Hi, all..

I've had several inquiries and got lazy about answering them, so I hope you don't mind my making a lengthy Sue-Post. (Okay, not lazy, loaded, Vicodin...just let me say that you NEVER want to hear the phrases "urethral stenosis" and "urethral dilation" coming out of your urologist's mouth.)

For the innocent...My band surgery was October 15th, 2002, in Monterrey, Mexico, with Roberto Rumbaut Diaz, a band pioneer surgeon and a band patient and a really nice, down-to-earth guy. Prior to banding, I went from my all time high of a BMI 52+ to about a BMI of 48 on the day of surgery.

For the first several months, I did okay. I recall that for my mom's 80th birthday, I finally hit a BMI of under 40...I was not morbidly obese! But shortly thereafter, I started dealing with reflux. I had to sleep sitting up. I took various drugs, but they merely lessened the problem. One day, I was having Breakfast with my cousin (an RN) and her husband (an MD) and was able to eat only about two tablespoons of oatmeal at 10:30 a.m. and realized that THEY were looking at someone with a bizarre eating program...maybe an eating disorder. I hopped on a train (I just happened to get to the station seven minutes before departure) and went to Tijuana and had Dr. Kuri unfill me.

My reflux immediately resolved. And my weight loss began to resolve. So I eventually went in for mini-adjustments. I had unfills for my panniculectomy surgery and for my breast reduction surgery. In between, I had small re-fills. In two or so years, I had a dozen adjustments.

But then I started to feel like my food was bouncing around in my esophagus. It would happen once in a while, and then more often. Not every time, and not just after I had eaten too much. Sometimes, I'd be having a cup of coffee before dinner and the coffee would bounce around. Other times, it would be Water. One day, I could eat a considerable amount of foods. The next day, one stupid bite of oven baked fish, and that was all I could eat.

Well...after you do that for a while, you tend to get a little nuts. Especially when well-meaning people start telling you you just have to "work your tool." And when a doctor who doesn't have a band wants you to go to a support group meeting so that you can hear other successful banded people telling you they ALL go through that, with every meal. (Yeah, right.)

I finally got to the point that most of what I was eating was Soup and ice cream. Because it would usually go down.

I decided that, since I was within ten pounds of my pre-op weight, I wanted to consider the DS. I had an upper GI done. My esophagus is widened. In doctor talk, it's "esophageal dilatation." I went to Dr. Ara Keshshian in Delano, California and told him my story.

He said, "Are you expecting me to look surprised? This is NOT the first time I've heard this story."

He told me that I needed to have my band emptied...but that he didn't have the needles because he didn't DO bands. So I went to Tijuana and saw dr. verboonen, as he was available right away. He, his partner, the lab tech and my husband watched as I drank the barium and it just sat there in my esophagus. Didn't move. When stuff that isn't blocked just sits, the additional diagnosis is "esophageal dysmotility," in other words, the esophagus is NOT moving the food toward the stomach. (Ignore doctors who tell you that EVERYONE does this.)

So, I'm scheduled for an endoscopy, to make sure that I'm not dealing with erosion as well. If that checks out, I'll be having the band removed and DS surgery within the next month or two.

So...wisdom? I learned when checking with European surgeons that band removal is a booming business there. One surgeon said that 20% of his practice is revising bands to Rny or DS. (Remember, bands have been there longer, so more people have had more time to encounter problems.)

That doesn't mean I think they are a bad thing. I just think that the band is good for whomever it's good for...but that certainly is not everyone. In fact, my insurance began covering the band after I self-paid, but is no longer covering it for people with BMI's in excess of 49...because they lose the same percentage of excess weight which leaves them still MO. And older people have more problems. I was 55. Esophageal dysmotility or "dysperistalsis" is more frequent in older people. Adding the band may just make the problem appear sooner and with more vigor.

Not here, but at another site where it is mostly newer people, the band-enthusiasm is not tempered by experience or reason. Here, there are old timers who have been through problems. For many, the band is the answer. For many others, it is not. I am one of the latter.

Thanks for your time,

Sue

Sue, thank you so much for sharing your story, and good luck with your DS. I have a question for you: When they remove your band will your esophagus return to normal over time?

The other thing is how this operation is a faliure even by very low standards.....people lose 40 to 60 pounds of 130 and then they think that is now ok.......that is not a success......it doesnt seem worth the expence or trouble or risk does it?

Well, that all depends on who is making the decision. The prospect of losing 30-50% of my excess weight seemed WELL worth the risk and trouble to me, as long as I could be sure there was a good chance it would STAY off. Nothing else I'd ever tried gave more than temporary success. Overall the risks of banding here in the U.S. are really quite, quite low when compared to other kinds of WLS, so there really was no contest in my mind. And the possible outcomes were all made crystal clear to me from the start.

