GeezerSue

A few comments from ANOTHER previously banded, now DS'd member: On eating crap...my DS "fixed" things so that my body thinks it had 20-30% of the fat I've eaten. It doesn't know about the other 70-80%. So if I eat three ounces (three servings) of Planters Mixed Nuts, I put in 45g of fat, but my body "ignores" 23+ grams and lets them move on through...and only 11+ grams are "accepted" by my system. In other words, I can eat crap and my body doesn't even know it happened. (This is not recommended, but it happens...and there are no plugs, no slimes, no barfing, no dumping.) On the safety of the band...it's a safer SURGERY. The eroded people had safer SURGERIES. But if the band slices through the stomach wall (that's what erosion does) it is no longer "the least invasive surgery around." After the safer surgery ends, life still goes on. On mortality rates...many surgeons are convinced that the DS is only for the SUPER MO. The Super MO can die from having dental novocaine. They are at death's door going into surgery. OF COURSE they have a higher mortality rate. My DS surgeon has had one fatality, that was from a mostly unrelated thing, but it was within the 30-day post-op window. He's done well over a thousand DS procedures, so his mortality rate is <0.1%...one tenth of one percent. Body parts...the unused portion of the RnY stomach stays in the body. The unused portion fo the DS stomach is removed. The "if you can't do it with the band" line of crap is well...big boy cow poo-poo. And insulting. And way wrong. (And at least potentially more convincing coming from someone who HAS done it with the band.) If the other surgeries hadn't proven themselves to work, insurance companies wouldn't be paying for them. (And because of the band's relatively poor showing in some studies, my insurance company no longer pays for banding on BMI's over 50.) If someone has the band and things are NOT working out, then they really shouldn't be afraid to consider something else. Remember, the definition of insanity is to keep doing the same thing over and over and to expect different results. For those who know, beyond a shadow of a doubt, that no matter what results and or problems they have down the line, they would NEVER consider one of the bypass surgeries, then I suggest looking into long term care insurance. Because if (I said "if," I'm not predicting anyone's future) the band DOES fail you and you end up morbidly obese again, your ability to care for yourself as you age (I'm pushing 60, so I know about this) decreases and MO just makes it worse. Night before last, we went to an Italian restaurant. I had some minnestrone Soup, salmon with spinach, penne with tomato cheese sauce, bread with cheese and butter dripping all over the place and cannoli. Last night, it was a Mexican restaurant and I had chips, salsa, half a tamale, half an enchilada, some rice and some Beans. I'm eating THOSE leftovers as I type. I'm half-Mexican and half-Italian. I've lost an average of a half-pound a day since surgery in November. I no longer barf up Water and I have my heritage back. Bravo and Ole! Editing to add...the DS is primarily malabsorptive. The malabsorption continues, which is why we continue to need our supplements.

The stuff that makes NSAID's work also thins the protective mucous layer of the stomach. So, it doesn't matter whether is it is crushed or taken as a liquid...it isn't the FORM of the drug but the CHEMISTRY of it that causes problems. Have you noticed all the drugs--and commercials for drugs--for stomach problems? Proton pump inhibitors and all that? those drugs ar not just for wls patients. They have become necessary since all those NSAID's came on the market. A banded stomach is at least as at-risk as a normal stomach... Meanwhile, Tylenol can take out your liver. One risk after another.

StrawartS...I just like palindromes.

NewSho, Well, then...BRAVO!

Pleatman can explain for himself...but Trace Curry, M.D. regularly posts on the OH LapBand board, too. I just think we're lucky to have them and ought to be delighted to hear INFORMED opinions, since there are so many of the other kind floating around. Well...I wish they were both a little more receptive to the DS, but...

I'm not at all concerned about *opinions.* I'm just concerned that the good doctor may think you are speaking on my behalf, which, of course, you are not. And it may sound condescending, but you ARE new at the band journey. Give it some time. It's like marriage...the honeymoon can be altogether different than the marriage.

I couldn't disagree more. I joined this board almost three years ago and was banded for over three years and I'm delighted that Dr. Pleatman is here. I've met a couple of his patients in real life--one doing great, one a real turtle, and he is adored by both. When people are new to any surgery, they are often heavily invested in THEIR surgery. To the point that any suggestion that some other surgery is a good choice or even a better choice than the surgery they chose, is perceived as a threat to their potential success. Dr.Pleatman is NOT here recruiting converts, that is blatantly obvious. And "information about the LapBand" includes what to do when the band was NOT the best choice. Relax about your choice, PhotoNut. If the band was the right choice for you, there should be no fear of how Dr. Pleatman is helping those who had different results. Topic at hand, rebanding after erosion: Tracey, there's no flippin' WAY I'd consider rebanding for myself after erosion. Erosion is ugly. It is the rubbing away of the tissue. The best predictor of future performance is past performance. Why would my body suddenly accept this appliance if it had already--back when the tissue was in GOOD shape--rejected it? Just doesn't even sound like a reasonable--for me--assumption. Sue

Yes, your surgeon should know so that it can be treated. If you are dealing with stomach acid in your throat, it won't get better by itself. Sue

Veddy veddy good.

