Busted my port (even more)!!

by Christine on June 11th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

Dang it! Yesterday I busted my port even more than it already was.

For those that are joining me recently, I have a dislocated port from my gastric banding surgery. You can read more about it by clicking here and scrolling down to “port problems.”  So the port is supposed to be attached to your abdomen by four little hooks on each corner of the plastic thingie. Previously, my port was attached by only two hooks; two hooks came undone, so the port stuck out periodically. It was very noticeable.

Yesterday I was out golfing after work, and man, my back really hurt! So I asked my friend if he would please wrap his arms around me, with the fists of his hand in my back, then squeeze and wiggle me around until my back cracked. He did it, but instead of my back cracking I felt this weird “POP” feeling in my abdomen. It didn’t hurt at all; in fact, it rather felt like cracking your knuckles.  Noticeable, but not painful. Perhaps a little “oogie” weird feeling.

Sure enough, I felt around and I lost yet another attachment, so my port is only being held on with one hook! Darn it!  It sticks out ALL the time now,  and is quite uncomfortable.  My clothes rub against it. When I lean over or lay on my stomach it hurts. When I carry my laundry basket or boxes or anything remotely heavy, it brushes against it and hurts.  It hurts more NOW than it did when it POPPED out of place!

The Bulge again. I'm not making this up.

(above, PREVIOUS port stick-outtage, from May of last year, 2010)

(Above, CURRENT stick-outageness, June 2011)

I need to get that fixed, and ASAP!

“But Christine! Didn’t  you schedule a time to get that fixed?’

Why yes I did, and ironically this weekend I was supposed to have surgery to get the port re-attached. However, the woman that works for my surgeon that was supposed to do the scheduling ended up quitting before she made the arrangements. And I didn’t know she quit until about two weeks ago when I called the doctor to say “Hey, I’m supposed to be having surgery in 2 weeks and I haven’t heard about the pre-admission testing, gotten confirmation that my insurance will pay for this, haven’t heard a PEEP from you guys. What’s up?”

(To which they told me that they didn’t have any record of this, so I’ll have to start from scratch in rescheduling.)

I hope my doctor can get me in soon. I need to get this baby fixed!

In other news, I golfed really well yesterday. Well, I suppose I golfed average overall, but I had a LOT of really stellar shots. Today we went bowling and I got two Personal Best records! I did awesomely!

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What to do with my dislocated port? More options!

by Christine on March 5th, 2011

filed under Christine's Life Updates, Gastric Banding Surgery

Yesterday I had a meeting with my gastric banding surgeon, Doctor P. It was a great meeting!

First, I gave him that Thank You card that I made, and I think he liked it. (I think it flustered him a bit!) I am extremely grateful for Doctor P’s help in getting me to a healthy weight for the first time in my life. I tried so hard to lose weight the normal way (aka: eat right, eat less, exercise more) with continual non-success. I really believe I could not have lost the weight if not for the surgery and thus Doctor P’s help. I am very grateful. Very.

Doctor P

Me with Doctor P!

Then I asked Doctor P for a little fill…just a tiny little one. He obliged my request but not without a long lecture about “Maintenance Mode” and the danger of following a number on the scale too closely. Doctor P recommended using the number on the scale as a general guideline: if the number increases, rather than running for a fill every time, I should ask myself, “Why did that number go up?” and then reverse whatever it is that I did.  Still, he gave me less than 0.25 ccs in my band (I apparently have something like 8.5 ccs in my band, for those that care) but man, I sure can feel it! It’s very tight, but it feels good. I will have to remember to chew my food really well for the next few weeks.

Doctor P asked me if I would mind getting in touch with their patient manager, perhaps to be used as a “successful patient” case to show off. I was flattered!  Then his assistant Kim, who is awesome and totally sweet, asked if I would mind coming to a few support group meetings to answer questions and talk a bit about my own experience. I can’t wait to do this!  Again, I was flattered that they would want me to participate.

Lastly, Doctor P and I had a little conversation about my protruding, dislocated port site. (My original post about my port site, from May 2010, is here, with photos.)  For those unfamiliar with the components of the surgery, a description + photos of the port can be found here. The last time we met, Doctor P seemed to recommend taking the port off entirely and putting a plug into the end of the hose. (read about that post here.)  That means that anytime I wanted a fill or unfill, they would actually have to make an incision into my skin in order to find the end of the hose, which would understandably be a big to-do. However, I’m very uncomfortable with that scenario; after all, I went in yesterday for a small fill. I had this HUGE surgery because I liked the idea of having a way to keep my weight in check, forever. I fully intend to use the gastric band in order to maintain my weight, and if you take the port off, that takes away my control over my body, my band’s control over my weight. No, I don’t like that option at all.

