Baba Wawa

I attached one of the result pages from my manometry. I have zero muscle function in the esophagus. My doctor is referring me to a renowned thoracic surgeon for evaluation. He is astounded that the disease has progressed so fast, never seen this before. He did recommend drinking carbonated beverages to help open the LES and it has seemed to help.

http://reference.medscape.com/medline/abstract/22791463
Since I've spent a bit of time researching this condition, I have come across this interesting study. The problem with achalasia is that the lower esophageal sphincter fails to relax when food is swallowed. The study found that carbonation lowers the pressure in the distal esophagus allowing it to open and allow the food or beverage to enter the stomach.
I've already been told to drink Water with meals to help push food through, so I'm going to test this theory and start my meals with a few sips of Perrier. It's 100% natural, the carbonation is very soft. I do drink it from time to time as a "mocktail" with lite cran-pom and lime juice over ice when I'm being social and the carbonation has never been a problem. My nut and doctor have both said that 0 calorie carbonation is an issue of comfort than anything else. Since my band is empty, it's really a non issue at this point.
I'm really concerned about the distention of the proximal esophagus when I eat or drink anything (manometry test used only 1.5 oz saline and it distended) and the cardiac irritation that ensues. If I can mitigate this while my doctors sort out all the various issues and come up with a treatment plan, I hope I can at the very least eat more comfortably and not feel like my heart is jumping out of my chest.
I have an appointment with the GI doc this afternoon.

Read everything you can, complications, successes and in between. In the end it is your choice. We are a community of people who found themselves linked by a common problem, obesity. As we move along in our journeys, we are all focused on our goal and may choose different paths to get there. I chose the band. I was successful, losing 65% of my excess weight, 90 + lb. I am also unsuccessful, since I have some serious complications which have caused me a lot of stress, pain and disappointment, at least a dozen diagnostic tests in the last year and I need at least one more surgery, maybe 2. I was compliant. That's no guarantee.
This is a big decision, so don't be in a rush. The fact you've been losing steadily since December is significant. 5 months of success is nothing to sneeze at. It means you've made some major lifestyle changes that can be permanent if you choose to continue to eat healthy and exercise. You might be one of the few people who are successful at diet and lifestyle changes, just as I am one of the few people who have Lapband surgery are compliant and still develop major complications through no fault of their own.

When my SI joint went out in '07 I did PT for a year 3x week. I transitioned to chiropractor after my progress plateaued, still see him every couple of weeks for adjustment. My right SI dislocates. My left knee needs replaced...not surprising the rt SI is a problem. I went from being unable to walk without assistance to walking 1.5 miles...it's painful but I CAN do it

Yes. Thank you. I hope so too!

I'm going to try this!

I don't dislike my band, but I sure dislike what it's done to my GI tract. I love that I'm under 200 lb and can shop in any store. I love that I can walk better, do more, but living with a motility disorder is very much a compromised quality of life. Different problems. The only + is that I feel better about how I look.

Read everything you can, complications, successes and in between. In the end it is your choice. We are a community of people who found themselves linked by a common problem, obesity. As we move along in our journeys, we are all focused on our goal and may choose different paths to get there. I chose the band. I was successful, losing 65% of my excess weight, 90 + lb. I am also unsuccessful, since I have some serious complications which have caused me a lot of stress, pain and disappointment, at least a dozen diagnostic tests in the last year and I need at least one more surgery, maybe 2. I was compliant. That's no guarantee.
This is a big decision, so don't be in a rush. The fact you've been losing steadily since December is significant. 5 months of success is nothing to sneeze at. It means you've made some major lifestyle changes that can be permanent if you choose to continue to eat healthy and exercise. You might be one of the few people who are successful at diet and lifestyle changes, just as I am one of the few people who have Lapband surgery are compliant and still develop major complications through no fault of their own.

http://reference.medscape.com/medline/abstract/22791463
Since I've spent a bit of time researching this condition, I have come across this interesting study. The problem with achalasia is that the lower esophageal sphincter fails to relax when food is swallowed. The study found that carbonation lowers the pressure in the distal esophagus allowing it to open and allow the food or beverage to enter the stomach.
I've already been told to drink Water with meals to help push food through, so I'm going to test this theory and start my meals with a few sips of Perrier. It's 100% natural, the carbonation is very soft. I do drink it from time to time as a "mocktail" with lite cran-pom and lime juice over ice when I'm being social and the carbonation has never been a problem. My nut and doctor have both said that 0 calorie carbonation is an issue of comfort than anything else. Since my band is empty, it's really a non issue at this point.
I'm really concerned about the distention of the proximal esophagus when I eat or drink anything (manometry test used only 1.5 oz saline and it distended) and the cardiac irritation that ensues. If I can mitigate this while my doctors sort out all the various issues and come up with a treatment plan, I hope I can at the very least eat more comfortably and not feel like my heart is jumping out of my chest.
I have an appointment with the GI doc this afternoon.

