Okay, it's so heartbreaking to hear of people losing weight and having to take the band out due to slippage or erosion. Is it something that just happens or is there a way to prevent this?

Linda

I brought those topics up to my doctor, Dr. Huacuz in TJ, he told me that slippage would be his fault, and erosion would be mine. He told me that if a band is not sutured well to the stomach it can cause slippage and that is why it would be his fault. He told me erosion is when I over eat and PB way too much so in effect it causes the band to wear or rub into the lining of the stomach because of heaving and over eating. He said that he makes sure to stich the band in really well, and that I would need to make sure to eat right! That is what was told to me, but I have heard different stories.

I'm not banded yet but my MD told me the same thing

Slippage is not always the surgeons fault. You can have slippage due to being too tight causing you to PB too often. It can also happen due to pouch dialation. There are no studies showing how or why erosion happens.

i didn't think erosion was anything to do with the band - rather your stomach eroding into the band

Okay, it's so heartbreaking to hear of people losing weight and having to take the band out due to slippage or erosion. Is it something that just happens or is there a way to prevent this?

Linda

PLEASE TELL ME WHY I'M COUGHING SO MUCH AND SLOBBERING ,AND COUGHING UP UNDIGESTED FOOD....MY WEIGHT HAS NOT CHANGED FOR SIX MONTHS ,FOOD AND LIQUID COMES THROUGHT MY NOSE CONSTANTLY ...I THINK ITS SLIPPED OR HAS A WHOLE...PLEASE HELP

cleopatra 3053-

i had the same symptons...go to your band doc immediatly. i thought i had slipped (those are signs of slippage) but i had not...my band had just shifted slightly...a small unfill has changed my life. i went from waking up coughing and throwing up through my mouth and nose 10 times a night to just several times a week. he thinks it was go away altogether soon.

do not waste any more time being miserable...go to your doc now!!!

My gosh Cleo that sounds awful.Hope you call your doctor. Donna

thanks everyone for the replies. what is PB?

Linda

PB is productive burping. It is kinda like throwing up,caughing,and burping all at the same time. The first time u get something stuck u will know what it is. Mine is kinda like a cough, I cough and the stuck food and slim comes up. You will also read the term "sliming" alot along with PBing. When the food gets stuck you start drooling like a mad man. The fluid that comes up with the food is the "slime", which is just like thick saliva. Your stomach produces it to lubricate the food cause it knows it is stuck. Some people say that their own personal PB is just like throwing up. Mine is not and I have found everyone is different. Hope this helps!

Erosion is not always the banded persons fault. I take exception to any doc that says the patient is at fault. I am an RN by the way. I also eroded after having the band for 18 months. The surgeon that took out my band was not the surgeon that put it in. The surgeon that took it out said there was a stitch that irritated the stomach wall and over time caused the outer lining to erode and allowed the band to enter my stomach. So it CAN be the docs fault too.

There are no real definitive reasons someone erodes. Even the band manufacturer told me this. The surgeon that took mine out told me this.

Just my opinion.

PB - oh, gross! But good to know!

Penni, I've seen you around the boards and I'm wondering how you are doing. Are you going to get banded again? Did you lose much weight with it? Did you like it while you had it? Are you keeping the weight off now without it. What did you think of the whole thing? - just interested if you want to tell me.

Linda

PB - oh, gross! But good to know!

Penni, I've seen you around the boards and I'm wondering how you are doing. Are you going to get banded again? Did you lose much weight with it? Did you like it while you had it? Are you keeping the weight off now without it. What did you think of the whole thing? - just interested if you want to tell me.

Linda

Wow so many questions. LOL!!

Not going to get banded again. Surgeon said there was too much scar tissue from the initial surgery and risk of erosion is higher with a second band. He suggested a bypass instead. NOT interested in that.

I lost 70 lbs when I had the band. I have since gained 50 of that back. But have maintained this weight for 6 months now. SO that is something.

While I had the band I hated it and loved it. I really wasn't in the right mind set at the time for the band. I saw it as a quick fix and didn't use it as a tool to LEARN the right way to eat.

I have mixed feelings about the band now. It does work and it did work for me, but if I had to do it again I just don't know if I would go that route again.

I am struggling every day with my weight. I am educating myself on the proper way to eat and exercise. It is hard and will be a forever battle for me. I can't take a day off to cheat. I will spiral down into that well again and I don't wanna go back there.

