SouthTX LapBand

No one mentioned the one great solution without any possibility of blocking you up --- a stool softener. Small soft capsules, one or two a day. Contains NOTHING to stimulate the bowel, so it is not a laxative. It just keeps the stool from getting hard (as it does when the system slows down and you are TRULY constipated). Sold OTC as Colace. Look for generics - dirt cheap. Safe and effective.

Hi, Almost Ready! Yes, he can purchase a "learn how to do fills" kit from Inamed. It is exactly like adding medication to any implanted port and cancer nurses do this, and he may have even done this in his medical training if he is a bit younger. He can probably find someone willing to supervise his training and maybe Inamed could even help him with suggestions.

Hello, Vines... Wanted to let you know that I have difficulty losing weight. I have very low basal metabolic rate (on thyroid meds, but they ain't magic), and I have Metabolic Syndrome, AKD Syndrome X, more tradionally known as pre-diabetic syndrome with HIGH INSULIN RESISTANCE. After eating, my eyes get very blurry and have for the past 3 years. Double vision, even. This is from the high blood glucose levels I get after "regular meals". Worse, the carbs trigger high insulin production, which makes me hungry for MORE CARBS, even as the blood sugar spikes. Let me point out that I have always had normal FASTING blood sugars. The only way I can eat and lose is to focus on Protein, include fats, but avoid all refined and simple carbs (limited green veggies & Beans in moderation are all I strive to limit myself to).. I, too, have to severely limit my calories to lose... that is why I'm so glad that a focus on Proteins can keep my satisfied, not hungry. I am hopeful for you --- just work on eliminating refined carbs and limiting the others.

I would suggest you join Houston Bandsters at YahooGroups.com. Active group and great resource. They even have f2f support group meetings.

I knew which incision was my port one (it was where I had asked him to put it).... and I was SURE I could feel it.... UNTIL I had my first fill. It was not under the incision at all. It was near the incision, but not underneath it. I can still feel what I was feeling before -- but I know realize that what I was feeling was scar tissue from the incision.

A fluroscope is often used to LOCATE THE PORT - my doc is very consistent in placing his (after 2000+) and knows exactly where to fill. Fluro was more important in earlier days when sometimes the fill needle missed the diaphragm and punctured the tubing --- nowadays, there is a rigid sleeve over the first part of the tubing to protect it from such misadventures. Additionally, a fluroscope can be used to watch the flow of a swallowed Barium-contrast drink so it can be SEEN if Fluid is passing thru the stoma - and how quickly it flows thru. However, it is not a fool-proof method. My doctor has you swallowing Water and he waits until you can really drink easily - then he makes you hang around for a few hours, drinking more, making sure you are good to go. But still, the stomach is a jittery organ, and you can't always predict how it will react to increased restriction. Some are tightest in the first few hours and/or days, others don't get tight until 4 days to 2 weeks out. You can never determine what your own experience will be like --- and it may be one way for you this time, but as time goes by, the experience may change.

It all depends on your doctor or fill technician. Some will fill you up til nothing you drink can trickle thru ... then begin backing off, bit by bit, til Water is passing readily. DO BE AWARE that many people achieve maximum restriction 4 days out from the fill, so it is necessary to be COMPLETELY TRUTHFUL & FORTHCOMING when describing to the fill person what physical sensations you are having. Many (not all) surgeons in the States are VERY SLOW and NEVER want to do the "directly to good restriction" stuff. Why? Who knows --- but there ARE those sadistic doctors who want the patient to be hungry and suffer and struggle to diet. Some of them truly think that the band alone should do the job, and consider the patient a wuss if they complain or continue asking for an adequate fill. Some think it is because the doctor makes good money on fill days, so prefer to make sure you have to come back 6 times or so. MX docs tend to give good fills (at least the ones I'm aware of), and I would SUSPECT that State-side docs who provide a year of free fills might be more aggressive with fills. The thing is --- It matters NOT if your doc is handsome, charming, if he sits on your bed and holds your hand ---- what MATTERS is aftercare. If he (or his staff) can't be responsive to your needs and concerns, if he makes you wait more than 2 weeks without losing weight (when you KNOW you are working the program), or thinks that going around hungry all the time is a virtue, then he is not the doctor you want doing your surgery. Unfortunately, most people hire a surgeon on glowing reports on the surgical experience ---- it is preferable to get in touch with his previously banded patients so you can get a fuller idea of his bariatric practice....

