Got the results of my Upper GI tests - Guess What?

[NewSho 20]

OK.

So I finally got the results of my Upper GI from my (potentially) new LapBand surgeon. (As some of you may remember, my LapBand surgeon of 5 years has 'fired' me saying that despite my protests, he will perform no further fills on me.

Ever.

Why?...Because my fill level is approximately 2.8 in a 4cc band.

Now he's always been conservative and he's very very stingy with fills - which is why I call him "Dr. No" but him refusing to fill me when I know I need more restriction has been an absolute death warrant for my weight loss. I'm struggling to fight to lose the same 3 pounds over and over and this has gone on for months.

Oh, "Dr. No" also went on to say that the band has done all it will ever do and that I've probably lost as much weight as I'll ever lose with the band. Um, problem is, I'm STILL fat! Technically by BMI standards I'm still obese at a BMI of 30 but Dr. No says "Oh you look great." This has been a real issue lately, as we don't agree on that at all.

Now keep in mind, I'm hungry more lately and I've absolutely stopped losing weight for eons...so this is a real problem and in the Battle of The Bands, of course, my surgeon won. He refused to fill me further and sent me a certified letter to that effect. Meanwhile I've been struggling to keep from gaining any weight, and trying desperately to lose a few pounds. Nothing has worked.)

But for months, I've been begging for more restriction as I really was fighting major hunger pains. Serious ones, not just head hunger - which is difficult enough to deal with even with good restriction.

Anyway, after months of desperation about thinking either I was the world's biggest LapBand failure (I've been banded 5 frustrating years) or that my band was either eroded, slipped or in some other type of jeopardy - I finally started looking to find other bariatric surgeons. I figured if the band was screwed up and if my original surgeon wouldn't help me, I'd just get revised to the RnY. I've really been through enough in 5 years of banding, so if I need an RnY bypass, I'd get one somehow. So I picked an experienced bariatric surgeon who had been doing RnY bypass and is just recently beginning to get more Lap Band experience. In fact, in his study of LapBanding, he actually worked under my original surgeon who is considered a veteran in the field.

Well guess what. The Upper GI/radiology tests came back and my (if he'll really take me on) new surgeon pronounced that my band is fine.

His quote: "It's perfect. It's absolutely textbook."

Huh?

Me? The world's biggest LapBand failure (BMI of 30 and still holding, dang it) has a 'perfect' band? No (evidence of) erosion, slippage, or other types of band problems?

Well, so then the question is - why don't I feel enough restriction?

Good question. Many surgeons find that the longer a patient has been banded, the more restriction they sometimes need. OK, fair enough, it's been 5 years for me.

Then, the new surgeon checked out my current level of fill - turns out, I had not 2.8, not enough even 1.8 - but approximately 1.75 in my band. (I hadn't actually been filled since late summer/early fall but I was at 2.9 late last year and had been told I had at least 2.8 back in late January while I went in for flouro. )

So the mystery is: What happened to my 2.8 or 2.9 fill level that I still supposedly had?

• When I went in for my fill in January with Dr.No - when he decided not to fill me - did he not accurately check my fill level? (Unlikely - he is absolutely on point on this things, usually)
  
• OK, then did he slightly unfill me without saying anything? (Hmmm, he's been definitely on a tear lately about not liking patients to have a higher amount of fill, but 2.8 is not that much for someone banded for 5 years) Would he just take a little bit back out?
  
• Or did my band simply 'sweat out' more than 1.0 cc of fill in less than 3 months?

We know that bands do lose fill level sometimes. Excessive exercise (errr, not very frequent, but I have been known to exert myself now and then), dehydration and simple osmosis sometimes makes the amount of fill decrease over time.

The new surgeon checked again, found that I really did have only 1.75 and since my test results looked good, decided to give me a tiny fill to get me back to 2.0

Then, he'll see how I do with that and then in 2+ weeks or so, he'll nudge me back up to 2.5 or so. That's a bigger jump but it's still less restriction than I thought I was walking around with. Then he wants another series of tests to make sure all is well.

