Erosions

[La_madam 20]

This is an excerpt from Dr. Ortiz's book on the Pors & cons of each technique. Fluoro and No FLuoro

Both are satisfactory in the sense the patient will acquire restriction level needed. FLouro is more expensive and requires special equipment, plus the barium that must be swalloed is not the best tasting bevergae on the planet. The advantage of using fluoro is that it provides and objective image for real time evaluation, which can reveal many things about the band besides the fill level. It can show band position, the size of the esophagus and upper pouch and of course the restriction level. In other words there is a much better interval view of the band then simply a fill without visual indications. WIthout fluoro there are advantages, but apart from the cost, I see no advantage of preforming it without direct visualization. Experienced band surgeons use the rule of thirds. A third of the patients will require one fill, a third will need 2 fills and a thrid will need three or more fills. The standard protocol in the US adopted by most surgeons is a gradual adding of volume. This works well but I prefer to get the restriction level to the correct ammount as soon as possible. This can be achieved more easily with the aid of fluoroscopy. One of the advantages of having a fill without fluoro is it can be done in a Dr's office without Fluoro the protocol used in the US right now is 1cc to 1.2 cc in the first fill and then visits every 2 weeks where incriments of .2 ccs are added the desired restriction is attained. Fills preformed outside of the US are usually more aggressive.

Hope that helps to answer your question Pat

[DeLarla 22]

The difference in money between fluoro and a blind fill can get pretty expensive in the United States. There's a doctor here in Vegas that charges $300.00 for a fill (but first you have to pay a one-time fee of $100.00 just to establish yourself with him.) So after you pay the first $100.00, then it's $300.00 for a "blind" fill. But if you want it done under fluoro, the doctor meets you at the hospital, and you have to pay the hospital separately for the fluoro. I'm not sure how much the hospital charges, but I'm sure it's several hundred bucks. You can't walk into a hospital for anything less than that.

[paula 4]

My first fill is Jan 10, that will be interesting, and he already said he's starting with 1cc, hummm.

QUOTE]

Pat, dont be alarmed with this. First fillls are usually the biggest one.

My first fill was 1.6 cc's.

From what I understand, we are missing a really good thing by not having the fill done under fluroscopy (sp?) .

Oh well, I guess we'll take the fill however we can get it, right?

[paula 4]

ok, now I feel like a dumb ass. I shouldve finished reading all the reply's before posting my own.

Lisa, thats good information to keep on hand. So checking on our band every 6 months to 1 year is geat advice! Thanks.

Michelle, now Im wishing I wouldve ordered one of those books! Are they still available?

[La_madam 20]

Yes Paula www.lap-bandforlife.com here is an excerpt on what you experienced when you thought you had lost some of your fill. I thought of you when I read it.

Here it is

Most experienced LAP-BAND surgeons reccommend the repurging of the LAP-BAND at the time of the first fill. Even though the band is purged of the air at the time of surgery, LAP-BAND surgeons usually find air in the band during the first fill. It is vital to understand why.Experienced LAP-BAND specialists have found that if there is air in the system, it will leak and part of the fill will be lost. liquid does not leak from the band normally, but air does. Therefore, if at the first fill the band was inflated with 2cc's of saline solution and an additional 0.5 of air were in the system, the total of 2.5 cc's provided a very good restriction. But in a couple of weeks time, the air leaks out and the acceptable restriction is now aduquate.

This could explain why you thought you had more of a fill then you did Paula and why when he pulled out the saline some was gone. You had air in your system

[DeLarla 22]

Thank you, Michelle. When will I be getting a full book report? I had no intentions of buying his book, but so far it seems pretty impressive. I may buy it afterall. Air in the pipes... who'da thunk it?

[DeLarla 22]

Michelle, keep posting those excerpts! Good info.

[La_madam 20]

I remember my first fill and I remember when he repurged my band for all of the air,I was warned about it by a felllow Ortiz bandster what to expect. it was a very strange feeling or sensation very hard to explain the feeling but very unbcomfortable for about 45 seconds to 60 seconds when I asked why he ( Dr. Martinez) was pulling the bottom of the syringe in and out he told me he was getting out all of the air in my tubing. I was told he only does it for your first fill..I did not have it done for my second fill but all of the 1.1cc's was still there from my first fill when I went in for my 2nd fill so there must be some truth to it.

[HarleyNana 10]

I know my doctor did a swallow test the am after surgery, I thought that was to see if the band had a leak and to be sure everything was in position. You best believe I will be reviewing this info with my Dr before the fill.

I may have mentioned in a previous post, he was familiar with filling the port without fluoro because he treated patients with cancer and had to use a similar device for injections.

Thanks for all the information, gee looks like I might have to order that book and give it to my Dr. for Cmas present.

[Staci 2]

Does anyone know if there are there any physical symptoms/signs at all?

Staci

[DeLarla 22]

Staci, you can have erosion with no symptoms at all. However, one big symptom is sudden loss of all restriction. If your band erodes into the stomach, food will pass right through. My friend didn't even know she was eroded till she went for a fill, and her doctor saw it under fluoroscopy. She did, however, say that she had been vomiting. There's still a lot to learn about erosion, so the best advice is to listen to your own body, and have your band checked via Upper GI and endoscopy frequently. If your band feels weird, or you have sudden changes in restriction, or if you get a port infection, these are things that should alert you to contact your doctor.

[leatha_g 4]

Staci, you can have erosion with no symptoms at all. However, one big symptom is sudden loss of all restriction. If your band erodes into the stomach, food will pass right through. My friend didn't even know she was eroded till she went for a fill, and her doctor saw it under fluoroscopy. She did, however, say that she had been vomiting. There's still a lot to learn about erosion, so the best advice is to listen to your own body, and have your band checked via Upper GI and endoscopy frequently. If your band feels weird, or you have sudden changes in restriction, or if you get a port infection, these are things that should alert you to contact your doctor.

Note to new bandsters.. loss of restriction means losing the sensation AFTER you have had it. This does not mean that someone who has not yet been filled or reached initial restriction has erosion. This is something that happens AFTER one has had some restriction and suddenly has to go for fills and gets no sensation of being filled several times over.

[melissalee 2]

WHat does a port erosion feel like or what are the symptoms of that? I seem to be doing fine most of the time, but lately, I've had pain on my side where my port is, almost like the type of pain of a cramped muscle if you do too many sit-ups or something (though it's been a long time since that's happened!). Does this type of pain/discomfort sound familiar to anyone?

[leatha_g 4]

WHat does a port erosion feel like or what are the symptoms of that? I seem to be doing fine most of the time, but lately, I've had pain on my side where my port is, almost like the type of pain of a cramped muscle if you do too many sit-ups or something (though it's been a long time since that's happened!). Does this type of pain/discomfort sound familiar to anyone?

Yes. It's very common to have complaints regarding your port placement. As far as I know, there is no 'port erosion' complication. Some people can have infected ports or flipped ports, but I've not heard of port erosion.

I had the left mid abdomen placement for my port and the first year, I was very aware of my port pretty consistently. If I wore clothing that binded against it, or sat bent at the stomach for hours it would become sore. Also exercising or pulling against it would irritate it. This too shall past, but you may be aware of it for quite some time.

[leo 4]

FYI Erosion happens when the band grows into the stomach lining, thereby blocking off the "hole" between the upper and lower stomach. It's kind of like a slippage but worse.

*for newbies wondering what erosion actually is