Who do you trust?

[babsintx3 0]

Hi Everybody,

I am really confused and slightly concerned. FOr those who dont know me, I have been banded more than 2 and a half years ago. I have had somewhere in the neighborhood of 8-9 fills, most done with flouroscopy and some blind. I have had almost no problems with my band, lost a lot of weight, only had one day bout of reflux which was resolved with an partial unfill. So things have been great.

I had plastic surgery last Aug 2005 and my plastic surgeon removed all of my fill by accident. At the time he did this, I supposedly had 2.4 CC in my band. I only asked him to remove .25 and somehow he took it all. I did not know this until oNe month post PS, I went to my original lapband surgeon for a RE-fill. He tried to withdraw saline only to discover there was nothing in my band.

My original surgeon decided he would only give me 1.00CC of saline. Well, 1.00CC of saline is like giving me nothing since I had no restriction with this amount. I went to his office one week later in pursuit of more restriction and he refused telling me to come back in 3 months and he would reconsider. Considering I had already gained 9 lbs with the unfill, I was not happy with that decision and found a new fill doctor in Dallas to do my fills.

I went for a fill in September with another doc. He bumped me up to 2.20 and told me to come back if I needed more. Since then I have not lost any weight, gained even more weight and I went to see him yesterday to get more.

During the visit, he pointed out to me with flouroscopy that my band is not in the ideal position and has slipped a little. He said the last flouro he did in Sept 2005 showed the same thing as well. Its no reason for big concern as long as I had restriction. He said future options if this fill he gave me didnt work was to:

1) Remove all the fill and see if the slip would resolve itself.

2) Reposition operation

He said the slight slip was not really my fault. It wasnt from pouch packing, since the pouch is not dilatated, just slightly larger because of the position of the band. He kept assuring me that it was a chronic issue and probably had been like this for a long time because I had lost oodles of weight, my stomach was now smaller than before and bandsters that are far along tend to have these minor slippages. He made it clear that my band is not eroded or damaged in anyway. He also said nothing needed to be done as long as I had restriction from the fills. He gave me .30 more. I now supposedly have 2.5 in my band.

The problem I have is that I dont have anyone else that I know in my neck of the woods who has been banded as long as I have. There are a few bandsters and other than some anedotal information about pouch size and slippage with long term bandsters, I really dont have any other information to know if what he says holds any Water. If he saw a minor slippage the last time I was there, why didnt he say anything? He said not to worry about it, but hey what else can I do? Anybody have any suggestions? Think I should get another opinion? Or should I just see if everything works properly with the new founded restriction I should be seeing? I was pretty wide open on the flouroscopy, so I am confused about what to do.....

Babs in TX

334/180ish

[leatha_g 4]

Interesting. I'd just be very alert to any new symptoms, such as nighttime reflux/aspiration. Otherwise, if you feel restriction and everything else seems okay. Can you get copies of your flouro and have your previous compared by your original physician?

[Thinjen 0]

I don't trust anybody. I only trust God. And my money reminds me of that.

[Dody 0]

I think even my money says "In God We Trust". It's a very good motto.

[donali 57]

I'd wait and see if the new fill helps. If it does, I wouldn't worry about the slip unless/until it starts giving you problems.

(((hugs)))

And congrats on all you've accomplished!! :humble:

[La_madam 20]

trust your gut instincts!

[babsintx3 0]

Hi,

I have now had this fill since yesterday afternoon. I only ate Soup today, coffee in the morning, but finally had a piece of fish tonight. I dont know yet if I have more restriction. Some gurgling, but to me, its hard to tell until I attempt to eat something more solid. I have the flu and really dont feel like eating anyway and had less than 1000 calories today and a grand total of about 800 yesterday. It doesnt feel much tighter than before, but then again, until I attempt to eat a rib or something, its hard to tell.

Leatha: NO problems with any reflux symptoms

Michelle: I will trust my instincts and see what happens. My instincts say the the added restriction will help even if its only mental. If its not enough, then I will go back and get some more. IT just seems strange that I would need more than the 2.5 I have. Usually when a band is refilled you need less and here I am at almost the maximum I have ever had in my band and still feeling like I could be tighter.

I have the feeling if I went with my flouroscopy to more than one doc, they would all say the same thing which is my pouch is slightly bigger than it should be and thus the reason why I dont feel as much restriction with less fill. I think long term some big losers seem to have this problem. I do know of one other girl who lost 165 pounds and had her band keep slipping. Some of it has to be behavior modification too I realize. I cannot depend on the band to do the work for me all the time, but it would be nice to have good restriction again where I eat half a plate of food and get full.

Babs in TX

334/180 ish

[GeezerSue 7]

Babs,

Since you have had only fouroscopy, and not endoscopy, I'm not sure how he's sure that there is no erosion.

Sue

[kimalicious 5]

If your band has moved around maybe you are needing more fill to take up the space that the band has moved. I would continue to see how you do with this fill and in a few weeks if your restriction is still low I would go for another fill. I'm guessing they problem with people who have lost a lot of weight is that there is no longer fat around thier stmach holding the band tight around the esophagus any longer. I would think more fill would keep it in place better. Just a thought. I could be totally wrong. What do you think?

[babsintx3 0]

Hi Geezer,

I dont think I am eroded. Call it gut instinct, but everything looks pretty much the same everytime I go. I am not going to get an endoscopy but if the problem with getting some restriction seems to be unattainable, then I will seek a second opinion. I DO have some restriction, just not as much as I used to. As Jack says so eloquently its easy to get off track which is definitely part of my problem. The other part is that I am used to the restriction and the third component is that my pouch is slightly larger than before.

