Adjustments:

The first 6 weeks after surgery the band will be empty allowing the stomach to heal and the band to adhere firmly to the stomach. Most people lose weight during this phase but some do not.

Adjustments or fills are painless and take just a few minutes. Some people are actually able to make it to their goal weight with no adjustments but they are the exception rather than the rule. Most patients require 3 to 5 adjustments before they are losing weight at an expected pace. Some patients need only one adjustment. Others may need 6.

Each person is individual; what makes this weight loss method so unique is the ability to adjust the band for each one's specific needs

How are the adjustments performed?

In the office, the area on top of the port is cleaned with betadine and then lidocaine is injected into the skin using a small needle to numb the skin. A larger needle is then placed through the skin and into the port. Fluid is then injected at amounts decided on by the surgeon.

How Do I Know If I Need An Adjustment?

Your weight loss should average 1-2 pounds a week. We all want immediate results now but banding doesn't work that way. Graph out your weight loss so you can actually chart your weight on a weekly basis. Do not weigh more than once a week, you are not going to let the numbers on a scale determine your mood for the day or week. Remember they are just numbers, guidelines of how you are doing but not definitive of success as we all have equally important NSV (non-scale victories) too. If you are following the rules outlined below and still are feeling very hungry or not losing weight, perhaps it is time to consider an adjustment.

Are you drinking a minimum of 70 ounces (2 liters) of water per day?

Actually the recommendation is to take your body weight, divide in half and that is how many ounces of water you need to drink per day to keep your cells flushed and everything in working order. It is hard but worth trying to use a water bottle with measurements on the side so that one can keep a track.

Remember to stop drinking liquids 30 minutes prior to a meal and no drinking during the meal!

You want food to fill your newly formed pouch and give you a satiated feeling. Drinking during meals can wash food through the stoma enabling you to eat more than you would if you did not drink while eating.

Are you engaging in some type of physical activity on a daily basis?

It is better to avoid the word “ exercise” because that happens in gym. So raking your yard, walking your dog, weeding the garden all count as do parking farther from the store and taking the steps instead of the escalator. Many of fat people have discovered Yoga; it helps to redefine physical space as one loses weight, which is an essential piece of reclaiming your bodies. Swimming is also a great form of physical activity for those with joint problems, and it is something one can do with children or families. Exercise is cumulative and it all adds up so every little bit counts!

Are you eating 60 grams of protein per day?

60 grams is not so much really. It is 3 ounces servings each meal. Figure your protein at 7 grams per ounce and so 3 ounces of chicken is 21 grams. Once you get the hang of it you become a pro at mentally tallying where you are at for the day. Remember that body can only absorb about 20 grams at a time so don't over do it. But protein is an essential building block for tissues and cells and protein helps turn off hunger and carbohydrates seem to turn it on. If you need additional help you might try www.fitday.com. to help you learn to track where you are. And again, don't worry if you are over or under, just make the adjustments. Letting go of food as a friend is not an easy thing to do but it has not been a good friend. It has betrayed by making you fat and unhealthy long term and only temporarily satisfies you. Sort of like a bad lover.

Are you staying away from liquid calories?

Cut the slush and mush once you are 4 weeks past surgery, it just goes down way too easy compared to 3 ounces of fish and some broccoli. Are you eating protein and produce and leaving out fast foods and junk? We all have bad days, forgive yourself and just move on, no more guilt. It is possible to eat on the road and have healthful meals, instead of a fast food try a grocery store deli.” I had five cocktail shrimp for lunch this week from the grocery store deli and they were healthful, high protein, low fat and I could eat them while I drive (one of my worst habits)”.

Rules for Adjustments

1. Do not eat 5-6 hours before an adjustment; the whole process is more visible on an empty stomach. 2. We prefer fills in the middle of the day as most of us are naturally tight in the morning and loose at night so middle of the day is a good average picture of general restriction. 3. Don't ever let anyone attempt to unsuccessfully access your port more than 3 times! It is the good old three prick rule, if they can't find it in three needle sticks save yourself the frustration of a possible tubing puncture or port damage by leaving - quickly! 4. A single serving size cup of applesauce sometimes gives a better picture of restriction than water because of the viscosity of applesauce. 5. After a fill baby your stomach for 24 hours or more by going back to a soft food diet. Right after a fill is not a good time to push the envelope and see how much you really can eat!

Be patient, sometimes is takes a week or so after a fill to feel full restriction. Conversely, some people have edema right after a fill and they may feel overly restricted the first several days. It pays to learn the subtle nuances of your particular physiology and then respect your body by not abusing it after a fill! Remember the amount of fill that each individual can tolerate without side effects is very different but it is a finite number. Keeping this in mind don't always expect your band to be the food police, we must each learn to identify our new feeling of full and respect feeling that by not overeating. Banding should not be enforced bulimia!

No matter how much fluid you have in your band there are only three kinds of fills, too little, too much and just right, the actual number of cc's is totally irrelevant. Via: www.obesitysurgeries.com