Well, Doctor P threw three more options at me. Before I get into it, here are a few photos of the abdominal muscles.

Option 1: Re-attach the port site to the outside of the abdominal wall, as it was supposed to be originally. The good side of this is that it’s the least invasive and probably the easiest surgery to achieve.  The downside is: (1) if the port came off once, it might come off again, and (2) even though the Realize Band has the thinnest port of all the gastric banding brands (it’s nearly twice as thin as the Lap Band port!), it will still be seen under the skin. Doctor P was still concerned about it eroding through my skin, since I don’t have a huge layer of fat under my skin to protect it from popping through.

Option2: Attach the port UNDER my abs. He said that has performed this version four times in the past: all four times have been with male patients. He said that men typically carry their fat UNDER their abs, whereas women typically carry it between the abs and skin. Therefore, he put the port under the abdominal wall because it would be less likely to be noticed and wouldn’t erode through the skin. However, he said in two of those four cases he ended up having to do another surgery and move the port to above the abdomen. The reason for that is because (1) the abominal tissue is extremely tough and tends to clog up the needle used to inject saline into the port, and (2) the abs scar pretty badly, making it really tough to poke through. I have to imagine that finding the port would also be hard, so it would end up being a lot of poking & jabbing with the needle until you found the right spot. That sounds hugely painful, doesn’t it?  I am not sure that I like Option 2 at all. It freaks me out!

Option 3: Doctor P thinks it would be possible to cut a small hole into the abdominal muscle and actually EMBED the port into my abs. That way it would still be easily accessible from the outside, but it would be more flush with the skin and not noticeable. It would not cause erosion through the skin this way. My surgeon has never personally done this before, and he said he would call around to other surgeons to see if they have heard of doing such a thing. I like this option a lot, but I have concerns about whether this will limit my range of movement & muscle capability in my abs (Doctor P says it wouldn’t but how could it NOT?) plus I’m concerned about how painful that surgery must me and the healing time to go with it. Still, I think I like Option 3 best, in addition with Option 1 (which I agree is perhaps not the best long-term solution).

So I have three options on the table. Which one makes the most sense to you? Which would you choose?

I have another appointment with another surgeon next week, so I’ll get someone else’s opinion at that time.  It seems like a big enough decision and a big enough surgery that I wouldn’t mind getting another opinion about my options. This is by no means a reflection of Doctor P, though.  He’s been nothing but totally awesome through this whole process, and I really appreciated him giving me more options yesterday.  He has given me personal attention and personal care through the whole process (he even does my fills himself, rather than having an assistant do it), which is definitely something unique to my gastric banding experience.

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Titilating Tuesday!

by Christine on August 31st, 2010

filed under Christine's Life Updates

Okay just ignore the title there. I wanted something alliterative, and this is all I could come up with.

Still sick. Getting better, definitely not going to die from this little cold. I went to bed around 8 p.m. last night. The sleep felt fantastic. I probably could use a little extra sleep now and then.

Yesterday I finally called my surgeon’s office and made an appointment with him. First of all, I want to get my port looked at.  I told my hubby that he has to come with me. What will happen is Dr. P will say, “Ah, Christine, that port is fine. Looks normal,” to which I’ll be a pussy and say, “Oh. Okay. It doesn’t seem ok to me, but whatever you say Dr. P, you’re the expert.”  Instead, hubby will be there to say, “Expert or not, this shit is NOT NORMAL and you WILL FIX IT. She does NOT want to go through life with this alien port getting in the way all the F-ing time. It’s broken. Fix it.”  See, I can’t seem to utter those words myself, so I need to bring in the reinforcements.

I’ve given it some thought, and I think I want a small fill as well. I’ve been eating more than I normally would, and things like bread are going down just fine, and they shouldn’t be. (DO NOT ask why I even KNOW that bread is going down. Why am I eating bread at all? Why go there??)  Anyway, a little tweak, and I should be fine. The weight loss should continue. It’ll be a challenge to convince Dr. P to trust me on this one when I know he’ll see my weight loss since my last doctor’s visit and claim that I’m doing just fine where I’m at.  I guess I’ll jump that hurdle when I get to it. My appointment isn’t for another three weeks anyway.

