Baba Wawa

Yesterday, I was Dx with achalasia (failure of the LES to open in response to swallowing). My surgeon is reluctant to recommend revision to sleeve as a result. Has anyone here revised with this condition and had a good outcome?

Had my follow up with gastroenterologist yesterday. He's done all he can, medically. I'm seeing a top doctor in this type of problem at a local university hospital. There are only a few options available, even surgically: 1. Remove band, evaluate gastro-esophageal junction, hiatal hernia repair, vagus nerve damage/injury. 2. Remove band, take down HH repair and redo it along with Heller Myotomy. 3. Remove band, implant feeding tube for 3-6 months to rest the esophagus. 4. Remove band, remove esophagus with reconstructive surgery (horrible option) The achalasia is "end stage" based on the manometry, but since pseudo achalasia is gaining prevalence in the banded population, I might get lucky and just end up with #1. Fingers crossed. My motility was 0% My appointments at the university start on May 17. Wish me luck

I copied and pasted, below, some of my early posts from the first few months after band surgery. I was so enthusiastic and on board with my new lifestyle. I was fully committed to learning everything I needed to know in order to succeed. I did not want to hear anything from anyone who was saying their band didn't work out. There were people who posted that they followed band rules and lost their band due to slips, erosion or esophageal dilation. I countered that very few complications are band caused. I suggested that perhaps they over ate, ate too fast...you get the picture. I was wrong to do that. It's true that early in our band journey we NEED to hear positive reinforcement that we made the "right" decision. That's why you won't see me post negative information on a post from someone who is doing well, newly banded or had decided to band and isn't asking for help deciding. If I posted in a way that seemed insensitive or overtly negative anywhere but on the complications forum, I apologize. I try to avoid that, but I'm human. I believed, as many of you do, that if I did all the right things, I'd keep my band for the rest of my life. I cannot convey the disappointment and even grief I'm feeling over the impending loss of my band. I'm also feeling a lot of anxiety about post removal. That might be bleeding thru in my posts. I'm in constant discomfort, unable to eat much of anything and generally not feeling very well at the moment. My point in this post is to encourage everyone who has WLS to listen, sympathize and file away posts about band complications. As I've stated in more than one post, the information might help you save your band one day. I don't want to scare anyone. I just want to share my experience within a community that might benefit from it one day. Don't be afraid to read my message. It can't hurt you. This was 2 months post op: Tonight I am going to a play with friends...I subscribe and we go out about every two months Nov-July. Yesterday I figured I should try on some of my smaller (size 24) clothes to see what I should wear. NONE OF THEM FIT! THEY ARE ALL TOO BIG! I am between a 20-22 so all the 24-26 and 3x are going to the donation pile or to my ebay collection. I went to the Talbot's outlet and bought two pairs of 22 WP shorts, very nice for $27 including tax. I now have one pair of jeans, a pair of capris and two shorts that I can wear. We always go to Maui in October and was trying on my dresses that I take with me and got into some of my Blue Ginger dresses I haven't been able to wear for a long time...some of the others are way too big.... Any way enough rambling on! Happy day for me! My first fill: I got my first fill today and it went very well...no pain and so far so good with water. I lost 5 lb in almost 5 weeks and due to travel plans in September and October opted to go ahead and get it now. My surgeon's office does them under flouro and it took about 10 min to do...port was flat on the abdominal wall and very easy to access. It did feel weird as she was numbing me up, but other than that couldn't feel it. I am hoping to up my loss to about 1.75 lb per week or 7-8 lbs per month with this fill... whew...glad to have that under my belt! A post on accountability: This morning it occurred to me that I have not lost any weight since the 30th of August. My first impulse was to post something on the forum regarding a stall, frustrated, etc, but then I got to thinking about it HONESTLY. I have not logged my food since the middle of July! I looked back and I remember thinking that this is so easy, I don't have to log every bite! WRONG! I lost consistently (even without a fill) 1-1.5 lbs per week while logging. Since I stopped logging I have lost a total of 6 lbs in 6 weeks, but nothing for the last two weeks. I don't think I am eating as much as I am burning, but how do I know??? This could be the 20% stall, but without documentation of my intake, I cannot really tell. My highest weight was 290 about 2 years ago. 20% of 