User Error????

Poodles · May 5, 2006

Well I went off the deep end in the Medical Study forum, but thought that I should put part of it up here for more exposure. I really want to know what you think about the following:

Why do people erode? Do they eat to much and put pressure on the band? Do they eat the wrong things/not chew enough and make the little pouch work to hard to get things thru?

Why do people have slips? Vomiting? Non-Compliance with the rules?

If I am a perfect little angel, do everything right, no cheating, no over-eating, only eat what I am allowed to. Walk the line, stay on the wagon, and sip sip sip and chew chew chew... will I still lose my band?

Is it the bands fault or that of the user for the failure of the Lap Band System?

Alexandra · May 5, 2006

Poodles, erosion is a potential complication for ANY sort of medical implant. There is nothing people do that causes it, or can prevent it. There is just an unknown element at play. Of course, it seems intuitively obvious that being too tight for too long would add to the risk of erosion, but there are lots of people who go that route and don't erode. So who knows?

Slippage might be more easily attributed to user "error," as you put it. Being rough on the stomach early on, overdoing the eating later on, these things can cause vomiting or other internal disturbance which, again, COULD add to the risk for slippage. But still, there's no absolute guarantee that even if you stick to liquids for two months postop and never eat more than a tablespoon at a time, you won't still experience a slip. There is just no way to be sure.

Overall, the chance that you will "lose your band" is in the low single digits no matter what you do. Your personal chances can be influenced by your behavior, but the biggest contributor is just luck.

Marimaru · May 5, 2006

I know there are a number of people on this forum alone who have lost their bands, who were completely complient, so I think it really just depends on the person.

Some people are going to be prone to erosion, some aren't. There is speculation that port infections are indicative of erosion, and infection certainly isn't the fault of the band wearer.

Sure, following the rules 100% will give you the best chance of keeping your band. It will also (in most cases) get you the farthest the fastest with your weight loss, so that even if you do lose your band (like La_Madam), you have that head start and can hopefully maintain your loss, if not lose more.

I like thought provoking questions tho. :eek:

PhotoNut · May 5, 2006

I am certainly no expert in this area, nor have I had any experience with slipping or erosion, so there may be some who think I shouldn't contribute to this thread. However, I will share with you what my Dr told me when I asked him these same questions.

A large number of erosions have been thought to have been caused by an older technique that was used when securing the stomach around the band. From what he tells me, they used to pull the stomach over the buckle of the band but because of its shape and harder materials, they found that most erosions began at this location. Now they turn the buckle outward and do not overlap it with the stomach. They also use the pars flaccida technique now, which allows a higher placement of the band around the stomach and believe that this may have lessened the risk of slipping and erosion. And finally, there is also the posibility of erosion being caused by surgeon's error during the placement of the band. (ie nicking the stomach, etc)

Slippage - My Dr said that most slippage is caused by the band being too tight. He told me that some Dr's fill a patient to maximum (unable to pass any liquid through the banded area) and then withdraw just enough fill to allow a small trickle of liquid to flow through. He said it is believed that this approach of starting out with so much restriction is no longer being used by many Drs as they feel it is better to slowly approach the right level of restriction without overfilling and risking slipping.

So, for what it's worth, that's what I was told. You can probably Google "lap band erosion" or "lap band slippage" and find more information. Although I have found it very frustrating to find any information about the band that is more up-to-date than 2003.

DeLarla · May 5, 2006

Poodles, regardless of what technique is used to place the band, a percentage of people will erode. I know a woman who had surgical screws implanted in her broken ankle that eroded and had to be removed.

The word "slippage" actually isn't when the band slides down, it's more that too much food crammed in the pouch forces the top part of the stomach up and over the band, which is something you can more than likely prevent by eating small bandster portions and not swallowing large chunks of food.< /p>

But erosion isn't the worst thing in the world. People that have learned to eat like a normal person may as well have their bands removed since they have the fat demon beaten, right? So if you end up being one of the unlucky eroded ones, maybe you'll be among those who have changed their eating habits for good. Most people do NOT erode, and those of us who do still have the option of a bypass. When I weight the pros and cons, I decided that my old life of 317 pounds wasn't living at all, so I rolled the dice and hopped on the surgical table. Please pass the scalpel! I suffered port infections, port removals, erosion, band removal, yada yada yada. All that sucked. But I'm squeezed into a tight size 16 tall instead of my old size 38, and I'm on top of the world!

Yes, I've gained back 10 pounds. Yes my old eating in the car bullshit is back. Yes I have esophagus problems...

But I have a life now.

kellymoos · May 5, 2006

Your band can also slip by PB'ing!

leatha_g · May 5, 2006

The band can, in fact, slip up and down on the stomach.

SOME slippages may be contributed to pouch packing.

SOME may be contributed to a sudden 'slip' of the band from it's correct position to something other than correct due to whatever reason ie, vomiting, pbing, an extreme bout of coughing/sneezing, maybe lifting something too heavy too soon?

The 'cause' of slippage really can't be narrowed down to 'user error' as a definitive answer. Statistics shows there are about 3% slippage - displacement of the band.

There are lots of folks out there with slipped bands, same as eroded ones. Some may have contributed, some may have simply been a victim of the odds.

My particular slippage - my doctor said it was clearly no fault of my own. My pouch was not distended. The band itself had clearly slipped farther down on the stomach than it was originally placed and the band itself was no longer positioned at an angle, it was now horizontal across the mid-section of my stomach. He said it appeared the actual stitches had come loose and allowed the band move from it's desired position. When we read the Operative record from the original Dr - it stated clearly that he had used the Pars Flaccida technique in stitching the stomach around the band, however, somehow over a period of a year, those stitches were no longer intact and the band became displaced.

As stated before, hopefully, if you baby your band, follow the rules to the 'T' you lessen your odds. If you vary, (ie, drink too much alcohol, take NSAIDS), you, personally, MAY have a higher chance of erosion.

If you eat more than 4-8 oz at a time, consistently, have yourself TOO restricted, PB too often - you may be raising your personal odds for slippage.

The pars flaccida technique has been in place for numerous years, that is not a 'new' thing. I believe the change was made in 2002? 2003? So any benefits from that change should be clear by now.

Honestly, when anyone is banded, they must know and accept that there are complications and they should be dedicated enough to the weight loss effort to take that chance because as far as I've heard, the odds are still the same.

Do ALL you can to lessen your odds, but please don't fool yourself into thinking that these things only happen to folks who stuffed their pouches (and you would never do that) or abused their bands. It's just not the truth.

Get your band. Take care of it! Get what you came for in the beginning, but as you can see, there are no guarantees, so I think you need to be aware of that as well. The more people who become banded, the more there will be with erosion, slippage, pouch diliatation, esophageal issues. YET = You're Eligible Too.

Poodles · May 6, 2006

Well, I am in it but good now. My date is set, my Myocel is in, my husband is ready, I am on my low carb diet, taking my meds, etc. They will have to cut me open one way or another this summer (for a hernia), so I might as well be banded while I am on the table for that.

Guess I will take a chance and just be the best bandster I can be. :eek: