Slip diagnosed 5+ years out

[Wheetsin 714]

Hello troubled bandsters! I was just diagnosed with a slipped band. I was banded March of 2006, and I know that my band was fine in 2008. I know it's futile to try and pinpoint a cause, but all of my problems seem to be associated with a pregnancy in 2008. In fact, I have neen researching the band + pregnancy since about 2007 and the more I read, the more I found it almost common for slips or other complications after childbirth.

My slip is a bit atypical. I wasn't particularly symptomatic except for a "new" band sensation that I didn't have previously, which would lead to nighttime reflux. All night long. And sometimes the next night too. I didn't have crazy restriction, I was not a frequent PBer (in the last 3 years I've probably had 2 PBs), I didn't have a sudden change in restriction, etc. And I don't fall into your typical "high risk for a slip" cartegory -- again, infrequent PBs, I maintained conservative restriction for most of my banded time - was only too tight once and I got an unfill the next day, I followed the rules that worked for me (not meaning I followed them selectively, but sometimes I had my own more restrictive rules... e.g. I was never able to tolerate a.m. foods/drink so I didn't try), etc.

I'm not surprised I have a slip because something about such significant changes in my band (the "new" sensation I mention earlier was pretty significant) this far out certainly didn't seem normal. I also sort of went into this expecting to have a complication of some sort some day. And now that more data is available than when I was banded, and I see the increasing rates of complications, I just sort sort of expected it. (In other words, I went into this knowing it was a forever comittment, but also knowing that forever might be cut short).

I've been given 3 options:

1. Since my only presenting symptom is occasional reflux (maybe once every month or two), and even completely unfilled I still have some restriction, I can ride it out and see what happens. This may well work, but I have concerns about dysmotility consequences... and while I'm maintaining my weight, and have since my daughter was born in 2008, I'm not losing. That's not a good thing.
2. I can go in for repositioning or rebanding, which I know tends to have lower and lower success rates as more long term data becomes available. I've had a band for a while - long enough to develop a love/hate relationship with it, and I'm hesitant to sigh up for another procedure that may or may not work properly.
3. I can submit for revision to another procedure. My surgeon recommended the vertical sleeve. I've always been hesittant to do anything that permanently removes part of my stomach because, if it doesn't work, what then?

Guess I have some thinking to do, but figured I'd say hi to y'all.

BTW, I was 380 lbs when banded. About 215 when I got preggers. About 280 at delivery, and about 265 today. That's with a goal weight of 180.

[Jennifer Hathaway 12]

I have already decided that if anything happens 2 mine I will have a revision to vs if I can. If my insurance will only cover rny then I will do that. I will not go at this.alone again.

[Mimilou2004 13]

I am a slip revisionist survivor and worry every day if today is the day it slips for the final time. My doc has already told me that if it slips he can't do another. My insurance doesn't cover VS only by-pass and that wouldn't be approved because I don't meet the standards. If worst comes to it, I will probably meet those standards within a year of band removal, and that is horrifying to me.

I wish you the best in your decision making and seriously consider the VS.

Mimi

[Wheetsin 714]

Rebanding isn't an option I'm considering. I'm seeing too high of a re-slip incidence, even when you "follow the rules." I'm just really dubious about the band's ability to stay with us long term AND be in good shape.

And at least right now, I don't want a malabsorptive procedure. I don't really want an -ectomy procedure, either. That's part of why the current complication rates for the band are so disappointing -- it had such promise.

My father had a band about 3 years after mine, and had to have it removed a few months ago due to gastroparesis and eventual slip (he did not have a slip prior to the gastroparesis, but I'm suspecting he had vagus nerve irritation). He was re-banded a few months ago because it was the only procedure his insurance would cover. He sort of assumes it will be forever this time, but the numbers are frightening.

I'm fortunate that I have options - my insurance covers removal, revision, and several bariatric surgery types including the sleeve. If they didn't, or won't cover whatever procedure I decide on, self pay is an option for me too. I'm probably 90% on the VSG.

Feels kinda creepy to eat/drink now, knowing I'm slipped, and wondering if every swallow is causing more organ compromise.

