Vagus nerve suspect in gastroparesis after banding

[Wheetsin 714]

Just sharing another complication story in case it helps anyone out there. This one involving a miserable band experience, gastroparesis, and a suspect vagus nerve.

My dad was banded in 2009. Despite numerous fills in his 10cc band, he never achieved what I would consider good restriction - he was constantly hungry, didn't have Portion Control, had no food type intolerances, or any of the 100 other indicators one might look to as a gauge for proper restriction. But he would say he was "PBing". Which, after questioning him, was not "PB" at all but was bona fide vomiting. (I no longer feel like a linguistic school marm for insisting there's a difference, and an inherent danger in not understanding the difference).

I think he was banded about a year, and in that time he probably went in for 30+ post-op visits. He'd have some trouble and they would unfill him. He'd do ok for a while and they would give him a slight fill. He'd have more trouble and they'd take more fill out. Up & down & around.

So finally it gets to the point where he's just manifesting really strange symptoms, like super delayed vomiting: eat peas on Mon, feel fine Mon - Wed, and Thu out of the blue vomit up peas. Violent, wrenching vomiting. And then he eventually got to where he'd vomit even if he hadn't eaten, and was starting to bring up the ubiquitous coffee grounds. I told him enough BS, demand a swallow test. Dr. agreed, he had one done, and he passed with flying colors. Esophageal motility on track, no prolapse, no erosion, pouch cleared in under 5 minutes. They scheduled him for an endoscopic procedure and he was absolutely riddled with ulcers. Poor guy looked like a pizza covered with white pepperonis on the inside.

AGB Dr tried to say "need unfill" so I had a talk with him, during which time I reminded him that the band doesn't work on a vacuum concept & you can't take out ccs from a band that's already empty. (Note to people out there -- never, ever, ever feel sheepish about advocating for your medical care). So he put my father on a 2 week liquid diet to see if things would calm down. 2 days into that diet the exact same symptoms are occuring, and now we're vomiting 24/7 with virtually no liquid/solid intake. So he calls me and I tell him to go to the ER, get hydrated, and don't leave until they tell you something.

I drive out to see him in the hospital and they have him forcing liquids down because "maybe" they'll stay down. Uh uh. We switch to IV hydration, and the vomiting continues. He's now afraid to swallow, and vomiting on a pretty regular 45 minute schedule despite being chock full of antiemitics. After 4 days in the hospital he's diagnosed with gastroparesis & xferred to AGB surgeon's care for immediate "let's see what's going on" surgery.

During surgery, a significant slip is noted (that apparently was not there during the tests about 2 weeks prior) and the band is deemed irrepairable & removed. As soon as he woke up from surgery he felt 100% better, and has not had a single problem since. This includes the past 6 - 8 months during which he was rebanded.

The best guess out there is that something in his band positioning was irritating the vagus nerve, which caused all the problems up to & including the onset of gastroparesis. Slippage was attributed to the vomiting attributed to the gastroparesis. AGB surgeon says "he had the problem before banding, and the onset/worsening is coincidental." Everyone else says it's the other way around. I know he had no problems, ever, before his first banding.

And I'm probably forgetting a couple things in there. My reliable memory is about 8 minutes, and we're talking months & months. The end.

[ThinSIstaSoon 2]

My bf was recently diagnosed with gastroparesis and the treatment for it is surgery and/or eating 6 small meals per day along with anti nausea medication...so my bf and I have a lot in common with the band. I have to eat 3 small meals but not drink with them, etc. Most people that have gastroparesis have and get it from untreated high blood sugars so knowing that I would question whether the band causes this chronic illness, especially when it sounds like the band would help someone with the illness. I'm glad your father feels better, I can relate too well to ur post, but I'd make sure his blood sugars are and stay in range. My bf is type II but was put on an insulin pump due to his diagnosis of gastroparesis. Goodluck!

[KayleighsMommy 16]

Just sharing another complication story in case it helps anyone out there. This one involving a miserable band experience, gastroparesis, and a suspect vagus nerve.

My dad was banded in 2009. Despite numerous fills in his 10cc band, he never achieved what I would consider good restriction - he was constantly hungry, didn't have Portion Control, had no food type intolerances, or any of the 100 other indicators one might look to as a gauge for proper restriction. But he would say he was "PBing". Which, after questioning him, was not "PB" at all but was bona fide vomiting. (I no longer feel like a linguistic school marm for insisting there's a difference, and an inherent danger in not understanding the difference).

I think he was banded about a year, and in that time he probably went in for 30+ post-op visits. He'd have some trouble and they would unfill him. He'd do ok for a while and they would give him a slight fill. He'd have more trouble and they'd take more fill out. Up & down & around.

So finally it gets to the point where he's just manifesting really strange symptoms, like super delayed vomiting: eat peas on Mon, feel fine Mon - Wed, and Thu out of the blue vomit up peas. Violent, wrenching vomiting. And then he eventually got to where he'd vomit even if he hadn't eaten, and was starting to bring up the ubiquitous coffee grounds. I told him enough BS, demand a swallow test. Dr. agreed, he had one done, and he passed with flying colors. Esophageal motility on track, no prolapse, no erosion, pouch cleared in under 5 minutes. They scheduled him for an endoscopic procedure and he was absolutely riddled with ulcers. Poor guy looked like a pizza covered with white pepperonis on the inside.

AGB Dr tried to say "need unfill" so I had a talk with him, during which time I reminded him that the band doesn't work on a vacuum concept & you can't take out ccs from a band that's already empty. (Note to people out there -- never, ever, ever feel sheepish about advocating for your medical care). So he put my father on a 2 week liquid diet to see if things would calm down. 2 days into that diet the exact same symptoms are occuring, and now we're vomiting 24/7 with virtually no liquid/solid intake. So he calls me and I tell him to go to the ER, get hydrated, and don't leave until they tell you something.

I drive out to see him in the hospital and they have him forcing liquids down because "maybe" they'll stay down. Uh uh. We switch to IV hydration, and the vomiting continues. He's now afraid to swallow, and vomiting on a pretty regular 45 minute schedule despite being chock full of antiemitics. After 4 days in the hospital he's diagnosed with gastroparesis & xferred to AGB surgeon's care for immediate "let's see what's going on" surgery.

During surgery, a significant slip is noted (that apparently was not there during the tests about 2 weeks prior) and the band is deemed irrepairable & removed. As soon as he woke up from surgery he felt 100% better, and has not had a single problem since. This includes the past 6 - 8 months during which he was rebanded.

The best guess out there is that something in his band positioning was irritating the vagus nerve, which caused all the problems up to & including the onset of gastroparesis. Slippage was attributed to the vomiting attributed to the gastroparesis. AGB surgeon says "he had the problem before banding, and the onset/worsening is coincidental." Everyone else says it's the other way around. I know he had no problems, ever, before his first banding.

And I'm probably forgetting a couple things in there. My reliable memory is about 8 minutes, and we're talking months & months. The end.

I'm happy your dad is doing better. I know you replied to one of my posts and mentioned your dad having GPS from the band, I'm glad to hear the whole story.

I suspect I still have it, even after band removal. But I had an erosion and from what I understand the vagus nerve can be permanently injured from an erosion. I have an appointment with my PCP tomorrow, and am going to make an appt with the gastroenterologist to see if I do still have GPS (I'm pretty sure I do, due to pain and nausea... thankfully never as severe as what your dad had!!)

My insurance does pay for weight loss surgery, so I am hoping that if I do still have GPS she will lobby for me to get a bypass done a bit sooner than the 9-10 months it takes through my insurance. Tomorrow will be 5 weeks since my surgery, and I have only gained 1 pound... but the fear f massive gaining is still there.

[Wheetsin 714]

He gained 30 - 40 lbs during his unbanded time. But he is also far from a model bandster (very bad choices). He has not lost anything since his new band was put on, but again - bad choices, and he's having to chase restriction. When he started talking about getting re-banded, he was hopeful that his insurance would cover a VSG but it was still deemed experimental.

Thinsistasoon - I just now saw your response. Thank you for the heads-up. He had a suspected heart attack a few years ago and a family history of heart disease so his doctor has him come in for labs every 6 months. His blood sugars are steady and in the normal range (and somehow, his cholesterol numbers are great - I hope I take after his side of the family, medically speaking!)