My concern is whether I have some sort of slow leak or something like that. (*sigh*)

Few years back, I had a leak in my tubing and NONE of my fill would stay in, so I'm on guard to see if anything like that happens again. I've had the unfilled band and it absolutely does NOT work for me long term. I need restriction, or else I will gain.

So let's see how this will go. I hope everything's OK. I'd like to get back to a real fill level again or else I'll never win the Battle of the Bulge.

Wish me luck.

Happy Band Journeys To All...

[3loves 0]

Very interesting.....it's nice to hear about those who have had the band long term. Sorry you have such a rough time though. :phanvan

Help me understand. Why would Dr No only put 2.8 in a 4cc band? I thought from reading threads here that the bands actually hold more than what they say. What is the deal with that?

You know, I just recently read about the Omnipaque used to check for leaks and some even use it for fills instead of saline. Did they use that on you? I'll look for that thread. Perhaps you already know about this, but I'll do a quick search.

I wish you the very best and don't ever think of yourself as a failure....even if you do switch to RNY, that doesn't mean you failed!! You have come so far and should be proud of what you have accomplished!!

Hang in there!! :gluck:

[3loves 0]

O.K. Here's the link with omnipaque. Hope you find it helpful.

http://www.lapbandtalk.com/showthread.php?t=16478&highlight=omni

[NurseTeresa 0]

Thank god that you found out that DR NO really was just being the total butt that you thought. Sometimes they think that they are GOD and they ARE NOT!!! Not all are that way but some are very bad at it(most are surgeons that have the God complex). I am glad you fineally found someone to take your case and to research what all was going on with you and that you have a real reason for no restriction. It always baffels me how a Dr can do this to a patient who has trusted them with their life. I will keep you in my prayers that all is well with your tubing and that it does not have a leak anywhere. Just keep your head up and keep being persistant. Thats what got you to this point. Great big (((((HHHHHHUUUUUGGGSSSSSS)))))))))! Keep us posted on what is going on with you.

[Kelliebelly 13]

Wow, thats great news. It must be such a relief for you. I too am shocked about the Dr not filling you past 2.8. I am 9.6mls in my 10ml band and he said if I need to we can go to 12ml in my band safely...so stopping at just over half way full is bizaare.

Anyway, all that aside youre going to back on the losing side with this Dr.

Good Luck

[StrawartS 2]

NewSho, I always read your posts with great interest. But you never mention who your doctors are, and I asked you in another post, but I don't think you replied. I am particularly interested in Dr. No, as I'm sure his other patients would be. Will you share?

[NeenBand 7]

It must be great to fininally have someone listening to you. Doctors just don't seem to get that although they have all the knowledge, we know our bodies best of all. We have been in our own skin long enough to *know* when something is up.

Let's hope it's not a leak.

Would you get re-banded if it was?

[PhotoNut 7]

I am so happy to read this thread! It sounds like you are getting back on track and it WASN'T YOUR FAULT! Yay! Someone go kick that stupid Dr that put her through this crap!

*hugs* I'm excited to hear good things coming from you now! Time to get back on the road to success! Yay!

[rachele 0]

New Sho, I hope this is it! I'm glad things are working out and your band is in tip top shape. Good job getting another doctor!

[Marimaru 7]

Glad to hear all is well in bandland, and that you have found a new doctor who seems willing to help you out!

[KarenB 0]

Your very interesting post shows how important it is for us to have a doctor who will actually LISTEN to us and to trust that we actually do know something about our own bodies.

It's also great to hear that someone who's been banded is in good shape.

Please let us know how the fill goes.

[DonnaB 3]

NewSho, you need to request your records from Dr. No. If he surreptitiously gave you an unfill, he owes you a refund. Seriously.

