Be honest....

Have you ever done your own fill/unfill? Even in a pinch?

Scenario; it's late at night, your fill is too much, you are barfing your guts out, you can't even keep saliva down. You can't reach your doc (maybe he's not returning phone calls, perhaps he's in Mexico, etc.) and you are getting dehydrated. Many ER's don't have docs working that have a clue about a band.

What do you do? Or, what have you done?

BTW, this is a private poll, nobody will be able to see your response.

I am an ICU RN, and if I was stranded on a desert island and couldn't get a hold of my surgeon by smoke signals, I would consider unfilling my band in that emergency situation. However, barring that remote possibility, I would not. The risk of infection is too high, and I am sure that I could talk an ER doc or IV Therapy or Chemo Nurse through finding and accessing my port for an emergency unfill.

That is a mistake I made when I had a bit of an emergency. I kept calling around to EVERY ER in my area and not a single doc knew what to do with my port. It never dawned on me to go to an ER and request a chemo nurse.

A good lesson for everyone that needs an emergency unfill in the middle of the night. Just because the ER doc doesn't know what to do, a chemo nurse would have experience with certain kinds of ports and s/he could do it. They would just need to be warned not to poke the tubing.

Wow, I voted.... 7% agree w/ me....hahaha. And so many wouldn't even consider it.

I learned a long time ago... a doctor is nothing more than resources. If he/she is only required to attend the seminar ONCE to get approved thru the makers of the band.... why can't we? It's not rocket science. But there are those that like to put the responsibility/risk into someone elses hands...I'm opposite. I like to be responsible for my actions and therefore in control of the outcome. If I goofed, it would be my fault and therefore I would have to live with it. If a doc goofs, he doesn't pay for it, he doesn't have to live with it. I DO!

Just my 2 cents worth.

{of course, I do my own brakes on my cars because it's so easy and the price mechanics charge is so outrageous...learned how and did it}

With all the money that docs make doing fills do ya'll really think that they are going to make a remote control fill device? My personal opinion is no. If I was a fill doc getting all that money I would strongly disapprove of someone taking that from me. For me, a self pay, I would jump all over the idea of a remote to fill or unfill. But the docs making the money probably will have a stong say in its creation. I don't think it will be available anytime soon! I hope I'm wrong, I'd sure like to save a crap load of money.

The remote fill or unfill will still be medically controlled by the Dr. is my understanding, it just eliminates the need for needles, and possible introduction of infection. The remote is carefully calibrated to increase the size of the band, thereby reducing the size of the stoma, doing exactly what the saline does now.

On another board we were discussing it, and a woman was explaining it to us, that had ask her band Dr. about it.

This is just my understanding of the conversation we had.

My Grandfather had a pace maker that was remotely adjusted. Recently my husband had a cardiac event monitor that was telephoned in and adjusted. I understand the future of the band is hoped to be adjusted in a similar way. Only trained Dr.s and hopefully more hospitals will have the ability to eliminate restriction without fear of harming the patient. The goal they were told is to be able to simply call your band Dr. in the event of an overfill equivalent, and place the phone in the area of the band, and they will be able to loosen the band.

I know my Grandpa had simply to hold the phone over his pace maker and adjusting it that way was done---so I have no doubt that eventually such a thing is possible.

I have never heard of any possibility that YOU (not you individually, but us as patients I mean) will have your own remote to your band. It will still be managed by a band Dr.

Yes they would lose the revenue from fills and unfills---but many include some in the cost. If it were to ever be possible to eliminate them, I am sure the overall cost of the band would go up to compensate. Many Dr.'s still tend to push the bypass, and there is not any fill/unfill follow up revenue with it. I figure they would figure out how to come out ahead...same as they figured out with this!!!

I think the overall charge would be similar, you just would not have issues of needle pokes, or saline, or leaks...it would definitely seem to reduce the risk of infection, as well as reduce the amount of items used that could cause problems. Now some deal with flipped ports---ports would not be needed. Tubing leaks and even separates some times, there would be no tubing....

Initially I am sure the cost would be considerably more, in order to pay for the equipment, as would be expected....but in time I would think the cost would come down just as some are finding it is now with the types of bands we all have.

That is one of the biggest advantages of the band in my opinion. If they come up with some new band to control that way, we are fully able to have one, nothing has been rerouted---it was a major decision maker for me!

I am excited to see what the future holds with WLS----just glad they are continuing to study and discover!

Now how long until insurance follows suit? None of us may live long enough!!!!!!

Kat

Wow that would be great Kat. I know you are right that they will find a way to make money on that too! So, if your port flips could it still work with out having surgery to correct it? That would probably be a relief to many that has had that happen. I wonder if it would eliminate the need for a port all together? I haven't done any research on it so I don't even know the basics. I am just to pessimestic, that is something I need to work on.

Well when you begin seriously researching how the band works, you will understand it a bit more. With a remote controlled band devise a port would not be needed.

Ports are connected to tubing which connects to the band. The saline is injected into the port, travels through the tubing and into the band to constrict it more. If they used the device we are discussing, no ports or tubing would be required.