[Magnifi8 0]

Your post voices exactly my main concern! That for a device that is supposed to last forever, once you've had it put in that is, it's starting to show higher incidences of complications the longer you go with it. I've yet to be banded as I'm still researching my options. I noticed that a majority of the folks on this forum are not senior bandees meaning 10+ years with the band. And I understand that it's still new for the United States so I continue to plug away with my research... thanks for posting! Hope all goes well for you!

Hello troubled bandsters! I was just diagnosed with a slipped band. I was banded March of 2006, and I know that my band was fine in 2008. I know it's futile to try and pinpoint a cause, but all of my problems seem to be associated with a pregnancy in 2008. In fact, I have neen researching the band + pregnancy since about 2007 and the more I read, the more I found it almost common for slips or other complications after childbirth.

My slip is a bit atypical. I wasn't particularly symptomatic except for a "new" band sensation that I didn't have previously, which would lead to nighttime reflux. All night long. And sometimes the next night too. I didn't have crazy restriction, I was not a frequent PBer (in the last 3 years I've probably had 2 PBs), I didn't have a sudden change in restriction, etc. And I don't fall into your typical "high risk for a slip" cartegory -- again, infrequent PBs, I maintained conservative restriction for most of my banded time - was only too tight once and I got an unfill the next day, I followed the rules that worked for me (not meaning I followed them selectively, but sometimes I had my own more restrictive rules... e.g. I was never able to tolerate a.m. foods/drink so I didn't try), etc.

I'm not surprised I have a slip because something about such significant changes in my band (the "new" sensation I mention earlier was pretty significant) this far out certainly didn't seem normal. I also sort of went into this expecting to have a complication of some sort some day. And now that more data is available than when I was banded, and I see the increasing rates of complications, I just sort sort of expected it. (In other words, I went into this knowing it was a forever comittment, but also knowing that forever might be cut short).

I've been given 3 options:

1. Since my only presenting symptom is occasional reflux (maybe once every month or two), and even completely unfilled I still have some restriction, I can ride it out and see what happens. This may well work, but I have concerns about dysmotility consequences... and while I'm maintaining my weight, and have since my daughter was born in 2008, I'm not losing. That's not a good thing.
2. I can go in for repositioning or rebanding, which I know tends to have lower and lower success rates as more long term data becomes available. I've had a band for a while - long enough to develop a love/hate relationship with it, and I'm hesitant to sigh up for another procedure that may or may not work properly.
3. I can submit for revision to another procedure. My surgeon recommended the vertical sleeve. I've always been hesittant to do anything that permanently removes part of my stomach because, if it doesn't work, what then?

Guess I have some thinking to do, but figured I'd say hi to y'all.

BTW, I was 380 lbs when banded. About 215 when I got preggers. About 280 at delivery, and about 265 today. That's with a goal weight of 180.

[JustFluffy 122]

Hi Wheetsin,

My band too has to come out (was banded April 2008), although not for slippage issues - I've had other complications. I originally requested my surgeon to revise to Sleeve. He told me it has a 1 in 4 failure rate and also to keep in mind that it has the highest complication rate of Band to other WLS Revisions. He said Sleeve wasn't for me - every patient is different though. I'm waiting for RNY insurance approval - has been a hard process for me. I too didn't want the malaborption issues either which is why I wanted the Sleeve, but after talking to my doctor and researching RNY (for me) is the way I'm going. I've gained back all of my weight the band helped me lose plus twenty pounds in the past two years. I know I need the medical assistance and am ready to get the band out and start living my life again. I'm not trying to sway you or anyone else one way or another...just wanted to pass a long the information for you to digest. Best of luck to you.

[Wheetsin 714]

When I had my band in 2006, I knew someone who was part of the original FDA trials. SHe has since lost her band (to be honest, she was having problems when I had mine and hers shouldhave been taken out long ago.) She is the most senior lap-band patient I know. Second would be a lady I met locally, who was 7 years out about 3 years ago. I don't know if she still has her band. I've tried to get back in touch with her but I haven't been able to. She doesn't use this board, but does use another -- I just can't remember which...

I still very much appreciate what my band could help me do. I would still do it again, all things being the same. I just don't know that I could advocate it for others seeing what the complication rates have become. I've read articles in the last few weeks placing them anywhere from 33% - 87%. If there's anything consistent, it's the inconsistency.