NewSho... I've been on the "band boards" for four years, and I think yours is the best answer I've read on this topic. Sue

First...the need for plastic surgery has WAY more to do with how overweight someone is and how LONG that condition lasted than it does with how fast someone loses weight. I lost slowly with the band and needed PS. I REGAINED and am losing quickly with DS and may need more PS...not because I'm losing quickly, but because the skin is stretched beyond its capacity to return to normal. Most doctors will tell you that if you have been 100 pounds overweight for any period of time, you WILL need plastic surgery. Then...the band is a safer SURGERY. And a shorter SURGERY. But, for me, for the surgery to be successful, I have to be NOT morbily obese when it's all said and done. To have ANY wls--even a "safe" one--and still be very obese or morbidly obese is NOT--to me--"safe." I got the band, went from MO to just O, started having complications and regained most of the weight. I had the band removed during a revision to DS and have NEVER been happier with a decision...except, maybe, that I waited so long to do it. About the "rerouted" comments...my band--and I am the exception, not the rule, to be sure--was rearranging my innards and causing them to malfunction. My esophagus worked only intermittently. It recovered, about 2.5 months after having the band removed, but it was miserable to live that way. Also--and again, I may be the exception--I can eat most foods now and I had a VERY limited diet while banded. I have to take lifelong supplements. Because I will have lifetime malabsorption. Which means that, for the rest of my life, a certain percentage of the foods I eat won't "count." Not for good (nutrients), not for bad (fats and cholesterol.) Good luck with your decision. But there are more than two wls's out there, so don't forget to consider the DS as well. Good luck.

Jan, I don't want to depress you. It does go away for MOST people, but not for everyone. MY personal expert on this topic is 'nicci6' who doesn't post here. She had two follow-up surgeries (I think) to correct the problem and finally had the band removed...and that helped but she has had occasional pain even since having the band removed. MIND YOU...most of us have left shoulder pain post-op and, slowly, it goes away. To find Nicci, you have to go to this site, where you should register and then post a message to her. Tell her that her fairy godmother sent you. http://www.wlsforum.org/index.php Sue

The best "CURE" for post-op constipation is WATER!!! Be VERY, VERY careful about taking any bulking granular laxative. It can cause a REAL mess, a mess that could have been prevented with more Water. ~~~~ 1: Obes Surg. 2004 Aug;14(7):1022-4. Related Articles, Links Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding. Herrle F, Peters T, Lang C, von Fluee M, Kern B, Peterli R. Department of Surgery, St. Claraspital, Basel, Switzerland. BACKGROUND: Constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer. DISCUSSION: Patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band. CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives. Publication Types: * Case Reports PMID: 15329197 [PubMed - indexed for MEDLINE] source: http://tinyurl.com/hwluw

NOT what you want to hear: it varies from person to person. JimmyC hasn't posted here in forever, but he was stopped up almost completely for almost two weeks. He just needed time to UNswell. http://lapbandtalk.com/showthread.php?t=1010

I've known people who were hospitalized and put on IV fluids for days just to get through the swollen stoma part. You are in no hurry. People survive for a long time on Water only...hydration is your most critical issue at this point. Probably not. Probably you just need more water. Mostly water and other clear liquids. Tea, popsicles, maybe some Jello or broth. Be VERY careful about laxatives. Do you live near Jamba juice or some such place? Get a fruit drink with a Protein boost or two if you feel tired or worn out.. ~~~~~~~ From PubMed: 1: Obes Surg. 2004 Aug;14(7):1022-4. Related Articles, Links Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding. Herrle F ,Peters T ,Lang C ,von Fluee M ,Kern B ,Peterli R . Department of Surgery, St. Claraspital, Basel, Switzerland. BACKGROUND: Constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer. DISCUSSION: Patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band. CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives.

Not only small sips, BUT a couple of things: •at six days post-op, MOST doctors want us on Clear liquids. Protein drinks are NOT clear liquids. And unless there is some reason you'll get sick without them (for a few days), I'd lose the Protein Drinks and go back to clear liquids; •and, once you irritate the stoma--the skinniest place between mouth and stomach--including the irritation of both surgery and eating, the swelling INCREASES and makes the next attempt at eating anything even more difficult. Again, the "cure" is to return to CLEAR LIQUIDS for a few days and then to SLOWLY start adding full liquids and then mushies, etc.

