SouthTX LapBand

Dear Anthony .... Several people here have asked you about fuller details in your banding. More than just hearing about the relentless pain and not being able to burp. (as an aside, It is highly unusual to not be able to burp at all -- afterall, the opening at the distal end of the esophagus just has to open up briefly, as it does whenever you swallow something... Tho it IS necessary to be relaxed enough to burp.... Tension can keep someone from burping - which is why the consumption of alcohol can lead to "accidental" noisy burps in someone who normally suppresses them.) Anyway, I have wondered about your degree of restriction and what sort of foods you have been able to regularly consume without difficulty. Do you still have to consume a soft diet or are you totally on a regular diet. I have been wondering how often you slime or PB, and what this tends to happen in conjunction with. What has your weight loss been and are you now at a normal BMI? I hope you can help by giving us a fuller picture, and if you have that band removed, I do hope you keep us updated about scheduling surgery and then, when you get home, I hope you let us know if it gives you the cure that you hope for. And ESPECIALLY, we will all want to know just what the surgeon finds wrong with the placement of your band --- your keeping us informed can help so many immeasureably by adding to the knowledge base, and can hopefully be of help in making sure this doesn't happen to other patients --- in that regard, it would be great if your surgeon sends Inamed a copy of your operative report and perhaps submits your symptom history and surgical findings to a bariatric journal. Thanks so much for sharing your (painful) journey with us.... Theresa Reynolds

just had a light bulb go on for me ---- sometimes it is possible to train yourself to sleep on the opposite side, facing another direction... But it is often necessary to re-orient the bed, doing some redecorating so to speak, for we often want to be closest to (or furthest from) the door, the bathroom, the window or such ... Before I plunked $3,000+ down for surgery, I'd give the mattress condition some thought --- and try the other things I have mentioned. Heck, I'd even ask my doc for a month's prescription of 10mg Valium (great for muscle strain and for relaxation, too) and try it with my new sleeping conditions. I am not trying to make you keep your band -- I'm trying to cure your chronic muscle strain. Mainly because I'm afraid that after all this time, the surgery might not do what you expect of it...

Hi Anthony --- I am IMPRESSED with your physical fitness!!! But I can relate to your theory of your possibly "guarding" during your sleep. This is not far-fetched at all. But this is what I might suggest as a first step before you invest $3,000 in having it removed. First, there is always the possibility of having the port location changed to a midline position.... I love having mine there.... But if I were you, that wouldn't be my absolute first thought. What I am going to suggest is your bed and aids to correct your sleeping position. I, too, sleep on side - consistently. One, the mattress. It should be turned periodically AND FLIPPED (twice a year) to even out wear and to prevent structural damage inside causing poor support. If you have been heavy, such structural damage happens much more quickly. Before you actually go out and replace a mattress (unless it is obviously sagging anyway), I would both flip & turn it, then add DOUBLE foam waffle pads (or the more expensive deep foam toppers). This will help even out your spine and take strain off supporting muscles. Then, I would get two body pillows and fasten them together or pack them together into a common covering that would feel comfortable to draw close to you. When you go to bed, wrap your upper arm around the pillows (I happen to use a large stuffed animal, but that is me). This will help keep your spine from assuming a twisted spiral position. Both have to be done together to work optimally.... But I would certainly be interested in knowing how you do. This is just an aside --- When I am tense and stressed about things (like my mother's health recently), and can find myself waking with tight and sore muscles. Some people find a lot of benefit for being adequately treated for low-level chronic depression which can cause chronic muscle strain.

I am on a number of lists, including MexicanBandsters and SmartBandsters, and I know people he banded 7 to 8 years ago. I, too, have heard nothing but good things about him. He is one of the two most lauded lapband surgeons in Mexico. I think you made a good choice. I would recommend him even over the doctor who did my surgery!

