. I think its good for all to know and understand what to expect, and yes, communication could be better. But it comes down to each persons perceptions and expectations.

I think after a couple of fills now, it woudl be very reasonable to try a local. Once your band has settled and you're comfortable with the process it can't hurt to give them a try for minor adjustments in the future. I still think your ahead of the game and it will work.

Best wishes in your journey,

Roger F

[NoWorry]

First, congratulations on accomplishing your goal, Roger. It's stories like yours that keep me motivated.

NO lies, just the info available at the time. With the addition of the VG comes safer placement with the longer length, but the greater capacity makes it more difficult to find a good level, but really its better for those who need it in the long run.

We are in complete agreement. However, my reference to the lies was the failure to update information as it has become available. A website is a dynamic tool and the absence of current information on it is a lie of omission, IMO. And it's dirty because the omission directly benefits the source of the inaccurate/outdated information.

I'm also not convinced that I needed a VG band in the first place. I'm not disputing it, because I don't have enough information to do so. However, I am using the following information as a basis for my inference: many patients with my BMI have been given the regular band; the VG band takes far less time to install; I have heard from a very reliable source that Ortiz desires to increase his clinic's ability to process 10 patients a day instead of the current 5 or 6. I do not believe that it's a big jump in logic to assume that the VG will become the default band of choice, if that is not already the case. Ortiz alludes to it in the Q&A section of his book, while not quite clarifying whether OCC itself has taken that position.

I think its good for all to know and understand what to expect, and yes, communication could be better. But it comes down to each persons perceptions and expectations.

I think those two statements are interdependent. Since each person's perceptions and expectations are usually generated by the information received, the poor communication itself is the likely cause of most incorrect perceptions and expectations. And since I lack Pammie's apparent ability to conclude from Inamed's brochure that multiple fills are needed in the months following surgery ('may' and 'more than one' are vague and highly misleading, IMO), I don't believe I had the information to develop accurate expectations.

Since I have that information now, it's clearly incumbent on me to adjust my expectations accordingly. And I believe I'm doing that. But I sure don't have to like it! And if I care for my fellow and future bandsters, I think it obligates me to share and proliferate the knowledge.

I think after a couple of fills now, it woudl be very reasonable to try a local. Once your band has settled and you're comfortable with the process it can't hurt to give them a try for minor adjustments in the future. I still think your ahead of the game and it will work.

Yes, thank you. That's my thinking exactly. I have no feedback on my local doctor, and while many bandsters have reported poor results from their local fill doctors, a significant number have also reported satisfaction. And it's not like I'm burning any bridges. If the local guy is not satisfactory, I can always trot down to OCC again.

Question for you, Roger. I have the clear impression that you set definable goals for your weight loss journey. Did you also set timelines for your goals?

Could you quantify the steps you took that lead to your success?

[LoriBecky]

I would like to know where you got the information that the VG band is quicker to place. I've watched multiple surgeries at OCC and the VG band didn't seem to take any less time than the standard band. I'm curious now and will forward your post to Dr. O for comment.

You're correct that the placement of the VG band has to do with a persons BMI but it also has to do with a persons anatomy and their height. A man is much more likely to get a VG band and a woman over 5'10" is also more likely to get a VG band. Since you are about 6' tall, I'm sure that was one of the determing factors in the band that was chosen for you.

I'll let you know what I hear back from Dr. O about the "quicker placement so more surgeries can be squeezed in" theory

[NoWorry]

I would like to know where you got the information that the VG band is quicker to place.

Let me put it another way. It is my understanding that the "regular" smaller band takes longer to place in patients with a higher BMI because it can, and usually does, involve the removal of fat deposits around the stoma area and requires a certain degree of time-consuming finesse by the surgeon. I know a patient - male, 5' 9" with a BMI of 44 - who was given a regular band at a local US hospital in May. The surgery took approximately 15 minutes longer than average for the reasons stated above. I don't believe that my conclusions based on that information are unreasonable, but I definitely welcome Dr. O's comments.

Not coincidentally, IMO, my friend was restricted immediately upon release, has received only a single fill of .8 cc and has seen a weight loss of 65 lbs in three months.

Perhaps you could also get Dr. O to comment on the average number of fills necessary to optimize a patient with a VG band, which is the bigger question here. I'm certain that many patients in this group would greatly appreciate an informed response. I definitely will.