How to tell it is time for a fill

I had the band done in May 2011 and I have had 2 fills since. I find I can eat more than I think I should and within 2 hours I feel hungry again. I do not want to be eating all day long but it seems like I get hungry too quickly. I stick to a high protien low carb diet with many fresh fruits and veggies. After reading some of the posts and seeing things people can't I eat that I can I am questioning if I could need another fill. The only foods that bother me are steak because it is too difficult to chew enough and carrots for the same unless they are cut very small. Any suggestions? I also have hit a plateau in weight loss at about 50 lbs. I feel so much better than I did before but I am becoming frustrated because I was losing steadily about 1-2 lbs a wekk and I have hit a brick wall.

Thanks for your help.
Amy

I'm big on writing things down.  I measure 1 cup of food and eat it.  IF I get hungry before the  4 hours mark, I know I am ready for a fill.  I may not feel satiated with the 1 cup, but I force myself to stick to it, so that I know I have a constant to gauge my hunger by.  This is a question my doctor asks each time, "how long between meals are you satiated."

I cannot eat dry chicken breast, raw or cooked brocolli or cooked carrots (I can eat raw)  Everything else I can eat.  I can eat bread of any kind if I take my time to chew well and eat slowly.

The most successful banders are the ones who keep up with their fills.  By going to see your doctor, you're also finding the encouragement and education you need from them.

Lastly, I don't see it as what I can and can't eat that determines my time for a fill, I see it - "how long between hunger pains.... "

I think if you are eating the amount of food your doc said to and get hungry soon less then 3 O\or 4 hours it is time for a fill. Just this past week I started getting hungry about every 2 hours.

I think it's time for a fill.  I think that's the most challenging part of this surgery is staying on top of that - when you get a little looser it is sooo nice to relax a little and be a little less concious of how you're eating (not what you're eating) - but I find when I can start chugging water and sit down and eat dinner - no matter how small the porition pretty quickly - that means it's time for a fill.  Anymore my fills are tiny like .25ccs -- and that get's me right back where I need to be.

Hi ,
I bookmarked this guideline and it really is good infomation.  Hope it helps


http://www.obesityhelp.com/forums/LapBand/4137018/When-do-I- need-more-fill-Education-document-re-post/#33781943

When do I need another fill?

First, let’s review what a GOOD fill is, and then we can discuss when another fill might be needed.


These are the things that together  help tell you that you have a good fill:

1.You are losing about 1-2 # a week or more, averaged over a month’s time or longer. Don’t panic if you have not lost weight for only a couple weeks – our weight loss will never be steady or predictable. The body needs regular rest periods to “compact". Still, try to never go beyond 4 weeks without losing – ask for help. 
2.You find your hunger is dimmed, and you don’t get very hungry between meals. This is assuming you are eating good band foods and following the eating guidelines like no fluids for an hour after eating. 
3.You aren’t thinking about food all the time. 
4.You are having no reflux and are only rarely having PB’s or getting “stuck,." Or having other problems.
5.You’re able to get the minimal calories in  -at least 1200-1500 a day, for women, and at least 1800 or so for normally-active men. Those starting heavier, or doing better than average exercise need more calories and more protein. Most docs now want everyone to have 90-100 gm a day of ptotein , to preserve muscle mass. 
6.We can eat  at least 2 small meals , and ideally 3, of solid protein and good carbs a day. (Some people are too tight to eat solids in the morning, and this is another issue to  cover another time)
7.You’re meeting the nutrition goals – the protein, fiber, calcium, omega oils, good carbs, etc. 



So, OK,  how do I know when I might need another fill??

1.Your weight loss has stopped for 3-4 week or more weeks IN A ROW, and you KNOW you’ve been doing pretty well with food choices, liquids, exercise, and the other things. . 
2.You are getting honestly  hungry again between meals and thinking about food a lot
3.You ARE NOT  having any regular  trouble with the last  fill. 
4.You find you can eat a lot more than you could before, even of good band foods. 
5.You’re honestly not satisfied with 1-1.5 cup meals – but  this only applies if you are choosing good BAND FOODS for that meal. 
6.It’s been at least a month since your last fill, and really see no improvement in food quantities or less between-meal hunger’. 
7.You are not relying on protein drinks, any other liquid calories, or soft foods  to get enough nutrition.


Before I go for another fill, what else should I check, to be sure?

1.I’m still eating pretty well – protein and veggies, mostly. 
2.I’m still getting about the same amount of exercise
3.I’m doing pretty well with getting fluid in
4.There really haven’t been any big changes in my life that are producing extra stress
5.I know the difference between “Head and Heart" hunger and real, physiological hunger. 



Why not just always go for more fill?

It’s always best to have as small a fill as you can have to still lose well. Fewer problems occur with smaller fills, but – still – you need ENOUGH to do well. It can be a fine line, so you have to be patient and flexible sometimes. WE should never run for more fill the second our loss slows or stops. 

Be sure you’re getting regular fluoros. Sometimes, if we find we can eat more and more and more, when we have had a fill that was TOO tight before, we might have a pouch dilation. This requires an UNFILL for safety. It would be dangerous to get still more fill if we have a pouch dilation.  A dilation can be seen only with a fluoro exam. 

These are signs of having TOO MUCH FILL:

1.ANY persistent reflux, especially at night
2.Any new or worsening asthma, new ear infections, new dental problems especially in the lower back teeth – these are all the subtle signs of reflux. , 
3. Unable to eat at least 2, and preferably 3, meals a day of mostly solid protein.
4. Depending on liquid calories, protein drinks, or soft foods to get in needed calories and nutrition. 
                
5. ANY regular trouble with sliming, pb’ing, barfing.  
6. Any persistent pain in the chest, a lump in the throat, persistent left shoulder pain (only after we have started with fills, not in the post-op period) 

Please never try to keep a “too-tight" fill –that is the biggest reason people have slips, erosions, and other very serious band problems. 



Sandy Richards, BSN, MN
Patient Educator 
updated August, 2009

 

The 3 question my surgeon asks to determine whether or not you need a fill are:

1.  Can you eat more than 1 c of food per sitting?
2.  Has your WL stalled?
3.  Are you hungry between meals (less than 4 hours between)?

If you can answer yes to 2 or more then you probably could use a fill.  At this point even a .5 or .25 can make a difference to your level of restriction and help you jump start your WL. 

Best~
Lisa O.