Okay I have a question.

My last fill was like 6 weeks ago. After that I was fine. Got full on small amounts and was having a hard time even getting 1000 calories in every day. I also couldn't eat chicken or bread.

For about the past 10 days I'm hungrier than usual, more often and eating more. I've been doing good to stay below 1300 calories. So today I saw my surgeon. He said that the fact that I can eat pizza and chicken now when I couldn't a month ago means that I most likely have stretched my esophagus. He said he isn't too worried about it though since I'm almost at his goal. He put in .1 cc and told me that whatever weight I lose after this will be all me doing it and not my band.

Isn't just possible that I can eat those things b/c my band has gotten looser and not from dilation? I've lost 12 pounds since my last fill. Also, his goal for me is 150 and he said today no more fills after this because I weigh 158 now. So hmm, I want to be 138 and I will get there either way with or without more fills but why is my fill level dependent on what he thinks I should weigh? Does that make since? I'm not trying to starve myself I'm just curious.

Once you hit your goal do you not need any more fills to maintain? I mean will your band just permanently stay at 7 cc's forever or what?

What he should do is not guess as to why but do a scan and know for sure. Unfortunately or fortunately whichever way you look at it they hold all the cards here and we are at the mercy or the benefit of their expertise. I have been told that if you do liquids for a few days to a week that the dilation will subside. I also read it on one of the posts here as well. I'm sure someone will have a better answer for you.

He said he could do a scan to see but he didn't think it was worth it since I'm so close to goal. So since I'm close to goal and won't be getting more fills does that mean it won't get any worse?

Oh and I should mention, I have no nausea, vomiting, reflux or heartburn. He just thinks because I can eat more my esophagus is dilated.

I think I would find another doctor if possible. What an ass (excuse my french). The goal should be yours and not his. I don't have a lot of faith in doctors a lot of times because I have seen so many family member's butchered by quacks. If it doesn't feel right to you and if he won't give you any more fills and you think you need them, go elsewhere. What an arrogant doctor. I can't find it right now but I believe when I originally read the lap band book that it said that fills may be needed over time as some of the fluid can leak out. What then? Sorry to get so mad but I don't get the arrogance of some of the doctors. What will your BMI be at "his" goal? Good luck to you. I'm glad my doctor let me set my own goal, he even said I could change it any time I felt like it.

I would go for a second opionion....I am new to this however have freinds that are 2-3 and 4years since banded and do go in for fills occasionaly to keep on track ..the fluid will evaporate over time

I believe diagnosis is through an upper GI and treatment is an unfill.

But he is the expert. My surgeon wants to do an upper GI once a year to be sure all is well.

what is Esophageal Dilation? I have almost constant problems with my throat. It always feels like I have a lump in my throat or that something is pushing up on it. They do the x-rays and tell me that I am not too tight that everything is moving thru fine.

I would question why he would fill if he suspected a dilation. Typical protocol would be partial or full unfilled to allow it go go back. Adding fluid can exasperated the problem

Do you guys think it's even possible that's it a dilation? I'm not sure it even is. I mean from looking at the symptoms I have none of the typical symptoms, I'm just able to eat thicker/chewier foods when I'm 4 to 5 weeks out from a fill. It's like this every time though. At my last fill in May it was the same thing. I was able to eat chicken and bread and then I got a fill and couldn't eat those anymore. Then starting about 2 weeks ago I was able to eat them again. Now that I got a tiny fill yesterday I suspect that I won't be able to eat those foods for several weeks.

I don't overeat and I keep my portions small.

If it's possible that it is a dilation then I should go for a second opinion, the only problem is where I live at, the only other Lap Band doctor that takes my insurance is 100 miles away and since I have small kids at home it's hard to see a doctor that far away on a regular basis, you know?

Amanda,

To my knowledge, an esophageal dilation cannot be diagnosed solely on ability to eat certain foods. I think it is much more likely that with weight loss the band has become looser around the stomach, thus enabling you to tolerate denser foods.

However, now that your surgeon has brought this up, it will likely bug you till you determine whether or not you really do have something going on.

I'm not sure if dilation is diagnosed via an UGI or an Endoscopy. An UGI isn't too bad, just drink or eat some barium and they take some xrays. An endoscopy is a bit more trouble, they usually give you some sedation, but don't put you all the way asleep and then a tube with a camera is put down the throat to look at the esophagus and sometimes even the stomach.

If your surgeon isn't willing to send you for an UGI and another bariatric surgeon is difficult to get to.. how's your relationship with your PCP? I think I could talk to my PCP and explain to him that I had some concerns and see if he would agree to order an UGI. An endoscopy I'd have to think about a bit. While a dilation is of some concern, an endoscopy doesn't sound like fun either.

Good luck on figuring out what to do.

BTW.. a Wise person once told me "When you hear hoofbeats, think horses, not zebras". Meaning consider the most likely explanation before you consider the more unusual. I guess the saying would be in reverse in Africa. ::grin::

A dilation should be able to be diagnosed via barium swallow and xray

This Dr sounds lazy and full of himself. If you are having any complication at all with the band, and you have any fears that something has happened with it, you should have an endoscopy or ex-ray with barium or whatever it is they do to be able to see it. It's not worth your health just so your dr doesn't have to do a bit more paperwork and/or save the insurance companies some money. It's also not worth all the time, effort, and money you spent on getting the band placed. You have to take care of yourself, don't just listen to the doctor and go on your merry way, sometimes doctors are wrong. You have to listen to your own body and demand what you need from the medical people..stand up for yourself!

Sounds like typical band progression to me... We get a fill b/c we become loose & are able to consume larger quantities & don't have a feeling of fullness for 3 to 4 hrs. I'm rather confused as to why ur doc would contribute u being able to eat more to esophageal dialation this time. . What about when u went in for previoss fills? Wasn't it the same circumstance?

Confronting ur doc is scary & we all want to believe our docs r truthful & care about their pts... Fact is sometimes they don't tell the truth! I personally drive 130 miles one way to see my docb/c I trust him & he's the best in the state. If I were u I'd seriously cosider getting a second opinion. @ least get a barium swallow study done to not only check for dialation but also to see how restricted u r.