Lots of luck and I wish you well with your journey.

Erosion is not always the banded persons fault. I take exception to any doc that says the patient is at fault. I am an RN by the way. I also eroded after having the band for 18 months. The surgeon that took out my band was not the surgeon that put it in. The surgeon that took it out said there was a stitch that irritated the stomach wall and over time caused the outer lining to erode and allowed the band to enter my stomach. So it CAN be the docs fault too.

There are no real definitive reasons someone erodes. Even the band manufacturer told me this. The surgeon that took mine out told me this.

Just my opinion.

Question for you, when you eroded what were your symptoms? What led you to know something was wrong? Was it a serious erosion or the beginning of one? Would you mind providing more details?

Also, do you think there is any chance at all that your band was too small for your stomach or did you have a fill that in looking back... might have been too tight? Sorry, I really want to gather information on erosion so anytime I have an opportunity to ask, I do.

The thinking used to be that NSAIDs caused erosion, then they discovered that wasn't true. Then they thought it was coffee and caffeine, that wasn't it either. Then they thought it was smoking. Nope, not that either.

Now they think it is caused by a band that is too tight. Either the surgeon put a band on that was too small for the patient or that the patient got a fill that was too tight for too long. This is the theory that makes the most sense to me.

Ever see an abused dog that has a collar on that is too tight? After months of this the collar starts to erode into their neck and it has to be surgically removed and repaired. The same thinking could apply here as well.

Also, why is it that some docs have such a high erosion rate (7-10%) and other docs have such low erosion rates (my doc is 0.0016%)? That kind of a difference can't be the patient base the doc attracts, that sounds like surgeon issues to me. The numbers lead me to believe that.

Of course, then there is infection. Poor sterile technique during a fill can cause a port infection and the infection can travel up the tubing to the actual band.

My doc has one eroded patient. The patient had her band for a few years and went to a US RN for a fill. The fill was clearly too tight and the patient knew it. She could barely drink liquids but she refused a slight unfill as she was losing weight like crazy and wanted to get to goal faster. So she went for months and months with a fill where she could hardly drink Water. I suspect her "too tight" fill is likely what caused her erosion from hearing her story on the boards but clearly, nobody will ever know for sure.

But this begs the question... is it the patient or the doc? How is it that my doc has one erosion in 1600+ bands and some other docs have a 4-10% erosion stat when according to Inamed global stats are 1.3%? If their infection stats were that high in comparison to other docs we would blame the doc. I'm not so sure it is any different here with the exception of fills that are too tight and the patient won't get a slight unfill.

I brought those topics up to my doctor, Dr. Huacuz in TJ, he told me that slippage would be his fault, and erosion would be mine. He told me that if a band is not sutured well to the stomach it can cause slippage and that is why it would be his fault. He told me erosion is when I over eat and PB way too much so in effect it causes the band to wear or rub into the lining of the stomach because of heaving and over eating. He said that he makes sure to stich the band in really well, and that I would need to make sure to eat right! That is what was told to me, but I have heard different stories.

I really question if you might have misunderstood this. I think you might have it backwards. Erosion is currently thought to be the doc's fault in general. Slips are typically the patient's fault. Not always, but usually. People that don't chew well, take bites too big, PB a great deal, keep fills that are too tight, etc... they are the folks that tend to slip more than others. I think there are some slips that nobody knows why it happens. But many times slips happen in people that didn't follow the post op diet, they don't chew food well, they eat things they know they can't tolerate, overeat, etc.

Another reason I suspect you might have the slips/erosion backwards is that it isn't the sutures that really hold the band into place, it's the scar tissue that forms around the band. The stomach is sewn up and over the band but the scar tissue that forms during the post op diet is what really secures the band into place. Theoretically, you should be able to remove the sutures after the scar tissue has formed and the band should stay in place.

wasabubblebut - I hope someone answers those questions - all very interesting, and I would like to know as well!

Penni - That's great that you're maintaining your 20 pound lost at least. For me it's a great accomplishment to maintain instead of gain. I know what you mean about it being a lifelong thing. I know it's going to be that way for me, whether the LB thing works or not.

Linda

Question for you, when you eroded what were your symptoms? What led you to know something was wrong? Was it a serious erosion or the beginning of one? Would you mind providing more details?