If you're not on solids and experiencing pain and difficulty swallowing you need to discuss this with your doctor. Personally, I would go back to liquids for a day or two and try again. Typically whenever I go in to the band doctor, I'm asked a series of questions:
1) do you find yourself looking for food during the day?
2) how much food are you eating at each meal? Is it dense Protein with veggies?
3) are you satisfied for at least 4 hours?
4) are you having any difficulty when eating, pain or other problems.
5) are you drinking 64 oz + per day, not drinking with meals or for 30 min after?
6) are you exercising?
7) are you consuming any alcohol?
8) what medications are you taking, including OTC, supplements and Rx? I don't know why 8 turned into an emoticon, lol!
This helps them to determine if you need a fill or perhaps in the case of #4, if you are having a problem that a fill will only make worse. Some people go a year or more without a fill and do very well.
Please post next week after your dr appt and let us know how it went

Are you feeling any better at all? That's got to be a drag. Sorry you're miserable ((()))

I agree--bye bye lap band, it's been real....a real pain!
I was banded almost 7 years ago. As of two days ago, I am banded no more.I can feel the relief already. The pressure is gone, no more pain, I can swallow normally, even my breathing seems better. I am wondering if my bowel issues will improve--so far, so good, but it's only been two days.
I have hated myself for the band's failure 6 of the 7 years. The first year, I lost a bit more than 100 pounds. My surgeon told me how wonderful I was doing, I got compliments galore, I looked pretty darn good, but I was in misery. I could hardly eat anything without being sick and vomiting and I had to travel back and forth to the surgeon (2 hrs each way) to get a fill, get some taken out, get some, get it all taken out, start again...and again. I had bad lower back pain the whole first year. The doctor determined that I indeed had gall stones--the probable cause of the back pain, so had my gall bladder removed--but after the surgery, I still had the same pain (gee, could it have been the band?). Then I developed very bad reflux--so bad I was vomiting in my sleep and aspirating it, and therefore, usually ended up on puffers. I then developed 'motility' issues where it felt like sometimes that food got stuck and I would have to vomit, in spite of eating slow and chew chew chewing. The motility issues even happened with Water. I was on Tecta for reflux, had nitro pills for the swallowing issues, puffers for my lungs, and then started meds for anxiety. I had no fill in my band for months at a time and still I could not eat a healthy meal without pain, difficulty swallowing, and vomiting. Then I discovered ways to "eat around" the band because I was hungry--this meant choosing foods that would go down more easily--fatty foods, foods with gravy, sauces, creamy things--and I started to gain weight. So I would go back and do the fill thing--and suffer again. The surgeon thought he should have a look at the band, even offered to replace it to see if that would help. So I went for that two years ago--a new band. That did not help. Same issues. I have not had a fill in about a year and have managed to keep off about 35 of the original 100 I lost.
Seven years of hell for 35 pounds. Hmmmm.
I know it works for lots of people. And for you lucky ones, hurray for you! Excellent. But please do not tell those for whom the band does not work that we do not try hard enough, that we do not follow the rules--it does NOT work for everyone and it is NOT our fault.

Vaso-Vagal Reflex is what you're speaking of. Your symptoms could be so many things that are easily remedied.
Dehydration: lowered hydration = less blood volume = low blood pressure which can make you feel lightheaded, dizzy, etc.
Calories: are you eating enough and is it nutritionally balanced?
Be sure to follow up with your doctor if your symptoms continue.

I would do it, but expect to revise at some point. The bigger problem is that I most likely cannot revise due to damage from my band. Given the same options at the same time, yes. Today, no. I would choose VSG.

Please read this with an open mind. It might just save your band and damage later on.
I've been trying to figure this out, since my Dx was confirmed last week. I kept my band loose, 3.5 cc in 11 cc Realize C band. I ate per my doctor's and nutritionist's directions. I didn't drink with meals, though drinking with meals might be better. I cut my food into 1/4 inch pieces, chewed 15-25 times. In fact, I was doing all this for 3 months prior to surgery. I ate 1/2 to 1 cup food, taking 20-30 min to finish. I stopped eating with the "soft stop" signs. I've come across some information that might explain what happened to me and why. So what's the problem?
The problem is that our pouch can only hold 1-2 oz of food. A half cup is 4 oz. If you're a little bit too tight, food will be retained in the pouch, putting back pressure on the gastroesophageal junction. Eating a cup of food a year or more out, isn't unusual and this would be 4-8 times the capacity of the pouch. As we're told not to drink at all with our meals, the food stays in the pouch, longer, which can be a problem. Any random tightening, a fickle band, can have disastrous consequences to the esophageal function. An ounce is appx 29 cc, my manometry test involved just 45 cc of saline (about 1.5 oz). It doesnt take much to cause problems. The esophagus is not intended to hold food at all. Continued episodes of this causes nerve damage and will present initially as heartburn or GERD symptoms. This is misleading and potentially damaging. How many times have you seen a post where someone states their heartburn had returned and their doctor puts them back on a PPI? What is needed is an Esophogram to determine if they've become too tight (if its been some time since their last fill) or a small unfill if they've had a recent fill. If there is any chest or epigastric pain, further tests would be in order to rule out esophageal problems. Manometry can pick up small changes indicating damage that cannot be seen with EGD or UGI, avoiding further damage by unfilling the band or removing it all together.
This sort of explains why the "rules" around eating and drinking with a band might result in fewer complications and that quicker pouch emptying might be a good thing. I've been drinking with meals again for a few months, but have noticed no difference in satiety.
Let me emphasize something here. This post is intended to educate and share knowledge in order to spare someone else the problems so many of us have had. Most of the time achalasia secondary to AGB is reversible with emptying or removing the band, but it is a contraindication to VSG, eliminating that surgery as an option for revision. Getting a band might prevent a person from being able to revise to their surgery of choice, eliminating all but malabsorptive options (RNY and DS).
http://www.ajronline.org/doi/full/10.2214/AJR.04.0655
http://link.springer.com/article/10.1381%2F09608920677522200 5?LI=true
http://www.ncbi.nlm.nih.gov/pubmed/22411570
http://www.searchmedica.com/xml-resource.html?c=pc&ss=defLin k&p=Funnelback&rid=http%3A%2F%2Fubm-search01.squiz.co.uk%2Fs earch%2Fcache.cgi%3Fcollection%3Dpubmed%26doc%3D61%252F21683 804.xml%26off%3D0%26len%3D-1%26url%3Dhttp%253A%252F%252Fubm- search01.squiz.co.uk%252Fpublic%252Fpubmed%252F21683804.xml& t=pubmed