I'm not impressed with your surgeon's response to your response to what seems might be only an overfill ... but could be signs of erosion. You need to be the squeaky wheel and pressure him to find out what's going on. Erosion is often signaled by a sudden flare up of port discomfort.

go to http://www.google.com --- I don't keep their sites bookmarked.

Heavens, I don't know anything about them -- I just happened onto their webpage one day a couple of months ago. But I do know that Dr. Kuri has regular fill dates when he is in town, so you could contact his website.. and also, as I said, Dr. De La Garza of Monterry, his website, too, as he refers to these independents I mentioned.

Hi, Trisha You need a New Start. You need an INTENSIVE new beginning. I would strongly recommend a few months with SmartBandsters - a top choice. It is hosted by Jessie Ahroni, PhD RN/Nurse Practioner who has been banded since 1997, who happens to also be the long-time fill technician for a WLS practice in Seattle. Her PhD is in Diabetic Care, so her nutritional and metabolic educational background is top-notch. There are many returning long-term bandsters who have been without good follow-up care, with weight gain or with little loss, over-restricted or under-restricted. Sometimes they used to be active, but drifted away and stopped losing weight. GOOD QUALITY AFTERCARE IS CRUCIAL to LapBand Success. If your doctor doesn't provide an on-call therapist, an on-call nutritionist, a support group hosted by his RN, fills with a tech who can spend time teaching you what you need to know and asking questions, then ANYONE, no matter how motivated, no matter how disciplined, can end up not losing. This is not your fault. But the rest of your banded life begins today. It's time to be pro-active, to take on the responsibility for your own aftercare. From your doctor's website -- ONLINE SUPPORT WEBSITES: LapBandTalk.com ObesityHelp.com SmartBandsters -- (my recommendation) http://groups.yahoo.com/group/SmartBandsters/ local support groups: BAYTOWN San Jacinto Methodist Hospital, Classroom B 4401 Garth Road – Baytown first Tuesday of each month at 6:30 pm. HOUSTON AREA BANDSTERS 1:00 pm every third Saturday at H3-Health, Hope & Happiness. 9950 Westpark Dr, suite 425 also active online group - many of Dr. Spivak's patients PSYCHOLOGICAL SUPPORT: Dr. Kevin G. Smith, Ph.D. 4318 Stanford 713-795 5151 Andrea Pucciarello, LMSW-ACP 4265 San Felipe, Suite 500 713-622-7002 Cindy Kilroy, M.S., L.P.C. 5810 Wanakah Dr. 281-798 5505

Actually, you can take the bus from CC to McAllen - much less wear and tear on the patient, and very inexpensive. Just before I selected a doctor, I considered Reynosa. The nearest other doctors who will follow other doctor's band patients are in San Antonio. It is a bit further to McAllen, but there ARE docs on this side of the border who will see you, too. Go here to search for docs & contact info. http://www.asbs.org/html/about/membersearch2.html Type in your zip code, and select LB in the other box (that says "surgery type), then hit search. The list will be in order of how far away they are from you. Scan the list for those surgeons who list FOLL in their listing of "what they do" for that stands for willingness to follow other doctor's patients. The reason why a city the size of Corpus Christi with its economic draw area has no bariatric surgeons of any kind is that they were run out of town years ago by huge malpractice awards commonly awarded in South Texas. Don't know when they'll venture here again.

Actually, you living in Las Vegas --- were you aware there are two local fill techs who will come to your home or place of business to give you a fill? They do follow-ups at the requests of several surgeons like de la Garza. Can't do it less expensively.

Don't know if there are any openings left, mind you. You would have to call long distance to his patient coordinator and find out...

ah ... you live in Vegas. Mountain time? Pacific? It would be an EARLY departure, but you could still make it a day trip. I just checked his website, and he does do fills on other doctor's patients, but I don't know if his fee varies. He DOES need to know ahead of time just exactly what band you have (see your device box & documents and have them on hand when you email or call). There is a trip this Saturday. Interested?

Mine is across the Texas border, in a small town. Where do you live? The trips leave the city at 8:30 am in the morning, are back to catch early evening flights out. Some people spend a night or two at the airport La Quinta and use the shuttle.

My doctor charges $50 for a fill in his office (in the same building as the hospital). If you need the flouroscope, that is either $75 or $100. The entire day's transportation, to and from the nearest major airport, is only $25 --- but a large van is used and "fill trips" are scheduled, on Saturdays.

