New Beginnings

[JOANNE M HOLL 388]

I've started over so many times. Had the saline removed several years ago prior to major surgeries, and after going through that period of trauma was again well & active. Each morning I started to listen for my band (I named it Cybil) and prayed to find my old "Zone". I revisited my old surgeon and he smiled and said I'd stretched my stoma and said he'd see me in a year. I visited several hours with the bariatric centre's nutritionist and she repeated the same old same old, which I know by rote. I've only gained some of prior loss back . . . . I want my old Lap Band back helping me!

[Sherlock1969 231]

I don't understand...you stretched your stoma? How did he determine that is was stretched? What is to be done about that? And why is the doctor waiting a whole year to see you again? Pardon my ignorance....

Edited January 17, 2014 by Sherlock1969

[NaNa 878]

I've started over so many times. Had the saline removed several years ago prior to major surgeries, and after going through that period of trauma was again well & active. Each morning I started to listen for my band (I named it Cybil) and prayed to find my old "Zone". I revisited my old surgeon and he smiled and said I'd stretched my stoma and said he'd see me in a year. I visited several hours with the bariatric centre's nutritionist and she repeated the same old same old, which I know by rote. I've only gained some of prior loss back . . . . I want my old Lap Band back helping me!

I am so sorry to hear this! If you have pouch dilation it does not take that long for it to heal, usually the treatment is to empty the band and let it rest for about 6 weeks and then slowly restart filling, some people can get back to the green zone with no issues, but after a pouch dilation you have to be more careful with portion sizes and measure and careful with Pbing and sliming.

You may want to seek another opinion with another surgeon and see if they can replace your band, if you have the older 4cc bands they were more prone to issues than with the newer bands, but all bands can have the same issues but the older bands were higher pressure which caused more issues.

Hope you can find answers.

Edited January 17, 2014 by NaNa

[steph2012 252]

Nana, I have a question for you. I understand why you have to be careful with portion sizes but why Pbing and sliming?

I've started over so many times. Had the saline removed several years ago prior to major surgeries, and after going through that period of trauma was again well & active. Each morning I started to listen for my band (I named it Cybil) and prayed to find my old "Zone". I revisited my old surgeon and he smiled and said I'd stretched my stoma and said he'd see me in a year. I visited several hours with the bariatric centre's nutritionist and she repeated the same old same old, which I know by rote. I've only gained some of prior loss back . . . . I want my old Lap Band back helping me!

I am so sorry to hear this! If you have pouch dilation it does not take that long for it to heal, usually the treatment is to empty the band and let it rest for about 6 weeks and then slowly restart filling, some people can get back to the green zone with no issues, but after a pouch dilation you have to be more careful with portion sizes and measure and careful with Pbing and sliming.

You may want to seek another opinion with another surgeon and see if they can replace your band, if you have the older 4cc bands they were more prone to issues than with the newer bands, but all bands can have the same issues but the older bands were higher pressure which caused more issues.

Hope you can find answers.

[NaNa 878]

Nana, I have a question for you. I understand why you have to be careful with portion sizes but why Pbing and sliming?

I've started over so many times. Had the saline removed several years ago prior to major surgeries, and after going through that period of trauma was again well & active. Each morning I started to listen for my band (I named it Cybil) and prayed to find my old "Zone". I revisited my old surgeon and he smiled and said I'd stretched my stoma and said he'd see me in a year. I visited several hours with the bariatric centre's nutritionist and she repeated the same old same old, which I know by rote. I've only gained some of prior loss back . . . . I want my old Lap Band back helping me!

I am so sorry to hear this! If you have pouch dilation it does not take that long for it to heal, usually the treatment is to empty the band and let it rest for about 6 weeks and then slowly restart filling, some people can get back to the green zone with no issues, but after a pouch dilation you have to be more careful with portion sizes and measure and careful with Pbing and sliming.

You may want to seek another opinion with another surgeon and see if they can replace your band, if you have the older 4cc bands they were more prone to issues than with the newer bands, but all bands can have the same issues but the older bands were higher pressure which caused more issues.

Hope you can find answers.