Hubby has never sat through a “fill” appointment before. I am secretly eager to see the look on his face when the doc pulls out the Mega Needle and jabs me with it. Ha.

Oh, the grand adventures in lap-band-land.

Yesterday’s intake:

8 a.m.: 3/4 cup cereal (100) plus skim milk (25), Dayquil (100)
10 a.m.: Almonds (45)
Noon: Homemade gazpacho soup (100 at most)
1 p.m.: Almonds (45)
3 p.m.: Crackers (60) and peanut butter (120)
7 p.m.:  Tyson chicken patty (180)  plus less than one slice bread (40), diet pepsi, Nyquil (100)

Total Cals: 915

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Common questions (with my answers) about the gastric banding surgery

by Christine on July 16th, 2010

filed under Gastric Banding Surgery, General Information

Gastric BandThese questions are based on keyword search terms in Google that directed visitors to my site. I hope these answers clarify some questions that you, my precious readers have about the procedure. If you ever have any questions about the surgery, you can always email me at: Sherazade96(at)hotmail(dot)com.

What are common gastric banding problems?

Great question! There are several complications that arise from the surgery itself as well as the band and port that are placed inside of you.  The most common complications, according to WebMD, are nausea and vomiting. These can be caused by the tightness of the band.  Minor surgical complications  (which occur less than 10% of the time) include problems with the adjustment device, wound infections, and minor bleeding. For instance, if the band is too tight or you “overeat” your band, you can cause the band to erode through your stomach lining.

Other possible risks include:

  • Band leakage
  • Acid reflux and/or vomiting
  • Erosion of the band into the stomach
  • Enlargement of the stomach pouch
  • Band slippage
  • Dehydration
  • No weight loss and/or weight regain
  • Blockage of the stomach outlet
  • Gas and bloating
  • Nausea
  • Constipation
  • Ulceration
  • Gastritis

So what about me? What have been my complications?  I do have regular acid reflux (never had it prior to surgery) that I treat with a Nexium pill every three or four days, as needed.  I also had stomach pain at one point, so I went to the hospital and was told that I had three stomach ulcers. I suspect these were caused my an overly stressful work situation, but they could have been caused by the gastric band.  I also suffer from mild-but-annoying constipation (read more by clicking here).  Finally, I have a problem with a protruding port. This is most likely caused by my port coming detached from my abdominal muscles, but I haven’t seen my surgeon to verify this. (Click here to read more about port problems)

Risk of death due to this surgery is about 1 in 2,000 patients.

Does the gastric band hurt?

I guess the answer to this is “yes and no.”  Immediately following surgery, I had pain and discomfort. My neck/back/shoulders hurt like a mofo because of the gas they use to inflate your stomach during surgery. This gas escapes the body by creeping upwards to the shoulder area.  I also had pain where they attached the port to my abdominal muscles. In both cases, the pain subsided less than a week after surgery.

When I received fills, it did not hurt. An inflated band did not hurt me.

Since that time, my gastric band does not hurt and should not hurt its patients. I’ve lost a substantial amount of weight, and because my port is protruding (really, I need to see my doctor about that) I sometimes lean on it funny, so it aches. But this is abnormal. I do not believe that the gastric band should hurt after you have healed from surgery.

My gastric band is still sore after a year?

Like I said above, it may be somewhat common for the port site to rub against something and get a little tender. And, of course, after your fills you should be a little swollen in the band/stomach area. Otherwise, But if your band hurts, much less a whole year after surgery, this is not normal! It indicates to me that you might be experiencing band erosion or an infection or something. Go see your doctor.

What are potential problems with the port after gastric banding?

The three most common problems specifically associated with the port are: port displacements, port rupture, and port infection.  Port displacement is where the port comes detached from the abdominal muscles, so it ends up kind of floating around. (This is currently what I am experiencing.)  Port rupture is where the seal on the port is not tight, and therefore leaks liquid (saline) into the body.  Tearing of the silicone rubber can be a manufacturing problem or can be caused the injection needle wiggling it loose.  Port infection usually presents itself early after band placement, according to a 2008 study.

Why can’t you eat celery with gastric banding?

Hmmm, curious question, but I like it! I’m going to guess that it is caused by the “shredded” nature of the celery stalk. You know how you can “shred” the celery like you can with string cheese? I’m going to guess that the celery shreds get wrapped up and caught in the small stomach opening, exactly the same way that long hair can get caught in a shower drain.  I recommend chopping the celery up horizontally into chunks (“against the grain”) like you would see it in a crock of soup. Then you should be fine.