The entire point of the band is to readily achieve satiety (feeling "full"), retain that feeling for a few hours, AND for that condition to induce behavior changes such that you can lose 1-2 pounds a week. The entire point of the band being adjustable is to make this "state of being" available to everyone who gets banded. If you are still "there", then it might be counter-productive to change anything at this point. When you have gone 3 weeks without losing weight and/or you are struggling to deal with hunger issues and/or you can only lose by "dieting", then it is time for a fill. Follow your instincts and let "the lady of the silicone fist" run your life.

Oh WOW! You are GOOD! The Fat Fairie does lend itself soooo well to preformance. More, please!!! :clap2: :clap2: :clap2:

Chronic Back & "under the shoulder" Pain Referred pain - that is pain coming from sources elsewhere need to be considered. For instance, the pain associated with disorders of the esophagus, stomach (penetrating ulcer), and pancreas may cause pain under the right shoulder blade. Any problem that causes irritation of the diaphragm can also cause shoulder pain. Pain from aortic dissection can also lead to referred pain to the upper spine and shoulder. A viral respiratory infection could leave you with pleurisy (inflammation of the lining of the lung) that might cause pain in your back. Pneumonia and pulmonary emboli may also do this. The most common “internal” cause for pain leading to the right shoulder is gall bladder disease. The term for this is “biliary colic.” A person with biliary colic usually complains of an ache or a feeling of pressure in the upper abdomen - but this may be totally absent. Instead, this pain can be referred (spread back) toward the right upper back. Ultrasound can be used to produce pictures of your abdomen to look for gallstones. Most episodes of biliary colic pass after one to five hours. Removal of the gallbladder can miss a stone in the hepatic duct or common bile duct. A growth on the ribs could cause shoulder pain and should be ruled out by an X-ray. Disc herniation and arthritis in the neck can cause cervical radiculopathy (pinched nerve) and this can cause pain to be referred to the shoulder. In fact, any patient complaining of shoulder pain should have their neck examined as well. Pain in the upper or mid back can come from trigger points in the muscles of the back itself, naturally enough. These muscles include the erector spinae, multifidi, trapezius, infraspinatus, subscapularis, serratus posterior superior, rhomboids, latissimus dorsi and serratus posterior inferior. Trigger points in the scalene muscles of the front and side of your neck can generate a constant irritating ache between your shoulder blades in your upper back. Very few people know that this is one of the very most common causes of back pain. A trigger point in the serratus anterior muscle under your arm can cause a persistent middle back ache at the lower tip of your shoulder blade that even a trigger point expert can overlook. Trigger points in the upper part of your rectus abdominis (stomach) muscle can be responsible for a band of pain across your mid back that will elude the best physicians, osteopaths and chiropractors. No kind of therapy applied to the back itself will relieve this pain. Finally, primary shoulder disorders such as rotator cuff tendonitis, bursitis, and arthritis can cause pain that starts in the shoulder but also travels to the upper back. A special type of bursitis –subscapularis bursitis- is felt underneath the shoulder blade between the shoulder blade and the back. Patients complain of a rubbing feeling and on examination, a grating sensation is noted. Obviously, the appropriate treatment depends on making the correct diagnosis. http://www.arthritis-treatment-and-relief.com/back-pain-and-under-the-shoulder-pain.html

I am scouring the online medical literature to see if I can find anything relevant or of help. I am learning. Questions - Is the pain constantly present? Does the level of pain ever vary? Does the pain tend to spike at certain times of the day/night? If so, when? Does it happen a couple of hours after meals, for instance? What can you DO that alleviates the level of pain? For instance, does applying pressure over the pain help at all? Have you been to a chiropractor and was he able to give you any relief? (if you haven't, I strongly recommend it as they can often do wonders with otherwise completely resistant back pain). My next post will be from an article I found on referred back pain, hoping it may seed some thought.

It means you have been over-eating, with the excess food (the "overflow" from the pouch) builds up and stays some time in the lower esophagus - which then relaxes and stretches to accommodate this extra food. When it happens on a consistent, often repeated basis, the dilatation would become constantly present. As far as I know, it is reversible. I have heard of it being treated by an unfill and restriction of intake to liquids and mushies for a period of time. You should call your doctor's office and say that you want to know WHY your dilatation happened and what you can do to get rid of it.. Since I'm not a doctor and only know what I have learned online -- which is not much. Theresa

UPDATE -- I note that Anthony says (on a new thread he just started -- DEDICATED & RESTRICTED to the topic of back pain related to having a lap band appliance) that .... 1) he was totally drained of fill 6 months ago 2) his regaining weight began at that point in time.. So while it is true that over-restriction can lead to soft-food syndrome and weight gain, it is not true for Anthony. Again, I thank Anthony for coming forward with this problem because it stands to help many people... Theresa

If you (or anyone) does want to investigate other surgeons in their area, there are two basic ways to approach it...... 1) contact your insurance company for THEIR list of lapband bariatric surgeons included under your plan 2) or if you are self-pay, just use this database - http://www.asbs.org/html/about/membersearch2.html Put in your zip code and select LB from the dropdown menu. The results are in order of distance from the geographic center of your zip code. "FOLL" being listed means that the doctor will accept patient transfers when you've already had your surgery done elsewhere.

