HELP...Many doctors, no answers???

[Carlene 12]

Can I induce any of the physicians who belong to this group to offer an opinion on this?

I belong to another board where a number of people are having potentially SERIOUS, recurring problems that may or may not be band related. (I have cut and pasted a series of posts below my message.) These ladies have all consulted their band docs, specialists, etc - without any concrete answers.

I experienced something similar about a year ago and my doctor slapped my butt in the hospital, unfilled my band, and put me on a course of IV, then oral antibiotics. His diagnosis was Aspiration Pneumonia.

The general professional consensus seems to be that these are not cases of Aspiration Pneumonia, otherwise they would not clear up without treatment.

I'm thinking there are just way too many instances of this for it to NOT be band related. Do we have anyone here with a similar experience?

Here are the posts...

Post #1:ffice:office" /><O:p></O:p>

Several months ago, I wrote a message to you about fever, teeth chattering, vomitting etc. This happens to me on a semi-regular basis -- 3-5 times a year. My PCP sent me to an infectious disease specialist who tested me for every possible inf,. disease. All were negative. I thought it was related to reflux, and you seemed to agree. My hiatal hernia was surgically fixed, yet I still have fever, vomitting etc. My doctors call this my "mystery illness", "fever of unexplained origin" in relation to the band.. My lapband was inserted in Oct '04. To date I have lost only 30 lbs. You can imagine how depressing this is. Have your doctors been any more forthcoming? These fevers (102 degrees and up) mean I am fighting an infection, but no one seems to know what. Any help would be appreciated.<O:p></O:p>

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Rose, I'm not a doctor, so I don't know what to tell you. I do remember you asking me about it because everytime I had reflux I also felt really yucky and fevery the next day.

I know for myself it's directly related to the night time reflux. I've always suspected that my body is ensuring I don't get any infection from the stuff I'd aspirated into my lungs.

I'm sorry that this is happening to you. I'll let you know if my doctor has any ideas.

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Robin<O:p></O:p>

I have these same symptoms. I, too, have nighttime reflux, but thought my symptoms were possibly gall bladder in nature. I wonder how many of us have this!!!!<O:p></O:p>

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For me, these types of symtpoms are directly related to my nighttime "reflux". I am sure I have aspirated fluids, and I probably don't get "sicker" because there is no food or stomach acid in it - as we discussed in the other reflux post, it's just liquid, and usually mostly saliva.

The next day, I feel downright sick for at least 4 or 5 hours. I feel fevery (though I don't always actually have an elevated temp), nauseous and headachy. It does pass as the day wears on - sometimes faster than others. My doctor said it would take an immediate doctor visit, a chest xray at least and probably blood work to see if there was anything incubating in my lungs. He told me if the pattern changes, to let him know, but if Tylenol and a few hours passing addresses it, that's what I should do.<O:p></O:p>

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Thank you for all your responses,

I have been on several courses of antibiotics. When the fevers etc. began, I would wake up with flu-like symptoms - so sick I could not get out of bed for 5-6 hours, but I would be fine the next day. Now I begin to feel sick 2-3 hours after I wake up and I am not better for at least 24 hours. I have had two MD visits during an actual episode. Bloodwork confirmed an infection. Chest xrays were clear. I was sent to an infectious disease MD to test for malaria, dengue fever etc (all have recurring fevers as a symptom) and was negative for all. I saw my PCP, gastroenterologist, lapband doctor, even my gynecologist . I guess I need Dr. House now.<O:p></O:p>

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Post #5:<O:p></O:p>

I had the same thing numerous times in the past. I would have fever the next day and felt generally run down and awful. I needed to spend the better half of the day in bed. Good thing I was not working during this period or I would have been fired for so many sick days. As it was I think my friends who did not know I had the band thought I was terminally ill.

The problem is stomach contents entering the lungs at nightime. This occurs during sleep when the musculature is completely relaxed. Also our saftey reflex called our " gag reflex" which causes us to cough and the opening to our trachea to close does not work as well when we are sleeping or in the supine position.

The lungs are "sterile" unlike the stomach, intestines and esophogus. Whenever anything "unsterile" enters the lungs the body reacts by creating inflamation, fever and white cells come to surround and battle the envader. If our immune response loses this battle it turns into full flegged pneumonia caused by the aspiration of the stomach contents.

This problem must be fixed for obvious reasons. Long term I believe you will permanantly damage your lungs with scar and fibrotic tissue. You will be at high risk for esophogeal cancer. ( and possibly lung cancer?) And people have been known to die from aspiration pnemonia, especially if it evolves into somthing called Adult Respiratory Distress Syndrome (ARDS), where the lungs go into shock and stop working. If you do survive you will have to endure a long serious illness requiring a stay in the ICU and a respirator.