I keep wondering when are people and the medical world "watch dogs" going to wake up and smell the roses?

I'd venture to say that the medical establishment here in the U.S. is steeped in rose fragrance, and is rather too reluctant to allow people who could benefit from being banded the opportunity to have it done. Certainly there are people for whom other sorts of WLS make sense as a first approach, but for the VAST majority of patients--no matter what the condition being treated--I believe doing the least invasive thing possible first makes the most sense.

Hi, again.

Rachele! How about you looked into DS because of me, but have decided to go with it on your own? Otherwise, I'd have to stalk you all the time because I'd feel totally responsible.

Anne, generally, an unfill improves the dilatation. I think my dilatation is due to the dysmotility. Physics. (If it isn't in the stomach and doesn't come back up, it has to be somewhere.) I *THINK* the food will actually have a bigger place to land with the smaller stomach than it does with the band's "upper" stomach, but I'm not sure if that will cure the problem.

Desertmom, the "success thing" is touchy. For ME, losing about a third of my excess weight was a good thing, but it didn't stay lost without causing me complications. For others, losing half of their excess weight is fine. (I have an age factor involved here, too...if not now, WHEN?) But, you are right in that--more and more--the literature refers to a sustained loss of 50% of excess weight as a success for bariatric surgery...and I want more help than that.

But re smelling the roses...Blue Cross of California is no longer authorizing the band for patients with BMI's of =/+50. That's based on the math that a 50% excess weight loss for higher BMI people will leave them MO...and the comorbidities that exist DUE TO MO will continue to exist..which, to their bean counters, means that banding for BMI's of 50 or above is not enough bang for the buck.

Desertmom, I'm hearing that you feel that the band was a WRONG step for you, in that you are taking the "blame." STOP!! It was the FIRST step. It was a conservative effort to rid yourself of excess weight without slicing and dicing your innards. It works (regardless of who is defining that word) for a good number of people and there is no reason to be blaming anyone--including yourself--for that choice. (My DS surgeon says that so many come to him for revisions and are blaming themselves for "failing" their first surgery, whatever it was. That garbage gets in the way.)

Think of a troubleshooting flow chart. I use a Mac computer. If it gets hung up, I try to stop the procedure in progress (the diets, gyms, pills, shrinks, etc.). If that doesn't work, it's time to "force quit" the program (Band). If that ever fails, it's time to force a quit and restart of the computer (bypass or DS). Am I an idiot for not trying to quit the program (bypass or DS) at the first sign of trouble? I don't think so. I think it makes all the sense in the world to take baby steps.

Again, thanks to all for the support.

Sue

Sue, please don't stop posting here after your DS. You're obviously very wise, and we need your input even if your story did scare the bejeesus out of me. And you use a Mac, which always earns points in my book (DH works for Apple).

Wow...what insightful ladies you all are... I have been banded since it seems the beginning of time... not really... I have had no problems until now being pregnant... I never made it to my goal weight ( I stopped short by 20 or so pounds...but my focus changed... I was trying to get pregnant and now I am... I hope that my issue (reflux) is due to pregnancy and nothing more... but I am glad to hear all of the other stories. To be informed is the best that we can do... especially for those of us who have already committed to this journey. I hope that all goes well for everyone in the future and after the twins are born I will probably try to loose the baby weight without a fill... will it be possible...who knows...but my never being tight seems to be the answer to my not having problems (referring to myself only) it seems I needed help to push away... that's why I did not have the bypass... I knew I loved food and just needed a push in the right direction... Just my 2 cents

Thanks for your story, makes me wonder about myself too. I just turned 58, so you saying more problems after 50, hmmm. I was banded in Mexico, 10 cc band, but my fill doctor could only put in 1.8 cc and thought there was confusion with my band size, said maybe I misunderstood, it was 10 cc across or another size because she does 3 cc normally as a first fill and the barium wouldnt go into my stomach with 3 cc, so she took me down to 1.8 cc, which didnt give me any restriction. I can eat anything, so maybe I dont have the older age issues you mentioned?

At least you gave us something to think about. Im sorry you are having issues with your band and had to be unfilled.

I wanted to add that I went to a seminar, 8 of us I think? One had a lapband and had gained weight so wanted it removed and have bypass. The lady leading the seminar lost 120 lbs via lapband, but got reflux so bad, she too had her band removed and had by pass. I was sitting there thinking 2 of out the 9 in the room had or wanted their bands removed? I came home and cancelled my lapband surgery, it sure scared me. I later rescheduled and went thru with it, but those odds are telling.

Edited October 5, 200817 yr by flowers