Dialation

[bbheim 0]

Today I found out that my band had dialation (not sure how to word this) and all my saline had to be removed. I went for a fill in March and told the doctor that I had no restriction and was having lots of GERD especially at night. Some nights I would wake up choking really bad. The doctor at that time, filled me with .2 cc of saline. The GERD got much worse and today the saline was removed.

Does anyone know anything about dilation of the lapband?

God Bless,

Barbara

[DeLarla 22]

Interesting, considering I had a long talk with my surgeon about pouch stretching versus slippage. According to him, there really isn't such thing as the pouch stretching or "dilating" so-to-say. What happens is the band slips down, thereby leaving the pouch bigger on the top. I asked him if packing the pouch too tight can cause this, and he said, "yes." He said it could happen if you over-eat a whole lot of times, or it could happen just from one incident, however, even a bad hiccup could essentially slip the band.

I asked him if carbonation causes slippage, but he said there's no proof.

Please forgive me if I didn't translate that in his exact medical terminolgy but I'm sleepy, and my thinking isn't too sharp.

He never mentioned removing all the saline to see if the band re-sets itself, but he did tell me if I (me personally) slip my band that he'll probably remove it since I'm still over-eating. Did any of that make sense?

[bbheim 0]

It did. My doctor didn't give me any information really. He just wants me to rest my pouch for six weeks and then see if it will be okay with a refill. He did mention that it would have to be removed if the break period did not work.

The doc did not give me any reasons why the pouch dilated.

[DeLarla 22]

He can't give you a reason because there's no way for him to know how it happened. I was at my surgeon's on Saturday, and he showed me a model of the stomach with a band around it. He showed me how the band slips down, which leaves the top part of the stomach bigger. So, the pouch didn't actually expand, the band just slipped lower. I've heard the band could slip upward, too. I'm not sure how that would happen, but I sure hope your unfill settles your band back in place. Good luck to you.

[NancySmiles 2]

why would he need to remove it? Can't he just slide it back where it should be???? Would you then have to be re-banded?

[the best me 6]

I'm a little confused about dilation...is that another way to say slipppage? Or as my Mexican doc says, "sleeepege"? Or does is have more to do with a "stretched pouch"? which, to me, would mean slippage? Also, slippage is repairable. It requires surgery, but not band removal, like Nancy said. help!

[2bthin 0]

Hmmmm.. slippage... My doctor pulled a small part of the larger part of my stomach over the band and stitched it so the band would not slip. Has anyone else's doctor done that?

2bthin

:banana:banana:banana+2 lbs gone!

[DeLarla 22]

According to Dr. Billy, it's all the same. I specifically asked, for example, if the pouch might get so stretched out that it would spill over the sides of the band. No, no, no. That's not what happens, instead, the band slips down. After it slips, you don't have the small pouch up on top any more, but instead you have a bigger pouch - NOT because it stretched, but because the band slipped down.

It's easier for a morbidly obese person to say, "my band slipped" then to say, "I overate and caused my pouch to stretch." Blame it on the band, right? It's a painful realization (to me, anyway) because it would ultimately be my fault if my band slipped due to overeating, but is it really my fault since I'm plagued with this disease of compulsive addiction?

That's the way it was explained to me. If anyone else has a more accurate explanation, please share.

[GeezerSue 7]

I'm thinking that what the doctor was saying is that you have "esophageal dilatation." (I hate the word "dilatation.)

If so, "Esophageal Dilatation" is the widening or expanding of the esophagus, at the bottom of the esophagus where it starts to connect to the stomach.

This happens when too much food is eaten. It packs itself in, waiting to get into the stomach. But it just sits there, because of the logjam at the band.

The usual treatment for this is to loosen the band and hope that the esophagus returns to normal size. (Because it isn't meant to be used as a holding area for the stomach.)

I did this a lot...maybe still do. My motility is slow...this is common in older patients. By the time I figure out that I'm packing it in, it's too late. It's all just sitting there. this can happen very easily when there is some swelling around the stoma area and the band is tighter than usual and, without aqny warning, you've overeaten.

[GeezerSue 7]

PS--"Esophageal dilatation" (widening of the esophagus) is also a treatment for "esophageal stenosis" (narrowing of the esophagus.) So it can be a diagnosis or a treatment.

[GeezerSue 7]

WARNING:

MY LAST SCIENCE CLASS WAS HS CHEM, IN 1963.

They passed me with a "Gentleman's D," to keep me from returning and taking the class yet again the following year. Seems they were still holding a grudge about the thing with the zinc and magnesium and the Bunsen burner and the explosion and all. Gawd...you'd think they would have planned on inquiring minds wanting to know.

Just so you know I'm a less-than-reliable source for scientific issues.

[Persimmon 0]

This is the standard technique...it merely reduces chances of slippage, doesn't eliminate it...the reason one of the symptoms of slippage is a sudden tightening unrelated to any recent fill is that the portion of the band not where the stitches are slips, the angle changes, because the stitched portion stays put...and thus the band ends up at the wrong angle, increasing restriction and often causing reflux.

Nancy

394/270/180

Hmmmm.. slippage... My doctor pulled a small part of the larger part of my stomach over the band and stitched it so the band would not slip. Has anyone else's doctor done that?

2bthin

:banana:banana:banana+2 lbs gone!

[Persimmon 0]

While some slippage might be the fault of the patient, not all is, so this generalization cannot be made.

Nancy

394/270/180

It's easier for a morbidly obese person to say, "my band slipped" then to say, "I overate and caused my pouch to stretch." Blame it on the band, right? It's a painful realization (to me, anyway) because it would ultimately be my fault if my band slipped due to overeating, but is it really my fault since I'm plagued with this disease of compulsive addiction?

That's the way it was explained to me. If anyone else has a more accurate explanation, please share.

[Alexandra 55]

I'm thinking that what the doctor was saying is that you have "esophageal dilatation." (I hate the word "dilatation.)

I hate that word too! It feels like it should be "dilation," but enough medical people use "dilatation" that it may be correct in that context. I'd hate to think it was just an error that was compounded through overuse.

I did this a lot...maybe still do. My motility is slow...this is common in older patients. By the time I figure out that I'm packing it in, it's too late. It's all just sitting there. this can happen very easily when there is some swelling around the stoma area and the band is tighter than usual and, without aqny warning, you've overeaten.

Sue, what do you experience when you're doing this? I've wondered from time to time if I do this too, but don't know how to tell. Perhaps I just have very little restriction.

[leatha_g 4]

And there is a difference in the actual esophagus and the pouch.. someone get a map!

The band can and does slip up and down, creating a larger pouch than was originally there. This does not have to be purely from overreating, as stated. Wretching one too many times, too hard, hiccuping, many things could cause it... No one really knows for certain. Some of our anatomies just may work differently. ?? As for the docs stitching the stomach around the band.. yes, most of them do that these days, but it's still no sure-fire fix. My operative record stated clearly that my band was stitched also, but somehow it tore away and still slipped.

They took the saline out of mine immediately when they saw the 'slip' and the stomach did go back down, but not completely, so they had to go in and TRY to maneuver it back into place. In doing that, the band broke, so they had to replace it instead. I've also heard of those who's bands went back into place and all was well... It's a crapshoot as to each individual case.