Gastric Band Surgery Q&A Part 2

by Christine on October 4th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

Periodically I go into the Google Analytics of my website and discover that some viewers are asking questions about the gastric banding surgery and looking for the answers at my website. Here is the lastest group of “Questions and Answers” about the gastric banding surgery that might be of use to new bandsters.  This is Part 2 of the Q&A. Read Part 1 of the Q&A here.

 

How do I know if my gastric band is too tight?
If you cannot take a swig of water immediately after a fill, then your gastric band is definitely too tight. That’s the easy part.  However, finding the right balance between “tight enough to lose weight and be happy” and “too tight” might be a difficult balance to achieve. I know that I struggle with this almost 3 years after surgery! If you are finding that you cannot eat enough calories to survive (you know, if you’re dizzy and having a hard time concentrating because you’re not eating enough), then your band is too tight. If you find yourself choosing protein shakes, milkshakes, ice cream, and soup all the time because anything more solid than that is painful, then your band is too tight. If you find yourself barfing during most meals because your food is always getting stuck, then your band is probably too tight.

All that being said, I like to have my band pretty tight—maybe even tighter than most people. I know that I can’t eat certain foods, especially breads and pastas. Just because I can’t eat certain foods doesn’t mean that my band is too tight. I know a lot of bandsters that can no longer eat steaks or dry chicken. Again, this is normal and not necessarily an indication that the band is too tight. On the other hand, if you simply cannot be happy unless you have steak, and you find your band too tight to eat steak, then you might want to consider getting some saline taken out.

All in all, there’s no real hard and fast rule about finding whether the band is too tight or not. It’s really a matter of personal preference. However, a good rule of thumb is that if you cannot swallow any liquid, or if you have problems eating solid foods of any kind, then you should definitely loosen your band a bit. Other than that, it’s a matter of what you can live with or not.

 

How long is the gastric band waiting list?
Honestly, I think it depends on what region of the world you live in, what hospital you are going to, what surgeon you are seeing, etc. I know in the UK, the country only allocates a certain amount of money for the gastric band surgery, and so you might be on the waiting list for quite a while. According to www.gastricband.org.uk the waiting list in the UK can vary from anywhere between 3 months to four years.

I was banded in upstate New York, USA. I was not placed on any waiting list. Once I completed all my pre-surgery testing and requirements, I was immediately put on the pre-surgery diet. My surgeons gave me 2 months to lose 25 pounds on the pre-surgery protein shake diet, and as soon as I lost that weight I had my surgery. And yes, my insurance paid for the surgery in its entirety, but that really depends on your insurance carrier, your health background, the hospital you’re going to, and a lot of other factors.

I really recommend you check out the forums at www.lapbandtalk.com, especially the regional forums to inquire about this question.  (FYI, LapBandTalk.com is free to use and is a fantastic resource for anyone considering the banding surgery.)

 

Does gastric banding hurt?
Yes, the surgery itself does. But I personally found it to be a tolerable pain, that did not last very long (only a few days…maybe 7-10 days) and went away little by little, every day.  I’ve read other blogs from banders that found the pain to be too much, too intense, and last too long. I think part of the pain has to do with your tolerance, as well as your surgeon’s capabilities.

The band should not hurt once your body has healed from the surgery. If you are in pain several week or months following your surgery, you should definitely talk to your surgeon to find out what’s going on.

Will throwing up hurt the gastric band?
Fantastic question!

In my personal opinion and experience, I think all bandsters experience purging/throwing up due to food getting stuck in the band. Bandsters have all kinds of terminology for this experience, such as “sliming” or “B/Ping” etc.  This is a very common occurrence, especially once the band gets close to your “sweet spot,” which is the optimal tightness that allows you to live and eat happily but still allow you to lose weight.

Despite the common occurrence of the purging episodes, throwing up can hurt the gastric band, so you should really be careful about it. I believe the band is most vulnerable during the early stages of the process, when the band is deflated and fits loosely on the stomach. If you have a violent barfing episode, the heaving of the stomach can dislodge the location of the band around the stomach, thereby reducing the effectiveness of it. If the band becomes dislodged, you might not realize it right away. The doctor can find if the band has moved by using an X-Ray, or if after a few weeks or months you are not losing weight.

However, it also makes sense to me that barfing can hurt the band if it is filled with saline and tighter. When you are heaving, your stomach might press against the band with such a force that it could rupture the band. (Think of it like squeezing against a full balloon. What happens? The balloon explodes!) If your band “pops” like a balloon, the only way to fix this is by replacing it with another surgery.