What happens if you spit up your food after having gastric banding?

This is totally common!  When you eat something that is too chunky, you don’t chew well enough, or perhaps is too doughy and clumps up in your band, then that food will sit on top of your stomach opening and have nowhere to go. Then, your body starts producing saliva (often called “sliming”) in order to try to break that food down with enzymes.  If you’re stuck really good, then that saliva will just build up. Then BOOM! You need to go puke your food up. This is really common, so get used to it. Learn to chew really, really well.

Is it common to be gassy with the gastric band?

This is one of the common side-effects of the gastric band.  My personal experience is this: for about 4 months following the surgery, holy smokes I was gassy! I farted maybe 100 times a day. It was pretty much silent and not-smelly, but it happened all the freaking time.  Eventually as my stomach started getting used to this new device gripping it, my body stopped producing so much gas. Nowadays, I’m back to a “normal” gassy state, as I was prior to surgery.  However, I wouldn’t be surprised if some people experience gas forevermore. I appear to be a “forevermore” person with my acid reflux; I assume gas would be a similar issue.

Should I be able to feel the port inside the stomach after having gastric banding surgery?

Well, the port isn’t inside the stomach.  The band is around the stomach and no, you shouldn’t be able to feel that through your skin! You’ll certainly notice the band as you start to get it tightened though!  But perhaps you mean the port.  For most people, the port is either located near your belly button or it is placed just under your sternum/breastbone. Can you feel the port through the skin? Initially, probably not. Most people have a substantial amount of fat covering the port, so it shouldn’t be really noticeable unless you press hard. As you lose weight, it will become more and more noticeable! This is a good thing: it means you’re losing weight!  Eventually, YES, you will certainly be able to feel it and, perhaps, even see it through the skin.

Is loss of appetite with the gastric band common?

Yes and no.  I mean, the gastric band is supposed to reduce the amount that you eat, but it does not necessarily work like a diet pill in actually suppressing your appetite.  So, theoretically your appetite should remain intact.  However, many people may notice that at certain points—especially immediately following a fill—that your appetite gets killed. I think this is normal, and eventually you’ll get hungry again. If loss of appetite becomes an ongoing problem, you may want to talk to your doctor about it. It could mean that your band is too tight.

Currently, I eat about 5 or 6 small meals per day. I eat to the point of fullness, then I stop. However, because I’m eating very few calories, I get hungry again 1-2 hours later. So I eat again. And so on. I DO feel hunger. Frequently.  I hope that explanation helps a bit!

If the doctor okays a gastric band how long does it take to have surgery?

That totally depends on your doctor and how long his/her waiting list is, and how long it takes for you to get approval from your insurance company. This could potentially be a very long process. For me, it probably took about 4 months after my doc okayed me for surgery.  For instance:

  1. First I met with my doctor to get evaluated and given a basic health physical. Let’s say that was at the end of October.
  2. My doctor then okayed me for surgery, pending the okay of several  people.  Let’s say this was November 1st.
  3. For the whole month of November I had a series of doctor’s appointments: a psychological visit, pre-hospital testing involving x-rays, a vile milkshake of barium to drink with more x-rays, and respiratory tests.  I also had to get a letter of approval from my GP.
  4. January I started my Medifast diet.  I had 8 weeks to lose 10% of my total body weight. I weighed 225 so I had 22 pounds to lose.
  5. Mid-February I had more testing to do at the hospital to clear me for surgery.
  6. I had my surgery at the end of February.

Why can’t I access the port to my gastric band?

The only reason that I can think of is that the port site has moved. The reason why it moved could be that it has dislocated itself from your abdominal muscle.  Also, it could be that the rubber silicone area of the port (where the needle is inserted) may have malfunctioned. Either way, this is not good, not common, and you should ask your doctor what you need to do to fix it. I’m not a surgeon, but I’m going to guess that you’ll need to have surgery to replace the port or to get it re-attached properly.

Gastric band port came through my skin…what now?

Yowch!! But, I’m facing a similar threat because of my port site! Go see the doctor IMMEDIATELY! An open wound like that can easily get infected. See a doctor now! Go! Shoo!

Interesting in learning more about the procedure? Have questions that aren’t answered? Then check out these pages:

Here are some resources about difficulties I’ve personally had with the band:

I know that there are other gastric banders reading this blog post. Can you offer any personal insights into the questions posed above?

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