3loves, a 4cc band actually holds 5cc according to my doctor. The 4cc's is the recommended max fill. I assume that a 10cc band actually holds 11cc's or more. Does that help or does that make things more confusing? lol

I agree with leenerbups and KarenB - doctors may have a degree based on averages and theory, but we're the ones living in our skin and we KNOW before they begin to surmise.

[NewSho 20]

Thanks to all my fellow Band Buddies for the support and encouragement. This has been such a wild ride, that I really appreciate you guys giving me your feedback.

NewSho, I always read your posts with great interest. But you never mention who your doctors are, and I asked you in another post, but I don't think you replied. I am particularly interested in Dr. No, as I'm sure his other patients would be. Will you share?

Actually I do 'share' a lot, including direct quotes from the surgeons themselves. I don't list them by names because the stories I tell are very personal and sometimes not very flattering to the doctors involved. But I can either edit what I say about them (and definitely not quote what they say) or I can tell my story without naming the involved surgeons directly. Those are my only options. So I use nicknames (like Dr No) rather than their real names. It just keeps me out of more trouble.

By not naming the surgeons themselves, I can speak freely about them. Now, when I'm giving specific types of recommendations I name specific names. If someone asks for opinions on doctors that I know or am familiar with, I do share information.

I'm the one who blogs/writes online about my own complex medical experiences, but I have to be careful when I'm so open about what happens to me. I'm already in a difficult position by changing doctors (not by choice, mind you, but by necessity) after 5+ years so, but the last thing I need is to be blackballed in the very small world of weight loss surgeons. I tell the Good, the Bad, and the Ugly - but without their real names. But all the things that doctors say are NOT fit to print. For example...

This is an actual conversation I just had, with a prominent doctor:

Me (speaking to doctor):

You know, doctor, I've experienced a bit of random swelling over the weekend.

Doctor:

Oh yeah? I had a little random swelling over the weekend too, and let me just say...my wife was very, very pleased...(He winks)

:rolleyes And that's the rated PG version of what he said. Trust me, if I listed my doctors' names, I couldn't print the things they say quite as freely. Hopefully that makes sense.

______________

NewSho, you need to request your records from Dr. No. If he surreptitiously gave you an unfill, he owes you a refund. Seriously.

Yeah, I got my records immediately after I received the certified letter that 'fired' me as a patient (or as an 'active' patient, so to speak). I saw nothing in my medical record details about a slight unfill there, but I honestly was suspicious. It's difficult, but I'm trying hard not to be paranoid - but after being frustrated for so long, it really makes me speculate...

3loves, a 4cc band actually holds 5cc according to my doctor. The 4cc's is the recommended max fill. I assume that a 10cc band actually holds 11cc's or more. Does that help or does that make things more confusing? lol

Yes in the Long Term Band patient groups, there are many patients with 4.2 to 4.5 or more in the band (probably including the amount in the tubing, it could maybe go to 5 cc total in a 4cc band).

I'm just so dang resentful that I've spent months wondering why a band filled not even 3/4 of the way full seemed just so scary to Dr. No - why is that? He never elaborated. What spooked him about me getting near 3.0? I have friends at 3.5cc or above in a 4cc and they are doing well.

Heck I don't want more problems so if I'm too tight, I'd just have them unfill me. So far only getting past 2.7 cc ever even helped me feel "real" restriction for the first time, and I only got that after 4 years of banding - so it's not hardly as if I rely too much on fills.

I know he's been apparently been reading some not-yet-published research done by the veteran Band pioneer surgeons about long term results of 'full' & 'overfull' bands - but sometimes I hate always being the one who has to have the new theories tested on them, just because I've been banded so long. That's getting old, LOL!

.

I agree with leenerbups and KarenB - doctors may have a degree based on averages and theory, but we're the ones living in our skin and we KNOW before they begin to surmise.

