DayOne Health

Follow up

I went in to emergency Monday night where I was deflated. Xrays were taken and showed band positioning was correct. In the AM I went for a barium swallow and it appeared my stomach was "normal". Doctor thinks I just irritated it and by letting it rest it should heal itself.

I was on liquids for 5 days, graduated to soft foods for the next few. So far so good. Next follow up in 3

Good to hear that you've seen your doctor and everything is fine

@@Damamma We would definitely recommend you to see a physician or have the fill done under the X-ray. Usually when a physician can't get to the port it's because of the port's placement or the fact that it tilted/flipped. Looking at it under X-ray would give a clear answer to what is going on.

The best of luck!

What you are experiencing is stretching of the pouch above the band. This happens when your band is tight enough for you to feel the restriction, but your portions are too big for the upper part of the stomach to accommodate them. Eating smaller portions and going easy on your stomach should make the stomach go back to it's previous size.

When that happens to our patients, we do advise them the same diet restrictions as your clinic. The important part is for you to either stop overeating or deflate the band so that the excess food can go down easier. Prolonged overeating with a tight band band can put you at risk of slippage, so if you feel like you would like to eat larger portions talk to your physician.

In terms of the reflux, we advise our patients to try not to eat later than 3 hours before sleeping and eat less heartburn causing foods. For many, trigger foods are tomatoes, coffee, chocolate, bell peppers, garlic, onions, and in general foods that are hard to digest.

Hope you feel better!

Best,

@@CherieRyde liquid diet is hard. No question there. It all depends on your clinic's dietary guidelines, but what we advise our patients is to test different types of shakes to see which they like best. In addition, you can make your own shakes (just keep them low carb and low fat - skim milk all the way) by mixing in fruit. You can add Protein powder if you are worried you won't get enough from other meals. You can also have popsicles and Jello if that's any consolation

We also allow our patients to eat strained Soups (no rice, no noddles, and no floating veggies) and some cream Soups (still keeping it low fat and low cal).

Best!

@@Bruce120 Sorry for that! Looked at your joined date, as opposed to the surgery date. The port should not significantly protrude, at least from our experience. You should definitely ask your doctor about it because ultimately the level of protrusion depends on the surgical technique.

You should contact your physician immediately. With the slipped band you would most likely have a severe stomach ache and wouldn't hold anything down; nevertheless, even if your symptoms are persisting your stomach must be aggravated from vomiting and you may have some pouch stretching (from increase in your portions, pouch stretch is quite possible). Pouch stretching may eventually lead to band slippage, so it is very important you see the physician. With your stomach swollen after being sick, it would be good to get some Fluid out to let it rest.

Please do not ignore the symptoms, and have your surgeon look at the stomach under an X-Ray. Better to be safe than sorry.

Wish you all the best!

On a side note, is it normal for the port to stick out quite a bit after surgery? I could literally see the entire shape of the port, and completely feel it with my hand. It sticks out like a sore thumb on my stomach. I just hope that it's normal, and it'll get better.

The level of port protrusion can be dependent on a few things: the way the port is placed, model of the band, and weight loss. Since you are a new patient, I'm guessing that your port was placed on the stomach muscle (right under your skin) and that's why it sticks out. Our surgeons prefer to put the port under the muscle so it doesn't protrude even if you lose a lot of weight.

Earlier band models had much larger ports and therefore were more protruding - especially if a patient lost a lot of weight. Nevertheless, since you had your lap-band placed in May this year, it is doubtful you would have Allergan's older model. The level of protrusion may also differ between LAP-BAND System and RealizeBand, but that is something we don't have much experience with since we work mostly with the LAP-BAND System.

The best advice would be to talk to your surgeon about it because if the port is protruding now, it most likely will in the future.

Hope this helps. Best!

Congratulations on your weight loss! You are doing great Just remember not to lift more than 10 lbs until the week 4 post-op (the port) and in general don't strain yourself too much.

Keep the good energy going and good luck!

First of all, you are doing amazing! Seconding other guys here, the last 20lbs or so is the hardest to lose. Sometimes you plateau, but you have to know that it's OK because it's just your body adjusting itself to the new weight. Nevertheless, you mentioned you can't eat... That's not good! Not good at all, and if that's the case, you need to contact your lap-band clinic and make an appointment ASAP. It is possible you are too tight, in which case you definitely need some Fluid taken out. Being even slightly too tight can put you at risk of stretching the pouch and even band slippage.

You are definitely NOT failing at anything and definitely NOT failing the band. You are doing great! Adjustments are a part of a lap-band follow up and it is recommended that you see your surgeon at least every three months in the first year after the surgery, and at least once annually thereafter. Visiting your physician does not always mean you will get an adjustment, sometimes it's good to visit just to check on the band under X-Ray. Every bandster should remember that visiting the clinic should not only be restricted to emergencies and getting adjustments! Book an appointment with your physician at least once a year - even if you feel great.

As mentioned by 2muchfun, when you lose weight it is normal to feel less restriction, so no worries there.

Hope this helps. Wish you all the best.

Has anyone tried compression garments? Or is that a bad idea?

It could potentially cause you more discomfort since it would press on your port and incisions.

The pain comes from the gas pushing against the diaphragm. The reason why you feel pain in your shoulder is because retained CO2 puts pressure on the phrenic nerve, which connects most of your internal organs. Since the pain comes from the gas pressure in your abdomen, the easy way to fight it is to walk around a lot and drink warm liquids. Walking around and warm drinks will give you "more space inside" and relieve the pressure. The pain will most likely get worse when your stomach is full or you feel bloated. To minimize the discomfort, stick to the diet prescribed by your dietitian (clear liquids) and use Gas-X thin strips. Heat, massage, and exercise seem to work best.

Hope this helps!

In our clinic's decade of experience we've seen maybe a total of 5 band erosions, and these were mostly patients who underwent surgery outside of the U.S. or in the early 2000s. In the beginning, erosions were more prevalent because of the surgical technique used to place the band and it has changed substantially since then. The device itself has also changed over the years. Some studies report higher percentages, but one has to remember that occurrence of band erosion is highly correlated with the surgeon's experience. In other words, check years of experience on your surgeon's bio and whether lap-band surgery is something he specializes in (ask how many lap-band surgeries he has done).

We haven't seen any erosions for quite some time now, and we know that other clinics in Chicago see them very rarely. Most lap-band complications requiring surgical intervention are issues with the port or band slippage, and even these happen very rarely (3% or less). Band slippage can be prevented in large majority of cases by keeping the band comfortably adjusted and not overeating.

Good luck!

The reason for the pre-op liquid diet is to help shrink your liver. Your liver and stomach are close together so making your liver nice and thin will allow your surgeon better access to place the band around your stomach. When you follow a calorie restricted, low sugar, liquid diet, your liver will shrink enough to allow for a safer and quicker surgery. The purpose of the diet is not to make you lose weight, although that is often a side effect. In regards to cheating preventing you from getting the surgery - your surgeon will cancel the surgery only if you you will still have solid food in your stomach just before the surgery. In other words, if you feel like you need to cheat, stop 3 days before the surgery and you should be fine.

Words of caution: liquid diet is hard, but its additional benefit is to upstart your diet and lifestyle change. Following the surgery, you will need to stay one more week on a liquid diet, and then slowly progress toward solid foods (week 4). Without the prior prep in dieting, you may find it even harder after the procedure. Diet following the lap-band surgery is intended to get your stomach used to the band and slowly ease you into a new lifestyle.

Good luck!