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DrHekier

LAP-BAND Patients
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Posts posted by DrHekier


  1. While on vacation many years ago to a location with many mosquitos, I took an antihistamine. (May have been Zyrtec.) It obviously didn't prevent being bitten, but it seemed to help me personally tremendously in terms of getting the bitten swollen areas to shrink in size and stop itching.

    Talk to your doctor.


  2. If it is simply flipped, she will not need a new port. In cases of flipped ports what typically happens is that the tissue through which the port is sutured gives way and the the port is free to turn around in the subcutaneous pocket.

    Securing it back into position is a straight forward procedure that depending on the patient often won't require general anesthesia; IV sedation is often enough. But it does need to be done under sterile conditions, generally in the operating room.

    Nothing can be done to prevent flipping; it is a relatively uncommon phenomenon and resuturing the port in place should be just fine.

    Don't feel sorry she had this surgery. You are seeing a very minor adverse event now. Fast forward 30 years from now if she didn't have the surgery. With morbid obesity she increases her risk of heart disease, stroke, diabetes, breast cancer, etc....

    She could be laying on her deathbed from some obesity related comorbidity 30 years from now and you would wish that something could have been done in the past.

    I'm hopeful you'll soon feel this is the best thing she has ever done for herself. And for you.


  3. Ask the surgeon directly if you can. Our practice is to generally to repair hiatal herniae if we encounter them.

    Two of our five bands today had hiatal herniae and were repaired at the same time. One of the other patients had a prior hiatal hernia repair, and the 'scar tissue' from the the prior surgery made the band placement much more challenging than usual, so it's not uncommon for some surgeons to decline to perform Lap Band surgery if a person has had a prior hiatal hernia repair or fundoplication.


  4. I got my first fill last week and so far, it is going well. However, I was poked four times before the doctor got the needle in the right place (no flouro).

    Has anyone ever developed a "leak" from the fill needle being inserted in the wrong place?

    I don't suspect a leak at this point, and am probably just being paranoid. Please share your experiences.

    In case you are worried that you might have a leak because you don't feel restriction, note that many people don't feel a significant amount of restriction with their first fill.


  5. Legend has it that Pablo Picasso was sketching in the park when a bold woman approached him.

    “It’s you — Picasso, the great artist! Oh, you must sketch my portrait! I insist.”

    So Picasso agreed to sketch her. After studying her for a moment, he used a few pencil strokes to create her portrait. He handed the woman his work of art.

    “It’s perfect!” she gushed. “You managed to capture my essence, in one moment. Thank you! How much do I owe you?”

    “Five thousand francs,” the artist replied.

    “B-b-but, what?” the woman sputtered. “How could you want so much money for this picture? It only took you a second to draw it!”

    To which Picasso responded, “Madame, it took me my entire life.”


  6. The LapBand was approved by the FDA in 2001, and by Medicare in February, 2006, so by definition it is NOT experimental, and has not been for 5 years. Those two facts should be the focus of your appeal.

    As my note from above, it appears that at least one insurance company is saying the Lap Band is experimental because they are using data showing that the GB is superior. So I suppose what they are saying is that the LapBand is experimental in the sense that the GB is more effective. I think there is a sufficient amount of data to support the LapBand over GB.and


  7. I completely agree with Dr. C.

    The VG has a much larger capacity than the other two sizes of Bands, and as a result is more likely to have retained air. As Dr. C says, it takes a fill or two to 'prime it', that is to say, get the air out. It is not uncommon for us to see less Fluid come out on fill #2, than what was put in on fill #1. We even see this at times with the 9.75 and 10 cm bands.


  8. I just had mine taken out two weeks ago. My band surgery is one week from now, so I have been eating little or no fat for a while now. My question is:

    What foods upset your stomach now that your gall bladder is out?

    Lettuce has been giving me fits, is this something that get better over time, or am I just stuck to a life with no salad?

    Generally gallbladder removal (cholecystectomy) should not affect your stomach directly. Some patients will note a difference in ablility to digest fatty meals, and as a result may have loose stools, or diarrhea, for a short period of time after surgery. This is because the flow of bile into your intestines is altered, and bile salts help package fat for digestion/absorption in the intestine.


  9. Here is a great link I have in my favorites. You can search by state.

    In addition to the Surgical Review Corp. linked to above, Medicare will cover surgery at centers certified for Bariatric Surgery through the American College of Surgeons, a seperate program. I don't have the link for that handy.

    From a sticky above I found this link for Medicare approved Bariatric Surgery sites:

    http://www.cms.hhs.gov/MedicareApprovedFacilitie/BSF/list.asp#TopOfPage


  10. From our experience with one insurance company that is denying the band they are saying that it is 'experimental' because they believe the gastric bypass is better than the Band. You can consider an appeal and you and/or your surgeon should provide articles comparing the LapBand to the bypass.

    Good luck!


  11. Many of our patients don't feel much restriction until the 2nd or sometimes even 3rd fill. In fact I think there was a thread here on this website with a poll asking how many fills it took for people to feel restriction.

    Also, it appears that those patients with the Vanguard or VG size Lap Band (which you have) may take just a bit longer to get to their sweet spot of restriction because with the larger size band there is more variability during your fills.

    Make sure you go to your surgeon's support groups. That way you can ask questions with people who are farther along than you, and also at the same stage as you. Our patients seem to get the some of best education from other patient's in the support groups.

    Of course, this site is a support group in and of itself, and you will find many people willing to help!

    Good luck!


  12. The only issue that I can think of is if you go on to have a stereotactic biopsy. For a stereotactic biopsy, you need to lay on your stomach for about 30 minutes or so. (Go to google images and search 'stereotactic breast biopsy') You may be a bit sore, especially at the port site.

    Since you have a palpable mass, there is a good chance you would be a candidate for an ultrasound guided biopsy, for which you lay on your back.

    Now of course, the mammogram and/or ultrasound may show you do not need a biopsy at all. Keep us informed, and good luck!


  13. About 2 weeks ago I attended a Lap Band symposium and the change for Aetna was mentioned. Apparently it just took place a few weeks ago. My understanding is that Lap Band and Gastric Bypass are now on equal footing as far as Aetna is concerned. In the past Aetna had extra criteria required for patients who wanted to choose the Lap Band as opposed to the gastric bypass, and those extra criteria are no longer required.

    Since this is a new development, your physician's office may not be aware of it.

    Good luck!

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