GeezerSue

I'm thinking that what the doctor was saying is that you have "esophageal dilatation." (I hate the word "dilatation.) If so, "Esophageal Dilatation" is the widening or expanding of the esophagus, at the bottom of the esophagus where it starts to connect to the stomach. This happens when too much food is eaten. It packs itself in, waiting to get into the stomach. But it just sits there, because of the logjam at the band. The usual treatment for this is to loosen the band and hope that the esophagus returns to normal size. (Because it isn't meant to be used as a holding area for the stomach.) I did this a lot...maybe still do. My motility is slow...this is common in older patients. By the time I figure out that I'm packing it in, it's too late. It's all just sitting there. this can happen very easily when there is some swelling around the stoma area and the band is tighter than usual and, without aqny warning, you've overeaten.

When I have restriction, I lose weight and get reflux. When I empty the band, I get rid of the reflux and gain weight. Right now, I have less restriction that the doctor wanted and I STILL have reflux. And I'm mostly out of the mood. The band works well for 75-80% patients. But not for everyone. I'm almost 59. I don't have a lot of time to have more surgery or to play this game much longer. So I'm making appointments for revision to DS. It was my second choice surgery and it appears to make sense to move on. It's a HUGE step, and I'm scared. But I have friends who have done well with it and seems like a real option. I was fortunate to have the resources, and a husband who didn't mind my utilizing them, to pay for the band out of pocket. And I'm not sorry I tried for the least invasive method to solve this problem. But I have insurance that pays for the DS and that's what I'm looking at right now. In no time at all, they'll be saying, "Sorry, dear, you've passed our cut-off age." So, I'm off to see some wizards, so to speak. My highest BMI was about 53. At surgery, it was 47-ish. I got down to 39, and that's when the reflux started. Currently, I'm at about 43. Would I do it again? Probably. Would I wait this long to move on? Probably not.

The band can "cure" reflux for those who have had it and cause reflux for those who have not had it. But reflux is not just an irritation. I've previously posted links to what that acid is doing to the esophagus...it ain't pretty. I've taken various drugs...but, to me, I'm merely patching something I'm simultaneously causing...by having the band there in the first place. Kind of like putting band-aids on a place I keep stabbing. So, no, it did not go away and is another reason I'm thinking of having my band removed. I look at my 82-year-old mother and see her frailty and wonder how long I can put up with this before I find myself suffering, but declared too old for surgery.

I've gained back the majority of what I lost. The band is successful for about 75-80% of patients. Therefore, one out of every four or five banded patients do NOT do well with the band.

Do a search here on his name..but spell it correctly. Rumbaut.

Gender? It's Geezer...as in, I'm an old broad.

You go to the literature...peer reviewed medical publications. Anyone who doesn't might as well use fortune Cookies. However, when you DO go the the medical literature, the band is not a walk in the park, either. Just a cursory search on the topic of adjustable banding reveals recent studies involving: •Access port site hernia •Lap-Band removal for band erosion •Severe intra-abdominal infection due to Streptococcus Milleri following adjustable gastric banding •Late gastric prolapse with pouch necrosis after laparoscopic adjustable gastric banding •Migration of adjustable gastric banding •Complications of gastric banding presenting to the ED •A minimally invasive solution for necrotic fundus following slipped adjustable gastric band •Port complications following laparoscopic adjustable gastric banding for morbid obesity •Obstructive symptoms associated with the 9.75-cm Lap-Band in the first 24 hours using the pars flaccida approach •Critical extreme anterior slippage (paragastric Richter's hernia) of the stomach after laparoscopic adjustable gastric banding: early recognition and prevention of gastric strangulation •Early lap-band erosion associated with colonic inflammation: a case report and literature review •Band slippage--a potentially life-threatening complication after laparoscopic adjustable gastric banding And those are only SOME of the articles from just THIS YEAR. Banding was my FIRST (but not LAST) choice. I used to be highly defensive of banding and, like most of the responses here, really down on bypass surgeries. But, to me, the object is to have the procedure that will save my life. And the band isn't doing that. So, I am one of approximately 20% of banded patients who does NOT get the desired result. I knew those statistics going in. I just wanted the least permanent and least invasive surgery which would WORK for me. I think that knowing that ANY of the WLS procedures has its plusses and its minuses leaves us in a better position to HAVE a second choice and a second chance should we be in that one-out-of-five for whom the band does not provide relief from MO. In other words, neither those on the other boards NOR those of us here should knock something we might later need. IMHO

Yup, the band is often the "cure" for reflux for those who have it...and is often the "cause" for those who don't. I'm glad you are one of the former...I'm, unfortunately, one of the latter. Keep up the good attitude!