290 is 58 and I am down 51 lbs from that weight so it is close enough to be called that, but most likely it is what I am eating, rather than how much. I have been eating more carbs... There have been numerous social events, so I have been drinking a bit of wine... And I have had some dessert... here and there... So now I recommit to journalling my food intake so I can assess why I am stalled and what to do to change it WITH SOME CERTAINTY.... I have lost an inch or so since the stall started, so it isn't really a stall, but a great opportunity to refocus my efforts towards meeting my goal of 1.5 lbs per week on average. I do have restriction and I need to do a better job of utilizing it to my advantage. Me, defending the band: Many folks who are anti-band will use a study that was published in 2003 and followed lap-band patients from 1997-2002...that would be like car and driver only reviewing cars made from 1920-1970 and holding them to today's standards of road-worthiness... The bands in use today are much more "user-friendly" and the surgeons who "install" them know a lot more about the causes of complications like those cited in the early study and MOST complications are caused by overstuffing the pouch and eating around the band (grazing, sliders etc) as well as over zealous docs who overfill bands. Go to the WLS failure forum, complications forum or regrets forum and read about the issues the people who have chosen many different surgeries experience, then you can be satisfied with your decision, whatever it may be. I also question why certain individuals feel the need to hang out here and tout their surgery. If they were as knowledgeable as they claim, they would be publishing a book on their surgery, pointing out the benefits vs the risks, and it would speak for itself. Here is an example of a study on VSG and it's failure rate...I found this doing a quick search and now it is out there and will be quoted by the VSG haters to support their position.... The exact failure rate of sleeve gastrectomy is unknown. Using the Spanish National Registry for bariatric surgery, Sanchez-Santos et al[7] reviewed 540 patients who had undergone SG either as a primary or staged procedure over a six-year period. The authors reported excellent overall outcomes; however, 15 percent of the subjects were considered failures based on weight recidivism in the first three years, with 3.3 percent of patients submitting to a second bariatric procedure. Younger age, lower body mass index (BMI), and thinner bougie size were attributed to improved sustainable outcomes. Similarly, Himpens, in an article by Deitel et al,[8] presented his early five-year results after sleeve gastrectomy at the First International Consensus Summit for Sleeve Gastrectomy in 2007. In 46 such patients, he reported a disappointing 37 and 23 percent inadequate weight loss and second procedure rates, respectively. More recent unpublished presentations by Himpens indicate failure rates as high as 30 percent in five years.[9] Studying the Austrian experience with SG as a stand-alone operation, Felberbauer et al[10] reported a seven-percent failure rate at three years based on a cutoff of 25 percent excess weight loss (EWL). Applying the traditional 50-percent EWL criteria, the failure rate increased to 25 percent.[10] Me supporting a struggling poster: Good for you Tanya....that is why the forums are here, to share and hopefully keep us from getting too complacent and not utilizing our chosen tool. The side note that I have been meaning to post since the day after I wrote this is that though I haven't lost pounds, I have lost a full size, so it isn't about just the weight. Perhaps it is time for a fill or a talk with your nutritionist to help you to get back on track... Congratulations on your recommittal and I will look for you to post your success!! This was me the first year. I was afraid to hear what might go wrong, just like many others. This is a support site for ALL banded people, not just those who don't have complications. Seeing the words can't hurt you, but ignoring signs of trouble can. Just an FYI to those who keep calling me a "basher", "full of bs as usual", "100% incorrect"...every time you call me a name, I will respond politely. I will also continue to post. I don't back down when attacked, but I refuse to attack back.

Help me out here...need links to articles citing what causes erosion.

The "sleeve" isn't a product...

Don't. If you're trying to improve your health, smoking is going to undo all your efforts.

Why are you depending on friends and hubby to get your a** to the gym? Just go! There's people there who are better able to guide and support you in getting fit.

I had my band removed 6 weeks ago. There was a lot of scar tissue around the esophagus and upper stomach. I had symptoms of end stage achalasia, verified by manometry. The achalasia symptoms have resolved after removal. I was on a soft diet for 4 weeks post op because of the tissue being so damaged. I'm fine now, but because of the damage I cannot revise.