Yes, exactly. Moments like this make me wish I had a LapBand surgeon that was banded himself or herself. I think it would go far to advance the study of the LapBand from a patient viewpoint, and not just from a surgeon's viewpoint. I know that the top Mexican surgeon, Dr Rumbaut has been banded for llike 8 years himself , and in Texas there is Dr Mary Hewitt in Houston (who does fills, but not LapBand surgery if memory serves) who is banded herself, in Florida there is Dr. Grossband who is banded, and I've heard Dr Jesse Lopez in Kansas might be banded, also... I know of quite a few banded doctors who are general MD's , but not that many LapBand surgeons who are banded. We need more banded surgeons!

Again, I'll keep everyone posted on what the newer surgeon (who is the complete antithesis of my former surgeon who I used to think I had a good relationship with.)

This new one is obviously very cautious of the fact that he's accepting a patient from a more prominent (in the LapBand field) surgeon. He might even feel sheepish about it (although one of my other non-LapBand doctors thinks it should be a feather in this new surgeon's cap, I think I feel more like a discarded tire than like a prize trophy patient) So I don't think I'll have to worry about the new doc asking me to appear in his brochures (like another surgeon had long ago asked me to do, once I reached my goal. Of course I'm still waiting to get there!:nervous )

Happy Band Journeys to all... My own journey never has a dull moment.

[babsintx3 0]

Hi New Sho,

I asked many of the same questions you have last year about missing saline, so I know where you are coming from.

I had PS and my plastic surgeon accidently removed all my fill during my TT and thighplasty. He insisted he didnt, but my lapband surgeon with flouro claims I had nothing in my band when I went for a fill post op 5 weeks later. Somewhere lies the truth, but my biggest concern is that my tubing was damaged during plastic surgery and that I might have a leak. I was freaking out!!! My lapband surgeon did not seem to want to allay my fears about the leak, so I am no longer getting fills from him. I went to a different fill doc who takes my insurance and he has been filling my band back up for the last several months. I still dont have the same level of restriction I had before surgery in August last year, but I am definitely geting there.

In years previous, most of my fills were done with flouro, so they were extremely accurate. If the radiologist said there was 2.0 in there, the next fill he would remove the 2.0 and it was all still there and then he would add more. I presently have 2.5 in my band and I DO NOT have the restriction I had before at the same amount. As a matter of fact, I had reflux at 2.5 more than a year ago and had to have some removed the last time I had that in my band, so longer term bandsters sometimes do need more restriction because they get accustomed to a certain restriction level and sometimes need more to help them get to goal. ANd sometimes, they also need an unfill to rest things for a while and actually need less on the refill. Everyone is different.

I found when I have "blind fills" at my surgeons office, they were always inaccurate. If he claimed he added, it was never the amount he said it was, whereas the fluro fills were always accurate. I think I have had a total of 10-11 fills in the last 3 years and 8 of them were done with flouro and the rest blind.

THe amount of fill is not important. This is just a random number and as long as your band is not completely filled and there is still room to add more, then there is no conclusive proof that there is anything wrong with your band. Whats important is whether you have restriction or not. If you dont have restriction, then you need more fill. Now if you told me that your band was filled up to the max and then some and you still didnt have restriction, then I would worry that you might have a leak. But since your DUMBO first doc didnt want to fill you up and rationed fills, then you really dont know whether you have a leak or not and you certainly wont know if more restriction will help you achieve your goals.

Focus on getting more fill, seeing if your band really works and if you are losing restriction after fills, then have it done with flouro for more accuracy. I know you have been through hell and back, but it sound more like a doc problem than a band problem at this stage. Hopefully the new doc will be better.

FYI: Dr. Adam Smith in Fort Worth is also banded and he is a lapband surgeon as well!

Babs in TX

334/180/190

-154

[NewSho 20]

Babs: Exactly1

Hi New Sho,

I asked many of the same questions you have last year about missing saline, so I know where you are coming from.

I had PS and my plastic surgeon accidently removed all my fill during my TT and thighplasty. He insisted he didnt, but my lapband surgeon with flouro claims I had nothing in my band when I went for a fill post op 5 weeks later. Somewhere lies the truth, but my biggest concern is that my tubing was damaged during plastic surgery and that I might have a leak.

