I have had my band for 2 years......I have done well and have been satisfied with the results. Each day is a new day and with the help and support of this board I have made it to my goal and have learned a lot along the way.

Some time ago, I developed a hernia. I do not know how I got it or how long I have had it.....It is right above the band and it became difficult for me to eat certain foods and I thought the band was tight. A few time after eating, I would throw up my food. I think this caused swelling and that caused the hernia to put more pressure on the band (or visa versa). This took place for a week.....I ate soft foods and still no relief. I had reflux, and pain. It then got to the point where I was on liquids hoping that that would calm down my esophagus. I did not know I had the hernia at this point. Well, I took a Prilosec on Sept. 20th hoping for some relief. The pill never did go down and caused such pain after 10 hours, that my husband decided enough was enough and talked me into the ER. We arrived at 1am.at Piedmont Hospital in Atlanta, Ga. I was in pain, tired, and getting dehydrated. I told the Dr. and every nurse I saw that I had a lap band and that I needed a Lap Band Dr. to take a look at it because what ever it was that was wrong, had to do with the band. I was there all night long......they said they would call in a Dr. that would be able to look at the band. They assured me of this over and over.....he never came to see me......at 7am they told me the Dr. on call was just arriving for duty and he would do a "Scope" or upper GI. or endoscopy. I waited until 1pm, sitting there.......then after being prepped for the procedure, the Dr. came into the room. I asked him if he was going to also tell me if the band was ok, or if it had slipped, eroded etc....he replied that he had no idea about the lap band and only did the endoscopy!! I was there from 1am until 1pm.....to be told this!!! I was told over and over that a lap bad Dr would be called in!!!!! Apparently they do not come in because they are afraid to take on a patient they do not know........

HOW DO I KNOW THIS????? READ ON LADIES!!!!

The Dr. does the endoscopy, tells me to go home and take Prilosec!!! Ha!

I was there because a Prilosec stuck in my throat for 11 hours!!

The next day, I decided after much thought to go to anoter ER....I was

weak, sick, and very worried about this problem so I decided to go to The Atlanta Medical Center also in Atlanta, Ga. because they have Bariatric facility where they do the Lap Band and the bypass and I assumed they would have a Dr. on call at their ER.....again, I go to the ER have bloodwork done, explain the problems I had and what the other ER did the night before.

My blood showed that I was anemic, and the white blood count was elevated. Here is where the nightmare begins......in walks DR. PATEL the ER doctor. He listens to me. I tell him what I have been experiencing for the last week and that I wanted the lap band emptied of saline to relieve the pain on the hernia. Just to get me through so that I could get to my surgeon in Costa Rica a few days later. Dr. Patel tells me that if I am looking for a "quick" fix that I am in the wrong place. He then goes on to say that because Piedmont Hospital "dropped the ball" why should his hospital have to deal with it. He then says to me "Why should I call in the Bariatric Dr on call?? He doesn;t know you.....He didn't do your surgery!!! I told him that I had never felt so ill in my life and that I could not take one more day of the pain.......he said "you look fine to me" I then told him that I had not eaten food for a week and that my blood work proved I was getting worse......he replied that "people do not need food to survive"!!! I asked him if he would turn away a patient who had heart surgery at another hospital 5 years earlier and came in the ER. Would he tell that patient that he would not call in a heart specialist because the Dr did not do his surgery and did not know him? He left the room......all the while keeping in phone contact with a Dr. Hixon who was the Bariatric Dr on call who refused to come in!! In walk Dr. Patel who tells me that they decided to admit me!! Me, who minutes earlier looked "fine" and did not need food to exist!! Whose blood work did not matter!! Dear me, I could not believe my ears! Obviuosly after I made the statement about the heart patient he got his sick act together.

I asked him if the Dr was coming in to see me....he said no, that he would be in on regular duty in the morning. I asked him if he was going to help me with the problem and he told me that Dr. Hixon might stop by my room if he thinks he needs to see me.......so, no real answer....no one there wanted to help me it didn't take a rocket scientist to figure that one out. I told him to take the IV out of my arm and that I would go home. I would not let them treat my dog after how DR. PATEL treated me. I went to see my PCP first thing the next morning, she prescribed meds for the reflux and said that she thought I would be ok until I could get to Costa Rica......

I went to CR a few days later and my Dr. emptied the band, said hr thought the band may have slipped but that after 3 months we would see what the results were. He is hopeful that it may go back into place and if not, the band will have to come off. I wil deal with that one day at a time.