Okay ... Next question that comes to mind. If this was present within 48-72 hours of surgery (as the major pain meds were being replaced by simple anti-inflammatories), then I would consider if the positioning during surgery, the movement back to your bed --- I would wonder if a strain was exerted upon a muscle group or something. The surgery itself does exert a great deal of pressure and pulling on the diaphragm muscles --- and it DOES leave it very sore & tender... and irritable. But that muscle gets over the insult within a few days, so I'm still puzzling. At this point, I would contact SEVERAL lap band surgeons who have long-term experience with banded patients (like especially in Europe, etc) and find out if they have ever had cases like yours --- for among scores of thousands of patients, one would have to assume that IF it is some sort of connected problem, that you are not the sole patient to have something of this sort. Your best bet starting bet would seem to be an email to Inamed's patient contact person (contact me for an email address). Next, a medical school bariatric program. There might be one in your state or near you. A letter of inquiry, an offer to send medical records, a request that they search the relevant literature and less formal mentions. One question I have for you ---- back pain is often caused by and/or aggravated by abdominal obesity paired with weakened muscle tone, and especially aggravated by even minimal degrees of lordosis. Wondering how much weight you have lost in the past 2 plus years since your banding and how much more active you have managed to become. My back pain did not begin until some period of time after I gained weight. Have any of the doctors referred you to physical therapy to help strengthen your core muscles? Has your surgeon helped you achieve steady weight loss? This was great for you to start this thread. It would be wonderful to help others as well as you sort thru back pain issues. Back pain is considered the MOST intractable and difficult pain issue to treat. I do feel for you. Theresa

I would think "gallbladder", too - but there could be other reasons. Is the pain constant or periodic? What can you do that takes the edge off the pain? Just because the pain started after the band doesn't mean it is related to the band. Time to see the doctor and ask him, "why does my back hurt?" Terrible to shell out thousands for surgery and still have the pain.

I simply can't imagine lying or dissembling when crossing the border. Of course, I live in Texas and maybe we just do things differently here. At a border passing like Progreso that is essentially a pharmacy & dentist mecca for Texans & Winter Texans, EVERYONE walks thru customs with your alcohol purhases & the bags of meds that you have purchased. If you are on a bus day-trip, an extra crew is sent aboard to rummage thru what is left on board. It's simply a matter of routine to be truthful, open & honest. It is expected and understood why tourists come across. Agents are trained to detect evasion & a case of nerves -- the expect you to come to Mexico for the cheap meds -- no crime. Now as to going across at Acuna, it is more a party place (at night), but during the day, it is a given that dental and surgical patients will be crossing. When you are banded, Dr. Jose R gives you the box and documentation that came from Inamed, along with his signed dictated history notes & the operatice reports, as well as the signed Inamed card you will carry with you from then on. When you are coming into Mexico, just say you are coming for surgery with Dr. R... and on the way back, flash the box and say you had surgery. They know what it contains - the antibiotics, anti-inflammatories, the tiny bottle of liquid pain meds. Dr. R's hand written prescription is in the box. Anything you can buy in a pharmacy is legal to dispense and you can bring back - no prescription needed, tho many people like to bring their own old bottles to show they are buying prescribed meds for themselves, but this is not necessary. Coming back with anything from anti-depressants, Viagra or antibiotics is "no big deal". You're not going to find pharmacies handing out diet pills, strong pain killers, cancer drugs or such, tho you can seek out Mexican doctors and clinics who dispense them WITH A PRESCRIPTION, in limited amounts. Never try to sneak back alcohol to avoid paying taxes, and don't lie about things that are no big deal and expected. By the way, when women come back and don't show the Inamed Lap Band box, just declaring "we were here for surgery", the guards are known to immediately eye your breasts!! :confused:

Read this thread - http://lapbandtalk.com/showthread.php?t=12356 about what Photo learned in her lap band informational seminar. Actually, the entire thread is pretty good. Another place to investigate Lap Band is SmartBandsters at yahoogroups.com. More and more lap band surgeons are being approached by previously operated on patients to have conversions to the lap band. You see, the lapband is a life-long adjustable tool. It never stops working - you just have to work with it and get adjustments as needed to lose and then maintain. But after 2 years out, many GP patients, of whatever sort, find that their gut begins to process and absorb calories better again and the restriction diminishes, too. And if they never really changed how they relate to food and thus started eating healthy, then they begin regaining the weight lost. This is not true of Bandsters who keep their band adjustment prime and eat the Bandster way ---- solid Protein first, green lightly cooked vegetables second, extras last.. And no drinking during meals and don't resume for at least 90 minutes to 2 hours. Spend some time investigating and learning the lifestyle changes either way involves and decide if you are ready to commit. I'm doing great now, but I had to work thru some issues before I was ready to commit. I had "last meal syndrome" really bad for about a month or two.

