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Lap band erosion



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Just me butting in but didn't you ask for a plastic surgeon? And I think Dr. Watkins gave you the name of a band surgeon. Or should I keep my big nose out of it? :eek:

Good point.

Dr. Blackstone is a gastric band surgeon.

She would also know some great plastic surgeons in the area.

Sorry for any confusion.

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Dr. W., I've really enjoyed your posts on this thread. They are very informative.

I've recently had to find a new fill doc, as my surgeon moved out of state. Luckily, I had a few to chose from. My surgeon was Dr. Zoe Deol in Troy, Mich. I believe that it's because of her excellent reputation that docs weren't leary at all about taking on her patients. I dedided to go to the Port Huron Lap Band Center which is farther away. They have a great reputation. And afterall, isn't that what's important.

Oh yeah, and I love my band! I like that all of my parts are still intact!

Great job on your weight loss!

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I asked the Doc for band surgeon names in last post and names for Plastic Surgery in another post

Try Dr. Robin Blackstone (band surgeon). She is excellent and she will know excellent plastic surgeons in the area. I was just at a meeting with Dr. Blackstone last week regarding the new REALIZE band. Here's her info from American Society for Metabolic and Bariatric Surgery website.

Robin L. Blackstone MD FACS (Center of Excellence)

Regular Member

Surgeries Performed:

LB LGBP

Scottsdale AZ USA

480-391-3885

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Dr. Watkins, I have been wondering if you know Dr. Tersigni, since you are both in the Pacific Northwest.

I know, not on topic:cry

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Just want to thank Dr Watkins and Wasa for sharing their thoughts with us. As a Mexican patient, I've found this thread most interesting and informative. It's great that both of you take the time to contribute your expertise. Merry Christmas.

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And also, the symptoms of an erosion are simply weight regain because you have no restriction.

Erosions don't typically cause any other symptom.

This isn't always true since I had restriction and continued weight loss with over 50% erosion. I didn't exactly have "medical" symptoms but food/liquid certainly did passed through my pouch much differently. The old gurgle sounds changed, and something didn't feel right. No pain or anything but I did have one PB right before my band was removed (had maybe 5 PBs in the 2 years I was banded.) My doctor indicated a port infection most likely lead to erosion since he was removing a lot of bands from people that had port problems such as port revision, flipped ports, pulled ports, infected ports. He also believes that a tiny nick on the stomach during surgery can go unnoticed, something so small that the doc will ignore. The smallest infection from the nick grows bacteria that can't ever be stopped, not even with antibiotics. The infection makes its way up to the port, and the rest is history.

I simply woke up one day feeling really strange, an eerie instinct or intuition that had me make an appointment for an endoscopy that confirmed I eroded.

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Dr. Watkins, I have been wondering if you know Dr. Tersigni, since you are both in the Pacific Northwest.

I know, not on topic:cry

I saw that he is in Coos Bay, Oregon but I do not know him.

The best way to research a surgeon is to call the hospital or surgery center where they work and ask the operating room nurses what they think of a particular surgeon. You will get great information from the people that work with surgeons (and are not in their practice). That's always good advice for any operation.

hope that helps

Merry Christmas!

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This isn't always true since I had restriction and continued weight loss with over 50% erosion. I didn't exactly have "medical" symptoms but food/liquid certainly did passed through my pouch much differently. The old gurgle sounds changed, and something didn't feel right. No pain or anything but I did have one PB right before my band was removed (had maybe 5 PBs in the 2 years I was banded.) My doctor indicated a port infection most likely lead to erosion since he was removing a lot of bands from people that had port problems such as port revision, flipped ports, pulled ports, infected ports. He also believes that a tiny nick on the stomach during surgery can go unnoticed, something so small that the doc will ignore. The smallest infection from the nick grows bacteria that can't ever be stopped, not even with antibiotics. The infection makes its way up to the port, and the rest is history.

I simply woke up one day feeling really strange, an eerie instinct or intuition that had me make an appointment for an endoscopy that confirmed I eroded.

Good point. Certainly every patient's symptoms are different. Many people feel that erosions make you really sick due to intestinal contents leaking out into the abdominal cavity. It is true that most erosions do not present this way. They typically present with weight regain. I have heard of "asymptomatic" erosions where patients continue to lose weight despite seeing an eroded band on endoscopy. Over time, however, the erosion tends to continue to the point of loss of restriction.

The good news is that erosions are so rare nowadays we don't have much experience with it.

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This isn't always true since I had restriction and continued weight loss with over 50% erosion. I didn't exactly have "medical" symptoms but food/liquid certainly did passed through my pouch much differently. The old gurgle sounds changed, and something didn't feel right. No pain or anything but I did have one PB right before my band was removed (had maybe 5 PBs in the 2 years I was banded.) My doctor indicated a port infection most likely lead to erosion since he was removing a lot of bands from people that had port problems such as port revision, flipped ports, pulled ports, infected ports. He also believes that a tiny nick on the stomach during surgery can go unnoticed, something so small that the doc will ignore. The smallest infection from the nick grows bacteria that can't ever be stopped, not even with antibiotics. The infection makes its way up to the port, and the rest is history.

I simply woke up one day feeling really strange, an eerie instinct or intuition that had me make an appointment for an endoscopy that confirmed I eroded.