As soon as he emptied the band, he told me to start eating good, healthy foods to get my blood levels back to normal. All of the symptoms went away immediatetly! Relief at last! No reflux, vomiting etc.....I feel great.

I am sharing this with you because although you may live in America, have full health care coverage, there are a few Dr. Patel's out there! Beware....if you are like me and thought that if you ever had an emergency with the band and would be safe in a hospital ER.....THINK AGAIN.

Let me add this quickly........a friend had her surgery in Mexico by the amazing Dr. Ortiz.....she did great also, no problems etc......but, had the same thing (no hernia though) happen while on vacation in Oklahoma City....went to an ER there and was admitted for 4 days, seen by a Bariatric Dr. who emptied her band for immediate relief and was treated like any other patient!! Three cheers for that doctor for honoring the oath he took to become a doctor!!:clap2:

I completely agree that the ppl in the ER need to be better able to handle lapband patients. I had a similar experience about two months where my band completely closed up for two days and I wasn't able to hold down my spit or drink Water so I went to the ER. Same experience--nobody knew what the heck I was talking about in the ER, one lady thought I needed my tonsils out when I told her I coudln't get down water! Ha! My only relief was that my doc was in surgery so she was able to come down in between operations and do a fluro and remove all of my saline to provide relief. I wish there was a way we could learn how to do fills--it seems so easy to me.... I don't understand why it can't be taught to more trained people?

~Liz~

03/10/06

241/161/160

5'7''

Was all this agony simply because you had your band placed in CR? Or was it because the illness had to do with bariatric surgery?

Sorry I was unclear, what i was trying to ask is if the drs. did not want to help you because you had your band placed in CR? Or if Dr. Patel was discounting your pain because you had bariatric surgery? Like is he anti-wls, anti-fat? I hope you do file a complaint the way those doctors treated you is unethical.

OMG!! Terrible, I have had similar experience with an ER for soemthing different.. I have been in medicine for 2o years and let me tell you, the one thing you need to do is report both hospitals to JACHO, call youe TV station and tell them the story...they might pick it up, and get a lawyer! You could have bcome severy ill or worst due to their NEGLIGENCE!!!!!!!!

Sorry for the bad experience.... hope you are better now...

Hi,

Ms. P,

I was wondering who diagnosed you with a hernia?? And if you have one, is there any reason it wasnt repaired?? In light of the problem you had, would it not make sense to have the hernia repaired.

Of course it doesnt change the outcome of the terrible way you were treated, but it would seem that this problem could happen again if you dont fix it.

I had my surgery three years ago here in the States and generally speaking, if you are not treated by your original surgeon or if you have a problem, for the most part you are treated like a leper. No one wants to touch other folks patients. And in the ER, if they see you up and able to walk around and your limbs are not falling off, then they don't see your problem as an emergency. And since most lapband issues do not qualify as medical emergencies unless you are throwing up blood or cant drink liquids or are completely dehydrated, most ER people dont want to deal with the UNKNOWN.

Now these are all generalizations, but mostly true. And what Elizabeth said about letting them know you have a medical device with a port in your abdomen and you need an RN with mediport experience to remove saline is the BEST advice of all for all bandsters to remember if they need an unfill.

I am really sorry you have been treated so poorly. I am glad that you will not be taking this lying down and that you intend to follow through. No one should have to be treated this way.

Babs in TX

334/190's

Well I can truely sympathize with you. The sad thing is that emergency rooms have no idea what to do with "lapband patients" and unless your doctor is part of that institution and can be called in, your left hanging out there on your own.

Let me interject here.....................

Do NOT let the DR. PATEL'S out there fool you.....remember where you are...

AMERICA.....they know full well about the Lap Band.....they DO NOT necessarily need to know how to treat a Lap Band patient...that is where the

telephone comes in handy.....that good ol' handy dandy thing!!

When a regular ol' Joe ER Dr like DR PATEL has no clue.....he then picks up the handy dandy telephone and calls in one of the many doctors the hospital has on staff or on call. The hospital he works at is Atlanta Medical Center which is widely known for it's Bariatric surgeries so this was no case of DR PATEL not knowing what to do about a Lap Band.....I even took the time to tell him about it and he assured me he knew what it was but the issue with him was as he stated.....they did not know me, so why on earth would they help me!.......This is a new one on me......I had no idea a patient could be turned away simply because they were not personally known by anyone at the hospital!! This was not about not knowing how to empty the band.....he refused to help me!!! Those of us that were banded out of the country for financial reasons are being treated like this by a lot of American docotrs. What they fail to understand is that any patient in this country is entitled to medical care regardless of who did the surgery. That does not matter!!