I'm glad you're happy, but I believe it's a few more than three patients with problems...and that's on this board alone. There are other support boards. But it is nice that you are having success. Edited to add: I just noticed on another thread that you are only ten months post op. I am NOT wishing you anything but success here, but for some people, the problems show up a little longer after surgery.

Having a band placed is nowhere near as painful--nor does the pain last as long--as having a knee or hip or ankle go out from obesity. It's all relative.

Well...I fit best in maternity clothes...because for some reason, my waist has decided to be my largest measurement. Weird to be in maternity items pushing 60. Anyway...layer stuff. I have a new outfit. It's a tank top (WORN TUCKED IN) and pants, that I wear with a blouse or sweater (WORN OPEN.) The tucked in thing IMPLIES a waist and the blouse or sweater hides the details. If I button the sweater, I look pregnant.

like at Scottrade or one of the other discount brokers, you can open an accunt for $500. I think I opened my account with a whopping thousand dollars...or two. You can make small quantity purchases. Each purchase costs either $7 or $12, the lower price if you just say "buy this," the higher price if you say "buy this at a price no higher than ___." So, the fewer shares you buy, the more it costs per share because of the commission. (ie--if you buy stock that costs $10/share plus commission, ten shares will cost you $10.70/share, a hundred shares will cost $10.07/share, because the commission costs are spread over more shares.) I didn't buy Inamed, because I thought it had done its thing, but I bought Johnson & Johnson, since their clinical trials are over and they should be about ready to market their product. I made about $11/shqare, but panicked at the vioxx/Celebrex thing and sold. Had I held on, I'd have made another $6/share. But like my best friend says, "If we had ham, we could have ham and eggs...if we had eggs." Happy trading. PS--some discount brokers give free trades to members who send new members their way, so if you have a friend who trades, go through that person. https://scottrade.com/

...and put bumper stickers on strangers' cars? Oh, wait! You just did! Never mind. Such tactics speak to this doctor's ETHICS...and I now know all about him I need to know.

http://lapbandtalk.com/showthread.php?t=5688&highlight=rumbaut

Returning to add: LuAnn, I wouldn't let them submit with a BMI of 34, until I read my insurance coverage. If the criteria is 35 with comorbidities...I'd wait, seriously, until after a bag of chips and all.

...at my height, the difference between a BMI of 34 and a BMI of 35 (which, with your comorbidities ought to do it) would be: •a medium to large bag of potato chips the day before the exam. That salt would cause me to retain enough weight...which, at my height, is only five pounds...to move me from 34 to 35. •I'd skip my morning diuretic...to retain yet more fluids. •and, I don't know the condition of your reproductive system, but there are days some of us weigh more than we weigh on other days. You might want to schedule the exam for one of those heavy days. Sue :::doing my part to legally use the system as it is:::

This might help: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15623442&query_hl=18

Well...then I can't invite you to come with me when I have MINE removed...if I do...but if I do it's gonna be damned soon because I'm almost in my 60's!

Alex is the expert on how to communicate with the insurance company. I was just trying to focus your efforts on how to "beat" their argument. (On another support site, I "insulted" someone because I felt her letter sounded to much like she was trying to prove she "deserved" the surgery...which wasn't anything her insurance cared about. Nor did they care about her low self-esteem, or any one of a number of other things that were mentioned. Insurance companies do not approve surgery we "deserve," they approve surgery we are "entitled to.")