Thank you for posting this. This is something I have thought about. If the erosion happened under the band wouldn't restriction remain the same?

I'm no expert on erosion and I hope I never have reason to be. I'm sorry you lost your band.

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Just want to thank Dr Watkins and Wasa for sharing their thoughts with us. As a Mexican patient, I've found this thread most interesting and informative. It's great that both of you take the time to contribute your expertise. Merry Christmas.

Thank you for writing this.

I don't think Dr. Watkins and I will ever agree on the topic but it's nice to have a rational (albeit short) conversation about the topic with a US doc.

The reality is that the SAME exact things happen in the US as Mexico. There are good surgeons and bad in every country. There are experienced and inexperienced surgeons in EVERY country. There are drug abusing nurses in EVERY country. There have been some estimates that 1 in 10 nurses in the US have taken narcotics from a hospital at one time or another. I'd venture a guess the stats are actually higher than that. I have no doubt it happens in other countries as well.

Mexican docs are indeed taking business away from US doctors. There are some people that don't want to pay the extra money for surgery in the US. There are others that wouldn't be able to HAVE surgery if it were not for Mexico.

There is an issue with follow up care but quite frankly, I've seen non stop issues regarding follow up care in the US too. A plan of follow up care is needed before having surgery in another country.

Mexico has an infection stat, so does the US. I've seen far more infections (thinking ratio here) in the US vs. Mexico. Not proof, just observation on these very boards. The CDC claims infection is higher in the US vs. Mexican hospitals for MRSA, the dreaded infection of all infections, as well as other strains of bacteria.

Mexican docs did train the new US docs in banding, they have more experience than most US docs and they also helped to perfect the band and the procedure before it was ever approved in the US.

You can't likely win a lawsuit with a Mexican doctor. Their country tends to side with them. But I haven't ever gone to a doc in any country when worrying about if I could sue them or not. If I worry if I can sue them I think I would reconsider going to that particular doc. The better docs will fix a mistake. They depend on reputation regardless of country and if they are worth their rep, they will fix an error without a lawsuit being necessary. Can you imagine how a patient could rip into a bariatric doc on a board such as this if he did indeed do something wrong?

I understand both sides to the situation. US docs are in a business to make money and if they are seeing business go to another country because they can do it cheaper, that does hurt the bottom line. No way to deny it. Then US patients come back after giving the big bucks to another country and they want follow up care in the US and office time is expensive. It can potentially cost a doctor money to do follow up care on another doc's patient. I just want docs to start being more honest about the bottom line. Not talking Dr. Watkins here, I'm talking ALL doctors. Instead of scaring them away (which Dr. Watkins did not do) with dishonesty and extreme cases that happen in the US as it does Mexico, be HONEST with us. We might be willing to pay a few more dollars if we understand the real bottom line.

My opinions only.

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my surgery was 11/30/07 and within one week after surgery the main scar (port underneath) was fairly red and it burned like hell for 10 seconds if I sneezed! went on antibiotics and things are much better with the redness and the pain. I still feel like I can feel the area underneath a little and since not have my first fill till 1/9/08 not sure what to expect I am alittle afraid that the muscle in there is maybe just sore or there might be a problem.... anyone out there have port issues to talk about? did wearing jeans bother for just a little while all of my other scars are healing great....:omg:

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I had surgery in Mexico and my fill doc here charges 1100 for one year of blind fills. But i was happy to find someone to do them. It is cheaper than flying back to Mexico every time I need a fill. I loved my doctor in Mexico, he was very nice and took lots of time with me to explain everything.I also love it that Dr. Watkins post here. Love all the info. Donna

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my surgery was 11/30/07 and within one week after surgery the main scar (port underneath) was fairly red and it burned like hell for 10 seconds if I sneezed! went on antibiotics and things are much better with the redness and the pain. I still feel like I can feel the area underneath a little and since not have my first fill till 1/9/08 not sure what to expect I am alittle afraid that the muscle in there is maybe just sore or there might be a problem.... anyone out there have port issues to talk about? did wearing jeans bother for just a little while all of my other scars are healing great....:omg:

If the redness and discomfort resolve completely with antibiotics that's a good sign.

If redness and port pain return within a few weeks of stopping antibiotics this would be suspicious for a port infection.

Time will tell.

hope that helps

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Thank you for all the valuable info you contributed in this thread. I've read it all. I moved last year to a new state and had absolutely no trouble finding a band dr. within 20 miles of me. I was banded at a Center Of Excellence. I was told that once the doctors checked over my records and made sure I was banded in the states that it would be no problem getting me in. I was so worried about great follow-up, and I'm simply amazed at the wonderful dr. I had for surgery and the one I have for my fills. He accepts a Medicare plan, Humana PPS. I pay a small co-payment and Humana pays the rest. He has absolutely no problem with it and I know he isn't making any money off this. He is also a very prominent surgeon in this area as we only have a few that do the gastric banding. He spends about 1/2 hr. talking to me each time I go. I had a fluoroscopy a mo. ago just so he could check on things. I have 4 cc in my band and although that would be way to much for someone else it is my "sweet spot". I apparently have little fat pad on my stomach.

I guess what I'm getting at here is that I would have major problems had I been banded outside the U.S. because the follow-up care I have here would not have been available to me. I say "Thank God every day that I was banded in the good old US of A".

Again thanks for all your good info.:)

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