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So, you have your first band adjustment coming up soon…. You may be feeling a mixture of anxious, excited or nervous. Let me reassure you this is completely normal!
So, after your surgery you would have completed your post op diet consisting of a period on fluids, soft and now happily established back on your textures…. Taking it nice and slow and steady applying your 20+ rule: no bigger than a 20p size food amount on your fork, chew at least 20 times, wait for 20 seconds before putting the next forkful in your mouth and watching the time and not eating past the 20 allocated minutes.
As long as you are managing textured/ solid food with no problems at all then it’s only at this point that you can be assessed and considered ready for more fluid in your band dependant on dietetic / nurse assessment
Most bands come in 2 sizes which will be determined by your surgeon at the time of surgery. Some surgeons add fluid to the band during surgery (primed)…. this can differ from surgeon to surgeon and patient to patient. This will be documented on your surgical notes for your nurse/dietitian to see.
Before your adjustment: There is no preparation to be done as such on the day, but we advise you not to eat or drink for around an hour beforehand just as a precaution. This ensures your stomach and band site are nice and rested prior to your fill. You should take a bottle of water with you to ensure this is tolerated and flows freely before you leave the clinic. During Covid restriction times you should also take a face mask with you ready for entry into the clinic
During your adjustment, your nurse/dietitian will more often do a fluid check to see what is in your band at the same time as adding the additional saline. (This really isn’t a big deal and is helpful for your filler to know this information) - sometimes “no free fluid” can be documented but you can occasionally find a couple of mls in there and this can alter the amount of fluids that is added. The fluid checks are an approximation as it is not always possible to fully aspirated every single drop out the band, but this will give you a decent calculation and starting point
How is the band filled?
It is a simple, sharp scratch needle procedure, taking no time at all…so please try not to worry... Most people just need to get the first fill out the way and can relax about this going forward. If you have been given a box following your surgery, you maybe a little horrified by the spare needle that is lurking inside it…eeek…!!! Honestly the needles in the clinics are so much smaller and thinner, this is just a generic needle provided to everyone by the manufacturer in case you have to access services outside of your providers clinics. To protect your port from damage and harm a special non coring needle is required.
Your clinician will assess your stomach with their fingers/hands to locate the port prior to inserting the needle. The saline solution will then we injected into the port and a plaster will be applied if needed.
After your adjustment: prior to you leaving clinic you will be asked to make sure that you are tolerating fluids well (hence the water bottle) Sip this nice and slowly and observe for any central chest discomfort, funny feelings in your throat, any strange noises or the feeling of regurgitation. Should any of these occur you need to discuss this with your clinician before you leave the clinic. If needed some of the added fluids can be removed if your band appears too tight following the adjustment.
You will be advised before you leave regarding the post fill diet you will need to follow over the next few days. This generally is 1-2 days fluids, 1-2 mash/soft then slowly progress back onto your textures. Some nurses/dietitians may advise you differently and it is usually longer if you have had a fluid check. Also, if you are sensitive to fills you may find that you alter this slightly yourself to accommodate any swelling around the band that you may be experiencing.
After your adjustment you may have a dietitian call planned in a few weeks to reassess your portions and hunger following your fill. They can then advise you if they feel you are ready for more fluid in your band. Adding fluid into your band shouldn’t be rushed! This needs to be done slow and steady in a well-managed way. Don’t forget eating habits of a lifetime just don’t disappear overnight and will need compliancy and dedication from you to make the changes required to be able to manage your band as it becomes tighter. If you don’t have a diet call planned, you might want to call your provider and book this call in however if your fills are done by a dietitian and not a nurse then the dietary advice and adjustment are done together so usually no need for calls
It really is exciting times and there will be definitely some similarities in everyone’s journey, so it is good to share your experiences. But remember not all journeys will be the same so if you have any concerns please do speak with your provider.
What should you feel after your fill?
You may have a little stinging sensation, you may develop a little bruise around the contact site or feel a little tender, but things should settle relatively quickly. If your port was difficult to access it might feel a little more tender but again this should settle fine
Once back on your textures you may, or may not, feel any difference in regard to eating, portion sizes and hunger. It can take a few fills to get the band working so try not to worry, and maybe even around 4-6 to start to get into the optimal zone. So, listen to your clinician, take on board what they advise and think positively…. Good things will happen and remember the band can only handle a small amount of fluid at a time which is why the fills are done in several stages.
There is nothing better than a band that is giving control but whilst you’re in the early adjustment phase the band may not yet be helping you much. This is why you need to be mindful of eating healthily and exercising regularly to continue on your weight loss mission. Weight loss can be variable during the first few months following surgery and it can even start to go back up again in some cases so the more you work on your diet and exercise the better your results will be!
And finally best of luck with everything - you’ve got this!! xx