fabfatgrl

It's not unusual at all to need a second fill quite soon after your first. Doesn't mean you've slipped at all.

I saw Dr. Pleatman for a fill... as well as a surgical consult for the VSG. I really liked him and his office. One nice thing regarding fills is that he had a small ultrasound machine in his office that he used to help find my port. A lot easier than having to go to a radiology group. His office is in Bloomfield Hills on Woodward near Square Lake Road.

She's very well thought of. Her husband is an Australian Lap-Band doc who has a ton of experience as well.

Hi Karen: Glad you're out of surgery and on your way to recovery! :confused: It will be interesting to hear what life with an RNY is like vs. a Band. I definitely know that some sort of revision is probably in my future... so trying to keep all options open.

I just gave birth to my third Lap-Band baby. I will say that my Band has definitely been different since pregnancies than before. I've been unfilled for all three pregnancies, but have never successfully been refilled after pregnancy.

Fills under fluoro are usually more accurate because the doc can watch the rate at which the barium flows through your Band. Also, they're a good idea at least once per year (if you don't do them for all your fills) to check on your Band, esophagus, etc. Having said all that, it's extremely rare for one to hit the mark on the first fill... whether done under fluoro or not. Many people find that they lose restriction quite soon after their first fill, so don't be surprised if you may need another one 8-12 weeks after your first. You should still notice a difference, though, with a fill than without.

Losing 3 ml seems a lot to me. Yes, a small amount of saline will be lost naturally according to most studies... but I've never heard of that much being lost in a band that wasn't leaking. I would ask your Doc to do a leak test at your next fill if you experience a similar loss. Instead of injecting saline, he can inject a dye that will show up on x-rays/fluoroscopy. Should be pretty easy to tell if there are leaks in your tubing/Band. Sorry this isn't a more positive post.

I'm wondering what they've done to improve the old Obtech Band. From what I remember back in 2001, the Obtech band needed a special solution for fills. It was also more prone to slippage vs. the Lap-Band.

I did... way back in 2001. Went to Dr. Rumbaut and couldn't have had better care or a more experienced surgeon. The only thing you need to be aware of is after care... cost of fills. If you're close to Mexico, then most of the Mexican docs will do your fills for free or for a small fee for fluoro. If not, fill costs can add up.

There have been more than one death, sorry to say. There is definitely a learning curve, however... so death is more likely in a surgeon's first 50-100 operations than after. A surgeon's ethics... and pre-op criteria also play a role. Some will ignore red flags, just to do the surgery. So, that increases operative risk. Once again, I remember when this death occurred, as I had been Banded about a year. The surgeon was not one I knew of from the FDA trials... or who was mentioned very frequently... so I'm assuming he could have been a newbie. BUT, the risk of one of the lap instruments nicking the stomach exists with any surgeon... which can lead to peritonitis and death. I definitely agree with researching your surgeon thoroughly. There's a reason I went out of the country in 2001 to Mexico to a surgeon who had done 3000 Bands already in 2001, when the FDA trial docs (the most experienced at the time) had done 30-50 MAX. Here's one that shows 10 deaths... just as a NB: pulmonary embolism is a risk in any surgery. Whenever you're operating on MO people, you're going to find a higher risk of PE and MI (heart attack). I think the confusion comes from the Lap-Band brochure that Allergan is still using that goes back to the original US FDA trials (1999-2000)... and they say there were no deaths resulting from the trials. They're not saying that there have never been deaths, but in the initial approval process for the Band there were no deaths reported. It's not the same as saying that there were no deaths. I'm sure if you email Don Mills at Allergan (if he's still there), he can give you some better stats. The Lap-Band does have the best safety record out there among WLS. We're at an advantage in that the surgeons are not cutting our stomachs, nor intestines... which just increases the operative risk. BUT, any surgery... no matter how simple seeming... carries the risk of death. The latest figures I could find on Lap-Band mortality rates showed a rate of 0.2%... which is fabulous as long as you're not one of those that die.