I went through something like this immediately after banding, except that I wasn't trying to eat anything. Your immediate problem is hydration while the stoma is swollen. Forget food. Do NOT try to eat anything solid...and I have no idea why you were not warned about that...but, forget any food for AT LEAST three days. The quesadilla irritated the stoma and the bread just made it worse. It needs a few days off. In fact, the stoma is so swollen that the brain thinks something is stuck, and is sending gallons of saliva down there to try to "wash through" whatever is stuck...which just gives you more stuff to pass through a really tiny hole. Then, you have to get Water in and if you don't you'll end up getting fluids IV. What Rumbaut had me do was eat ice chips and the occasional teaspoon of Maalox. But focus on the ice. (I know that many people use WARM water, but rumbaut had me on ice chips. Whichever works better for you.) Also, spit. I know you're not getting any sleep. So plant yourself on several pillows the bed or the sofa with several layers of towels and a small trash can lined with trash bags and stop swallowing all that saliva and just spit it out. You may finally fall asleep and drool a lot. Don't worry about it. Just pull out that towel and go to the next. The less slime you're trying to deal with, the better. This will pass, but when it does you need to go back to Clear Liquids for a few days, the slowly add full liquids, the pureed, etc. If at any point you irritate the stoma and start with this routine again, go back to square one and go even slower. If you cannot get fluids in, you will need to go to an ER and get hydrated. I've met people who were very swollenlike this for a week or ten days post op. Now you know that you are someone who is very sensitive to fills. Good luck. Good luck.

I don't read that the way you do. To me, it says "We cannot and will not approve anything that is not as good as or better than conventional therapies"...and "conventional therapies" usually means RnY. If that is the only basis on which they have denied the claim, then your job is to prove to them that it IS as good as or better than RnY. None of the other stuff--letters and documentation, etc.---matters. So before you send all of that stuff off, call Don Mills at Inamed and ask him for the citations (in peer reviewed medical literature and such) which establish that the band IS as good as or better than the conventional therapies. I don't mean to sound bossy on this point, but I think people get so wrapped up in trying to get the band, that they miss the details. The deal is that once they have denied you based on their excuse that the band isn't good enough, the ONLY argument that matters is that the band IS good enough...not how much you deserve it or messed up your life is now or how much better it will be after you lose weight, or that sort of thing. In fact, when our daughter was denied for BR surgery, the letter included the cites for their side of the argument. I used other points made in THOSE SAME ARTICLES to argue our side and they could see that it was just going to be enormously difficult to win a debate with a mom who had nothing better to do than read medical journals, and she was approved. Just remember that you need to focus on providng them with data which disproves their data, and therefore undermines their argument...which also would include other plans which a) have a similar efficacy and safety clause, and approve the band. Good luck.

I have to disagree here on a couple of points...no matter HOW you lose 100+ pounds, it is very unlikely that you can do so without saggy, baggy skin afterwards. Hell, many, many normal weight women need plastic surgery from stretched skin from a 40-60 pound gain during a particularly "fattening" pregnancy. Stretched skin does not "reform." And I disagree with your position that bypass is the right surgery for the super obese and band for lightweights. I don't think the more experienced band surgeons would agree, either. Some superobese do great with the band..and some lighter weight MO's don't.

If you're talking about an open enrollment period at his place of employment, you don't need to take a chance. Call the insurance company--or check their website--to determine their policy for covering bariatric surgery. (And don't let them get away with saying it has to be "medically necessary." When they told me that, I said, "So, if any doctor says I need this, you're going to pay for it, right?" THEN, they found the criteria.) If it looks like you meet that criteria, change insurance in November, but change back the following year. Unless the insurance is $1000/month out of pocket, you'll still save money. And even if THAT doesn't work, see if his employer offers a Section 125 account, which will let you pay out of pocket with tax free money.

All a bra will do is keep you from rolling over them in your sleep. (I LOVE massage therapists...mine wanted me to use an old Edgar Cayce cure of flannel pads of...I dunno...cod liver oil (?) wrapped around my hanging pannus to make it go away. Yeah, right.) I'm happy with my breast reduction and my tummy tuck and, if I lose 100 pounds, I'll do it again.

I'd go for protein and water.