Dr. Katkhouda is a pioneer in laparoscopic bariatric surgery in the United States. He is Professor of Surgery and Director of the Department of Surgery's Laparoscopy Program with the University of Southern California's Bariatric Surgery Program. Dr. Katkhouda agrees with his colleagues that obesity treatment does not end when the patient leaves the hospital. "These patients have a radical change in their lives," Katkhouda observes. "Without food for comfort, depression sets in. Support groups and nutritional counseling are key." Copyright © USC Bariatric Surgery Program 1510 San Pablo Street, Suite 514 Los Angeles, CA 90033 Phone: (323) 442-6219 Fax: (323) 442-6280

2 addendums --- add this word "The MOST important variable (after a proper FILL program) in whether or not Bandsters are successful" and I meant to say more clearly that some patients fail to ever get a fill ... some get too tight, but don't go in for an unfill ... and some get frustrated with a protracted expensive fill process (or are never taught what CAN be achieved) and simply "give up". Theresa

I would not consider Pleatman a respected lap band surgeon based on how poorly he has helped his paying lap band patients lose the weight they sought his help with. This shows a lack of education about the entire process, dynamics, psychology and such. Taking out a TOOL that could STILL be utilized successfully with proper teaching, coaching, counseling and support .... to then do a procedure of surgically altering your insides ..... WHEN ALL TYPES OF GASTRIC BYPASS have a much worse long-term "success rate" than that 25%. Lap Band surgeons are increasingly approached by all types of bypass/RNY patients who are over 2 years out who are seeking to be banded because the gut has adapted and is absorbing more and restriction has been lost. The MOST important variable (after a proper program) in whether or not Bandsters are successful over the long term achieving good weight loss along with achieving better physical health and conditioning is ONGOING GOOD EDUCATION & SUPPORT on how to become a successful Bandster. If good fill programs, education and support is available, patients still always have the CHOICE to 1) not go back for fill adjustments 2) learn to "eat around the band" Some fail to deal with all the psychological hurdle we all face in learning how to replace food with other non-food activities which give the person the same satisfying "rewards" that comfort food once did. Some are, on the hand, having to deal with negative inner and outer dialogues that make them feel that they do not deserve to be slender and healthy. And sometimes, we have those close to us that overtly or subtly work to sabatoge our progress. Sometimes we need to separate from certain people or other situations, and/or get the help to become strong enough in self to no longer be influenced by the dark forces. The Band is not magic. It cannot make me do anything I do not want to do. It is a tool that HELPS me achieve what I want to do. With my help, my band can help me become healthy, let me live to see my grandchildren grow up and my children reach retirement. It is already making my life better. It has already increased my self esteem and sense of self worth.

Tammy, I am very concerned for you. I would strongly recommend you speak to your surgeon's office on Monday. about a consultation with his Nutritionist. And you DEFINITELY need an unfill. Most lap band professionals would suggest a total unfill, getting you on a HIGH Protein balanced diet, then after all your lab values look good, starting you on fills again, after a few months. You are in a very precarious metabolic state. You are starving and your body is digesting your muscles. You are nutritionally deficient in all dimensions. This can so far that you even endanger your heart health. Malnutrition is one of the main causes of long-term BYPASS deaths. You are living life like a anorexic. And maybe you desire this too much to listen to me --- but if you are heavily conflicted about resuming a balanced diet to recover your health, then you should consider asking your surgeon's office for a referral to one of his preferred consultants.

PS: The fact that Dr. Garza WAS able to capture my attention stop the "attack" and get me engaged in "polite conversation" was what he needed to determine my condition. These other physicians and surgeons, just down the hall, are available to check on patients if need be when Dr. Rodriguez is in surgery with another patient or not immediately available.

