Replacing the Gastric Band Port

by Christine on July 7th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

Yesterday I had my surgery to replace my gastric banding port.  I was replacing it because it became detached and was floating around quite obviously and was a nuisance. (However, the port’s ability to give me “fills” still worked.)  Here are some “before” pictures of why I wanted to get it fixed:

Dislocated Port

This is from about a week ago. This is a more extreme angle (looking down on it)…here is what it looked like yesterday before going into surgery:

Port

Prior to this surgery I had met with my surgeon twice to discuss my options with the port. You’d be surprised at how many options there are! My options were slightly more complicated since I’ve lost a lot of weight and have less fat on my body, which means there are fewer places to hide this bad boy.  (I discuss this in more detail, with some photos of how the port is actually attached on the abdomen, in this post.)  The options included:

1.) Putting it back where it was originally and just re-attaching the brackets into the abdomen. With this option the port would still be seen through the skin, slightly, since it is raised up an inch or so. The port could be moved to another location, such as under my breasts or on my side, but to be honest it would show even more there since there is less fat and skin there. However, it could be moved to another location.;
2.) Place the port UNDER my abdomen, which would require any future fills to penetrate through the abs and “guessing” where the port is located underneath. This would make the port unnoticeable under the skin;
3.) Cut a hole into the abs and embed the port in the abdomen. This would allow the port to lay flat and would be completely unnoticeable under the skin. However, this may comprimise my movement with my abs;
4.) Of course, because I have reached my goal weight (more or less), there is always the option to remove the port entirely. He could plug any remaining fluid in the band, cap off the end of the hose, and just take out the port. If I wanted any fills in the future he would actually have to make an incision into my skin, find the hose, and do it messily and manually, but it could be done.

I met with another bariatric surgeon at another hospital to get a 2nd opinion.  He recommended re-attaching the device exactly where it was originally on the abs, and just securing the port properly this time.  I agreed with the logic of this, and returned to my surgeon and requested that this be done.

Yesterday was the big day!

hospital

Pre-Operation

I had no pre-operation testing done, as I had to with the original gastric banding surgery. I had no psychological exam, no overall physical. I did not need to get a referral from my general physician. I did not have to do the breath test. I did not have to drink that horrible barium drink. I did not have to get X-rays (probably only because you could clearly see the detached port, without the need for the X-ray!). I did not need to get any blood tests done.  No pre-testing at all. I simply called my surgeon to say, “I’m ready for this to happen; can we please schedule it?”   I was told not to eat or drink anything after midnight the night before surgery.  I did not have to do that full line of laxatives.

Day of Surgery

I showed up at the hospital yesterday at 9 a.m. and checked in at the main desk. They took me to the surgery’s waiting room where I checked in a second time. They gave me my wrist band there.  After waiting for a few short minutes they ushered me into the prep area. They asked me to undress and put on the room (disrobing everything–no bra or underwear). They gave me booties and a saucy little cap to wear. I took out all body jewelry. They asked me 1010 questions about my overall heath and medical history, my emergency contact information. They had me sign a few forms of paperwork consenting to the surgery, the anesthesia, etc.  The nurses took my vitals (blood pressure, temperature, pulse, CO2 levels). There was nothing invasive about this, nothing painful. I was in a good mood, actually–I couldn’t wait to get this done!

My surgeon had originally requested that I only have local anesthesia, which means that I would be drugged up but essentially awake during the surgery. However, when my anesthesiologist came in, he recommended that I have a combination of local and general anesthesia, and I wholeheartedly agreed with him. I did NOT want to be awake for a single moment of it! I happily signed the consent form for the combination treatment.

My surgeon, Doctor P, came in to say hello to me and to discuss exactly what was going to be done. We agreed that we would replace the port on top of the abs, in the same location (he uncovered my robe–with a nice view of my cootch of course–to look at any other options for putting the port. We didn’t really see any, so we decided to keep it in the same spot. He explained that he would go over the old incision this time, then place the port a few inches to the right of the incision. (The port can’t be directly under the incisioin because it would probably pop through it.) He could, however, replace the port with one that is smaller in circumference and lower profile.  What do I mean by “lower profile?” Well, you can kind of see the difference in these two photos.

