Hi everyone.

I know the subject of erosion is running rampant around here lately, but I have a question for those who have had the band removed (and anyone else who'd like to chime in).

I understand erosion can be caused by any number of things. I've heard mention that the body sees it as a foreign object and attacks it, causing the erosion.

I think I've mentioned before, that I have an underactive thyroid that I'm being treated for. My dr told me that my immune system is attacking my thyroid, trying to destroy it, for which, I take medication daily.

Now to my question....for those who had to have your bands removed, did any of you have an underactive thyroid? I'm just curious. If that's the case....I wonder if that could happen to me when/if I get banded? Something to think about and ask the dr about I guess.

Thank you!

Hi everyone.

I understand erosion can be caused by any number of things. I've heard mention that the body sees it as a foreign object and attacks it, causing the erosion.

Thank you!

The band is not seen as a foreign object, so therefore the body does not attack it. There have been no known or reported cases as of June 2005 stating that the band was rejected, according to my surgeon. Now there have been on known cases stating it hasn't either.

The erosion does not occur because of the body rejecting it. There are several factors that can develop causing erosion.

If you already have concerns regarding your immune system then I would do more research and talk with your surgeon more about having the band placed. Make sure you have all your questions answered before making that surgery date.

The band IS a foreign object because the port is connected...that is the foreign object. That my dr. has told me definitely. I have an under active thyroid also, but I don't think that causes erosion.

My dr. has already told me that because of the lap banding I will need antibiotics before any dental work also. That makes it a pretty foreign object I would say.

I'll definitely make a list of questions for the doctor to answer, including asking him out of the number he's done, how many had to be removed. I understand that several people with underactive thyroids have had bands and so far no erosion.

I'm still in the learning phase and a bit ignorant, but from what I've read, there is no one concrete reason why this happens. It seems like you're either lucky to not have it happen or unlucky that it does. Seems like I'm looking for 1 definite reason why this happens.

I did read something from, I think, a UK website (my kids were bugging me to use the computer so I didn't reasearch it further), but this woman said she converted to a MIDband because she had trouble with her first one. She didn't say what problems she had or what kind of band she had first, but that was 6 years ago and she's doing well. So maybe its the type or brand of band causing this, I don't know, but I'm going to look further, because I am not familiar with the different types of bands.

Thank you both for your thoughts, I wonder if anyone else has any input on whether the band is considered by the body a foreign object or not. My husband broke his arm several years ago and has a steel plate and screws in his arm.....seems like the body, would consider that a foreign object as well. The whole thing is a mystery to me thus far......research.....research!

Thanks!

ANYTHING implanted in your body is a foreign substance. If you have a splinter in your finger, it will get infected because it is a foreign body. Plates, screws, iud's.......anything the body didn't produce on it's own is considered a foreign substance. Plates and screws don't wear out, but the bands are made of a plastic/rubber substance and my dr. tells me it could erode in a yr. or possibly never erode. It is simply the bodies resistance to a foreign object, and the band is easier to erode then most implantable things.

I never meant to imply the band isn't a foreign object. All I was addressing was that the body doesn't reject it and therefore cause erosion.

First, the port is not the only thing implanted into the body that could be seen as foreign in your statement. The entire system from the band to the tubing to the port can be seen as foreign.

Second, the band itself does not erode. Neither does the tubing or the port. The port is made of metal surrounded by plastic. This port material is the same thing used in Port A Caths used for Chemo patients. If you ever get a chance to look at a Lapband Port turn it over and it says Port a Cath on the underside. I saw this while in my surgeons office when I had port issues earlier.

Third, the stomach wall is the part that erodes. Want proof? Look at my thread where I posted pics. You can plainly see the band intact and inside my stomach.

The reason the reports of erosion in LapBand patients is "easier" is because this device has something to wrap around. The other devices, most actually, just lie on the surface of the organ or right under the skin of the person. Our ports for the LapBand for instance. Has anyone heard of where the port has eroded out of the abdomen or into the intestines?

Look I am not saying I am the authority on the subject. All I am saying is ask the questions that give you peace of mind. Get the tests that give you conclusive proof of your fears. Don't second guess yourself and don't take advice or opinions as facts. Do your own research and be an informed consumer.

We good now?

ANYTHING implanted in your body is a foreign substance. If you have a splinter in your finger, it will get infected because it is a foreign body. Plates, screws, iud's.......anything the body didn't produce on it's own is considered a foreign substance. Plates and screws don't wear out, but the bands are made of a plastic/rubber substance and my dr. tells me it could erode in a yr. or possibly never erode. It is simply the bodies resistance to a foreign object, and the band is easier to erode then most implantable things.

Thank you Penni and Dody for the good discussion on this subject. I saw your pictures Penni, that's what got me thinking more about this. I hope you are doing well. I would imagine it to be disheartening to have it removed.

I will definitely do my research and hope you all don't mind me asking questions.