We have the right to medical care! My sister is an ER nurse and could not believe what happened to me! Dr. Patel was rude, insensitive, and most of all he violated the oath he took....BOTTOM LINE! No excuses for his behavior!! t

My my......I do not find that hard to believe about Dr. Hixon.....

you would not believe this but while in that hell hole the woman who is in charge of processing your insurance card, photo i.d. etc came in to the

room I was in to get my info. I had just had the verbal assualt lashed upon me

by Dr. Patel and was in tears. She was so sweet and kind. She listened quickly to what happened and said......ask for Dr. Titus Duncan, Dr. Hixon has a very bad reputaion here!!! OMG do you think I would stay after all that happend, then to hear that!! I told them to get the IV out of me and got the heck out of there......I hope my story gets the Atlanta medical Center and the lovely staff that works there out in the public eye where they belong!!

Hi Ms. P,

I know that I will get my ass grilled for this and that you are upset but.....

After going through something similar with a lapband surgeon here in TX who refused to treat me although he accepted me as a patient and then abandoned me after telling me I had a concentric slip, partial prolapse and pouch dilation... just because he didnt like something I said...

From a legal standpoint, you don't have a leg to stand on. Ethically, the Dr. is an ass#$%$ and a dredge of society. But legally you would have to prove that as a result of his failure to unfill your band that you have had some kind of permanent damage to prove patient abandonment. The way ER assessment works as I mentioned in my earlier post, If you are not bleeding, if your temp is normal, if you are not showing dehydration, then they don;t have to admit you and they don't have to treat you regardless of what resources are available to them and how much they know about your medical condition.

I feel your pain. I had to contact 5 other surgeons before I found one who would even talk to me about my band. They surgeon who finally took me as a patient did so because I was forthright about my situation and what happened with the previous surgeon. Now if you want to make waves, you have every right to. In my case, I couldnt since the doc I went to is buddies with my original band surgeon and 3 others that operate out of the same facility. I was afraid to make any problems for fear that no one would treat me in the future. Whatever you decide to do, try to take your anger out of the equation. Hard to do ( I am a hot headed broad myself! LOL) but do it for you.

Babs in TX

334/190 ish

Hi,

Ms. P,

I was wondering who diagnosed you with a hernia?? And if you have one, is there any reason it wasnt repaired?? In light of the problem you had, would it not make sense to have the hernia repaired.

Of course it doesnt change the outcome of the terrible way you were treated, but it would seem that this problem could happen again if you dont fix it.

I had my surgery three years ago here in the States and generally speaking, if you are not treated by your original surgeon or if you have a problem, for the most part you are treated like a leper. No one wants to touch other folks patients. And in the ER, if they see you up and able to walk around and your limbs are not falling off, then they don't see your problem as an emergency. And since most lapband issues do not qualify as medical emergencies unless you are throwing up blood or cant drink liquids or are completely dehydrated, most ER people dont want to deal with the UNKNOWN.

Now these are all generalizations, but mostly true. And what Elizabeth said about letting them know you have a medical device with a port in your abdomen and you need an RN with mediport experience to remove saline is the BEST advice of all for all bandsters to remember if they need an unfill.

I am really sorry you have been treated so poorly. I am glad that you will not be taking this lying down and that you intend to follow through. No one should have to be treated this way.

Babs in TX

334/190's

Babs,

Thanks for your reply.........I was diagnosed with the hernia at Piedmont Hospital which was the first ER I went to.....when the dr. there did the endoscopy he said I had a hiatal hernia and to go home and take Prilosec for it! Hello.....couldn't swallow Prilosec. Like I said, I was in the ER because I tried to swallow a Prilosec some 11 hours earlier! I was in the recovery room after the endoscopy was done, and as soon as I had my 45 minutes, I was wheeled out to the parking lot to be picked up. My PCP whom I saw 2 days later after all of this mess, advised me to see a Gastro specialist and gave me a referral. The ER's saying or claiming they do not know about the band and are scared to death about it and say that if you are stable and not in immediate danger of death so they do nothing for you is dead wrong.....first of all, how do they call one stable who has not had food in a week? Whose blood work is bad? Who is hooked to their IV? It wasn't Kool-aid in the IV either....they thought I needed it so there was a problem!!