As it is now, ports are stitched into a muscle, each Dr. having his or her preferred placement. Sometimes they do flip, having popped stitches, or the muscle contracting just so. Many can be re positioned in the office in a minor procedure with a local anesthetic, others require a minor surgery to fix.

Will be exciting to see what course this band takes in the future! It is already such a huge change from the original non adjustable bands they used!!!

Kat

First time I saw this thread was pre-band, and I thought that's a crazy concept.

Now having been overfilled, and being able to feel my port perfectly.. if I had the tools and knowledge, I definitely would have done it myself..

That is crazy! I would never do a fill ! - but an unfill - definitely! Or let me say it this way - my brother in law is an RN - I would have him do it (my doc is 2.5 hrs away - no one within an hour even knows what it is, except fellow banders) so I would have my b.i.l who is an RN do it if I had to get an emergency unfill.

Think I will take him with me to my first fill appt so they can train him on emergency unfills!

That and he is going to get it done too...so it would be good for him to go. LOL

Amy

Hell yes I would do it. After experience the first "too tight" episode this weekend and having to race 4hrs away to get an unfill, that is after I tried with one of my hubbys insulin needles to unfill it myself. Yeah, I know, insulin needles are too small and too short to make it to the port, but I was DESPERATE!!! So, that being said, if I could get a kit, I would have no problem doing the unfill myself. Since I can't really feel the needle sticks in my stomach, due to fat or maybe the nerves not being healed all the way, plus I can feel my port perfectly, I would have no problem doing it myself. And hey, if I can do an unfill, I would probably be willing to do a fill. I hope I never again experience being too tight again! That was just awful!!!

Hell yes I would do it. After experience the first "too tight" episode this weekend and having to race 4hrs away to get an unfill, that is after I tried with one of my hubbys insulin needles to unfill it myself. Yeah, I know, insulin needles are too small and too short to make it to the port, but I was DESPERATE!!! So, that being said, if I could get a kit, I would have no problem doing the unfill myself. Since I can't really feel the needle sticks in my stomach, due to fat or maybe the nerves not being healed all the way, plus I can feel my port perfectly, I would have no problem doing it myself. And hey, if I can do an unfill, I would probably be willing to do a fill. I hope I never again experience being too tight again! That was just awful!!!

Don't don't don't do it yourself. Not unless you know sterile technique and have been trained in dealing with ports. Wrong needle (as you attempted) can damage your port and poke a hole in your tubing. Then there is the infection issue, and potentially losing your band or your life.

Accessing your port is NOT like drawing blood. A whole different kind of sterile technique is needed.

Go to an ER and when they don't know what to do ask them to get a chemo nurse. She'll know alllllll about ports. YOU explain the tubing, she'll know the rest.

xxxxxxxxxxxxxxxxxxxxx

This is sickening & frightening. Just letting on that it's something to consider puts ideas into desperate minds. Ports aren't there to poke as you please; the object is to get as few fills as possible by a qualified practitioner to avoid potential damage to the port. Filling & unfilling on a whim goes against all the basics of Band care. Any "QUALIFIED" practitioner in the United States would have their license revoked for allowing patients to practice on their own bodies. Hotel rooms and bathrooms aren’t the place for fills; people have fainted during fills - then what? Is there a qualified assistant around in the event of an emergency? I doubt it.

I HAVE done the ER routine, they have no clue what to do. As for the environment... have you ever worked in a hospital? They are so full of virus/bacteria it is unbelievable. There was a study done a few years ago about patients entering an ICU. Within 20 minutes they could measure the effect of the bacteria as the patients were building antibodies within that time frame just from the new stuff they were exposed to.

If you can fine a link to that study, I would be interested in reading it. Yikes! Us ICU nurses must have super duper ninja antibodies built up!!

i live 2.5 hours from my doctor and he said that wouldnt happen to that extreme because they always make us drink a lot before we leave to make sure it stays. but my surgen said my local hospital could do it if i really needed them to

I agree that your local hospital likely could do it--whether they would is the question, and often the problem.

While it is nice to be able to see the barium go through on a fill with fluoro, and most if not all Dr.'s require you to drink Water in the office following a fill--neither of those guarantees you that you will not react to the fill later, and be too tight or swell following a PB to the point of being unable to so much as swallow saliva.

When it happen to my SIL, she was fine with the water in the office but withing about 8 hours she knew she was too tight. Just after we got home----our fill Dr. is over 6 hours away!

IMHO the best thing to do is be proactive, as opposed to reactive. Plan for those possibilities now! Speak with your local PCP, have them refer you to someone who is used to accessing ports. In my case it is my former oncologist--I set it up with him prior to being banded! I did my level best to cover all my bases, since I am rural, and not close to where my banding Dr, is.

There are any number of things that cause us to swell, and it is not all related to the fill, so I would suggest mapping out a strategy now, and not waiting until you are sick and miserable! Better to be prepared and not need it, than need it and find out they refuse to assume the liability of accessing your port! Many do refuse!

You are almost halfway Purplegirl--way to go!

Kat