The First Four Weeks After LAP-BAND Surgery

We generally start to add saline to the band atthe adjustments is to achieve the feeling of
about 4 weeks after placement. During the first 4satiety, of non-hunger, of disinterest in food.
weeks you are not going to be feeling veryWhatever volume of fluid is needed to achieve
hungry and you will be losing weight. In particular,this is the correct volume. Increasing the volume
it is usual for you to feel no hunger or interest onbeyond is likely to harm, not help. You will be in
food during the first week and most of thewhat we call the "red zone". Too much fluid and
weight loss occurs at that time. During the nextthat is where you will be.
three weeks the feeling of hunger and interest inIn the LAP-BAND world on the Internet, in the
food returns and the weight loss slows or stops.discussions across Web sites, there has built up a
Remember that feeling of lack of hunger and lackconcept of "the fill" as if this is the be-all and
of interest in food during the first week. That isend-all. It is not correct. Correct adjustment is so
the sense of satiety that we are seeking tomuch more than going to a "fill center" and getting
reproduce. We will be looking to return you toa "fill." It is a real clinical consultation. It involves
that state of satiety by adjusting the band. If yousitting down with someone knowledgeable and
remember it well, you can guide us. You can sayexperienced, usually a physician or a news
if you are not back to that point or alternativelypractitioner, talking about your eating pattern,
you can recognize that you have returned to thetalking about any difficulties, reviewing for
same level of satiety as in the first week.symptoms that something might not be right,
Typically, by the end of that 4-week period, youlooking at the weight loss, giving advice regarding
will notice that you are eating too easily, you caneating, exercise and activity and, after all that,
eat larger amounts of food than you thought youmaybe making an adjustment. The adjustment is
should be eating and you may be getting hungrya part of the clinical consultation; it is not a
between meals. This is normal. These are theprocedure independent of clinical assessment.
signals that you need fluid added. We will start thisWith the addition of fluid we are looking to
at 4 weeks. The amount of fluid we add dependsachieve two effects-satiety of the feeling of not
upon a number of factors and is really a medicalbeing hungry even when you haven't been eating,
decision. It will depend on the type of band youand satiation, the feeling of being satisfies after
have, the amount of hunger or satiety you haveeating. The effectiveness of the band will vary
experienced during the four weeks, the weightdepending on whether we are near the optimal
loss that has occurred and the approach to thesetting for the band or not. Whether you feel a
adjustment used. Normally, for the 9.75 cm andsense of satiety and satiated helps us know if we
the 10 cm LAP-BAND VG series we will add 1.5need to add more fluid at each visit or whether
mL. For the LAP-BAND AP series we will confirmwe are near to the optimal setting for the band
that the baseline amount of 3 mL is present andor not. Whether you feel a sense of satiety and
then add between 1.0 mL and 1.5 mL to give asatiated helps us know if we need to add more
total volume of 4.0-4.5 mL.fluid at each visit or whether we are close to the
It is worthwhile being aware of the approximateoptimal setting. It is very important that you
amount of fluid in the band but please do notunderstand these effects. If you do, you are able
focus on this too much. There is nothing magicalto work with the band to get the best result and
about any particular volume and there is noyou can guide us in achieving a correct balance
reason to believe that the volume your friend hasfor you.
is any better than what you have. The key to