DOnt know what to think, LONG

[babsyintx 0]

Hi Everyone,

I went for a fill on Friday morning done by flouroscopy which I hoped would be my last fill to get to goal. I was also hoping that I would never need another fill again. Instead of the radiologist I normally have, they scheduled me with a new guy. Of course I was livid cause my regular guy has done my last few fills and I feel very comfortable with him.

Anyway, I decided to let the new guy do it after talking with him a little about my fill history. Apparently he had done some fills over several months and wasnt a complete newbie.

A little fill history first:

Banded June 23, 2003

August 2003 - 1.00 CC by flouro / No restriction

August 2003 / 1 week later: upped to 1.75 with flouro/ Some restriction

October 2003 - upped to 2.00 with flouro - Good restriction No reflux or PB's

January 27th - Upped to 2.25 by my surgeon/ Vey snug and loosened up over summer 2004

August 11th - Found out that I had 2.5 in my band instead of 2.25 I thought I had Had my band tweaked to 2.6. This fill done by flouro

August 27th - Surgeon unfilled to 2.4 cause it got too tight and I refluxed one time. No flouro

December: Discover I only have 2.00 in my band instead of the 2.4 I thought I had. Received a .25 fill bringing me to a supposed 2.25 total.

THe radiologist did a swallow test prior to the fill. He said that I already had good restriction and the barium was pooling in the upper pouch. I explained to him that barium wasnt food, so I did not think that this was a good example, since I can still eat quite a lot of solid Protein in one sitting. He called my doc on the phone and asked his opinion. My doc recommended that I not get a fill based on what he heard. I explained to the radiologist that I do not PB or slime and rarely even have a golfball feeling. I have not had a PB since May 2004 and only 4-5 times since being banded . He said that he would increase it by .25 if I wanted, since I have far less than I thought I had and obviously could handle more since I have in the past.

Anyway, he gave me the fill and afterwards, he gave me another barium swallow. Results regarding restriction pretty much the same as the first one. But then he started studying the pics a little more and he noticed that I have a dead spot in my esophagus that doesnt seem to push the food through. He even started to go on to say that he thought there was something odd about my band. Bla Bla Bla. Had me turn sideways and then he said it looked fine. I questioned him about the dead zone he was referring to. He said that it appeared that part of my esophagus does not seem to spasm or push the food through. He commented that maybe heavier food like chicken or protein goes through faster because of the weight of the food,, whereas the liquids tend to sit in my pouch longer because of the dead zone he was referring to. Naturally, this scared me. I asked him if he thought that this might be a result of long term banding and should I worry. He said it was possible that my esophagus operated this way pre band. Anyway, this would explain why I dont PB so easily, since I dont have the gag reflex.

I left the hospital scared and worried. Did I really only have 2.00 in my band and not the 2.4 my doc said he unfilled me to in August? Cause if I had the 2.4, and the radiologist was mistaken, then I now have 2.65 in my band, whiich is th most I have ever had. Or did my doc miscalculate, lie to me about how much he unfilled me or am I losing Fluid somehow? And what about the dead zone. Is my esophagus dying or something or should I get a second opinion? So far I have had no problems with this new fill. I went to a Christmas party in the evening and ate pretty much everything including fruit, fish, crackers, cheese etc.

SO now, I have less in my band than I had earlier this year and more than I have had since August. I was afraid to leave the area and called my docs office to explain my concerns. Apparently my doc came to radiology to look at the pics. after I left. He said that he thinks I am too tight based on the pics, but there is nothing wrong with my band. He did not comment about the dead zone, since I dont think the radiologist mentioned anything to him about it. I noticed my doc has been bordering on conservative as of late since he has been having to do more and more unfills due to tight bands, refluxing and PBing. Other than the one time I refluxed, I have had almost no problems and I can eat anything including bread, chicken and steak. So is he being cautious or does he really believe that I am too tight? I can only go by the bandster rules and I have not been losing a pound a week for quite some time now. Yes, I am still losing, but not at the rate I would like.

What do you think I should do? Get a second opinioin?

babs in TX

334/188/170

-146

6/23/03

[claraluz 2]

In the beginning, I kept losing Fluid in my band. I would get a fill, but when I went back, there was less in the band than they had put in. I personally wonder if it was because for my first fill they poked me many times and I wonder if they poked a hole in the tubing. But I've heard that it is natural for the band to lose some Fluid. Now when I get fills they put in a thicker fluid than saline and that has done the trick. I always forget the name of the fluid they put in.