Much to my dismay, my severe reflux was not simply fixed by the repair of my slip and Hialtal Hernia. It occured after incremental unfills. I was simply too tight. Dr. Feilding's last unfill did the trick.

However, unfills before the Hiatal Hernia and slip repair were not effective. It was the combination of the surgical repair and the incremental unfills. I have had no problems since ( almost a year) I can eat a full meal and go right to sleep without a problem.

I wish everyone who suffers from this gives it full attention, repairs what needs to be repaired and lossen up by all means.

Best of luck, ffice:smarttags" /><?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com<ST1:place w:st="on">Nancy</ST1:place></st1:City><O:p></O:p>

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Post #6:<O:p></O:p>

Thank you all. I am hearing my symptoms repeated as you all report yours. I have another gastroenterologist appointment next week and will reiterate what you all have told me about your symptoms. How can so many MD's, including lapband surgeons, and gastroenterologists not have heard of these symptoms? From all your comments, it seems as though reflux is what we are all suffering from. I will also mentiomn these symptoms in a message to Anne (aefpa), in hopes that she can ask Dr. Fielding about these continued fevers etc. I am, clearly not the only lapband patient with this problem. It is ridiculous to think no one (MD's) know what we are experiencing.<O:p></O:p>

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[Alexandra 55]

Wow, that's really interesting information. I'd be curious to know if people on this board who have or have had reflux experienced the same symptoms. Thinking back on my own experience I'd have to say yes, I did, back in early 2006 when I had significant reflux for almost a month. I thought at the time (and still think) that an allergic reaction was responsible for the initial swelling that caused the reflux in the first place, so at that time I blamed the allergies for the whole package of lousy feelings.

I think the idea that aspiration of any substance into the lungs creates an immune system reponse is quite on target. If a bandster is dealing with reflux to this degree, clearly it has to be addressed, and quickly.

[gonnabethin 10]

Unfortunately when someone has a fever that clears on its own, not much is done to investigate. NOT all aspiration pneumonias cause fever, not all fevers mean bacterial infection. Some are viral and some are possibly the body re-recognizing a foreign material. Fever is just the bodys' defense to a perceived threat- if nothing materializes the fever resolves. Sometimes it is seen in illnesses that have not fulminated. Examples are gallbladder disease, appendicitis, H. Pylori, C diff, auto immune causes- there are literally thousands of reasons the complex human body can run fever. Some people when they are tired and run down will feel achy, chills and sometimes run fever, this is their body saying- Enough! get some rest. Unfortunately sometimes we eat contaminated foods that are not enough to cause GI symptoms but the cells can trigger a we might be sick alarm. So unfortunately wait and see is the only thing available for lots of intermittent events- wait until they develop enough symptoms that the problem can be identified.

I fully believe that reflux is capable of triggering the same response from the immune system and fever could be one of the symptoms, as well as chills, achy and feeling generally bad!!

Sorry, I know that wasnt helpful but it is the reality of a non perfect non star trek triquarter world.

[barbara465 2]

Although I don't have reflux anymore I do run a fever after a fill. I sometimes do so after an unfill, but always after a fill. It takes about 1 hour and then wham, fever, chills, and a very tired feeling. A few hours on the couch with a blanket and socks on my feet seems to cure it.

Although this is not a reflux issue per se, I wonder if it has something in common with the symptoms offered in the thread.

[Trace Curry 1]

I think patients who have nocturnal reflux probably all get some aspiration, whether or not they get pneumonia or not depends on a number of factors. I'm surprised it doesn't happen more often to be honest. The only way to solve the problem is to unfill the band, but this may lead to less weight loss. The presence of a hiatal hernia would certainly aggravate the problem.

I hope I answered the question!

Dr. C

Cincinnati, Ohio

www.TheBandDoctor.com 877.442.BAND

DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

[Carlene 12]

I think patients who have nocturnal reflux probably all get some aspiration, whether or not they get pneumonia or not depends on a number of factors. I'm surprised it doesn't happen more often to be honest. The only way to solve the problem is to unfill the band, but this may lead to less weight loss. The presence of a hiatal hernia would certainly aggravate the problem.

I hope I answered the question!

Dr. C

Cincinnati, Ohio

www.TheBandDoctor.com 877.442.BAND

DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Actually, we were wondering if these symptoms (chills, fever, flu-like aching) which seem to reoccur on a regular basis ARE, in fact, band related. Are they dangerous? Should a person who experiences this on a regular basis have their band unfilled?

Sorry I wasn't more specific in my first question.