Hi all .... The reason I am dragging this old thread up to daylight again is because I wanted to speak of Dr. Jose Rodriguez, the private hospital he practices at and who he has for support in case of an emergency. First of all, ONLY have your surgery scheduled there Monday - Friday. No Weekends. More than half of the building where the small 10-bed hospital is located consists of the clinics, upstairs & down, where the doctors have their offices. Among the doctors in practice in that building are cardiologists and two other laproscopic surgeons. Dr. Rodriguez uses chiefly very safe hypnotic anesthesias and avoids the gases that cause frequent post-surgical nausea. But one of the side effects of the one of the meds is the patient having the SENSATION of being unable to catch their breath --- thus displaying hyperventilation & panicked efforts to breath. Usually the patient will have no memory of this (or anything else) that happens during after coming out of recovery as the amnesiac stage is still present. However, the reason I bring this up is that it happened to me ---- and I have the isolated memories of Dr. Jose Rodriguez AND other doctors at my bedside. I remember because one of them said my name, catching my attention, and introduced himself -- a Dr. Garza -- very handsome, and I greeted him and shook his hand. I also have the memories of the oxygen mask and finger clamp monitor on me ... and a sweet woman stroking my face and calming me. I was never in any danger, but until he was CERTAIN of why my symptoms had suddenly developed, he had access to reinforcements in other surgeons.

Hi, DeLara .... Just came back to mention that ALSO Dr. Jose Rodriguez (and possibly other Mexican surgeons) routinely use the Inamed Mini-Port which is still an extra $500 option with many surgeons.... What I have read of research to date is that it is STILL not known just exactly why erosions happen --- only that they are most common after about 18 - 24 months out. What have you heard or read about that point recently?? And have you read the Israeli medical school where they have been doing dual-surgeries? They reband at the same time they surgically correct the erosion? I sure hope you are able to be rebanded soon. I noted your dates... and feel terrible that you had two port site infections. When I got home and ran out of antibiotics, but still had warmth over my port, I went on Amoxicillin for more days. I wonder if port site infections are simply common for all hospitals or more common if done in smaller private hospitals where things like advanced sterilization equipment and air filtration systems in surgical suites is not so likely.

I, too, was banded in Mexico by Dr. Jose Rodriguez --- but I was not fortunate enough to have had Barbara as my contact person, tho I have come to know her since my surgery. The new "patient coordinator" mis-informed me about many things, lied to me about many things, and was appalling misinformed about living the banded lifestyle. I found out that a lot of this was due to the fact that her self-education consisted mainly of learning about how traditional bypass patients must live and eat. I have had my first fill, and it took me right to my sweet spot, so my losing schedule has gotten a jump start. I have learned from my time on SmartBandsters at YahooGroups that many US surgeons are timid with fills and can take months to get you anywhere close to good restriction, so I really appreciated Dr. Rod using his "patient feedback" technique of determining proper fill. One thing which going to Mexico REALLY has going for it, tho (if you are Self-Pay), is if you should have complications of any sort, they won't cost you an arm and a leg. You are put up and treated at doctor expense, save for extra meds and such, if needed. So that part -incurring extra expense- IS something for you to consider when you don't have insurance or loads of money or credit to pay for extended days of care. Another consideration is that you should find out EXACTLY how many surgeries the surgeon you are considering has done. Less than 300 tends to mean more complications. Another consideration is the surgeon's attitude and his staff's attitude towards banded patients. Mixed practices have generally poor track records of giving banded patients adequate support or accurate information. The tend to not have separate support groups for banded patients, so your support group exists primarily for the needs of GP patients. These are also, of course, considerations when looking for someone to provide fills State-Side. Support groups and knowledgeable support staff is so crucial. No one can get by on just monthly support group meetings. You have to expect to get intensive education and emotional support from groups like SmartBandsters, which is used by NWWLS for support for all their practice patients and their fill technician, Jessie Ahroni, is the group leader and main source of advice. Summing up, you can expect EXCELLENT surgical and fill expertise for many Mexican banding surgeons ---- but outside Kuri & Rumbaut, you will have much heavier needs for self reliance in making certain you provide for your own psychological and nutritional learning curves.