Oh dear me... :confused: I'm sorry -- but I am learning SO much and you are helping so many people... so do know that your postings are very appreciated. It is highly disappointing to regain weight on the band, but it does happen in certain situations. Most often, it happens in cases of under-restriction and over-restriction. Again, what I hear is that you are too tightly restricted, and have been for a very long time. Why do you think your doctor has chosen to let this continue like this when your degree of restriction has had such negative adverse affects? The fill tech I most consult with would suggest an immediate partial unfill. This strong degree of restriction has not resulted in a reduced calorie consumption which strongly suggests "soft food syndrome". Or, perhaps, you may be drinking with meals or too soon after meals. Something that needs to be done is to carry a small spiral notepad around with you all day long for at least a week, writing down every last morsel you put in your mouth -- and detailing the exact quantity. Use a set of measuring cups and measuring spoons to do so accurately. Then sit down at http://www.CalorieKing.com and find out what your ACTUAL calorie intake has been for that week. Remember that none of us have a clue as to your identity and no one but you will ever see the contents of that spiral notebook and no one but you will ever read the totals you calculate at CalorieKing. In order to lose 1 pound a week, we must eat 3,500 calories LESS than normally (if, that is, we are currently eating so as to maintain a steady weight). in order to lose 2 pounds a week, we must then add enough EXTRA physical activity to burn an extra 500 calories a day. Of course, avoiding carbs and focusing on Protein will cause our metabolism to be boosted (takes more calories to digest and process proteins). Also, keeping well hydrated boosts metabolism. When we are dehydrated, our core body temperature drops. Staying in a colder environment and wearing less coverings to stay warm burns extra calories (so does drinking cold liquids). You are already doing GREAT where it comes to having built muscle mass, so you've got that cornered. I, like others with High Insulin Resistance, aka Metabolic Syndrome, aka Syndrome X, has ferociously strong hunger attacks triggered by the consumption of carbohydrates -- particularly the more refined "white" calories like potatoes, rice, Pasta and the digestible sugars. When I am starving, I end up eating too often --- refilling my pouch more than 3 times a day. I have to strictly limit my carbs so I don't overeat and have irresistable cravings for MORE carbs. I have recently come to recognize that some runners, after bypass operations, have a difficult time because they can no longer carb-load for long runs and races, and they need to become informed that carb-loading is not necessary ... that Proteins CAN do the job. Anyway, hope you don't feel I'm preaching to you --- I'm talking to anyone in general who might have similar symptoms and want to understand why they are gaining weight... If your surgeon is not doing the best possible job for you (and it is true that MANY surgeons in the States do not really understand, haven't yet learned, good band maintenance skills), then don't be shy about telling him what you want... Or, if he won't listen and respond appropriately, then find another band fill technician to consult. To find out more about fill surgeons & techs near where you live, you can join http://groups.yahoo.com/group/SmartBandsters/ and ask that question (and as many others as you like, of course), plus you can try going to http://groups.yahoo.com/ and search for lap band or bandsters and your state's name, for you might find a group. You can also try out WiseBandsters (which is ONLY for people who aren't newbies any longer). Managing to live a successful banded life is NOT easy and does not come automatically. It is a PROCESS of learning, un-learning and re-learning, best supplemented by a great medical support team and a great support group of knowledgeable and caring people. SOME people are lucky enough to have all that, altogether, with the surgeon they choose, but this is more the exception still, than the rule. So much is so often left on our own shoulders --- for us to struggle to find our own way. We often have people arrive back on the support list I belong to who lost for awhile, but then began re-gaining. It IS possible to get back on track... with intensive support and commitment to change --- and usually a fill or unfill. added --- BTW, a way to find a new surgeon to handle your fills is to use this search database for the American Society for Bariatric Surgery http://www.asbs.org/html/about/membersearch2.html . Just enter your zip code and select "LB" from the drop down menu of choice. Once you have your list, then search for those who ALSO list "FOLL" meaning that they will take on other doctor's patients. The listings are in order of distance from where you live, and includes full contact info, even web sites when available.