I think your surgeon is wise to be conservative about fills. My surgeon told me that when the band is filled beyone 2.25 cc, the complication rate goes up. And if the fluroscopy shows that you have good restriction, it's hard to argue with that.

I would talk to your doctor or surgeon about the "dead esophagus" problem. And actually, I think it would be worth it to schedule an appointment just to talk to the surgeon about the whole situation. The truth is that you have done well with the band and have lost much more than the average bandster does. I know you want to lose the rest, but if your experience is like mine, you may find that you have to work harder for it now than you did in the beginning.

I'm sorry you are having these problems.

Nancy

[Alexandra 55]

Hi Babs,

Gee, that doesn't sound good, does it? But I'll bet it's less serious than the radiologist made it sound. He's just a radiologist, not a gastroenterologist or whatever expert would be the right one to comment. It may indeed be possible that your esophagus isn't responding the way he might have expected it to in a non-banded person, but it may not be as serious as "dead" sounds.

My doctor described a phenomenon he is expecting to see as time goes by and there are more long-term bandsters. He said it's possible that the esophagus in a banded person might indeed become less sensitive over time just because it gets more stimulation than in a non-banded person--food remains in it longer even when the person overeats only slightly on occasion.

While this could lead to stalled weight loss or even regain, it may prove to be an unavoidable consequence of having a band, and could be something we can easily live with as long as it doesn't progress beyond a certain point. And he didn't say it was unavoidable at all, just something he thinks he'll be seeing more of as time goes on. Maybe cases like yours are what he's talking about. If we do lose some sensation over time in our esophaguses (esophagi?), it's going to be ever more important to make our heads govern what we eat, not our bands.

Too-tight fills, as we all know, are a route to trouble. I may already be as filled as my doc wants to make me--I'll find out on December 23--and if that's the case I'm going to have to live with that. Weight LOSS is not my primary concern at the moment; it's the continued good health and safety of my band so I can keep off what I've lost already. And I'm WAY farther from "goal" than you are. What would be the worst-case scenario? No more fills, or no more band?

It's not at all surprising that you're not losing a pound a week now, since you have so little excess weight left to lose. A tighter fill wouldn't necessarily improve that, and could lead to losing your band altogether.

As far as the actual amount in your band I have always said it's not about the fractions of cc's that can be measured going in or out. It's not worth agonizing over where that .25ccs went or didn't go. All that matters is how you feel and how your band is sited. If your doctor says it's good, let it be and just keep working on eating less. That's the way to lose weight, or so I've heard.

[HarleyNana 10]

Gee Babs with everything else you had going on, this is not the info you needed. Sorry I don't have any advice, but I do care and hope all is well.

[babsyintx 0]

Hi Alexandra:

I spoke to Cynthia Jones here in TX (she lost 210 pounds and is at goal) who owns Bandlandia. She suggested that I get an EGD to check esophagus function. She thinks that all bandsters should get one every year. I am sending an email to my surgeon and he is calling me this afternoon to review the flouro fill notes etc and address my concerns. Your doc sounds like a smart guy and I agree with his theory.

Babs in TX

[ShrinkingViolet 1]

I have never had a fill so I have no experience with that and can't address it.

But I do have experience with losing large amounts of weight. You have lost a lot of weight and your current weight is 188 if I am reading correctly? It is very normal for weight loss to slow down, sometimes significantly, as you get closer to goal. I know your goal is less than 188, but our bodies are by nature reluctant to lose weight, which is one of the advantages of banding. It helps you restrict your calories to the point where your body is forced to give up the fat, because there's not enough fuel to meet its needs--a 'famine.'

The consequence of this is that your body imagines it's being starved and functions less efficiently in order to "conserve" what it can for times of "famine." Then when you eat more than you regularly do, you will gain weight.

So if you are 300 pounds, eating 1200 calories per day, the more you lose weight, the lower your caloric needs and eventually 1200 calories will not have the same results. Also, unless you lift weights/strength train while losing weight, you will lose muscle along with fat. Muscle burns more calories per pound than fat.

One way out of this rut is to increase the amount of muscle you have. This will speed up your metabolism so that you can eat the same amount and lose weight again.

Of course, you probably know all this....but maybe it will help someone who doesn't so they don't get discouraged.

You have done great so far. If I do as well as you have done, I will be over the moon!!

Oh, and I want to add that I am sorry about the difficulties you've been going through. Stress also makes it tougher to lose weight and this may be part of why your weight loss has slowed down somewhat. Stress releases some chemical that tries to hold onto fat. (Is it cortisol or something?? I can't remember what it's called.)

Good luck! You look great.