Frequently Asked Questions

SURGERY
       

LIFESTYLE
       

Q: Does the Lap Band limit any physical activity?
A: No. In fact, Lap Band patients take part in all kinds of sports activities.
 
Q: When can I go back to work? When can I start exercising?
A: You should be able to return to work three to five days after Lap Band Surgery as long as you do not need to lift, push or pull anything over 10 lbs for the first two to three weeks after surgery. You may begin light exercise only one week after surgery, initially walking then gradually increasing exercise as you lose weight.

Q: When can I start driving a vehicle, after surgery?
A: We recommend that you rest for two to three days, then you resume driving.

Q: Can I become pregnant if I am a Lap Band patient?
A: Yes. Obesity produces a hormone imbalance that can make it difficult to become pregnant. Many patients are able to become pregnant after they have lost some weight. The band may be emptied during pregnancy. Women with Lap Bands have had and are still giving birth to babies with normal birthrates.

Q: What is the most common reason for retaining or regaining weight? What is the best way to avoid these two pitfalls?
 
The most successful Bandsters focus on three key areas:
      
         1. Protein
         2. Water
         3. Exercise
   
If you’re focusing on these three areas and you are not losing, you would probably benefit from another fill.
       
The most common reason for weight retention is not having the proper level of restriction. Another issue would be lack of exercise. Exercise is key in any weight loss program. Building muscle mass increases one’s metabolism. Another key to long-term Band weight loss maintenance is developing good habits during your weight loss phase; for example: exercise, eating slowly, watching your portion sizes, limiting treats, etc. Regular exercise such as walking four to six times per week for 30 minutes will help you lose the weight and keep it off.
   

NUTRITION
       

Q: Other than the obvious high calorie foods, are there foods Bandsters should avoid?
A: Each stage will be different. You should be sure to include high fiber and high protein foods. You will be eating a lesser quantity of food, but will still need to receive the same levels of protein and fiber as before. We recommend that you not drink carbonated beverages because they will most likely make you feel uncomfortable; carbonation may cause distention underneath the band so that you may feel bloated.

Q: Is it wise to drink prior to eating since it’s advisable not to drink with meals?
A: You should drink in-between meals. The general rule of thumb is nothing 30 minutes before or one hour after, but that varies. If you drink too closely to your meal, you may fill your pouch with liquid, leaving no room for food. If you eat during or right after, you will be pushing your food through your pouch, thus, eliminating satiety. Plus, drinking water in-between meals helps you to lose weight.

Q: How many meals should Bandsters focus on? Three meals or six smaller meals per day?
A: The Bio-Enterics literature says three meals per day. Some follow this regime, others have three meals per day plus a snack. Yet others eat six smaller meals throughout the day (200-300 kcal each). Those that eat three meals might eat a 300 kcal breakfast, 500 kcal each for lunch and dinner, and a 200 kcal snack.

Q: Is snacking a no-no?
A: Snacking can definitely sabotage your weight loss and the usual snack foods are a no-no. High carbohydrate foods will give you calories without satisfaction. If you’re hungry you should try to have only protein. If you need something sweet, try some fruit (it has fiber). You may also “snack on water” since hydration is also important.

Q: What is the average caloric intake during weight loss?
   
This depends on the person and the fill level. Here are some ranges:
   
Liquid stage 800 – 1200 kcal/day
Puree stage 1000 – 1300 kcal/day
Normal food (post-op/ pre-1st fill) 2000 2200 kcal/day
Post-1st fill 1600 – 1800 kcal/day
Post-2nd fill 1200 – 1800 kcal/day
             
Some people keep their intake levels much lower, but others find that they stop losing weight if they go too low, as their metabolism shuts down. The goal here is not to feel deprived, but to figure out how you can avoid that feeling and still lose weight.

Q: Should I take vitamins or protein supplements after surgery?
A: Usually, you won’t require any type of food supplements because the Lap Band procedure does not have any effect on the absorption of nutrients. With the Lap Band you will still obtain the vitamins and nutrients from what you eat; Lap Band Surgery is considered a “restrictive” vs. a “mal-absorptive” surgery.
      

A BANDSTER'S GLOSSARY
       

Adjustable Gastric Banding (AGB) - This is the generic term for the banding process.
 
Aftercare - A general term comprising the ongoing post-surgical fluid adjustments to the band, fluoroscopy, and nutritional counseling most patients receive.
   
Band - The generic term for the actual band used in the AGB process, including both Bioenterics and Obtech (Swedish) bands. 
 
Banding journey - A metaphor to describe the unfolding process of life before and after deciding to "get banded". 
 
Bandster - A person who has undergone or is researching the Lap-Band or Swedish Adjustable Band as a Weight Loss Surgery. 
  
Barium swallow - An X-ray test used to define the anatomy of the upper digestive tract. The test involves filling the esophagus, stomach, and small intestines with a pink (pleasant tasting) liquid material (barium). 
 