All that being said, I’ve personally never heard of anyone having these problems – either band slippage or band “poppage”—because of a barfing episode. It’s just something to be aware of and watch out for. I think this is relatively rare.

 

Why has the gastric band come loose?
Oh dear! Your gastric band may have come loose for a number of reasons. Perhaps there’s a leak in the band itself, in the tube, or the port, or in any of the connections. There’s a lot of ways a leak can occur in the whole gastric band mechanical system. The band could also be loose if it merely has slipped from its ideal location. For instance, if it slips up the stomach, you probably would feel like it is very loose.

These are very serious causes, and only your surgeon can fix these problems if they occur. However, there might be a fairly simple reason for your band feeling a little looser. Your band is a semi-permeable membrane, which means that your band can actually absorb and release liquid through its lining! A lot of bandsters feel like their bands get tighter when they are stressed out, or feel like they get looser when they are dehydrated, like after a night of drinking. Therefore your band might feel a little bit loose just because you’re dehydrated. Eat something salty and drink a lot of water and see if your band feels any better in a day or two.

If you suddenly feel like your band is much looser than it was before, then you really should make an appointment to see your surgeon. He can check to see the saline level in the band or do an X-ray to see if the band has slipped, both of which are fairly painless and non-invasive tests.

 

Does a gastric band affect pregnancy?
The gastric band does not have to negatively affect pregnancy, but it’s important to understand the unique concerns that expecting mothers might have. Read my article about pregnancy and the gastric band here.

 

Can gastric band slip and then go back again?
If your gastric band has slipped from its location around your stomach, it’s possible but unlikely that it would go back again. If it slips, it is most likely to stay “slipped” until your surgeon goes back to replace it in the correct location.  Sorry! I stand corrected! See Angela’s comment at the very end of this post. Angela said that this very thing happened to her…her band slipped out of place. She had an un-fill, and then the problem corrected itself.  I had no idea that this was possible. Interesting, and thank you for sharing Angela!

 

Can you feel the gastric band through the skin?
No, you cannot feel the gastric band through the skin, but you may be able to feel the gastric band’s port through the skin. The port is the receptacle where your surgeons inject the saline. Read more about the components of the gastric band system in this article.

 

Gastric banding menus
Here are some resources for finding out what to eat –or not eat!—with the gastric band:

  •  This page lists the post-surgery diet requirements, as well as a list of foods that are typically not processed well by band patients.
  • Here is a list of mushy food ideas.
  • This forum has a lot of great food ideas.
  • This website has some food ideas.  

 

How much food can I eat during the mushy stage?
You should only be eating no more than a cup of mushy foods at any given sitting.

 

How do you locate the lap band port to make it unnoticeable?
It’s unlikely that a severely overweight person can see the port through their skin. However, as you lose weight and get closer to your goal weight, the port may become noticeable, either by touch or by site. I had many talks with my surgeon about this very topic of moving my port (which had become dislocated) to a place less noticeable. There are a variety of locations where your surgeon can put the port to minimize its appearance through your skin, from putting it under the abdomen, moving it to your side, etc.  Read about these options in more detail here.

 

Will the port from my gastric band protrude if I lose a lot of weight?
It might, possibly yes.  See this page for some ideas about moving the port if it is really bothering you.    Please note that the different banding systems have a different profile port. For instance, the Lap Band system uses a port that has a higher profile, which means that it sticks out further than other systems.  I have a Realize Band system, which uses a smaller profile port, which means that it’s flatter and thinner than the Lap Band system. However, many surgeons find the Realize Band port to be difficult to access when the patient is very overweight and has a lot of fat covering the port. It’s difficult to find where the port is because it is so much flatter, so the doctor might have to jab around with the needle a little more to find the injection site. Even more reason to find a surgeon with a  lot of experience, so you can minimize the needle-jabbing process!   My surgeon told me that a lot of doctors put a smaller profile port on male patients and a higher profile port on female patients. Doctors do this based on their experience and comfort level. You should discuss the type of hardware that he’s putting in you before your surgery, so you are aware of what you’re getting. Don’t forget that you can have an opinion about what kind of system you receive from your surgeon!

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  • Angela Vaughan

    Just some clarification on the question about what happens if your band slips and if it will go back on its own….Mine did slip. So I was unfilled and after a week it went back into place. My PA said that it was not uncommon for that to happen, and i haven’t had any problems since.

    • http://www.phoenixrevolution.net Christine

      Thank you so much for sharing your experience, Angela! I had no idea that it was possible to auto-correct itself. That’s so interesting! Thanks again for sharing!!