I had no symptoms, I had a feeling something was not right and wanted the doc to do an ENDO. He reluctantly did but supported me in the decision. He was just as surprised as I was the it had eroded. I was 50% eroded into my stomach. I can post some pics if you like.

Also, do you think there is any chance at all that your band was too small for your stomach or did you have a fill that in looking back... might have been too tight? Sorry, I really want to gather information on erosion so anytime I have an opportunity to ask, I do.

My doc said he thought it was due to a stitch irritating the stomach wall on the outside that allowed the band rub a hole in my stomach and make it's way into my stomach from the outside.

The thinking used to be that NSAIDs caused erosion, then they discovered that wasn't true. Then they thought it was coffee and caffeine, that wasn't it either. Then they thought it was smoking. Nope, not that either.

Now they think it is caused by a band that is too tight. Either the surgeon put a band on that was too small for the patient or that the patient got a fill that was too tight for too long. This is the theory that makes the most sense to me.

Erosion is just too difficult to diagnose right now. In order to say for sure what causes it you have to get it at the beginning and that is just too difficult to do at this point. There is NOT one definitive cause for erosion.

Ever see an abused dog that has a collar on that is too tight? After months of this the collar starts to erode into their neck and it has to be surgically removed and repaired. The same thinking could apply here as well.

Also, why is it that some docs have such a high erosion rate (7-10%) and other docs have such low erosion rates (my doc is 0.0016%)? That kind of a difference can't be the patient base the doc attracts, that sounds like surgeon issues to me. The numbers lead me to believe that.

My opinion on this is that some docs have a low rate because not all patients return to the same doc to have the band removed. So their rates will be low. My doc probably has a high rate because he removes lots of eroded bands from other docs patients. His personal rate is low because he watches his patients closely. He requires you come in for a visit every month or two months to get a check up and check in with him. He always returns phone calls and emails. He is a very hands on doc. I have seen some docs at the first sign one of their patients is having complications they bail on the patient and ignore their phone calls and emails. That is just unprofessional now.

Of course, then there is infection. Poor sterile technique during a fill can cause a port infection and the infection can travel up the tubing to the actual band.

My doc has one eroded patient. The patient had her band for a few years and went to a US RN for a fill. The fill was clearly too tight and the patient knew it. She could barely drink liquids but she refused a slight unfill as she was losing weight like crazy and wanted to get to goal faster. So she went for months and months with a fill where she could hardly drink Water. I suspect her "too tight" fill is likely what caused her erosion from hearing her story on the boards but clearly, nobody will ever know for sure.

An RN should NEVER EVER access a lapband port unless under the direction of a band doc, in the office, and in a controlled environment. Contrary to the information out there Inamed does not certify anyone to give fills. There is no certification process, according to Inamed, for giving fills. I asked them about this once before when there were alot of supposed certified people out there giving fills in hotel rooms. Inamed told me they did not offer any certification classes to anyone for this. Only docs are cleared to do fills. It is under the docs supervision and his discretion to allow an RN to do a fill.

But this begs the question... is it the patient or the doc? How is it that my doc has one erosion in 1600+ bands and some other docs have a 4-10% erosion stat when according to Inamed global stats are 1.3%? If their infection stats were that high in comparison to other docs we would blame the doc. I'm not so sure it is any different here with the exception of fills that are too tight and the patient won't get a slight unfill.

I really question if you might have misunderstood this. I think you might have it backwards. Erosion is currently thought to be the doc's fault in general. Slips are typically the patient's fault. Not always, but usually. People that don't chew well, take bites too big, PB a great deal, keep fills that are too tight, etc... they are the folks that tend to slip more than others. I think there are some slips that nobody knows why it happens. But many times slips happen in people that didn't follow the post op diet, they don't chew food well, they eat things they know they can't tolerate, overeat, etc.

Another reason I suspect you might have the slips/erosion backwards is that it isn't the sutures that really hold the band into place, it's the scar tissue that forms around the band. The stomach is sewn up and over the band but the scar tissue that forms during the post op diet is what really secures the band into place. Theoretically, you should be able to remove the sutures after the scar tissue has formed and the band should stay in place.

Just to clarify something, I think it is wrong to say it is the patients fault for something and it is the doctors fault for something. Fault should not be placed for a complication unless it is blatantly obvious. No one knows for sure what causes slips, erosions, etc. It is just too grey an area. There is speculation as to what MIGHT have caused the problem but to say it is the patients fault for this but not this is unprofessional and immoral in my opinion.