Update: my achalasia was caused by my lapband, which was removed 6/7/13 in a 3 hour surgery. I had a tremendous amount of scar tissue. My hiatal hernia repair could not be taken down. I'm not a candidate for revision. I'm doing well and am maintaining my 100 lb weight loss. I no longer have food getting stuck in the esophagus and ALL my symptoms have resolved!

This could be pressure on the vagus nerve.

I've tried to tell my story here and been shot down over and over...I'm done. I suffer every hour with the damage done to me by this band. I swallow, it comes up, over and over again. I'm losing, but there's no celebration. I hurt, but there's no supportive words to help me cope. My voice doesn't matter. I've never met a more unsympathetic or insensitive group of people. I hope you never feel like I do right now, cause some of you will. Have a good life.

I've had this on my signature for some time now, don't think anyone has actually bothered to read it: Disclaimer: Opinions, advice and all other information expressed by participants in discussions are those of the author. You rely on such information at your own risk. You are urged to seek professional medical advice for specific, individual situations and not rely solely on advice or opinions given in the discussions. The content of my posts and any responses to posts that I make are solely based on my own experience and opinions. I am not a medical professional and do not profess to have expert medical knowledge. I try to be supportive and helpful, I may post something that you do not want to hear. Should you take issue with any of my responses, I will be more than happy to discuss it with you, via PM. My intent is to provide information, not to "stir the pot", if it doesn't apply to you, don't take offense. I don't sugar coat or coddle.

Who is bashing anything? I'm being bashed constantly on here. As my disclaimer says, ", if it doesn't apply to you, don't take offense."

This is your journey, not his. You're example could help him to develop a healthier lifestyle. I live in an 8 person household...everyone was overweight except my hubby. Everyone is on low carb now because they saw the difference in me and my dietary habits, it's contagious, but has a long incubation period, lol. Keep it up, you'll do great!

IMHO not drinking while eating contributes to the build up of pressure on the GEJ, contributing to esophageal problems. Why? 1) pouch holds 1-2 oz 2) meals should be 4-8 oz (per most doctors) 3) even eating slowly, more than 1-2 oz will be in the pouch during meals. There's no way to monitor the rate at which food passes thru, since there are so many variables in anatomy, bands, types of food, etc. 4) drinking a small amount of Water with meals helps food to clear the stoma and doesn't really diminish satiety. This at least, is the belief of bariatricians in Europe and Austrailia. The pressure on the GEJ leads to nerve damage, leading to motility issues that can worsen when the pressure is relieved, there's no "study" to confirm this, but is a growing consensus within the WLS community. Just so you know, my doctors and the doctors of people I know with this type of issues are all saying this...I didn't make it up, lol.

The symptoms of GI problems started about 15 months after. The pain presented like cardiac problems at first, but after my gallbladder removal, they dramatically increased. The achalasia came after my unfill last June.

Your dad isn't an ass, he's scared of losing the old you, his food buddy. Tell him that you are inside that obese body, unhappy with your physical self, but you'll always be his loving daughter. Forgive him for being insensitive. It takes time. George Takei posted this on Facebook recently: You don't have a soul. You are a Soul. You have a body. Your soul loves your father, that's not changing.

You mean this one?

Gastroparesis is basically paralysis of the stomach. food just sits there, causing pain, nausea and vomiting. It can come on after a viral infection, upper abdominal surgery. Often, the cause is unknown. Surgery, such as WLS or gallbladder surgery is often cited as a cause due to damage to the vagus nerve during those procedures. It is standard of care to protect the vagus nerve when doing surgery, but sometimes in isolating it and "protecting" it, it is injured. I have mild gastroparesis and achalasia (esophageal disease). Both are uncomfortable and require lots of lifestyle changes, including eating a low Fiber, low residue diet (complete opposite of the Lapband diet). I find that green tea with essential peppermint oil, about 10 drops, helps with the spasms that can occur with these disorders. I hope you find some relief soon. Best of luck to you.

I have posted about finding a solution, often. My objective is to encourage those considering a band to ask for a manometry test to screen for a predisposition towards these problems. This seems to be tied into hiatal hernia repair as well, so very relevant to our WLS community. I hope hope you are able to overcome your issues too. I've fought hard to keep my band, but it must come out.

I have gastroparesis and achalasia caused by my band.