THANK YOU NW FILLS!!!

[PAMMIE]

FOR THE LAST 36 HOURS, I HAVEN'T BEEN ABLE TO EAT NOR DRINK A DROP OF ANYTHING. EVEN WATER CAME RIGHT UP. I CALLED NW FILLS AND THEY JUST SO HAPPEN TO BE IN THE GIG HARBOR AREA THIS EVENING GIVING FILLS BUT IN MY CASE, UNFILL. I STILL HAD 2.4 IN THE BAND AFTER A YEAR AND A HALF FROM MY LAST FILL. THEY REMOVED .4 AND I'M IN HEAVEN. ON THE WAY HOME A BOTTLE OF WATER WASN'T A PROBLEM TO GET DOWN AND I FEEL SOOOOOOO MUCH BETTER. THEY SAID THAT I MAY HAVE TO EVEN GO WITH LESS NOW THAT I'M WHERE I WANT TO BE BUT WE'LL SEE.

THEY HAVE SOME REALLY GOOD TIPS ON THEIR WEB SITE I THOUGHT I'D POST HERE AGAIN, THANK YOU LADIES, I COULDN'T BE ANY HAPPIER WITH YOUR SERVICES

http://www.northwestfills.com/education.php

FILL INSTRUCTIONS

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!

EMERGENT/URGENT BAND PROBLEMS

What is the difference between Emergent, Urgent and Normal band problems?

EMERGENT: Harsh vomiting (different than pb’ing), unable to swallow saliva or any fluid. You need to go to the Emergency Room and have them give you an IV to hydrate you. You need to tell them you have a lap band and need to have a fluoroscopy to see if it has slipped or you are closed off due to swelling. You need to take your surgeons phone number with you so they can call and talk to him.

Dehydration: symptoms include dizziness, low blood pressure, disorientation, not able to make decisions appropriately. If someone else thinks you are in need help, you probably are because you are too ill to make that decision. It takes more than 24 hours to become dehydrated.

URGENT: When you have frequent throwing up 3-4 or more times per week, you need to be seen by your fill clinic to get a bit of saline removed. If you have heartburn or reflux, you need to be on over the counter Prilosec twice a day, possibly remove a bit of saline from your band. If you let it go on, you risk slippage of the band. After you have a bit taken out, stay on liquids for 1 week, mushy for 1 week, introduce solids slowly.

If your band slams shut after you have had a fill, you should return to your clinic for a bit of unfill. Don’t let it go on too long, you risk slipping your band and dehydration. This prevents and ER visit.

Normal Problems: You can’t eat solids in the morning. Try drinking something hot. This may open your band up and allow you to eat. If you can’t eat in the mornings, try going on liquids for 3 days, then start eating breakfast, larger lunch, smaller dinner. Sometimes this will reset your eating habits. If you just can’t eat in the morning, but can eat later in the day, go ahead and drink a protein drink in the morning to get your protein in. We normally say no liquid proteins, but once in awhile is ok. The whole process behind the band is to eat our protein in solid form, not liquids.

Pb’ing, yakking, tossing your cookies: Are you eating too fast? Not chewing enough? Taking too big a bite? Swallowing hot things too soon? Maybe you need to coat your meat with BBQ sauce or something to help it go down. Try eating with a baby spoon to make sure you are taking smaller bites.

IF you have the flu: You should be fine, but if you are throwing up too much, some fluid out of you band would help. You can drink flat 7-up, gatoraid, apple juice, whatever, forget the calories, just stay hydrated.

WHEN TO CALL YOUR DOCTOR:

Get an unfill if you can’t swallow your spit.

Get an unfill if you can’t eat regular food.

Gen an unfill if you are having heartburn or reflux.

Call your doctor emergently if you are throwing up blood. You might have a tear or rupture in your esophagus. Be sure to tell them you have a band. They may think you have an abdominal problem. Not all problems are related to the band. Just make sure they have the information anyway.

Go to the ER if you haven’t been able to drink any liquids for 24 hours.

Call your surgeon with any concerns.

DO NOT LIVE WITH THROWING UP FOR MORE THAN A FEW DAYS. THE WEIGHT YOU ARE LOSING IS WATER, NOT FAT!

This is not the way to lose weight. You are depleting yourself of needed vitamins and nutrients your body needs to survive.

THINGS TO DO BEFORE AND AFTER YOU GO TO SURGERY

1. Go on a liver shrinking diet, no matter what your BMI is. It makes the surgery much easier.

2. Take a side and front picture full body.

3. Take your measurements. Neck, both arms at the heaviest, chest, waist, hips, heaviest part of thighs and calves, both legs.

4. Find a fill doctor before you have the surgery.

5. Plan out and budget for 3-7 fills. Once you have your fill doctor, figure out how much you are going to have to spend on fills. Plan on the higher number, hope for the smallest.

6. Practice taking pea sized bites, chew, chew, chew.

7. Practice not drinking with meals. Stop at the first bite, wait 45-60 minutes after the last bite to drink again.

8. Plan what you are going to eat in each stage of the band. Day 1-4, clear liquids. This can include popsicles, jello, clear broth, apple juice, white grape juice, anything you can see through and is liquid in the melted stage.

