GeezerSue

The best "CURE" for post-op constipation is WATER!!! Be VERY, VERY careful about taking any bulking granular laxative. It can cause a REAL mess, a mess that could have been prevented with more Water. ~~~~ 1: Obes Surg. 2004 Aug;14(7):1022-4. Related Articles, Links Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding. Herrle F, Peters T, Lang C, von Fluee M, Kern B, Peterli R. Department of Surgery, St. Claraspital, Basel, Switzerland. BACKGROUND: Constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer. DISCUSSION: Patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band. CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives. Publication Types: * Case Reports PMID: 15329197 [PubMed - indexed for MEDLINE] source: http://tinyurl.com/hwluw

NOT what you want to hear: it varies from person to person. JimmyC hasn't posted here in forever, but he was stopped up almost completely for almost two weeks. He just needed time to UNswell. http://lapbandtalk.com/showthread.php?t=1010

I've known people who were hospitalized and put on IV fluids for days just to get through the swollen stoma part. You are in no hurry. People survive for a long time on Water only...hydration is your most critical issue at this point. Probably not. Probably you just need more water. Mostly water and other clear liquids. Tea, popsicles, maybe some Jello or broth. Be VERY careful about laxatives. Do you live near Jamba juice or some such place? Get a fruit drink with a Protein boost or two if you feel tired or worn out.. ~~~~~~~ From PubMed: 1: Obes Surg. 2004 Aug;14(7):1022-4. Related Articles, Links Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding. Herrle F ,Peters T ,Lang C ,von Fluee M ,Kern B ,Peterli R . Department of Surgery, St. Claraspital, Basel, Switzerland. BACKGROUND: Constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer. DISCUSSION: Patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band. CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives.

Not only small sips, BUT a couple of things: •at six days post-op, MOST doctors want us on Clear liquids. Protein drinks are NOT clear liquids. And unless there is some reason you'll get sick without them (for a few days), I'd lose the Protein Drinks and go back to clear liquids; •and, once you irritate the stoma--the skinniest place between mouth and stomach--including the irritation of both surgery and eating, the swelling INCREASES and makes the next attempt at eating anything even more difficult. Again, the "cure" is to return to CLEAR LIQUIDS for a few days and then to SLOWLY start adding full liquids and then mushies, etc.

There was a time, about three-and-a-half or four years ago or so, when Inamed...then BioEnterics...changed manufacturers for the port and there were lots of problems. I was never TOLD exactly what the situation involved, but I was able to figure out from observation that ports were being replaced, and the patients were not paying for the surgeon or replacement port. And I also noticed that patients were keeping track of mileage and even going for the port change-out to doctors who did not do the original band. There was even a Yahoo group for people with screwed-up LapBand ports. But the problem went away, and I suspect, that in the then relatively early life of the band in the US, the problems were resolved without fanfare but with a confidentiality clause. Betcha!

Good. Or at least, MOSTLY good.

Don Mills at Inamed told me several years ago that the band can CURE reflux in those who suffer from it pre-op and CAUSE reflux in those who had never had it.

It might help and you should call your surgeon. (But those drugs probably shouldn't be taken forever, so give yourself time to heal and then bug your doctor nonstop.)

Thank you, Dr. Pleatman...you Silver-Tongued Devil...for the direct approach. My band is sitting in a baggie with my Bio-Enterics (pre-Inamed) "owner's manual."

Ou daughter has lived in the area for eight years...uses taxis all the time because--according to her--they are more reliable than trying to find a parking space in LA and nobody has to be the designated driver. And...you will have all the same logistical problems with cash for the parking lot, etc. The hospital will secure your stuff, but you can have money to pay the taxi in the trunk of your car at home...when he drops you off there. One day post-op none of us belongs behind the wheel.

It IS on the site of a surgeon who does the DS. But the cites (at the bottom) are from published, peer-reviewed literature.

When it's all new, it's easy to feel like you've pulled something every time you move more than you did the day before. Band wisdom is that if the port area is not red, or hot, or oozing anything...give it a couple of days. If it IS red or hot or oozing anything, contact your surgeon ASAP.