I was just given my first fill this past Monday, one day short of 5 weeks after my surgery. I asked him, "How much are you going to give me?" "You will tell ME," he replied. My mouth fell open. Whatever could he mean? I have spent months reading the boards and lists, with people posting, My doctor gave me "___cc's" ..... often followed with complaints that they didn't feel ANY sense of restriction, that they were still starving, and, in the worst of cases, that their doctor didn't want to see them again til at least another 6 weeks. And some of these fill appointments were EXPENSIVE and involved long drives and taking time off of work. So here is how my "patient-directed and -led fill" proceded. He palpated my sternal port position. He prepped the field. He mixed the solution (he prepares a custom solution of a certain osmolarity). He drew up the solution, inserted the syringe and needle into the port, then helped me to sit upright. He then handed me a 12-oz bottled Water and requested that I take a small drink. He then asked me to tell him what I was feeling. I told him I could feel a sense of coldness in my lower esophagus. He pulled a bit of Fluid out, and I reported feeling the water gurgle down. He then directed me to swallow again, and upon my explaining how the water felt going down, he continued to slowly withdraw a bit more fill. After several rounds of this, I was able to drink as rapidly as I cared to and finished the bottle. Burps also came easy at this point. Thus I was pronounced properly restricted at one step removed from where I could still feel a sense of pressure under my breastbone when swallowing. We stopped where I had no unusual sensations of any sort connected with the swallowing of large gulps. I went out and had a regular meal that evening. My "don't eat one more bite" full-enough signal is a diffuse tickling sensation over the entire rear pharynx. I am tight in the morning, needing a warm beverage to loosen me up enough for yogurt. Now, at 4 days past, I am feeling a bit tight today, with my morning tightness not having dissipated very much today (tho it fully has on all previous days this week) but I was still able to eat and drink my fill. And I have had no problems getting down my many meds and supplements. I had been simply starving for several weeks and was so wide open, I am relieved to have already reached the legendary "sweet spot". I am reminded that another patient of his who was banded in August was also given enough of a fill the very first time to reach her sweet spot. She later talked him into giving her a teeny tiny increase --- which she had to have fully removed (the increase, that is) a day later because she couldn't even swallow her spit. So the moral of the story seems to be that asking for patient feedback in determining good restriction seems to have something going for it. Maybe when you only charge $50 a fill, there's not that much profit to be made from seeing your patient every month or two, again and again and again? My Mexican surgeon, with thousands of lap band installations under his belt, seems to simply be exceptionally skilled at quickly bringing a patient to the maximum freedom from hunger. I love my band. I think I will name her Lola.

Hi, Angie .... Just a 0.1cc or 0.2cc increase or decrease difference can be the difference between "I can't swallow anything but liquids" and "I have to eat Bandster Style & chew chew chew, but I'm NOT HUNGRY any more and I'm losing weight." From my time on SmartBandsters support group at YahooGroups, I've discovered that many US doctors ARE very conservative. They start low and slow, they often don't want you to come back sooner than one month, and when there is need for an unfill, they tend to take out way too much --- or sometimes all of it. Mexican docs, perhaps from having so much experience over the years, tend to use that "sit up and drink" style. As long as you don't lie to your doctor about what you're sensing, things seem to usually go well. They just don't want you to leave town for several hours. I have also discovered that some people start tight and loosen up in a week, but others are like me and tighten up significantly about 4 days out. I'm still tighter in the morning, losest around supper, then tightening again late. And Jessie Ahroni just told us all something I had never known before -- that a pre-dinner alcoholic drink will loosen your band!! :paranoid I learn something new every day still. Anyway, why not take a bottle of room temp Water with you this next time, have your fill around 11am or 1pm, and suggest to him that the two of you try this? I'm losing faster than I had expected to be, but I know with every pound lost, my caloric needs fall --- and that I will be losing slowly enough after I hit 180.

Well, that showed a lack in my understanding to date --- I had THOUGHT I had learned that the stomach wall begins to grow over and encompass the band, rather like how a tree's bark grows over a wire wrapped around the trunk.... and that the band can even eventually erode through the wall of the stomach, ending up on the inside. However, I did find that article (they were Israeli surgeons at Tel Aviv University Medical School, not Spanish) and sent you the abstract via your email address. I had read a bunch of abstracts that day and failed to remember that they HAD done surgical repairs in between the removal of the band and reinstallation of the same. For those who are interested in their successful study, here is the link - http://www.ingentaconnect.com/content/fd/os/2005/00000015/00000006/art00018

