Increase your chances for a good fill

[Dolittle]

Increase Your Chances for a Good Fill

The following suggestions are good rules of thumb and will greatly increase your chances of getting a good fill.

1. Make sure you are very well hydrated when you come in for your fill appointment. That means at least 6 to 8 full glasses of liquid every day for at least several days before the fill.

(Remember, water is your friend).

Drink especially well the morning of the fill. If you're flying in, it can be much harder to stay hydrated, so take an empty drink bottle and fill it after you pass airport security. TSA rules state you can bring an empty water bottle past the TSA security check point. Ask the flight attendants for a refill of your water bottle if needed. They say that every hour you’re in the air, you lose 8oz of fluid. So, If your flight is 3 hours long, your down 24oz of fluid. So drink up!

2. Do not to have any solid foods for at least 6 hours before the fill. Don't eat a huge or late dinner the night before. If you're having any trouble (reflux, possible slip, etc) please have nothing but fluids after dinner the night before.

In some cases, food can still be in the pouch for 12 or more hours.

Any food in the pouch will make it impossible to give a good fill, or get a good fluoro.

3. Don't drink cold fluids for an hour before the fill. That will shrink your stomach and give a false fluoro reading, and a poor fill. Room temp fluids are fine.

4. Avoid getting a fill during a menstrual period or a few days before an expected one. During this time, girls are usually retaining water, and the fluoro will not be as accurate, and the fill will not be either.

5. If at all possible, hang around for at least a few hours after a fill. Don't run right back home or to the plane. It takes the normal swelling after a fill 1-2 hours to develop, and by that time you might be too tight and need to come right back.

6. If you fly in, If at all possible, stay overnight and catch a plane out the following late afternoon or evening. If you are too tight, this will allow time to get a small unfill before you leave. This is not very convenient, but sure beats having to possibly return to TJ in a few days, on short notice, in pain, and at high last-minute plane fares! This is "prevention!" Overfills are not common, but they do happen, even under the best of conditions. Be prepared, and think about this overnight stay. Test your fill the next day before you leave.

7. After a fill, please have liquids only for at least 24 hrs. This allows the stomach to rest and heal. Then, a day of soft foods, then back to regular foods. Full liquids are fine, no need for clears. Remember, if you staying over night test your fill before you fly out.

8. Review the eating and food guidelines again before every fill. You’ll need to refine your eating more and more with higher fill levels, and there will be less and less room for goofs. As you reach a higher fill level, you'll no longer be able to "get away" with things you might have before!

9. Please don't get a fill if you are having any trouble with the current level of fill. This means any regular pain, PB or barfing more than maybe once a week at the very most, not able to get enough

calories in, not able to drink enough, able to eat only soft foods or fluids.

More fill will NOT help, and will make things worse. Discuss all this carefully with your doctor. You may even need an UNFILL, to keep your band and stomach safe.

10. First fills are routinely given at 6-10 weeks after surgery, but only as you need them. Many people do, some do not. Your doctor will help you decide if you need a fill, just ask. There is no rush for fills. Too much can very easily get you in trouble, and you end up further "behind" than if you had gone slower with fills.

11. Give a fill at least 2-3 weeks to test it. Some fills don't "settle in" for a week or two, and sometimes more. Your weight loss is what determines how a fill is - not any feeling of restriction, necessarily.

12. One of the most important things in determining if a fill is good is choosing proper band foods. Soft foods, liquids, junk foods, sweets, etc, will never be well-restricted, and will never tell a thing about having a good fill or not. Only solid foods give useful info.

A good test meal is 2-4 oz of solid meat or chicken - be sure it's soft and moist - and about 1/2 cup veggies. You should be able to eat about a cup of food (no less) and this should keep you satisfied for about 3-4 hrs.

13. Plan regular meals. A good fill will keep you satisfied for 3-4 hrs, but no longer. If you are hungry 5 hrs after lunch, it is not because you have an inadequate fill! Regular meals at planned times are important for a number of reasons; including avoiding snacking, maximizing your calorie burn and normalizing metabolism, which is essential for weight maintenance later on.

14. Learn to recognize your "soft stop" sign. Common ones are chest tightness or "fullness", a sudden runny nose, a single hiccup or burp, an eye twitch, back pain, left should pain. All mean the pouch is full enough and we should stop eating, even spitting out the bite that may be already in our mouths. If you do not, you could progress to the "hard stop" - slimming, pb, barfing.

Please remember that good fills are very elusive, even with highly- experienced docs and fill people. There are just too many individual factors involved that the doctors cannot control. Even the fluoro is only a clue, and not entirely accurate - for some of the reasons above.

It usually takes 3- 5 fills to slowly and safely creep up on a good level, and they can be safely given a month apart.

Trying to go faster with a bigger fill is not the solution, and the stomach rebels at big sudden fills. The goal of the first few fills is not to achieve a good restriction, but to gradually get your stomach used to some pressure so you can tolerate a good fill later.

SLOW and GRADUAL is the key!

Going slowly with fills can be frustrating, but is well worth the wait to avoid problems.