Body Mass Index (BMI) - Measures body mass; it has the highest correlation with skin-fold thickness or body density. The standard formula for calculating is (Weight in Kilograms) / (Height in Meters Squared). 
 
Fill - A syringe injection of saline into the sub-muscular port in order to increase the pressure of the band around the stomach. This is the process that allows doctors to adjust the pressure of the band, thus affecting the amount of food patients are able to eat and how quickly their food drops into the lower stoma. Fills are usually first given 6-8 weeks post-op. Most patients find that they need several fills before feeling a significant level of restriction. 
 
Fluroscopy - A video x-ray procedure that makes it possible to see internal organs in motion. As far as banding goes, this involves swallowing a barium liquid and having the doctor or radiologist watch its progress to the lower stoma, to ensure the patient isn't over-restricted and the band is in the proper position. 
 
Gastroplasty - Any surgical treatment of the stomach or lower esophagus used to decrease the size of the stomach. 
 
Laparoscopy - A surgical procedure in which a tiny scope is inserted into the abdomen through a small incision(s). This procedure minimizes surgical risk, recovery time and long-term scarring. 
 
Leak - A leak in the band can either be small or dramatic and treatments can range from more frequent fills to removal and replacement of the band. A leak is rarely dangerous, but it can decrease the efficacy of the band. 
 
Liquid diet - An eating plan that only allows only food that can be drawn through a straw. This is prescribed for the first two weeks after surgery. Often patients will go on a liquid diet after getting a fill until they are comfortable with their food going down. 
 
Migration - A more serious, but rare, complication where the band cuts into the wall of the stomach. Often this can be attributed to the band placing too much pressure on the stomach and cutting off circulation in the affected areas. The usual remedy is releasing all pressure on the band to allow the stomach to heal. Removal of the band may also be necessary. 
 
Motility - The ability to move spontaneously. In regards to AGB, it means the ability of the esophagus to push food from the upper pouch through the stoma and into the lower stomach. 
 
Non-Steroid Anti Inflammatory Drugs (NSAIDs) - A large group of anti-inflammatory agents that work by inhibiting the production of prostaglandins. Examples include: ibuprofen, ketoprofen, piroxicam, naproxen, sulindac, aspirin, choline subsalicylate, diflunisal, fenoprofen, indomethacin, meclofenamate salsalate, tolmetin and magnesium salicylate.. These are to be avoided post-operatively as they irritate the gastric walls. We recommend that patients use acetaminophen for fever and pain.
 
Obtech Swedish Adjustable Gastric Band - The SAGB is very similar to the Bioenterics band, except that it is considered a low-pressure band. This means that it has a greater total volume than the Lap-Band, therefore needing more fluid to exert a similar amount of pressure on the stoma.
 
PB Productive burping - This is a 'bandster' term that refers to the regurgitation that most Bandsters will experience at least once in their Bandster lives when we've eaten more or larger pieces than than can be passed through the stoma. Since the food has not been digested, there is no odor, stomach acid, or retching involved but there may be a varying degree of phlegm that accompanies it. PB episodes may last anywhere from 1 minute to two hours, depending on the individual and circumstances. After a PB episode, under most circumstances, it's best to refrain from eating at that meal and let the stoma rest. 
 
Plateau - A period of time, at least 2 to 4 weeks, whereby a Bandster maintains (instead of losing) weight. It is common for post-op patients who are 4-10 weeks out to experience a plateau before getting their first fill. Many Bandsters take a plateau at any point as a sign that they need to get another fill. 
 
Port - The subtanceous dongle at the end of the tube connected to the band. This is where the surgeon will inject fluid in order to increase pressure on the band. Many people can feel their ports under the skin&especially as they lose weight. The area around the port is often tender for several weeks post-op and can become sore if the surrounding muscle is stretched or worked too vigorously. 
 
Posterior stitch - The surgeon stitches the band around the back of the stomach. This technique reduces slippage rates and is the standard operating procedure for Lap-Band insertions. 
 
Pouch - This is the 30ccs "upper stomach" that is created when the band draws the entire stomach into an hourglass shape. This is where your food will go after swallowing, where it will slowly pass through the stoma into the lower stomach and through the digestive tract. 
 
Restriction - This is the feeling of being able to eat only small amounts of food. Some Bandsters talk of 'passive' restriction when their band is empty, wherein they are able to feel full on less food but where they feel no pain if they overeat. As the band is filled, the tighter the restriction should feel. Many Bandsters report that it takes 2-4 fills before feeling restricted enough to lose weight at an appropriate rate. 
 
Slippage - This is where the band moves down the stomach, often causing significant pain to the patient. Slippage usually occurs if the band is too tight or if the patient frequently 'challenges' the band with excessive vomiting.
  
Stoma - Artificial openings between two cavities or canals. In this case, it is the passage from the upper pouch and the rest of the stomach.

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