Today was my monthly fill appointment. It occurred to me that many folks following my blog don’t know how the lapband works and what these appointments are about. Here is a brief summary.

When they surgically placed the band, it was placed near the top of the stomach. This formed a small pouch on top the stomach that my esophagus empties into. The lapband slows the movement of food through this pouch. It is basically tricking my stomach into thinking that is full with a much smaller amount of food.

Fills are the means by which the band is adjusted. A fill is a saline solution injection through a port under my skin connected to my band by a tube. The more fluid in the band means a thicker band and smaller stomach opening. This keeps the food in the small pouch longer and prolongs the feeling of satisfaction with a much smaller portion of food. These fills are done through a series of monthly appointments where my progress, health and nutrition are monitored. Depending on my state, a fill may or may not be administered.

Now, the tricky part of this weight loss solution. Too loose a band means the food flows through quickly, and you can eat just about anything at any time. Too tight a band means the food can get stuck. When it’s stuck, there is only one direction food can go. Up it comes (if you are lucky) and you feel miserable. People look for their proverbial “sweet spot”; just enough restriction to discourage overeating and not too much to result in a stuck band.

I am teetering on that sweet spot. My band holds 14cc of liquid. I am at 7.5cc. I can definitely tell it is there. In recent weeks, it has made its presence known. These episodes have generally been times when I challenged the band with foods and quantities that I knew were wrong. So, it’s doing its job.

At today’s fill appointment, I was considering a small adjustment to just “seal the deal”. I wanted more, more, more weight loss! My surgeon, nutritionist and nurse practitioner were dead set against it. I lost 7 pounds this month; on the high end for lapband patients. I have lost 45% of my excess body weight in 7 months; well ahead of the national average of 40-50% after 2 years. In the bariatric center’s eyes, I am quite successful.

I agreed with the center’s staff and am going another month on my current fill level. I believe that I need to change some of my personal eating habits in terms of snacking and portion control. So, wish me luck this coming month on keeping this trend going. Bad eating habits are the hardest to change.