Dear Kathy .... What I would ask you is this? Are you eating the Bandster way? How soon after you eat do you find yourself hungry again? Have you been regularly eating bad choices? The band can not control your selections of foods to consume, it can only keep you from being hungry WHEN you are eating the Bandster way. You have been losing weight at almost 9 pounds a month and that is a good rate. It would not do you any good if you went for a fill and ended up PBing, sliming and in pain, and ended up needing to go back in rapidly for an unfill. Like Jessie always says, the band is a tool to control hunger so you don't have to totally rely on will-power like we have in the past. The band keeps you from having to suffer hunger pangs and uncontrollable cravings. Only you know how you are eating, what you are eating and whether or not your fills have gotten you to the point of good restriction. I have excellent restriction, but I know that I could pack away a lot of holiday goodies IF IF IF I decided to pick them up and put them in my mouth. But I want to be thin more than I want to taste goodies. So for today, and then tomorrow, and then the next day, I will make the decision to work with band, be grateful for my band, and keep my focus on my goal. And since I am not perfect, if I DO pick something up, it will be for a controlled tasting, a sampling. I will not stuff my face. I will continue to eat mindfully. I will not start out by planning to do so, but will not beat myself up if I taste. How do you fill about your current fill level? Are you still going hungry? Are you avoiding liquid calories and soft calories? Are you eating solid Proteins and firm vegetables and fruits?

I went to a doctor across the Texas border and he is great. He put me in my sweet spot with only ONE fill, and will sometimes send patients home with a fill, too. With Southwest Airlines flights and people he employs who will drive you where ever you need to go, things can be both simple and inexpensive. I had pre-surgery jitters, too --- but they would have been much worse for State-side docs with little experience and poor track records of post-band care.

Going Back was always my pick for I had read so many stories of inexperienced and overly cautious docs in the States. I was self-pay and didn't have hundreds of dollars to pay out every month or two. But my experience in going back to my surgeon was SO MUCH MORE than I had ever expected -- see my story here -- what talent in hitting "sweet spots" in only one fill.... :banana http://www.lapbandtalk.com/showthread.php?t=12718 The distance there is somewhat over 250 miles for me, and smooth open highways all the way, only a few stoplight towns to slow me down. The doctor has someone in a city two and a half hours away who will pick people up from the airport and make a day trip, getting you back to the airport later in the day (or to a hotel if you prefer to spend a night). Southwest Airlines is so competitive and when Jet Blue invades Texas this spring, there will be price wars. I prefer to take the bus, along with my favorite pillow, some Snacks, something to drink and a good book. So cheap. Some prefer the train as it is the same price. You can take a cab across the border for the 5 or so blocks to the private hospital where his office is upstairs.

Hello, Dr. Pleatman. I recently read the abstract of a research paper of a group of lap band surgeons in Spain who reported good results in simultaneous removal and replacement of the band in cases of erosion. Not having read the entire paper, it is quite possible that cases of severe erosion (where the integrity of the stomach cavity has been compromised) were not included in the study, but if you are interested, I'm almost certain I bookmarked it and will be glad to track it down for you. I am trying to remember my Google search string. Hope this has been of some interest to you.

I did some research on this a few months back, and found that SOME states have Medicaid that will approve bariatric surgery (like South Carolina where it approves MANY) surgeries... But Maryland approves ZERO. Texas Medicaid approves some, but you have to have your doctors go to bat for you --- and then you are limited to the the number of available surgeons. So happy to hear that there is one in the Dallas area. But to get back to Medicaid --- one thing I used to hear, again and again, is that Medicaid WILL approve traditional bypass surgeries --- but NOT LapBanding. This was so in South Carolina and Texas at that time. Understandable, given that we are still having to fight regular insurers to include it under covered procedures. Traditional ByPass surgeons often are fighting extending coverage to the Band, even tho it is an FDA approved device. I wish you luck and look forward to finding out if you can indeed get approved!!!! Please keep us posted as I have a lot of people who will keep his schedule busy. Theresa

Hi, GlitterQueen and NavyWife!! Thanks for the hello's... I had my surgery done Tuesday, released 24 hours later, home in another day. Absolutely zero pain, nausea or problem of any kind. Great experience in Acuna (not so afterwards) and great price break for both surgery and fills. I consider myself more than lucky -- blessed.