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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Constipation and port replacement surgery do not go hand in hand.

by Christine on July 12th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

Constipation. Port-replacement surgery. Let me tell you something, folks. The two do not and should not go hand-in hand. I haven’t pooped in about 2 weeks, and my body finally said that it had enough. It had a two-week compacted, compressed poop that was about 14 miles wide and hard as a fucking brick firmly lodged somewhere in my poop track.

Even on a good day that piece of shit would have been hard to push out of my body. On a good day it would take a little stool softener, some prune juice, some abdomen rubbing, some wiggling back and forth to loosen that baby up and get it moving on its way. I’d probably put on some relaxing music in the potty, some ridiculous glamor magazine that was handed down to me. I might file my nails on the potty or brush my cat’s fur while waiting for the action to happen.

But add into the mix a very sore abdomen–so sore, in fact, that I’m on some pretty heavy-duty drugs to make the healing process better, and you get a very ugly scene.

This morning I woke up SOBBING on the toilet. It hurt so bad I stuck a suppository up my ass.  (Leftovers from the first time I had the gastric banding surgery, I might add, so we’re talking about 2 year old suppositories. Do those things have an expiration date?) I laid on the bathroom floor massaging my abdomen. I sat on the toilet and was rocking so hard back and forth that I nearly rocked the toilet off its base. I prune juiced it, coffeed it. I laxa-tatived it.  No matter. This ginormous piece of shit was going to lodge itself stubbornly just out of reaching room, just inside my syphinxtor, and there wasn’t a damn thing I was going to do about it.

It was a real lose-lose situation. Either I was going to go to work with a painful turd stuck inside me all day, or I was going to have to risk tearing my poor abs apart trying to push that son-of-a-gun out of me. I opted for the 2nd choice. In the end I was victorious, but let me tell you, there were some casualties along the way. Each of my 6-pack gunmen are down for the count, and I’m not sure what kind of resuscitation I need to do to bring them back to life.

I’m pretty sure my neighbors heard my orgasm-like screaming as I was finally freed from the concrete poop. They’re probably going to high-five my husband the next time they see him mowing the lawn.  There’s a fine line between shrieks of ecstasy and cries of pain, let me tell you. I doubt I’ll have to heart to tell them that my husband is not, in fact, “da man” and it’s my toilet that deserves praise for its hard work today.

A note to anyone that will be going through the gastric banding or port replacement surgery in the future: start taking stool softeners regularly so that when the “urge” hits you, it hopefully won’t be a painful process.

Holy cripes.

In better news: A Dance with Dragons (by George RR Martin) hit the bookstores today! Did you get your copy??

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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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Port Replacement Surgery Scheduled!

by Christine on June 22nd, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

Take 2!! My new surgery date is July 6th. This will replace my obviously dislocated port. Woohoo! I’m so glad they could squeeze me in SOON!  The doctor said the port replacement surgery will not involve any Pre-Admission Testing (aka: that super-disgusting barium drink. UGH!) and will be a 30 minute procedure using a local anesthetic.  Obviously I’ll have to take that day off from work, and I think I’ll take the next day of work too (although that would probably be unnecessary???).  Doc says no heavy lifting or anything for about a month after surgery.

I am relieved that the surgery date is on the books! They are still checking to ensure that my insurance will pay for the procedure.

In other news, I was doing a lot of running around for work these past few days.  I work for an engineering company, and we’re demonstrating a new remediation technology to a bunch of important clients. Today I was running around a sand quarry in a torrential downpour, overseeing the putting-up of a tent, the catering delivery, schmoozing with the important people, etc. I love being out on site, whether that’s at a construction site, checking out a completed project, etc. It really gives me a great sense of appreciation for what we do, the clients we serve, and the kinds of projects we do.  However, running around and schmoozing leaves me dead tired, not to mention always a little frazzled. “Did I do enough? Did they like me?” Ugh, I hate the second-guessing game.  I stopped at home for lunch and made a pot of tomato soup (with skim milk).

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