I do not see them telling the people who crowd the ER's with sore throats, sore legs, and the umpteen other nonsense reasons they go there to go away because it is not an emergency!! They will have a lot of lawsuits on their hands if they continue to refuse to deal with lap band patients.

I know I sound fighting mad and on fire......because I am!

Sorry I was unclear, what i was trying to ask is if the drs. did not want to help you because you had your band placed in CR? Or if Dr. Patel was discounting your pain because you had bariatric surgery? Like is he anti-wls, anti-fat? I hope you do file a complaint the way those doctors treated you is unethical.

Thanks for your post......I have no idea what was running through that man's sick veins.......He was just an ass I guess, or he was covering for Dr. Hixon

who may have refused to get off his chair at the country club......whatever his reasons were he has not seen the last of me!

I'm sorry for what you went through and how you were treated. I'm sure I will be flamed for what I am about to say, but it is not attacking you, just meant to point out problems with obtaining band care, so that we can all think about how to get the care we need if we have a band problem.

One of my concerns about having a band is the potential need for having an emergency unfill. Most ER's WILL NOT know how to do this, WILL NOT have a band surgeon on call, and WILL NOT have the correct needle. Most ER doc's (as well as other non-banding docs) don't really know what a lap-band is and don't have a clue about how to help a patient with a band problem. The reality is that the percentage of the population that is banded is still miniscule and it is not practical for ER docs to be trained on the band.

The needle that is needed to safely access the port is a long, straight Huber tipped needle. I believe it is only available through Inamed. It is not the same as a port-a-cath access needle which is short and bent at a right angle so it can be left in the port comfortably during a long chemo infusion. Chemo ports are on the upper chest and right under the skin. Chemo needles would be too short to reach most lap-band ports. Regular needles do not have the special tip and can permantly damage the port membrane causing it to leak.

ER doctors are not trained to access lap-band ports. Surgeons who do not place bands are not trained to access lap-band ports. Primary care doctors are not trained to access lap-band ports. The only doctors who are routinely trained to access lap-band ports are lap-band surgeons. The other possibility would be to ask for an interventional radiologist. They are trained to access anything with long needles. However, they are NOT required to come in to do this at night or during a weekend unless it is an IMMEDIATE life threat.

How do I know this? I have a relative who is an ER doctor, have discussed with him and asked him to check the current versions of the leading Emergency Medicine textbooks and there is not even a reference to the lap band in any of these texts in their thousands of pages.

I'm not saying that your care was appropriate, just that this is a problem that does not have a simple solution if you are not near your lap band surgeon. You were still treated horribly. I've often worried about how I would get help if if had a problem and was out of town.

I've been tempted to ask my surgeon for a needle to keep with me in case of emergency, so I could try to talk an ER doctor though the procedure. I don't know the answer to needing an unfill when you are away from your surgeon or fill doctor. It would be interesting to hear what Inamed recommends in a situation like this. This will become a more common problem as more and more people are banded. I just don't see this becoming a standard ER procedure. Have you tried talking to Inamed about this situation for their recommendations?

The ER is obligated to provide stabilizing care, not to solve your band problem. Stabilizing care would include labs, IV fluids, and making sure that you do not have a condition that requires emergency surgery. There have been a few cases where a band has slipped so badly that it cuts off the blood supply to the stomach and that situation would need emergency surgery. If this needed to be done at a hospital without a band surgeon, it is possible that the band would have to be removed by a general surgeon and it might have to be done as open surgery.

Not to frighten everyone more, but if the hospital has a band surgeon who is not on call for general surgery and is not your surgeon, he/she can refuse to see you when called by the ER. Other than stabilizing you for immediate life threats, it is not the ER's responsibility to solve your band problem. Medical liability is a complex area, but unless you were permanantly harmed, you have no legal recourse. You should certainly let the hospital administration know if you feel you received poor/rude treatment.

I'm going to talk to my surgeon next time I see him about what I should do if in a similar situation while out of town. I've been thinking about this after a recent trip to Europe and having some anxiety about trying to get help in an non-English speaking country if I had a problem with my band.

I wonder if Inamed has a 24 hour 800 # that ER doctors can call for advice if faced with a band problem. I encourage everyone to discuss with their surgeon how to get an emergency unfill while away from their surgeon's area.

