:help: I went in for a fill today and the woman told me that my pouch was stretched...then she told me it was no big deal. I asked if it would go back and she said not without a total unfill...then I would gain. She told me it was not necessary and sent me on my way like everything was ok. I need more information...this can't be as simple as she made it out to be. What did I do to myself (ok I know I overate) but what are the effects?

...Malice...:help:

I am no medical professional. However, I have had slippage and been re-banded and it was speculated my pouch was distended. As it turned out, mine was clearly a slippage instead, but I was told at first that I needed to be totally unfilled to allow the pouch to move back down. In my opinion, SHE SHOULD NOT have put a fill on top of this problem. You have lots of time to lose weight. a few weeks unfilled seems far better than getting a fill on top of a distended pouch. I'd ask the doctor and state your concerns. Remember, this is not a race, there is no hurry. The health of your band and your esophagus is far more important. Just my opinion!

Is this woman an RN, or a nurse practicioner? I agree that she should not have filled you on top of a dilated pouch/esophagus. Over-eating is the usual cause, but being too tight can cause it, too. Sometimes just a partial unfill will fix the problem. Talk to your doctor.

Yes nurse practiioner, but she is also head of the fills i believe. She told me that my stomach would not go back unless I had an unfill but I had nothing to worry about...i knew this didn't sound right. Anymore thoughts, anyone have this same experience. Just a bit panicked...

A question for all. How much do you have to overeat to have the puch stretched?

I was way to full yesterday and panicked too.

Malice, I hope you get answers, I would go for the unfill rather than risk re-surgery or losing the band.

Leener,

I don't think there is a specific 'amount' that one would need to stretch the pouch. I think it is something that occurs after a period of time, if you consistently eat more than the initial size of the pouch that was created during your surgery. I believe it is calibrated about around 4 oz.

There was a test that was passed on from some old timers called the 'cottage cheese' test. Originally RNY'ers were encouraged to try to keep in mind the size of their pouch by practicing this test on occasion. I have attached a link to the steps involved.

wehttp://www.geocities.com/sweetartz1975/cottagecheese.html

A question for all. How much do you have to overeat to have the puch stretched?

I was way to full yesterday and panicked too.

Malice, I hope you get answers, I would go for the unfill rather than risk re-surgery or losing the band.

www.geocities.com/sweetartz1975/cottagecheese.html

www.geocities.com/sweetartz1975/cottagecheese.html

Thank you ma'am.

Thankee very much! Good info.

I'm gonna try that test -- wouldn't the water dilute through out the cottage cheese though? Oh well, at least it would be a ball park amount. Even though my weight loss is continuing, I feel like I may eat too much at one sitting. I can easily eat 1.5-2 cups of food -- no prob.

I wondered the same thing, but another thing I have done is to just get the small 4 oz serving of cottage cheese and eat it and see if I feel full when it's done or if I think I could still eat more.

Excellent info...thanks ladies!!

Jack, I have provided a link to the warnings in Inamed's handbook. I'm not nearly as good at quoting some scientific or statistical things as I am in sharing my own personal experience which I fear may be misconstrued as negative information. Pouch dilatation is a common occurence amongst bandsters, especially after a period of time has passed. Usually, it requires having the band unfilled for a period once it's detected.

Hope this helps to explain.

Quoted from the Patient Handbook at Inamed.com

"

WARNING: Esophageal distension or dilatation

has been reported to result from stoma obstruction

due to over-restriction, due to excessive band

inflation. Patients should not expect to lose

weight as fast as gastric bypass patients, and

band inflation should proceed in small

increments. Deflation of the band is

recommended if esophageal dilatation develops.

WARNING: Some types of esophageal

dysmotility may result in inadequate weight loss or

may result in esophageal dilatation when the band

is inflated and require removal of the band. On the

basis of each patient's medical history and

symptoms, surgeons should determine whether

esophageal motility function studies are necessary.

If these studies indicate that the patient has

esophageal dysmotility, the increased risks

associated with band placement must be considered.

WARNING: Patients with Barrett's esophagus

may have problems associated with their esophageal

pathology that could compromise their postsurgical

course. Use of the band in these patients

should be considered on the basis of each patient’s

medical history and severity of symptoms.

Link provided for verification and additional reading.

http://www.allerganandinamed.com/pdf/health/94800-12_LB_Product_Data_Sheet.pdf#search='esophageal%20dilatation%20lap%20band'

Malice,

Of any problem to have, a "stretched pouch"--if that is the layman's term the nurse is using for "esophageal dilatation," is one of the easier ones to try to cure. Most of the time, all or most of the saline is removed and the esophagus--in the absense of too much food putting pressure there--cures itself. It takes a while...but it happens.

One might want to try to determine WHY the dilatation is occurring--is the patient eating too much or too fast, is there a hernia putting pressure the esophagus from outside, is there esophageal dysmotility keeping the food from moving into the stomach--and resolving the causative problem to prevent a reoccurence.

MILD dilatation is pretty common...and, as long as it stays mild, is not the sign of trouble. Perhaps your doctor has told the nurse to disregard MILD dilatation and make sure he knows about severe cases. I think I'd want him to take the time to tell me what I need to do to prevent doing anything that causes any real damage.

Thank you, because honestly i'm terrified and almost in tears. I don't know what to do and I have no idea why she told me not to worry about it and gave me a fill anyway. I know I got it by over eating...it was my own fault. It's easy to say don't do it and alot harder to actually do it. UGH! There is just so much going on right now...I don't need this to. I just got my band in November and I guess I had the "it won't happen to me syndrome. I was an idiot, I ate too much. I am slowly discovering that I have more issues than I realized and it sucks A WHOLE LOT. Just bear in mind that it is not worth it. Don't over eat...don't hurt or sabotage yourself, it can happen...very easily.

(((((((((MALICE))))))))) slow down girl. It may not be YOUR fault at all. It very well could be that you've been over-filled and the pouch is distended above the band. I certainly do advocate asking the doc to show you the pics and explain WHY you would continue to fill over the stretched pouch as opposed to unfilling and allowing it to go down for awhile. Empower thyself with knowledge and have them inform you as to why their decisions. Please don't beat yourself up.

Definitely, begin again. Use only cups and saucers to eat from. Put your fork down between bites, don't eat for extended amounts of time. Choose only hard Proteins for awhile. Try seeing how little you can eat as opposed to how much you can get in. It's a learning process and you're not yet done. Don't give up, just keep moving forward trying to do the right thing MOST of the time.