Well...the thing is that for some people sliming can lead to PBing....and we have to be very careful with putting too much pressure on the band, this can also dilate and swell the pouch....

Sliming is not that harmful since you are only spitting out slime and not causing pressure..but they should be avoided....everyone who gets a lap band and get to the green zone WILL at SOME point slime and PB it comes with the territory, we are not all perfect, however it should not be several times a day or even daily, you should keep them very rare...this is why we should always focus on eating taking tiny bites and chewing to mush, and not be distracted to minimize sliming...

I slime about 2 times per week,...it's just a way a life for me, but I don't do it daily.

[JOANNE M HOLL 388]

I don't understand...you stretched your stoma? How did he determine that is was stretched? What is to be done about that? And why is the doctor waiting a whole year to see you again? Pardon my ignorance....

The little new stomach above my band I know of called a stoma. He had a barium procedure done and they filmed it.. . . . in his head I think he says this,"I'll see you in a year," because BCBS insurance will pay for yearly visits! Some doctors don't care that much for us but they like the steady flow of green $. He fills in the office for my surgeon from University Hospital.

I'm planning to visit with my PCD soon and maybe he can recommend someone different & closer to my home. I drive 210 miles to my original bariatric centre and I guess that is why I felt such a downer.

Each morning I have my Protein latte and try for my lost "Zone".

[JOANNE M HOLL 388]

I've started over so many times. Had the saline removed several years ago prior to major surgeries, and after going through that period of trauma was again well & active. Each morning I started to listen for my band (I named it Cybil) and prayed to find my old "Zone". I revisited my old surgeon and he smiled and said I'd stretched my stoma and said he'd see me in a year. I visited several hours with the bariatric centre's nutritionist and she repeated the same old same old, which I know by rote. I've only gained some of prior loss back . . . . I want my old Lap Band back helping me!

I am so sorry to hear this! If you have pouch dilation it does not take that long for it to heal, usually the treatment is to empty the band and let it rest for about 6 weeks and then slowly restart filling, some people can get back to the green zone with no issues, but after a pouch dilation you have to be more careful with portion sizes and measure and careful with Pbing and sliming.

You may want to seek another opinion with another surgeon and see if they can replace your band, if you have the older 4cc bands they were more prone to issues than with the newer bands, but all bands can have the same issues but the older bands were higher pressure which caused more issues.

Hope you can find answers.

Thanks. What is pouch dilation? I have a 10 CC Vanguard Band placed in 9/8/06. I have never ever wanted it removed. And I really don't know about replacing it. . . . it was working fine before my breast cancer surgery.

[lisacaron 5,075]

Hi Jo,

Did you have to do chemo and/or radiation in combination with your surgery? If so, that is most likely the cause of the dilation that's going on.

There are some affects chemo has on the digestive system. If you are all well and healed up from your surgery, you may need some additional time for the band dilation that's going on to shrink back up.

I bet your doing great, and getting in that Protein is a big key to helping your body heal. When my sister in law went through her rounds of chemo and radiation after surgery we would give her some Protein shakes to help her keep up her strength and help her heal especially since she wasn't very fond of eating much. (from the chemo she developed thrush and chewing was painful for her.)

Giving her the Protein was the best thing we could have done for her, when we saw her Dr. again he told us as it was helping her to heal. For you Jo, if you go back to some shakes like in the pre-op you will get some good nutrition as well as shrink that dilation faster hopefully and you can get a fill again sooner rather then later.

I'm so glad that you are feeling better!!

[jennybean 175]

I believe pouch dilation and stretch stoma are the same thing.

[Bandista 7,466]

Hi Joanne, so glad to see you here -- I know you had some tech issues. We missed you! I am a novice, just banded in November, but what about the 5-day pouch test or all liquid reboot phases that some people do as part of routine band maintenance. Do you think a full liquids rest for your stoma might help things get back to where you feel comfortable? I do a shake every morning of Muscle Milk and frozen peaches or blueberries, etc. It is absolutely delicious and I feel like I could drink a few of those every day and be done with it. However I know I'm supposed to be eating real food, which I enjoy, so I'm making sure my other meals are fish and veggies, chicken and veggies, chili, etc. Still, I think I could go for this occasional all-liquids to get back on track or regain the messaging the stoma needs to provide to the brain, etc.

Good luck to you and don't forget it's January which for me anyway is not an easy time. Don't let the January blues get you down -- you are picking yourself right up and getting your band back the way you want it. I truly admire your fortitude and wonderful attitude. Have a great day!

[rosettag 122]

Hi Joanne, I keep repeating that my band is my best friend,

Cybil is your friend , a long-standing friendship.Sometimes friends go away for some reason, but they come back, and when we meet again , it is as though time has not passed and we can start again.

You (I mean , you and Cybil) will make decisions about what and how to do.

Hugs !!!

[NaNa 878]

I've started over so many times. Had the saline removed several years ago prior to major surgeries, and after going through that period of trauma was again well & active. Each morning I started to listen for my band (I named it Cybil) and prayed to find my old "Zone". I revisited my old surgeon and he smiled and said I'd stretched my stoma and said he'd see me in a year. I visited several hours with the bariatric centre's nutritionist and she repeated the same old same old, which I know by rote. I've only gained some of prior loss back . . . . I want my old Lap Band back helping me!

I am so sorry to hear this! If you have pouch dilation it does not take that long for it to heal, usually the treatment is to empty the band and let it rest for about 6 weeks and then slowly restart filling, some people can get back to the green zone with no issues, but after a pouch dilation you have to be more careful with portion sizes and measure and careful with Pbing and sliming.

You may want to seek another opinion with another surgeon and see if they can replace your band, if you have the older 4cc bands they were more prone to issues than with the newer bands, but all bands can have the same issues but the older bands were higher pressure which caused more issues.

Hope you can find answers.

Thanks. What is pouch dilation? I have a 10 CC Vanguard Band placed in 9/8/06. I have never ever wanted it removed. And I really don't know about replacing it. . . . it was working fine before my breast cancer surgery.

Hi Joanne,

Ok, you have the older type model band, the 10cc Vanguard bands are no longer used in the US just like the 4cc bands, they were all higher pressured bands that were hard on the body, but many loved their bands, I loved my old 4cc band too, however the 10cc VG band were bigger than the 4cc bands, but they were still higher pressure.

Pouch dilation is actually a mild complication of banding, many people do not know if their pouch is dilated, some think after a while they can eat more food, they will go and get a fill, this can be dangerous because if the pouch is dilated, it needs to be treated and the usual treatment is removing saline to remove pressure off the pouch...and wait about 6 weeks and start refilling the band...

The classic signs of pouch dilation is reflux at night after a too tight adjustment and then after being too tight too long the pouch will dilate.

This is why many people suffer complications and don't know why...this is why those who have been banded a long time greater than 2 years need to have their bands checked yearly to check the pouch size before adding more saline....many surgeons don't check they will just blindly fill the band and they have no clue if the pouch is dilated....mild dilation is not harmless...

But if the pouch gets huge...it will prolapse and cause band slippage...and this will require surgery to fix or remove the band...

Someone can have mild pouch dilation and pouch dilation can get severe with slippage...mild pouch dilation can be treated with unfilling the band and watching portion size, but slippage must be treated with surgery removing the band or re positioning or replacing depending on the damage...

Here is some more info on pouch dilation and symptoms and prevention....

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874894/

In summary, pouch dilatation with or without slippage is a long term complication in LAGB patients; the percentage observed in our three-year study was 11.1%. Except for posterior slippage, these complications show an association with postoperative management, such as over tightening of the band or poor compliance among patients. Gradual band adjustment with strict follow-up and continued dietary consultation will prevent or minimize occurrence of these complications. From a technical point of view with consideration of accurate pars flaccida techniques, accurate seromuscular bites are very important because inaccurate gastrogastric fixation can be loosened with time (stitch burst), and eventually make the portion of the fundus redundant below the band. Removal of the fat pad on the cardia with coagulation greatly facilitates the accurate seromuscular bites. In addition, adequate wrapping also stabilizes the gastric band and minimizes the fundal prolapse, thus avoiding slippage.

Edited January 18, 2014 by NaNa