The picture on top clearly is higher/more raised up than the port in the 2nd photo. I believe he changed my port to a smaller/lower port.

He said that the port is attached using something comparable to a nail gun that is strapped into the abdomen.

During this process Doctor P asked if he could look at my body to assess my loose skin. He asked if I was interested in getting a tummy tuck or have loose skin taken care of. I said, “HELL YES and please feel free to take care of that today if you can!” He laughed and said he couldn’t.  He looked at my skin and it’s honestly not that bad, but the worst area is definitely my lower tummy. He asked if I would like to meet a plastic surgeon, and I said yes please. I thought me meant a referral, but no–he walked out and returned with a plastic surgeon friend of his who was in the hospital today. That plastic surgeon took a look at me and said he could help. (again, lifting my gown–another full cootch shot! I swear I was a vagina-flashing machine yesterday) and actually laughed when I asked if insurance might possibly pay for the cosmetic surgery, to which he said, “oooh definitely not. You don’t have enough loose skin.”  But he gave me his card and said that we could definitely negotiate a price–he chargest flexible rates that vary depending on the amount of work that needs to be done. When he left the room my nurse whispered, “I’ve seen his work and he’s VERY good, if you were interested in that.”  Hmmmm….interesting!

After that it was just a few minutes of waiting. They added some pain killer to my I.V. and then they wheeled me into the Operating Room around noon. I remember looking up at the lights in the O.R. and they were a little fuzzy to me, so I asked the nurse, “Was that pain killer you added to my  IV back there?” and she said yes. About .000005 seconds later I blanked out. And that was it!

The surgery itself lasted an hour and a half, which really surprised me that it took so long!  I woke up around 1:30 in the recovery room. I remember during my original surgery I took about an hour and a half or 2 hours to wake up from my anesthesia fog. This time it was about 20 minutes tops. And I felt really rested and recooped too!  My abs ached a little bit, but it wasn’t too bad. On the pain scale (0=none; 10=lots) I was about a 4. I felt pretty good!

I drank a little apple juice, changed my clothes (a little painful, since it involved the use of my abs), played a game on the Ipad with my husband, and then they wheeled me out of the hospital. That’s  it!

After Surgery

I was really surprised at how painless this surgery was, especially compared with the original surgery. I had my hubby pick up my prescription to pain meds on his way back from taking the cat to the vet.  They prescribed my Oxycodone, which surprised me! That’s heavy duty stuff!  Well, let me tell you what….about 2 hours after I got home the medicine they gave me started to wear off, and the pain level significantly increased. One oxy, and it was much better.  I went to bed at night with no problem. But when I woke up, ooooh my pain was up to a 6!! OWCH!  I took 2 Oxys and I’m feeling significantly better now.

As for food, yesterday I had soup–tomato soup and then chicken noodle soup. I realized afterwards that it went down SUPER easily.  I am not sure, but I suspect some saline came out of the band when they replaced the port.  (((insert sad face here)))  I hope that’s not the case, but I have to see my doc in a week anyway, so I can just get filled up at that time.  I wonder how the surgeon knows that the new seal around the port is working properly? Hmmm.  Today I will move to more solid foods to see how my tightness level is.

Here is a picture of my tummy today…already I can tell that there is less “pooch” to my stomach because of the flatter port, even though my tummy is significantly swollen from the surgery.

I think that pretty much covers everything. If you have any questions, just ask!

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Off to the hospital for gastric banding round 2!

by Christine on July 6th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

I’m off to the hospital in a half an hour to get my broken port fixed! I’m nervous (mostly because he’s using local anesthesia, which means he’s not knocking me out! AH!) but mostly I’m just excited to get this baby fixed. It’s been detached since Surgery #1 two and a half years ago, and it’s just gotten more obvious and more detached since then.  I hope this fixes it for good and that it is no longer noticeable!!!  Wish me luck!!

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