There was a time, about three-and-a-half or four years ago or so, when Inamed...then BioEnterics...changed manufacturers for the port and there were lots of problems. I was never TOLD exactly what the situation involved, but I was able to figure out from observation that ports were being replaced, and the patients were not paying for the surgeon or replacement port. And I also noticed that patients were keeping track of mileage and even going for the port change-out to doctors who did not do the original band. There was even a Yahoo group for people with screwed-up LapBand ports. But the problem went away, and I suspect, that in the then relatively early life of the band in the US, the problems were resolved without fanfare but with a confidentiality clause. Betcha!

Good. Or at least, MOSTLY good.

Don Mills at Inamed told me several years ago that the band can CURE reflux in those who suffer from it pre-op and CAUSE reflux in those who had never had it.

It might help and you should call your surgeon. (But those drugs probably shouldn't be taken forever, so give yourself time to heal and then bug your doctor nonstop.)

Thank you, Dr. Pleatman...you Silver-Tongued Devil...for the direct approach. My band is sitting in a baggie with my Bio-Enterics (pre-Inamed) "owner's manual."

Ou daughter has lived in the area for eight years...uses taxis all the time because--according to her--they are more reliable than trying to find a parking space in LA and nobody has to be the designated driver. And...you will have all the same logistical problems with cash for the parking lot, etc. The hospital will secure your stuff, but you can have money to pay the taxi in the trunk of your car at home...when he drops you off there. One day post-op none of us belongs behind the wheel.

It IS on the site of a surgeon who does the DS. But the cites (at the bottom) are from published, peer-reviewed literature.

When it's all new, it's easy to feel like you've pulled something every time you move more than you did the day before. Band wisdom is that if the port area is not red, or hot, or oozing anything...give it a couple of days. If it IS red or hot or oozing anything, contact your surgeon ASAP.

Here is a comparison chart which includes the complications of the various wls. http://www.dssurgery.com/generalinformation/comparison.php I have to take issue with some of Nurse Teresa's facts, though. For one thing, there are many doctors who think that DS should be reserved for the super MO or BMI's of 50-55 plus. In any surgery--even a tonsillectomy--super obese patients have a higher mortality rate. If we compared stats (like mortality rate) among like-BMI patients, I don't think there would be much difference at all. Yes, the surgery is more complicated. But mine took LESS THAN two hours including band removal. That is why it is more important to me that my surgeon has done over 1000 of these procedures than how many other surgeons do it. Yes, there is malabsorption, but THAT IS HOW WE LOSE WEIGHT. The DS works by allowing patients to eat stuff that the body does not process and absorb. Malabsorption is not some unexpected, negative side effect...it's what makes DS work. The smells--well those stats vary. food that is not totally processed by the body WILL smell bad on its way out. A good deal of that can be controlled by diet. There are supplements, like Devrom, that some people use to eliminate odor. I had lunch with a RnY patient friend the other day and we each had to deal with our surgeries. She had to watch out beause of dumping: "The ‘richer’ the food, in terms of molecule size or sugar content, the more Water will rush into the small bowel to dilute it. This is referred to as ‘early dumping.’ Suddenly, the heart will pound and beat rapidly; you may feel dizzy, and overwhelmingly tired. The bowels may gurgle and churn, and will feel bloated and gassy. This might be followed by loose stools and even vomiting. It is not dangerous, but it can be frightening to the uneducated patient. ‘Late dumping’ is caused by an insulin response to the ingested food. One might feel flushed, sweaty, fatigued, and experience all the signs of hypoglycemia (low blood sugar). You can avoid early and late dumping by avoiding the foods that cause dumping. In other words: sugars, starches, fried foods, fats, and high glycemic foods. The glycemic index refers to how swiftly the sugars from the food enter the bloodstream after eating. Each person has a different tolerance, and you will discover what your personal safe foods might be throughout your post-operative life. Person A might have no problem with bananas, Person B might dump every time one is eaten, and Person C might be able to do a rare banana, only if it is a little bit green. You will learn what your own trigger foods might be. Be aware that these may change over time, as your surgical tool matures. What you tolerate in your early post-operative course you might not tolerate later, and vice versa. Every body and everybody is different!" (source: http://tinyurl.com/mzf98 ) In my case, with the DS, I had to decide if I REALLY wanted drawn butter with the lobster. I could eat it without getting palpatations, but it would probably mean "unpleasantness" in the bathroom the next morning. A bunch of us--band , RnY and DS--all went out beach-themed place together. The RnY people waited to taste the drinks of the DS people to see if they were too sweet and would cause dumping. At the time, I had the band (and problems) and had to skip salads and crab cakes (too much bread) and a cup of coffee AFTER lunch. Every surgery brings its own challenges. When I first joined a wls board, ALL of the ER trips for bowel obstructions and similar problems were RnY patients. My advice is to research the surgeries. That means reading the medical literature and talking to people who HAVE HAD the surgeries and to medical professionals who HAVE PERFORMED the surgeries. Find the online groups and even in-person support groups. Good luck. Sue Not trying to talk anyone into a DS, but trying to make sure people hear more information from those who have made that decision.