See, I wondered about this too. As you may remember, I had a TT about 13 wks ago and my access port was moved, of course. I didn't choose to get an unfill before the TT (some patients I know did, some didn't and they both seemed to do fine but it took the unfilled ones longer to get back to their restriction level and I couldn't chance it). However the PS (Dr. Big Needle ) I picked is both LapBand-knowledgeable and a colleague of my original surgeon, Dr. No. In fact, Dr No got to poke his head in during my surgery (long story) and Dr Big Needle was kind enough to let Dr No sort of determine to what location the port was moved.

But just after surgery I felt more restricted and had less appetite. Now, this could have just been a normal post-op swelling thing but unfortunately the restriction went away. But I did wonder about this very thing.

I was freaking out!!! My lapband surgeon did not seem to want to allay my fears about the leak, so I am no longer getting fills from him. I went to a different fill doc who takes my insurance and he has been filling my band back up for the last several months. I still dont have the same level of restriction I had before surgery in August last year, but I am definitely geting there.

Yep, it's like you're reading my diary. Exactly where I am - after 5 years I hate that it came to that, but as I posted before - once we started disagreeing about my fill and restriction level - my original surgeon dropped me like First Period Calculus class.

In years previous, most of my fills were done with flouro, so they were extremely accurate...I presently have 2.5 in my band and I DO NOT have the restriction I had before at the same amount. As a matter of fact, I had reflux at 2.5 more than a year ago and had to have some removed the last time I had that in my band, so longer term bandsters sometimes do need more restriction because they get accustomed to a certain restriction level and sometimes need more to help them get to goal. ANd sometimes, they also need an unfill to rest things for a while and actually need less on the refill. Everyone is different.

This last time, in January, I went in for the fill under flouro. That's when Dr No refused to give me a fill (though I'd been complaining of lack of restriction) and he tested it then, under flouro, and proclaimed me to have just about 2.8 or so.

The amount of fill is not important. This is just a random number and as long as your band is not completely filled and there is still room to add more, then there is no conclusive proof that there is anything wrong with your band. Whats important is whether you have restriction or not. If you dont have restriction, then you need more fill.

Now if you told me that your band was filled up to the max and then some and you still didnt have restriction, then I would worry that you might have a leak.

Yes, Babs, and what's so sad is that I've been walking around thinking that this so-called 2.8 fill wasn't enough restriction and that if I couldn't ever get any more fill that it was time to look at other surgeries or procedures.

But since your DUMBO first doc didnt want to fill you up and rationed fills,

I can't call him a DUMBO (although you are more than welcome to, believe me) but for sure, he RATIONS fills. Up until this fall, however, I'd been getting them only when I needed it - and it was working. But I couldn't convince him to give me one for more than 6 months and since then I've been struggling hard to keep weight off.

Focus on getting more fill, seeing if your band really works and if you are losing restriction after fills, then have it done with flouro for more accuracy.

Right. I think his office fill back to 2.0 was a good start but I agree that I should get back ASAP and see if I can at least get back to 2.5

I know you have been through hell and back, but it sound more like a doc problem than a band problem at this stage. Hopefully the new doc will be better.

From your lips, Babs...my fingers are crossed. I'm trying to stay positive and not drag all my emotional LapBand baggage over to my new surgeon - I deserve a fresh start !

FYI: Dr. Adam Smith in Fort Worth is also banded and he is a lapband surgeon as well!

THANK YOU - you are so right! Dang it - THAT'S the name I couldn't remember. I mentally ran down every surgeon's name in the Metroplex, but couldn't remember Dr. Smith...in fact, I think he's the one whose wife is banded also: they are a banded couple, right? My friend who went to TCU went to him, I'm almost positive. He's near the school, I think. We should really compile a comprehensive list of banded surgeons one day - I think it's valuable.

So far having a teensy bit more fill is going OK but I really need to get back to my 'normal' fill level.

Fingers crossed!