Here is a comparison chart which includes the complications of the various wls. http://www.dssurgery.com/generalinformation/comparison.php I have to take issue with some of Nurse Teresa's facts, though. For one thing, there are many doctors who think that DS should be reserved for the super MO or BMI's of 50-55 plus. In any surgery--even a tonsillectomy--super obese patients have a higher mortality rate. If we compared stats (like mortality rate) among like-BMI patients, I don't think there would be much difference at all. Yes, the surgery is more complicated. But mine took LESS THAN two hours including band removal. That is why it is more important to me that my surgeon has done over 1000 of these procedures than how many other surgeons do it. Yes, there is malabsorption, but THAT IS HOW WE LOSE WEIGHT. The DS works by allowing patients to eat stuff that the body does not process and absorb. Malabsorption is not some unexpected, negative side effect...it's what makes DS work. The smells--well those stats vary. food that is not totally processed by the body WILL smell bad on its way out. A good deal of that can be controlled by diet. There are supplements, like Devrom, that some people use to eliminate odor. I had lunch with a RnY patient friend the other day and we each had to deal with our surgeries. She had to watch out beause of dumping: "The ‘richer’ the food, in terms of molecule size or sugar content, the more Water will rush into the small bowel to dilute it. This is referred to as ‘early dumping.’ Suddenly, the heart will pound and beat rapidly; you may feel dizzy, and overwhelmingly tired. The bowels may gurgle and churn, and will feel bloated and gassy. This might be followed by loose stools and even vomiting. It is not dangerous, but it can be frightening to the uneducated patient. ‘Late dumping’ is caused by an insulin response to the ingested food. One might feel flushed, sweaty, fatigued, and experience all the signs of hypoglycemia (low blood sugar). You can avoid early and late dumping by avoiding the foods that cause dumping. In other words: sugars, starches, fried foods, fats, and high glycemic foods. The glycemic index refers to how swiftly the sugars from the food enter the bloodstream after eating. Each person has a different tolerance, and you will discover what your personal safe foods might be throughout your post-operative life. Person A might have no problem with bananas, Person B might dump every time one is eaten, and Person C might be able to do a rare banana, only if it is a little bit green. You will learn what your own trigger foods might be. Be aware that these may change over time, as your surgical tool matures. What you tolerate in your early post-operative course you might not tolerate later, and vice versa. Every body and everybody is different!" (source: http://tinyurl.com/mzf98 ) In my case, with the DS, I had to decide if I REALLY wanted drawn butter with the lobster. I could eat it without getting palpatations, but it would probably mean "unpleasantness" in the bathroom the next morning. A bunch of us--band , RnY and DS--all went out beach-themed place together. The RnY people waited to taste the drinks of the DS people to see if they were too sweet and would cause dumping. At the time, I had the band (and problems) and had to skip salads and crab cakes (too much bread) and a cup of coffee AFTER lunch. Every surgery brings its own challenges. When I first joined a wls board, ALL of the ER trips for bowel obstructions and similar problems were RnY patients. My advice is to research the surgeries. That means reading the medical literature and talking to people who HAVE HAD the surgeries and to medical professionals who HAVE PERFORMED the surgeries. Find the online groups and even in-person support groups. Good luck. Sue Not trying to talk anyone into a DS, but trying to make sure people hear more information from those who have made that decision.

A couple of years ago, Don Mills of Inamed told me that the band can "cure" reflux in those who have it pre-op and can cause reflux in those who never had it. On of my negative consequences of having the band was reflux. Your physician needs to know so that the impact can be lessened. Long-term, acid in the esophagus is not a good thing.

You know, I don't know WHAT--if anything--my doctor submitted to my insurance for the band removal part of the surgery. He DID submit for the DS and they paid him. His "program fee" (that's out of pocket for me) is $1000 more for revisions...maybe that's where he makes up the difference.

I would not have the RnY, but I DID have my band removed and I got the DS.

First, I'm sorry that yet another one of us is having to go through this. That said, decide NOW what you are going to do NEXT about weight loss, because that might save you the time/money of a third surgery, (band in/band out/different procedure.) Some people are at a good enough place that they decide to go it alone. A couple of us had the band removed WHILE having the DS. (In my case, the surgeon's program fee is $1000 more because I'm a revision, but that's WAY cheaper than paying for a third surgery.) I think someone here has had an RnY or is thinking about it. I think there MAY be a tendency, once we decide that band IS coming out, to want it out NOW. I'm just saying that factoring in your NEXT move in weight loss, may be worthwhile. Sue

Sometimes it doesn't matter what you keep out of the house. There was a bit on TV the other day about a high school that took out all the junk food machines. The next day, a couple of entrerprising students started SELLING junk food at school...and one of them reported making (probably her gross sales) $50 the first day.

Like Michelle, once we SAW the esophageal problems, I couldn't wait to get my band out. UNLIKE Michelle, I had it done along with the DS. I'm so sorry for you, Kel... Sue

NSV = Non-scale Victory

Why would he expect you to get by on a half-cup BEFORE a fill? That is insane. The band is healing into place, your stoma is no longer swollen...OF COURSE you can eat. Has he DONE this before?

Good luck with your surgery...but a little bit of a warning. After you lose a ton of weight and you have hangy bits, you'll probably want plastic surgery, and THAT'S where you'll likelly hit a snag. Because smoking interferes with the skin's healing process, more and more PS's are refusing to perform surgery on smokers. They don't want the complications. Just so you know going in. Sue

I'd say, "not unless you are in mortal pain." Some people think that it's the pill in the stomach that causes the problem. Ain't so. The mechanism that causes the NSAID to work ALSO causes a reduction in the lining of the stomach. the acids have a chance to burn holes in tissue that is not designed to handle acid. All those Prilosec and Prevacid and Zantac commercials (and the others) are NOT just for bariatric surgery people. They are selling THAT stuff because they've done such a good job selling the NSAID's. (And just to make you crazier...my cousin died at 57 because tylenol killed his liver.)

USC doesn't do banding, but they DO charge $800 for their program fee for support for RnY/DS surgeries. My surgeon charges $2000 ($3000 for revision patients) for his "weight loss program fee." Interesting enough, those fees are now tax deductible...as long as you have (well...in my case...a Letter of Medical Necessity stating that the program is for the treatment of a disease such as obesity or hypertension. which should be here soon so I can "ransom" my three grand out of my Section 125 account.) However, when we go into the area of pre-paid follow-up we get iffy, because pre-paid medical is NOT deductible...but, the support groups, dietary advice, education, etc. are all okay.

I've got my band...in a baggie. I was banded in Mexico but UNbanded in the states.