All of the links work, Lizrbit... not sure what the problem is for you... but perhaps that's why you can't find any thing that says that. Even Allergan will tell you about Band deaths. They're included in their FDA PMA, btw. There were not in the immediate US FDA clinical trials.. but deaths had occured prior to that in Europe and Australia, and deaths continue to occur in the U.S. Probably the risk is less than 1%, but it still exists. The links all work for me. Not sure why they're not working for you. Heck, you can even go to the FDA and look at the PMA for the Lap-Band and see the deaths mentioned. The first link is from Sept 5, 2002: "City Councilwoman Brenda Scott died from a severe infection in her stomach, three days after having stomach-reduction surgery, an autopsy report indicated. The medical examiner classified Scott's death Monday as accidental, caused by a condition called peritonitis, administrator Steve Brown told The Detroit News. Peritonitis is an infection of the abdominal lining, often caused by surgical mishap. Last Friday, the 47-year-old Scott underwent the LAP-BAND System procedure to restrict the size of her stomach at Port Huron Hospital. She left the hospital Saturday morning. By Sunday night, she complained of abdominal pain and was taken to Detroit Receiving Hospital. She died Monday morning." You can Google "Brenda Scott" and Lap-Band and it should come up. The other links come from PubMed which has all of the Peer-Reviewed Medical Sources. Can't find a more unbiased source that that... BTW. You can go there yourself, and search on Lap-Band (or preferably Adjustable Gastric Banding" and mortality (death) and the articles will come up. Deaths DO occur with the Lap-Band. Not sure if it's just that you're not used to searching medical journals, or just want to believe it to be true. Risk is lower than with other obesity surgery, but they exist. No reputable surgeon would ever tell you that a Lap-Band death has not occured... nor would Allergan. Really not sure where you've got your info from. PubMed Home

That's not true. Sorry. I know of at least one who died quite a few years back. She was a city council woman from Detroit and had surgery in Port Huron, Michigan. I remember the case specifically, because she was the first US death I remember. Detroit City Council member dies after undergoing surgery - News I would be very shocked to learn she was the only one. (Here's another Death Favorable early results of gastric banding for mor...[surg Endosc. 2004] - PubMed Result 10 deaths (but a 0.53% risk) Lap Band adjustable gastric banding system: the It...[surg Endosc. 2003] - PubMed Result Another death Long-term results of laparoscopic adjustable gastr...[Obes Surg. 2002] - PubMed Result etc.) Your'e talking about surgery on morbidly obese people. The risk of death, pulmonary embolism, etc. can't be ignored. Does the Lap-Band have a great safety record?? Yes. But ALL surgery carries risks.

Erosion is serious business. Your stomach can be extremely damaged... it's not the same as a slip at all. Depending on the degree of an erosion, it can not only prevent a surgeon from placing a new Band, it can keep him or her from doing any revision surgery. It really depends a lot on how badly the stomach was damaged. Personally, it would seem too risky to me. I'd look at other options. But here are some studies anyway... Obes Surg. 2005 Jun-Jul;15(6):849-52.Links Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement. Abu-Abeid S, Bar Zohar D, Sagie B, Klausner J. Department of Surgery B and the Advanced Endoscopic Surgery Service, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Israel. dr_subhi@tasmc.health.gov.il BACKGROUND: Intra-gastric band migration (band erosion) following laparoscopic adjustable gastric banding (LAGB) is a known complication requiring revisional surgery. Management has most often involved band removal and suturing of the stomach wall, followed by delayed replacement at a third operation. We report our experience with simultaneous band removal and replacement. METHODS: Between May 2001 and December 2003, we performed 754 laparoscopic operations using the Lap-Band ®. Patients developing band erosion were treated by laparoscopic band removal and immediate replacement of a new band following gastric wall repair. RESULTS: 16 patients (2.1%) developed band erosion after a mean of 23 months following surgery (range 11-40 months). Patients presented with epigastric pain (6), port-site bulge (3) or were asymptomatic (7), band erosion being suspected during fluoroscopy for band adjustment and confirmed by gastroscopy. Postoperatively, 11 patients developed fever that responded to antibiotics. No patient suffered from intra-abdominal infection, wound infection, pneumonia or pulmonary embolism. Mean hospital stay was 4 days (range 1-8 days). CONCLUSION: Band erosion following LAGB can be treated safely with simultaneous laparoscopic band removal, gastric wall suturing and immediate replacement of the band, thereby preventing weight gain, the appearance of co-morbidities and the need for additional surgery. PMID: 15978157 [PubMed - indexed for MEDLINE] Obes Surg. 2003 Jun;13(3):435-8.Links 11-cm Lap-Band System placement after history of intragastric migration. Vertruyen M, Paul G. Department of Laparoscopic GI Tract Surgery, Europe St-Michel Clinic, Brussels, Belgium. marcvertruyen@belgacom.net BACKGROUND: Intragastric migration (erosion) of the band after laparoscopic adjustable silicone gastric banding (LAGB) is a serious late complication. It requires removal of the entire system. Subsequent recurrence of obesity can be treated by laparoscopic placement of a larger band: the 11-cm Lap-Band System. METHODS: In 727 laparoscopic gastric bandings using the 9.75 Lap-Band, 10 cases presented with intragastric migration of the band. The same complication was encountered in an additional 4 patients who had previously been implanted with an Obtech band in another hospital. Laparoscopic removal of the band was performed in all cases. In 9 cases, after a delay of 6 months, a new gastric band was placed using the 11-cm Lap-Band, because of uncontrollable recurrence of obesity. RESULTS: No complication was observed during the laparoscopic removal of the system. The placement of a new band required conversion to laparotomy in 1 patient who had previously received an Obtech band which had been placed using the pars flaccida technique. After a mean follow-up of 21 months, no intragastric migration of the new bands was noted. CONCLUSIONS: Laparoscopic placement of an 11-cm Lap-Band in patients with a history of intragastric migration is a safe procedure. It allows effective control of recurrent obesity. The laparoscopic procedure was easier in patients initially operated using the perigastric technique. PMID: 12841907 [PubMed - indexed for MEDLINE] Obes Surg. 2001 Dec;11(6):744-7.Links Lap-Band erosion: incidence and treatment. Niville E, Dams A, Vlasselaers J. Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium. erik.niville@ping.be BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is an effective and safe surgical treatment for morbid obesity. Migration of the band through the stomach wall is a well-known late complication that may jeopardize the aim of the treatment--permanent weight reduction. METHODS: 301 patients were followed for > or = 2 years (mean 39 months) after a Lap-Band procedure. Cases of erosion were studied retrospectively. RESULTS: 5 patients (1.66%) developed erosions. Laparoscopic band removal was carried out in these 5 cases without complication. The first 4 have received a new Lap-Band, and all are doing well. CONCLUSION: Band erosion is a bothersome late complication after LAGB and requires band removal. Rebanding is a feasible option. Further study and longer follow-up are necessary to determine whether these patients will develop erosion again. PMID: 11775574 [PubMed - indexed for MEDLINE]