Your post voices exactly my main concern! That for a device that is supposed to last forever, once you've had it put in that is, it's starting to show higher incidences of complications the longer you go with it. I've yet to be banded as I'm still researching my options. I noticed that a majority of the folks on this forum are not senior bandees meaning 10+ years with the band. And I understand that it's still new for the United States so I continue to plug away with my research... thanks for posting! Hope all goes well for you!

[Wheetsin 714]

Leslie - that's interesting. My surgeon's recommendation for me was the sleeve. He said he does not recommend it for ALL band-to-something revisions, but thinks it will work well for me (as my problems were not around non-compliance, and I'm also assuming because I did not have an erosion or other serious damage complication.)

I've not heard of any failure rates. Is that a failure to be able to perform the procedure (as in, too much scar tissue or too many adhesions), or a failure to work, or something else? I'm having a hard time imagining the cause for failure, but I'd love to know more if you have any additional information. (I"m sitting here poring over the possibilities and really can't come up with any -- at least not any that will still allow a RNY to be done).

RNY would have to be an absolute last chance for me. I know several people who have had it for a while (7 - 10 years) and they are all miserable. Not that everyone will be by any means, but seeing what they're going through, and hearing what they are saying -- I think I would have to try everything else first, and if I went malabsorptive I would probably go DS but I don't know - haven't really given it any thought.

I too am just sharing info -- but really would love to know anything more about the failure rates that you know (I've heard 4x greater risk, but not that procedures couldn't be done.) I 'll have an EGD done later this week - it's required by insurance for band removals - and hopefully I can meet with the surgeon shortly after. I'll definitely ask him about this.

Thanks and best wishes!

Hi Wheetsin,

My band too has to come out (was banded April 2008), although not for slippage issues - I've had other complications. I originally requested my surgeon to revise to Sleeve. He told me it has a 1 in 4 failure rate and also to keep in mind that it has the highest complication rate of Band to other WLS Revisions. He said Sleeve wasn't for me - every patient is different though. I'm waiting for RNY insurance approval - has been a hard process for me. I too didn't want the malaborption issues either which is why I wanted the Sleeve, but after talking to my doctor and researching RNY (for me) is the way I'm going. I've gained back all of my weight the band helped me lose plus twenty pounds in the past two years. I know I need the medical assistance and am ready to get the band out and start living my life again. I'm not trying to sway you or anyone else one way or another...just wanted to pass a long the information for you to digest. Best of luck to you.

[JustFluffy 122]

Leslie - that's interesting. My surgeon's recommendation for me was the sleeve. He said he does not recommend it for ALL band-to-something revisions, but thinks it will work well for me (as my problems were not around non-compliance, and I'm also assuming because I did not have an erosion or other serious damage complication.)

I've not heard of any failure rates. Is that a failure to be able to perform the procedure (as in, too much scar tissue or too many adhesions), or a failure to work, or something else? I'm having a hard time imagining the cause for failure, but I'd love to know more if you have any additional information. (I"m sitting here poring over the possibilities and really can't come up with any -- at least not any that will still allow a RNY to be done).

RNY would have to be an absolute last chance for me. I know several people who have had it for a while (7 - 10 years) and they are all miserable. Not that everyone will be by any means, but seeing what they're going through, and hearing what they are saying -- I think I would have to try everything else first, and if I went malabsorptive I would probably go DS but I don't know - haven't really given it any thought.

I too am just sharing info -- but really would love to know anything more about the failure rates that you know (I've heard 4x greater risk, but not that procedures couldn't be done.) I 'll have an EGD done later this week - it's required by insurance for band removals - and hopefully I can meet with the surgeon shortly after. I'll definitely ask him about this.

Thanks and best wishes!

Hi Wheetsin. I think the failure (from his explanation to me) is running into complications. He said the tissue of the stomach where the band is paced gets very thin under where your band is placed. If converting to the sleeve - there is a better chance of leakage at this area. I really think it should be taken on a case by case basis. I'm not ideal for sleeve, but it sounds like perhaps you are.

My doctor has the most experience in RNYs, has done sleeve and other WLS as well - he has been a surgeon for over thirty years. Saying this - I'm very comfortable with him doing my RNY conversion but would be hesitant with the Sleeve. Like patients - I think doctors are all different as well. You have to be comfortable with their level of expertice.