Lucky

1/31/05

274/153 at goal

Hi Lucky,

I loved your post. I agree with almost everything you said except the part about Huber (non coring) needles vs regular ones for an unfill. Although there is a small possibility that damage could be done with a regular needle or a chemo needle, a nurse from the oncology department or a radiologist could very very easily do an unfill if it were medically necessary.

When I had plastic surgery, I actually had my lapband surgeon's office offer to give my plastic surgeon a Huber needle to do a partial unfill pre op. The hospital where i had my plastic surgery had them readily available anyway, but the reality is one day before I had my PS, I specifically went to my PS who tried to do an unfill with the Huber and couldnt and we just agreed when he was in my abdomen that he would do it then. He did it with a regular needle and actually had less trouble although ironically he removed all my saline.

Getting a complete unfill is relatively easy and most any oncology nurse or radiologist can do it. Getting a fill is harder since all the saline must be removed and the new amount put in minus air bubbles and .10 or .25 CC in accuracy is a much more difficult task because we are talking spit drops here as far as quantity.

The big issue and the one we need to be aware of is being able to be our own advocates and knowing what to ask for in addition to having an action plan if something serious occurs with our bands. Going on vacation in a foreign country could be a problem, but if you are local, then contact every hospital in the area and find out if they have the resources to help you if there is an emergency with your band.

Since almost all band related complications are not life threatening, we probably won't ever get joy from the ER since their job is to stabilize and then wait for a specialist to handle the situation.

Babs in TX

Mrs. P --

That is such a shame about your experience. I live in ATL and I know Piedmont has no bariatric program so they wouldn't make my list for an ER visit. (even though it was likely a matter of geography -- and it IS a good hospital with a good reputation). Your move to Atlanta Medical because it had a bariatric program seemed logical. I still think you should complain to a medical board, the CEO of Tenet (which owns Atlanta Medical) and the state health division that oversees hospital care in Georgia. Some of the best surgeons in the country are in our area -- and even though an ER visit was required -- perhaps a call to one of them with a recommendation on what to do would have been helpful. Dr. Champion comes to mind. Also, Dr. Ponce in Dalton has done more band surgeries than anyone in the U.S., I think. (I had three surgeries and my best experience by far was Emory Dunwoody) Know none of that is helpful to you now -- but am sharing that info for anyone else in our part of the world with future emergencies. (Think they wouldn't "touch you" because your band was done outside the US?) Highly recommend establishing a relationship with a local band doctor. Glad things are better for you. God bless.

Elizabeth

8-28-03

revision/slippage 3-05

removed/slippage 3-06

I sure am glad I stumbled on to this post. I have been banded for a year and a half ande have lost 96 pounds. Everything has been great until about the past week. I have had acid reflux since I was four years old and was thrilled when it went away when I got the band. Now a year and a half later, I am getting a burning sensation when I eat like acid and PB daily if not 3 or 4 times a day. My eating habits have been crap lately since I am the caretaker of my mom who had a right hip replacement 9-18-06. I finally brought her home on this past Monday. She has had me hopping thru hoops 15 hours a day to please her...but anyway. After reading this post I am afraid. Everything I eat burns. The amounts I eat have dropped in almost half. Suggestions? I will get ahold of Dr. Benavides Monday am....thank you for this post even though you have open my eyes to the ignorance of the band in hospitals...

I know this is somewhat off topic, but based one your experience, and the last trip I had in the ER, I called the Patient Co-ordinator.

I had a TERRIBLE nurse that I feel put me in great danger. Didn't check my alergy band, used things I was alergic to, treated me like dirt. Didn't once take my vitals and didn't draw the labs that were ordered. All very potentially dangerous.

Thank-you for giving me the strength to report this jerk to the Omsbudman. I know that if he treated me this way, he's treated other people that way.

I've been tempted to ask my surgeon for a needle to keep with me in case of emergency, so I could try to talk an ER doctor though the procedure. I don't know the answer to needing an unfill when you are away from your surgeon or fill doctor. It would be interesting to hear what Inamed recommends in a situation like this. This will become a more common problem as more and more people are banded. I just don't see this becoming a standard ER procedure. Have you tried talking to Inamed about this situation for their recommendations?

I have syringes and huber needles given to me by my care dr. I would have no problem doing my own unfill in an emergency with unwilling medical personnel. I carry one of the needles in my wallet. I hope I never have to use them.