I had not seen it... but this is just one woman's blog and opinion. There's a lot published out there in peer-reviewed journals that contradicts what she's saying. I also really recommend reading the book "Rethinking Thin." It was just released a few months ago and is written by the NY Times Science/Health writer. Goes through all of the obesity research. Bariatric surgery is the only chance a MO person has of maintaining any weight loss for any period of time. Most surgeries will give a MO person the chance of maintaining at least a 50% EWL for five years. Nothing else comes close. Studies Bring New Hope for Obese | TIME "However, a small preliminary study presented at the conference could change some of this thinking. Researchers found that the average cost of bariatric surgery is often completely recouped by the patient after three years, after which time the medical expenses of patients who did not have surgery are twice as high. "Patients who come in for surgery have a lot of medical problems," says Dr. Anita Courcoulas, lead author of the study. "It makes sense that it would end up costing less." A larger study still needs to be done, but this new research shows that surgery may actually be the cheaper option in the long term."

I've had a Band for six years. Weight wise, I'm pregnant with my third Bandster baby and unfilled. The biggest issues I've had is in trying to refill the Band following pregnancies. It just hasn't worked the same. However, up until this pregnancy, I'd maintained 65 out of a 95 pound weight loss with no fills. So... not too shabby. I haven't experienced any reflux, errosion, etc. The biggest issues I've had are cost-related. It sucks to still have to pay for fills and unfills six years down the line. As a stay-at-home Mom now, it's a much bigger impact on me financially then when I was working in corporate America. The Band was the right surgery for me at the time. I don't regret it at all... even though , at the time, it wasn't even FDA approved and I traveled to Mexico for surgery. I would not have been comfortable going through three pregnancies with any other WLS. Having said that, if I were to look at surgery today (not wanting any more kids), I'd probably go for a Vertical Sleeve Gastrectomy. The fill-factor gets old... fast. It took me five or six fills to get good restriction the first time. I've had numerous fills and unfills... and each has cost me on average $350. I'm going to try refilling again after this pregnancy (due any day now)... and see how it goes. If I still can't manage any restriction, I will probably have a revision.

I think it would depend on where you were going and for how long. My husband is Egyptian... and if we were to visit there for any long period of time, I would probably go unfilled or with a small fill because I wouldn't know what to do if I got stuck or had troubles. Having said that, personally, it was so nice to go to France with my Band... to eat "normally"... enjoying everything, but in small portions... and then come home having lost 5 pounds. I will say, that as a 6-year Band veteran, sometimes being restricted does get tiring. You want to be normal. You want a break. So, I can see taking a few months off from being filled to just be normal again as well as to see what you've learned by being Banded. That's the beauty of the Band. You can do that!

I used to use Dr. Overcash in Ocala, FL. No idea if he's still doing fills for Mexican Bandsters as it's been almost 4 years.

So, I just realized that today is my 6th year Bandiversary. Wow! I can't believe it. Life changed so much in the past six years. Got married, had two babies... and am about to deliver my third. Up until this pregnancy, I had maintained 65 pounds out of a 95 pound loss with absolutely no fill. Prior to being Banded, I had never lost more than 17 pounds... and that involved being at a vegan ultra low-fat spa for a month. (Gained it back in two weeks.) I was never the person who lost a lot of weight, and then gained it back and then some. I was the person who never lost more than 5 pounds. The person who never felt full until I had my Band. I've had some trouble with trying to refill my Band post pregnancies... but other than that, nothing negative. No reflux, slips, erosions, etc. Band looks the same as it did six years ago on the x-rays. I'm going to try to refill again after this pregnancy... so we'll see. In about six months, I'll see where I'm at. I may go back to my normal setpoint, -65 pounds with no fill. Fills may work, and I may be less. Or I may be pretty much where I am now. If I decide to go with a revision, I'd probably go with a VSG. But, right now, I'm doing a wait and see.

What does your gastroenterologist say? Honestly, I would go with his and your surgeon's opinion... rather than us random folks on the board. Was the reflux worse when you had a fill?? Even though you still suffer now, is it at all better?? That might give an idea as to how the Band is impacting this. Still, go with the specialists... I'm sure they understand your disease and the issues the band could cause.

Hi Vanessa: Honestly, ever since my first pregnancy ended, I've had trouble with my Band everytime I've refilled. It's always looked fine on fluoro.. but behaved strangely. It's driven me crazy... as I self-pay for fills and fluoro... only to have to have the fill removed a few weeks later. I'm wondering if part of it is psychological... that I just couldn't get back into thinking/eating like a Bandster. I also experienced tremendous hunger along with my restriction... which had never happened before. I'm going to try and refill again after this pregnancy... and will give it 6 months. If I can't figure things out, I'll probably have my Band removed and go for a VSG. I hope you have better luck than I did If you're breastfeeding, your hormones still could be a little wacky. Karla

I've gone through three Band pregnancies (well, on my third). I've noticed that especially post-pregnancy, my Band can be very wacky! Even with no fill. Sort of like when I get my period. No doubt due to the weird hormones and such. So, just wanted to let you know that you're not alone. As for the rules... Chew! Chew! Chew! Chew to mush! No drinking with meals or for one hour after. (I usually drank up until the meal came... but only Water.) No carbonated beverages. No alcohol. If you're breastfeeding, be sure to keep taking your prenatals. I ended seeing a bariatric nutritionist, and she had me on six small meals/day rather than three. It seemed to work better for me as far as weight loss went. Exercise. Every day. No excuses. Not a real rule...but for me... I was always extremely tight in the AM, so Breakfast was usually sugar-free Carnation Instant Breakfast w/ hot skim milk... or if I was feeling decadent, Godiva Hot chocolate w/ hot skim milk. Then around 10:30 or so, I'd have either cottage cheese and fruit or maybe a scrambled egg + 1/2 apple.

I've never heard of that... in over six years of being Banded. If your Band had issues (like with the port)... it would be unrelated to your activity.

Good luck with all of your appointments. Even if she's scheduled to arrive at JFK at 3:15... who knows when she will... or how long it will take to get through customs. I don't wish a bad experience on her... but I've picked up many people there on Int'l flights... and usually they take up to 1-2 hours to make it to the outside. A lot depends on the number of flights arriving at the same time to clear customs though.

PB stands for Productive Burp. Basically, it means that you regurgitate what you just ate. It's not like the typical vomiting one has when sick... usually it's a little cough or burp and up it comes. (You're emptying the pouch that your Band forms, basically.)

Glad you were able to keep your Band. For those who are wondering, yup, Dr. Feng did leave LapSF last Fall and started his own practice in San Mateo John Feng MD - Bariatric Surgeon - San Francisco's Bay Area Bariatric Specialists Crystal Springs Surgical Associates San Mateo, San Francisco, Palo Alto, San Jose, CA.