9. Day 4-10, full liquids. This includes any blended, non thickened soup, thin mashed potatoes, yogurt, cottage cheese, sugar free puddings. Anything you can still drink through a straw. Protein drinks are ok until you start eating real food.

10. Day 11-21, mushy stage, anything you can eat if you had no teeth. Take any food, put it in the blender. You may need to add a little milk, water, juice or broth to thin it a bit.

11. Week 4-real food. Start with your protein. Usually 3-4 oz. Then eat ½ cup of veggies or until you are full.

12. Week 6, you may be ready for your first fill. If you are still losing, try to put it off as long as possible.

13. After you fill, you should stay on liquids for that day, go to mushies the next day. Regular food the next. Give your fill a chance to work. If you stop losing, eat more than you know you should, get another fill.

HOW TO EAT LIKE A BANDSTER

1. Eat small portions: eat just to the point of fullness.

2. Eat slowly: but not for more than 20-25 minutes.

3. Take small bites and chew, chew, chew.

4. Practice mindful eating: at mealtime, sit down and focus on the meal, no TV, no reading. Focus on your food.

5. Limit soft foods: eat dense protein (chicken, fish, beef, etc) at least twice a day.

6. NO DRINKING WITH MEALS and for at least 1 hour afterwards. (you are washing the food through your band and not letting your band work for you)

7. Eat protein first, then veggies, then starch.

8. Eat healthy fresh food and complex carbs. Stay away from the refined sugars.

9. Less than 30% of your calories should come from

10. No liquid calories except 2 glasses of skim milk.

11. Eat 3 small meals per day plus 1 planned low calorie snack. NO GRAZING.

12. Limit calories to no more than 1600 per day. Average is around 1200 per day.

13. Drink 64 oz of water per day.

14. Exercise vigorously at least 3 times per week.

HIGH PROTEIN FOODS

Serving Size

Protein Grams

Serving Size

Protein Grams

Almonds 1c

26

Red Snapper 3oz

39

Barley, Uncooked 1c

16.5

Salami 1oz

6.9

Baked Beans ½c

8.1

Scallops 5-6 Med

39.5

Kidney Beans ½c

7.2

Shrimp 5 Large

15.5

Lima Beans ½c

5.4

Shrimp, Canned 3oz

20.8

Bean Soup 1c

7.6

Baked Ham 3oz

26.3

Corned Beef 3oz

22.9

Boiled Ham 2oz

14.5

Hamburger 3oz

21.8

Lamb Chop, Broiled 4oz

20.2

Roast Beef 3oz

23.3

Lentil Soup 1 Cup

5

Beef Pot Pie

23

Beef Liver, Fried 3oz

13.2

Cottage Cheese 1/2c

13.6

Calf Liver, Fried 3oz

15.1

Fried Chicken ½ Breast

24.7

Lobster 1c

19.5

Chicken Drumstick

12.5

Mac & Cheese 1/2c

8.4

Chicken, Dark 3.5 oz

29.3

Malted Milk 8oz

11.1

Chicken, White 3.5oz

32.3

Whole Milk 1 Cup

8

Chicken Salad ½ c

17.4

Onion Soup 1 Cup

8.1

Oyster Stew 1 Cup

15.8

Pea Soup 1 Cup

13.3

Perch 3 oz

22.5

Egg, Boiled

6.3

Pork Chop 3.5oz

21.4

Egg, Scrambled

7.1

Bakes Sole 3.5oz

30

Baked Flounder 3oz

30.2

Broiled Trout 3 oz

20.3

Water Packed Tuna ½ c

36.4

Turkey, Dark 3.5oz

30

Turkey, White 3.5oz

32.9

Haddock 1 Fillet

16.6

Yogurt ½ c

4.4

[Dontondan]

Pammie,

It was nice to see you this evening, sure wish you could have stayed for the meeting, it was pretty interesting. NW Fills is really great! Glad to hear that you are feeling better now.

Donna

[MamaMichelle]

Pammie-

1st off, I'm glad you're feeling better!! Thanks for posting all the great info, espcially the protien info!

Now a question, what caused the sudden restriction? Did you reecently have a fill that was too tight or did you just become tight all of the sudden out of the blue?

[caro]

Pammie, I am looking for a place in Portland that has Fluoroscopy but have not been sucessful. My daughter lives in Seattle and it would be cheaper to fly up there (Amd less time) then back to TJ so thanks for the information, if I can't find anything closer, this looks good. I'm so glad you're doing better!

Caro

[PAMMIE]

DONNA,

IT WAS SO NICE TO MEET YOU ALSO. NEXT TIME I WILL STAY. I GOT TO LISTEN FOR ABOUT 15 MINUTES AND SHE WAS VERY INSPIRATIONAL. I JUST WANTED TO GET HOME AFTER THE RAIN ALL DAY AND NOT FEELING WELL.