Best of luck Wheetsin - let me know what he says. I actually have my pre-op for surgery on Monday (July 18th) - found out today I was approved by my insurance :-)...I will get more information then.

[Leesha 0]

Hi there,

I was banded in Mexico in 2002 a month after the fda approved it here in the US.(I had it planned before the approval and was self paying) I just found out today that my band has slipped. I gave birth in 2008 and really believe that my slippage is related to that pregnancy. I was at goal weight (my goal that is)when I found out I was pregnant with my son and had all the Fluid removed from my band. I gained about 40 pounds during my pregnany and after 2 years of trying to lose the baby weight decided to go and get the Fluid put back in. I almost wish I hadn't even found out because now I am faced with the realization that you seem to be dealing with... is the band really forever? I was slightly naive when I was banded to begin with and didn't really think about the long term complications or reality of living with a band for my entire life. I was 22 years old and all the information then was pointing to it being a forever kind of deal. Since I was banded in Mexico I seem in higher self paying category than if another American doctor had perfomed the original banding. I am really feeling frustrated, sad, and wondering what the long term complications of a slipped and unfixed band can mean. I am lucky to have very few symptoms and am not in any pain at this point.ide I am considering going back to Mexico to have Dr Rumbaut do the repositioning. I just thought I would share a little bit of my story...

Leesha

[Wheetsin 714]

Sorry, I have not checked here in a bit. Leslie - I have found out that my surgeon does revision surgeries at least 2 months apart. While I'm impatient, I do like that idea. A lot of surgeons will do them in one procedure and although I'm not a surgeon, requiring some down time seems like the way to do it. During the first surgery he removes the band, and repairs adhesions (the exterior damage to the organs & surrounding tissues that we're all going to have). The second procedure is to create the sleeve.

I had my EGD two weeks ago, but haven't yet been able to meet with the surgeon. I won't until we receive the insurance approval (nice, huh?) My surgeon is very skilled and I am a "repeat customer" but I still have a ton of questions for him around the revision process. E.g. if the highest risk is leak, and a leak is repaired by applying mesh and blanket sutures, can you just do mesh & blanket sutures from the beginning?

Leesha - good to hear from you. We have extremely similar stories except for our initial bandings. As I mentioned earlier, I have been given the option of keeping my slipped band, and even getting fills as tolerated. But when I started thinking about it, I just wasn't sure how that was an option. I'm at higher risk for additional prolapse, I already know I can't tolerate fills -- the EGD left me very swollen and it was about 8 days before I could eat solids. The swelling immediately brought back all the reflux and heartburn, and removed ANY thought I might have given to keeping the band because it's completely evident that anything brining about restriction (internal, like the EGD or a stuck piece of food -- or external, like a fill) is going to renew the symptoms I have. (Like you I have no pain, and no sickness... but I do have a feeling of pressure most of the time when I eat solids, and if that pressure isn't gone by bedtime, I will start refluxing within 10 minutes of falling asleep... it's truly like clockwork).

I do need to follow up with a question to my surgeon's office. The xray showed a "profound" slip -- I didn't see the xrays, but I was told that the angle of the band was almost opposite of what it should be, and that based on the xray alone I would not be a candidate for repositioning/rebanding. The EGD showed a "partial" slip. So I don't know if the slip has actually improved since getting completely unfilled, or if those two things that seem a little contradictory actually aren't.

There are still three people I know, banded longer than me, that I'd like to get back in touch with. Aside from those three, whose band status is "unknown" -- 100% of the people I know banded around my time or earlier have had slips and/or removals. EVERYONE.

The band helped me get almost to goal weight. It definitely helped me conceive my daughter. I'm not anti-band, and I don't "hate" my band. I wish I had known then, the current stats for failure rates. If I could trust myself to keep the weight off, I would have it removed and never regret a thing, and never look back. But I don't trust myself with that (I'm still carrying my 40 lbs of "pregnancy" weight, and my DD will be 3 in October). Do I think it can help people lose weight -- I know it can. Do I think it's a long-term solution -- absolutely not.

[Jachut 487]

Hi Wheetsin, so sorry to hear your troubles and issues. I think I agree with you, you just hear so many problems with revised bands, its like once you've had a problem you're going to continue to have more, whether they fix your band or put in a new one.