The problem is if I go to three different lapband surgeons, they will all have a different opinion about what to do. So short term, I will see what happens and then go for another fill if thats an option.

Jack: I have not given up, just taken a reprieve from the process. I know I am back on the band wagon to some extent. As soon as I feel better, I am going to start my exercise regime again.

Babs in TX

[leatha_g 4]

Babs,

I can tell you that after my slippage and subsequent new band etc. I have NEVER had the same overt symptoms of 'stop' since. This, I think sets the stage for pouch dilitation because there are just no stop signs and if you're hungry, you just tend to eat more than you would with the signs. I think it has to do with esophageal motility for me. I know there is restriction somewhere, lower down perhaps, or the esophagus is more pliable and less responsive, but something isn't the same. I continue to tell this to my doctor, but he just doesn't hear it.

[babsintx3 0]

So Leatha,

YOu've lost that loving feeling... heh? LOL

All joking aside,I completely understand what you are saying. When I try to explain that I am able to eat and always have been able to eat more than the average bandster, the docs just think it is a lack of compliance issue. That is not the case. I dont get the full feeling that quickly and only once in the middle of my journey I actually had true restriction. Although I did not have reflux, my TMJ was acting up from the tension in my jaws from chewing everything to death, Water was gurgling down like a true clogged pipe and I wasnt really happy with that feeling either. But it did keep me from eating!

It may actually be the reason why the band does not work for some people and why there is so much difficulty for some to find the right level of restriction. Sure they can strangle hold someone to prevent them from eating and this will cause reflux or some other problem, but if bandster doesnt feel some kind of full feeling, how can they maintain the smaller quantities? A lot depends on esophageal motility issues or lack of , possible achalasia issues, which invitably will lead to pouch packing if you are not aware that the 12 oz steak you ate was too much by just eyeballing it ! LOL) I think that there are lots of components here that come into play and that is why long term compliance and understanding what you need to do to maintain your weight are so important. I know I eat more than before. An example would be if I go to Chilis and get lettuce wraps, I can eat more than 1/2 -3/4 whereas before even half seemed like an insurmountable task 1 1/2 years ago. In many respects this is similar to a RNY patient who has stretched their pouch. It happens very slowly over time and I am sure that most folks are not even aware that they are eating that extra ounce or two. THats why making smart choices further out is so important and far more important than the first year of banding. It no longer is about getting another fill. SOme bandsters think if weight loss stops or the trend is gaining that another fill will solve the problem. YOu can only go so tight before you are too tight and can no longer eat the solid Protein which is important for weight loss.

Of course, it would be nice to hear from some of the docs on this issue..... Any of them out there want to respond???

Babs in TX

334/180 ish

[itsyvonne 0]

Did you lose your saline during plastic surgery because he replaced the port with a low profile one?

I am considering whether or not to get the low profile port, but one of my biggest fears is messing with my restriction and getting into a situation similar to what you are enduring. I also wonder if getting unfills (or changing saline level drastically) can increase the risk of slippage.

My original band slipped after this cycle:

one slight unfill due to reflux

complete unfill about 3 months later due to continued reflux

endoscopy - no problems seen

one fill after about 4 months of being unfilled (upper GI showed no slippage)

slippage about 2 months after that (I had been banded about 3 years at that point)

[babsintx3 0]

Hi Yvonne,

I asked my plastic surgeon to remove .25 from the 2.5 I had in my band. I started to develop reflux a few weeks prior to plastics. I dont know how or why he took out all of it. It was an accident though because while I was knocked out he did the unfill and it was noted in my file that he used blue crystalline (sort of like food coloring) just so he could be accurate about the partial unfill. People think that 2.50 CC is a lot of saline, but this is such a small amount it could be quite easy for a surgeon to accidently remove it all especially someone who doesnt do this on a regular basis. FYI: My plastic surgeon was very familiar with the lapband, I was not his first patient . He did not replace my port with low profile. Apparrently a new one would have cost me 700 dollars (supposedly that would be his cost from INamed) and I did not have the $. Its possible with the total unfill that my band slipped slightly, but I think it was like this before the PS. I guess I will never know. Whatever you do, dont get an unfill if you can avoid it. I regret asking for one, but I didnt want to have problems postoperatively where I couldnt eat . You really need the nutrients and the extra food to help with the healing process.

Babs in TX

[itsyvonne 0]

How frustrating! I can believe that it could easily happen, though. That is what makes me nervous about having the PS replace my port ... when he replaces the port I believe the protocol is flush the port & tubing with saline and then fill.

I'm still communicating back & forth w/my band surgeon to get all my questions answered (via email). Luckily my band surgeon does work pretty closely with my PS - but he won't be there at the time of surgery, and this port replacement will be a "first" for my PS).

The band surgeon told my PS to refill me to a level just below where I am now, and that we'll make up the rest with a fill or two post surgery. I am really worried about this, though!!! ackkk!!

Regarding your case - I WOULD perhaps want to seek a second opinion. However, I wouldn't necessarily not trust this person - it sounds like he is very experienced, and as long as you are not having symptoms, it may be okay. If you have an uneasy feeling about it, though, please do seek a second opinion.

-Yvonne

P.S. Are you unhappy at all with the bulge of your port after PS? I am thinking that maybe I should just live with the bulge (which may not even be noticeable) and not expose myself to the risk of the port replacement.