MORNING MS MICHELLE,

THE RESTRICTION JUST CAME OUT OF THE BLUE AND I WAS PRETTY MISERABLE :lb12: . ALL NIGHT I SOUNDED LIKE A GURGLING PLUGGED UP SINK WHEN I OPENED MY MOUTH LOL. THE GALS SAID IT WASN’T UNUSUAL AFTER LOSING THAT AT SOME POINT I’D NEED AN UNFILL.

CARO,

DRIVE ON UP, IT'S NOT THAT FAR. THE HUBBY WORKS FOR THE AIRLINES AND SOMETIMES I CATCH A FLIGHT FROM SEATAC TO PORTLAND IF EVERYTHING FROM SEATTLE IS OVER BOOKED. IT TAKES MORE TIME TO GET THRU SECURITY AND ALL THE HASSLES THEN JUST DRIVING IT. AND, YOU CAN GET A GOOD VISIT IN WITH THE DAUGHTER IF YA COME UP FOR THE WEEKEND

[WAgal]

Wow...the band is such a mystery! I'm on my way within an hour to see the NWfills ladies. I'm going for my 2nd fill there instead of TJ since my schedule will not permit me to travel to TJ right now. Im glad you and Donna think so well of Robin and Kitty. I've heard only such nice things about them from our NW bandsters. Okay.. I'll post how it goes afterwards. Pammie I'm glad you are better and that it was resolved soon enough. I know about the gurgling sounds... I know it so well. I feel like I should see a plumber instead of doctors when I hear that coming from inside my mouth!! LOL! Just lightening the seriousness of the matter. It scares me still to think after you've reached your goal then the band can still just act up out of nowhere?

Blessings,

Hanna:)

[PAMMIE]

Wow...the band is such a mystery! I'm on my way within an hour to see the NWfills ladies. I'm going for my 2nd fill there instead of TJ since my schedule will not permit me to travel to TJ right now. Im glad you and Donna think so well of Robin and Kitty. I've heard only such nice things about them from our NW bandsters. Okay.. I'll post how it goes afterwards. Pammie I'm glad you are better and that it was resolved soon enough. I know about the gurgling sounds... I know it so well. I feel like I should see a plumber instead of doctors when I hear that coming from inside my mouth!! LOL! Just lightening the seriousness of the matter. It scares me still to think after you've reached your goal then the band can still just act up out of nowhere?

Blessings,

Hanna:)

LET US KNOW HOW IS GOES HANNA

[mom12]

Pammie,

Since you have been at this for a while, I have a question. Does the rumbling, noisy stomache ever go away. I am 14 days post op and everytime I lie down it is like a symphony in my lower stomache and intestines.

[PAMMIE]

Pammie,

Since you have been at this for a while, I have a question. Does the rumbling, noisy stomache ever go away. I am 14 days post op and everytime I lie down it is like a symphony in my lower stomache and intestines.

YEAH, YOUR STILL HEALING AND YOUR BODIES GETTING USE TO EATING LESS. ONCE YOU GET BACK ON SOLID FOODS AND GET USE TO SMALL AMOUNTS, IT GETS BETTER

[Bandiva]

These ladies are amazing and so helpful! Thank you!!!!

Victoria

[mlgpdx]

Hanna / Pammie

A fellow bandster had a fill without fluro last week and said it took the fill Dr. like 9 pokes to find her port. She said it was SOOO painful she asked for another shot of liodicain (sp) She now has a huge black/blue bruise.. I was so freaked out by her story I swore I would never get a fill without fluroscopy! BUT NWFills has such rave reviews can you give me a little more feedback and tell me how many pokes till they found the port.. pain.. etc??

thanks guys!

Checking airline prices in june/july they are up to $400 + from PDX to SAN... uh.. not gonna happen so I want to drive to NWFills.

xoxoxo

[Dontondan]

Hanna / Pammie

A fellow bandster had a fill without fluro last week and said it took the fill Dr. like 9 pokes to find her port. She said it was SOOO painful she asked for another shot of liodicain (sp) She now has a huge black/blue bruise.. I was so freaked out by her story I swore I would never get a fill without fluroscopy! BUT NWFills has such rave reviews can you give me a little more feedback and tell me how many pokes till they found the port.. pain.. etc??

thanks guys!

Checking airline prices in june/july they are up to $400 + from PDX to SAN... uh.. not gonna happen so I want to drive to NWFills.

xoxoxo

They are excellent, got me the first time I think, couldn't tell, couldn't feel a thing. They do it a little bit different from OCC. They have you lay down and they had me raise one leg and lift my head at the same time and up pops the port! They told me to do this at home and it will make it easier as the port will come right up. Kitty is so experienced and very gentle and kind, I have a HUGE fear of needles, get panic attacks, hyperventilate and stuff like that. I didn't ever see the needle or feel a thing the entire time. I almost passed out at OCC and spent 20 minutes on the table to get myself together the first time, but the second time I was fine and up and walking right away, sipping on water and doing fine, went to the support meeting right after in Port Orchard. They come there every other month to service people in this area.

It was good, all good! I was one that said I would never have a blind fill, but I have no regrets at all and feel very confident with them.

Donna