So today I had an emotional day of eating because I had "only" lost 6 pds after my fill was done 10 days ago. For some reason I thought I should loose at least 10 pounds within 2 weeks of getting my fill due to the liquid diet we are on at first etc... My 5 pounds were in the first 6 days with around a 4/10ths of pound per day for the remaining 4 days. Because I can't seem to Celebrate the positive and focus on the negative.....I ate a chicken, bean & cheese burrito from Chipotle and I couldn't feel more miserable!!! I felt sp bloated and non-functioning that I just cried because I had been doing pretty good after my fill in 4 years.
So being the type A Project Manager I am... I divided my 30 meals I have had in 10 days by my 27 successful meals I have eaten and my track record is actually 90%!! That was so more significant to me than the pounds I hadn't lost!!!!! 90% of my eating was successful in the last 10 days! That meant the world to me. I think I also realize the scale is a trigger for me and isn't healthy and I can't focus on it like most of you can. I thin I will have to focus on successful meals per week instead of pounds for a while.
Not sure if anyone else has had to deal with this and found ways around it but I thought I would share just in case. It made me feel more proud of my accomplishments than I had been filling.

Looks great!!

Have you found any solution to this problem? I was Dx with achalasia last week.

I got a new appointment for manometry on 4/9

Thanks everyone! Still waiting on the hospitals to get me a manometry appt sooner than 4/23.

Almost 3 years, Kime Lou...I posted my band history in my blog. The last 15 months have been problematic, though.
They were very impressed that I lost 20 lb since my band was emptied last June.

It would be great...I have peristalsis, though. The valve just won't open in response to the contractions. In the esophogram, the barium sloshes around as the esophagus contracts attempting to push it thru. The distal esophagus was ballooned out. The radiologist and PA were visibly alarmed by what they saw.
The other issue is the palpitations I get as food passes through the LES, once it does open are cardiac irritation.
Once the barium landed in my stomach, my band sort of flopped and tilted to one side...it's so loose.
I'm terrified of life without the help WLS has provided. I'm also tired of doctors, tests, surgery...my husband is stressed over all this as well.

Today, I was Dx with achalasia, failure of the LES to open and allow food to enter stomach. This wasn't present 9 months ago when I had my last Esophogram. This is a serious problem and is most likely going to require removal of my band.
Achalasia is a rare disorder, with about 2000 people Dx annually in the US, about 1:150,000, but I was told today, it is occurring in about 1% of band patients.
To say I am devastated, would be an understatement. The only revision option open to me is RNY, which is not feasible, for other reasons.
Following the rules, keeping your band lose, is no guarantee.

I think that when our bands are working great, we're losing, complication free and enjoying doing things we haven't done in years, we are willing defend our tool and our choice vigorously against "band bashing".
The problem is that often the signs that things are getting off track are confusing, feel like other minor issues, until we hit a wall, so to speak. The problems I'm hearing about with bands and motility often feel like something else (esophageal spasms feel like angina) or something commonplace, such as Constipation. The other big red flag is when you hear of someone stuck on Water or other liquid. They think their band has randomly tightened, though they haven't had a fill in months or years. In this case, they might be experiencing what I am...achalasia, failure of the LES to open in response to swallowing. This is above the band, food, liquids back up in the esophagus causing dilation and damage.
When I post of complications I've had, it is purely to educate, inform and help someone else who might not realize they're experiencing the early warning signs of band complications. Knowing these signs, reacting quickly could mean they reduce the pressure in their band, lessen the damage and save their GI tract from permanent and painful damage. The intent is not to bash, just to inform.

Sorry, I didn't mean to put words in your mouth. Just having a rough day