May 2010 Realize Band implanted, hiatal hernia repair, uneventful recovery

Aug 2010 fill 3 cc

March 2011 fill .5 cc

Summer 2011 began to have epigastric pain at night.

Sept 2011 stomach virus

Sept 2011 pain upper right quadrant, duration 2-5 hours increasing, then subside quickly

Oct 2011 barium swallow, band fine, slow esophageal emptying

Oct 2011 upper abdominal ultrasound positive for gallstones

Oct 2011 gallbladder removal

Feb-May 2012 increasing GERD symptoms, nighttime epigastric pain radiating to shoulder, neck, jaw, back. Palpitations gradually increasing in frequency

May 2012 had cardiac work up, stress test, echocardiogram, negative for heart disease. BP was elevated, so new drug Rx, resolved palpitations/hypertension. Epigastric pain persisted.

June 2012 upper GI with barium shows stoma at band is nearly closed. Barium drips through, but no stream. Barium is backed up into esophagus. PA removes all saline (3.5 cc confirmed, clear, no sign of infection). Under flouro, barium is still in esophagus, emptying slowly. PA and Radiologist are concerned, but decide after I drink 8 oz water to schedule me for follow up 5 @ weeks.

July 2012 follow up, lost 4 lb. still having problems eating anything fibrous, but able to eat, at least. Barium swallow shows smaller than expected stream thru band, but also shows slow esophogeal motility, but not so slow as to require follow up. PA states that since I'm tolerating food, losing and have a bit of a motility issue, she won't fill me, but cautions me to stay on the band diet and if I'm able to eat everything and quantity increases over 1 cup, to come in for another evaluation.

Oct-Dec 2012 In early October, became very intolerant to most foods and started having nighttime pain again, GERD symptoms. Symptoms subsided for two weeks, then returned. Taking PPIs for GERD, probiotics and experiencing extreme constipation. BMs only every 8-10 days. Bloated miserable, having pain, feeling like food is stuck. November, saw GI doctor and he ordered EGD, soft low fiber diet. December EGD negative for Hpylori, celiac, erosion, Barrett's. Prescribed Amitiza for constipation. Antispasmodic for GI spasms.

Symptoms improved.

Feb symptoms (intolerance of meals, feeling stuck, etc) returned. Consult with GI doc, schedules GES. Results normal gastric emptying times, but abnormal esophageal retention. GI doctor follow up in 2 weeks.

March 2013: barium swallow:Dx achalasia, severe esophageal dilation due to LES failure to open in response to swallowing. Discussed options for removal/revision and further testing.

April 2013: esophageal manometry test to determine if achalasia is primary or secondary. If secondary, band IS the problem and it will have to come out. If primary, surgery may exacerbate the condition.

Update: GI doctor has done all he can for me. I'm scheduled in late May for evaluation with one of the top esophageal surgeons in the nation to discuss band removal, redoing my HH repair and looking to see if my vagus nerve has been damaged.

High weight 290 lb

Surgery weight 281.5

Band emptying weight 225

Current weight 202

Goal weight 170

At all times my PCP, Gastroenterologist, Cardiologist and Bariatric Surgeon were in communication. Procedures, records and test findings were shared.

Preexisting IBSd. Hypertension, hyperlipidemia, sleep apnea, GERD.

Sacroiliac Joint Dysfunction/Spinal Stenosis

Left knee osteoarthritis-replacement recommended

Still taking all medications I was taking pre-band + amitiza, antispasmodic and additional hypertensive drug