My view of the band was ALWAYS that it was unlikely to be forever and Prof O Brien himself said to me that 20 years was an ambitious goal, certainly very possible but that forever just couldnt be guaranteed given current knowledge (this was six years ago, but still applies). I am thankful each day for my healthy functioning band. Having had my own cancer battle over the past 12 months, I've really had to assess what my band, my health and my new body mean to me and to be honest, my weight and maintaining my achievements was right up there, right alongside surviving the rectal cancer. It means that much to me. For me personally "ectomy" doesnt frighten me anymore. I'm sitting here five days post op from having an ileostomy reversed, with my new plumbing adapting every day to once more having to function. I dont have a rectum, I have my colon (a third of which is gone) directly joined to the outside.

But malabsorption does frighten me, reason being, I went through hell and back deciding whether to reverse this ileostomy. To my surgeon, it was a nobrainer, I was young, fit, active and attractive (his words, not mine, lol), so to him, it was automatic that I wouldnt want to have a bag to slow me down. To me though, I was thinking, I'm young, fit, active and attractive and I have a bag, I dont want to be living on a restricted diet, needing the toilet up to fifteen times a day, perhaps incontinent, passing foul smelling gas without control and suffering chronic sore but from the constant diarrhoea. Ok, so none of that has happened to me in a severe or unmanageable way so far but boy it was and is a scary prospect. What's a bag compared to that? But you probably remember WasaBubbleButts poking fun at the RnYers and Bypassers on the Obesity Help forum, oh boy, what hilarity over charcoal underpants and Just a Drop toilet deodorisers. What derision towards people who considered THAT a trade off for weight loss. Doesnt seem all that funny for me now, but you know, it definitely IS a possibly result of such surgeries.

In the face of that "ectomy" doesnt scare me at all. I might have to also have my uterus and ovaries removed pending some genetic testing, meh, not using them anyway anymore. I really wouldnt hesitate to lose part of my stomach, truly. And if THAT didnt work for weight loss, truth is, nothing is really going to long term. Its a fact. All of these surgeries should work maybe to a lesser degree than you might like, but like you know, nine times out of ten, complications aside, when they dont work its the patient, not the surgery. Having had a taste of living life with a dysfunctional, uncomfortable and potentially embarrassing bowel situation quite similar to what can happen after malabsorptive surgeries, I'd go the sleeve in a heartbeat if I was going to revise to another surgery.

Just my 2c. Everyone feels differently and is more or less tolerant about certain things than others but that's the way I'd look at it.

[Jack 855]

It is sad to learn of such difficulties old Bandster Buddies are having. So far my own seems to be trundling along with minimal issues other than episodic fickleness and occasion mass gacking for a few days. My Internist recently advised against further fill at this time due to an imaging study 2 years ago showing motility issues and mucosal thickening. Placement seems proper and generally is pretty well behaved. I haven't attempted the 'stress-by-pregnancy' test yet and will avoid such as long as possible....

I'd be most interested in your ongoing seminars on hardware and updated surgical options should you care to share them.

I'm convinced there IS a way to dump the remaining 'weight to goal' by at LEAST another 20 # and then retire with ample satisfaction from the ongoing battle.

Perhaps I should regard my plateau of the past 3+ years as a GOOD thing. My internist tells me this point may be "as good at it gets".

cheers to us all and best wishes for the coming struggles

[Buffie 1]

Hiya, I haven't been on here in years. I'm having this uncomfortable foreign object removed as well (of course that's my experience ONLY). I'm done with the obstructing, the throwing up, acid relfux (No, my band isn't too tight, it's almost empty), and now I'm having pain under my ribs again. I'm going for the sleeve as soon as I have my gastroscopy to make sure there's no erosion. It's been a good run, but I'm DONE. I have 60 pounds to lose now, I regained 25 that I lost.

Cheers,

Buffie

[nomadem 1]

Were you banded with the older high pressure band?

I was banded in late 2007 with the older 4cc band, I had it replaced in 2008 after a slip with the 14cc band and have done much better. I will keep this band as long as I can bc the risks of bypass (family member suffered) and sleeve scare me more than having my band replaced.