Thank you

I did read something from, I think, a UK website (my kids were bugging me to use the computer so I didn't reasearch it further), but this woman said she converted to a MIDband because she had trouble with her first one. She didn't say what problems she had or what kind of band she had first, but that was 6 years ago and she's doing well. So maybe its the type or brand of band causing this, I don't know, but I'm going to look further, because I am not familiar with the different types of bands.

Yes I know who you mean--I believe she's a woman from the UK who had a lap-band and converted to the Midband. I don't think she had erosion, though ... I think she had slippage or reflux/esophageal problems.

I had the opposite - I had a Midband, had reflux very badly and eventually had slippage. Now I have a lap-band and am very happy so far.

What does that prove? Absolutely nothing...but just wanted to put in my 2 cents that I don't think erosions are higher with any particular brand of band - or at least, there's not enough data out there to prove that yet.

I have read that erosions could be related to some anomaly happening in the original surgery.

hi

Just an opinion.The band is a foreign object fitted tightly around the stomach.Anyone that has worn a ring or bangle or something that fitted tightly must have noticed how an indent is formed at the site.I think what happens is that some people get a slight inflammation at the band site or that the band just irritates the stomach and it starts eroding....interesting enough a lot of people with erosion reports "port issues" or port pain and I think it is inflammation....that is what the body does when it is trying to protect or reject.....

Penni,what port issues did you have?

I have always had a lot of port pains....sensitive to the touch and deep stabbing aches around the port area....I thought that is "normal" as people are always saying it is ok to have port pains....(combined with the increase in stomach ache between boobs under ribs where I think band is situated...cant wait to go for the endo after holidays....)

Desertmom, what a good visual, I never thought about it that way, but it stands to reason.

By the way, I take Synthroid for underactive thryoid too.

The antibiotics before dental work is a new one for me. I'd never heard that one before. I've had dental work done a couple of times since banding without any pretreatment or problems. I'm wondering what in the world that is about? I'm definitely against over use of antibiotics anyway, considering the ever increasing resistance of bacteria, so I'd love to hear more about the rationale behind that. Anyone know more?

Penni is right about the port. We have lots of patient's with medi-ports. Many with chronic diseases and frequent hospitalizations other than cancer, where they've had so many needle/iv sites that a medi-port is the only veinous access we can get now. Sickle Cell disease, patients who need dialysis, etc...

More good information.....Now another question in light of that. If you have port issues, inflammation or what have you....why does that cause the band to erode? Is it that the infection starts there and somehow travels to the band?

I'm wondering how normal having pain there is for everyone?

Thank you again everyone!

Port issues & Antibiotics with Dental work

Port Issues = I began about two months out having this HUGE (size of a softball) redness surrounding my port area. It was raised, itchy, hot, and red. I assumed it was a reaction to the port but didn't know for sure. I sent pics to my Mexico surgeon which went ignored for two weeks. I finally called him and was ignored. Long story short by the time I finally was told to come and see him in TJ the tubing was almost protruding through my skin. You could feel it through my skin. I have pictures I can show of both items. Anyway, Dr. Billy fixed the problem for me and I was fine for 18 months. However, the port issues I had initially "might" have contributed to my erosion.

Antibiotics with Dental work = Neither my initial surgeon nor Dr. Billy have suggested that I would need to be treated before dental work. I even asked my own dentist about this when it came up before. He said "there is no reason for you to be treated with antibiotics just from the lapband surgery. Most times being treated with antibiotics would mean that you have a pre-existing condition that requires this therapy regardless of the lapband surgery." That is my input on that subject.

I wish I had time to really dive into this post considering I'm on thyroid meds for underactive thyroid, PLUS I have Sarcoidosis, an auto immune disease. And YES my port immediately became infected. But if Sarcoid or Thyroid would reject the port, why didn't it reject the whole band?

I personally don't believe my thyroid or autoimmune had anything to do with it. I think my surgeon did sloppy work or just a fluke.

Donali, Karen, Michelle, Diane, Penni, Francesca, Karen, etc... all eroded. Did they all have my same conditions? Uh, nope.

I'm not being mean, I'm just too busy to get fluffy right now, but I mean well!

My dr. has already told me that because of the lap banding I will need antibiotics before any dental work also. That makes it a pretty foreign object I would say.

Thats interesting?? hhmmm .... I have never heard of this. I also have two dental surgeons in my family. This is news to me, I'll have to ask again. I was told there was no need for anything, even when having gum or dental surgery.

There's a difference between rejection and infection. Rejection is a term generally used when referring to transplanted organs, which contain antigens that are recognized by the body as foreign tissue. The body's immune system then produces antibodies to destroy the foreign substance. Silicone rubber is of course a foreign substance, but the body does not mount an immune response to it.

Infection, on the other hand, is generally related to bacteria. If your port site gets red and inflamed, it is due to infection (or possibly erosion, where the infection tracks along the band out to the port).

My understanding of erosion is that it is caused either by sutures too tight around the buckle, or having the band too tight for too long.

Mark Pleatman MD

Bloomfield Hills, Michigan

248-334-5444

www.laparoscopy.com/pleatman