First, the goal of adjusting a band is for the patient to lose between 1 to 2 lbs. a week with the patient not experiencing hunger for about 3 hours after a solid meal. Of course we do not want the patient to be vomiting or experiencing acid reflux which could indicate that the band may be too tight. If the patient is not losing between 1 to 2 lbs. per week and is hungry between meals an adjustment should be considered.
Bariatric surgeons use several different methods of “filling” adjustable gastric bands.
Some surgeons use a standard volume for each fill without regard to how well the pouch is emptying. They will usually have the patient swallow water before leaving the office to make sure the band is not too tight.
Other surgeons make adjustments under Flouroscopy. In this situation saline is injected into the port to adjust the outlet of the pouch above the band while the patient swallows a chalky liquid. An x-ray machine called a fluoroscope allows the surgeon and/or radiologist to view the liquid as it travels down the esophagus and through the outlet of the gastric pouch into the rest of the stomach. Based on how quickly the fluid empties, the band can be adjusted to change the rate of emptying. This requires doing the adjustment in the Radiology Department or by using expensive x-ray equipment in the office. And this approach exposes the patient to radiation with each adjustment.
The method I have chosen is called a “water test”. With each adjustment I temporarily overfill the band and have the patient sit up and swallow cold water. This will make the water back-up in the esophagus causing a pressure sensation in the chest like the feeling of needing to burp. I adjust the band by removing some of the fluid from the band until the water is released from the pouch and the esophagus. When the patient can drink water without difficulty the adjustment is complete. This allows the adjustment to be made in the office with a high degree of certainty that the adjustment is correct. Also the patient is not exposed repeatedly to radiation.
I have been very pleased with this method. In fact we have achieved an average of 63% loss of excess weight in just one year for those band patients who see us each month in the office for evaluation. Of course, patients do not need an adjustment each time as long as they are meeting their goals.
It is really hard to lose weight most especially if we don't have any decipline and focus.Just like my experience, I tried to work on anything that will help me but I keep on "cheating" and still back to the old way that I'm doing. I saw one advertisement on the internet about the rocalabs formula that will give us the same effect of having the actual gastric bypass surgery but no surgery at all. Is this something new? How long it has been available? Have guys heared anything about it? Is it really effective and much safer than gastric bypass surgery?
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