Rough Road With My Band - COMPLETE UNFILL!!!

I've not been on these boards for quite some time but I'm sure there are still some familar faces around.  I am 18 months out of surgery and I have always had a tough time with my band.  In the beginning when I lost the most weight it was me struggling with the loss of food and being able to eat like and eat whatever "everyone else did"  but in the past 6 - 8 plus months it has been not being able to get to the right spot with my band.  

I've holding out on going to see a Dr. due to insurance and job change so my last check in was very end of October where I had a very small fill.  I had started to suffer from reflux in September and the band was checked (fluoro) and it was fine - no slip. 

However in the last 2 months my reflux has been so severe that I can't eat or drink anything without major burning in my esophagus and pouch area.  After about a straight week of feeling on fire with no relief from an OTC acid reducers or tums I decided to seek out a new Dr. 

I had my appointment with him yesterday and he got all my history and obtained some notes from my other Dr. Due to the severity of the reflux, he said my stomach really needed a break and we needed to find out what was going on and he did a complete unfill!  I am TERRIFIED!!!!  I haven't had an empty band since I had surgery.  

He put me on meds for reflux and scheduled for a barium swallow and blood work. 

I am curious to know if others who have had unfills or slips.  How you got through it with no fluid in your band.  Did you gain weight, did the issue get resolved.   Anyone else have issues with severe reflux and if so was it a slip, erosion or just your body reacting to the band? 

My surgeon was optimistic about wanting to do a revision - he said for sure if there is a slip I can either revise to another surgery or fix the band.  He asked me if I liked the band and was I happy and I told him no that the band has not exactly been ideal for me having battled fill, unfill, fill, unfill for the past year and never being able to get in a good zone and sliming and pb-ing all too frequently and just never really do well with many solid proteins. He simply turned to me and said  then will just take the damn thing out and revise" . I was surprised he was that light about it but perhaps he has soon way to many issues with the band in his patients. I'm not sure...he was not exact the band but it certainly did not seem like his WLS of choice.

The recommendation was that revising to another resitrctive procedre was not the best choice for me to get to goal and he was rather adamant about revising to RNY and not a sleeve.  He also said that if there is not a slip and the reflux was that severe with only 4cc in the band then the band mechanics is just not ideal for my body and I can't keep having such severe reflux and not be able to eat regular food (non sliders) and in that case it should still come and be revised. 
 
He is hoping to be able to use the last year of medical history and visits to my previous surgeon as "attempted" weight loss for insurance purposes.  The issue with the insurance may be that regardless if there is a problem with the band, they may require another 6 months of presurgery diet/weightloss history attempts. The office in fact told me that if the band has to come out for medical reasons, potentially based on the insurance that I would FIRST have to have it removed and then wait the six months and go through nutrition counseling AGAIN and then have to get approved AGAIN from my insurance. I don't even have the same insurance policy as I had when my first surgery was approved.  I'm already frustrated.

I've asked some other OH'ers who have had revisions if they experienced this so I'm waiting for some feedback.

Trying to take one day at a time but that is easier said than done especially with the fear of weight starting to come back on while things are figured out. I told him I cannot go back to where I was before.  So I am hoping once he gets the tests results back we have an answer and can move foward one way or antoher.  I just hope this isn't along road ahead of me.  If I end up having to keep the band, I will make it work the best I can and the best my darn body lets me but I hope if for medical reasons it does not stay that I still have an opportunity to have another WLS.  I still have 100lbs to lose to get into a "normal" BMI!!!  Fingers, toes, hairs everything crossed over here that I'm not going to battle with this friggin' insurance company to help! 

 I am currently unfilled due to an ulcer that was diagnosed with an endoscopy I had done a little over a month ago after having problems with heartburn for several months.  During this past month I've lost about 5 lbs.  So, being unfilled does not mean that you will gain weight.  I am eating low-carb, stick with bandster-size portions, and eat 3 meals and 2-3 snacks a day.  Basically, I went back to what I was doing while losing weight during my first year of banding.  I am hoping my current unfill plus treatment with a Protein Pump Inhibitor (PPI) will resolve my problem and that I can re-gain restriction in a few months.  If I continue to have heartburn at a moderate fill level, I may be looking for other options as well.  

I'm not sure why the doctor has you scheduled for a barium swallow after being unfilled.  It's my understanding that the barium swallow is just to show the amount of fluid passing through the band, which is a moot point with no fluid in there.  You need an endoscopy to see inside the band, to determine whether you might have an ulcer, erosion, or slip.  If it's a slip, the unfill may correct it, and you may be able to re-fill the band after a rest (if you want to continue trying with the band).

But, even with good restriction, you still have to make good food choices and exercise.  No weight loss surgery is going to allow you to "eat like everyone else", but a malapsorptive surgery may get you better weight loss results.  Keep in mind that even gastric bypass patients tend to regain their weight after a couple of years unless they have learned and stick with new eating habits and exercise.  

Tami

Wow, we could be twins.  I had my lap band placed 9/14/2009.  I lost about 70 lbs within 8 months and haven't lost any since.  I have had a year of fills, unfills, stuck issues and pbing.  I had a barium swallow and an upper GI, and everything was fine.  However, I recently got a fill of .5--half of what I had taken out prior to Christmas.  And guess what???  Again having issues.  It doesn't matter what I do.  I just post on the VSG board that I was approved, yesterday, for lap band removal and a sleeve.  I am so happy because the ins. co. had initally denied the request.  Even the nurse was surprised! 
If you can, get revised.  I am not a proponent of any surgery (except I can say with confidence that I would not suggest the band to anyone), so whatever you and your surgeon deem best for you.  But I would get rid of the band if at all possible.  It isn't going to get better--I thought the same thing; if I had to, I would deal with the band.  But since my fill, I know that I can't.  Even if I hadn't gotten approval for the sleeve, I think I would be getting the band out.
Good luck to you!  I am keeping fingers crossed for you too!

Wow that is crazy!  Can I ask on what grounds they approved your revision?  My Dr. seems to feel that if it was a "mechanical error"  meaning like the mechanism of the band just didn't work well on a particular patient and their body did not tolerate it and always caused problems for which we would contstantly have to be treated, then it should approved under a revision.

Are you getting a removal and sleeve done at the same time.  Did the mention anything to you about the sleeve giving you the same issues because it's still restrictive procedure?  That is what they told me but I see so many people go from a band to sleeve and become rockstars!

Trust me if I have ANY opportunity to get rid of it I will but at this point in fear I would keep it if I had to and perhaps just deal with it unfilled rather that get it removed and keep trying for a revision.  I would honestly not take back having the band - I would never have lost the weight without it but if I had it to do over again my choice would be VERY different despite any risks! 

My reflux is not as bad to today since being unfilled so I hope that gets better.  With nerves playing a role I don't have much of an appetite today anyway.

Congrats on getting your revision....hope some of those good vibes rub off on me!

I will send many good vibes your way.  They didn't really say why it was approved, and I don't know the wording the dr. used in the paperwork. But I can tell you that I have had 15 fills and 5 unfills in 18 months.  I have documented my journey, and I think that they sent that in with the request.  The only thing they mentioned about the sleeve is that there is a slightly higher risk for problems because I have already had one surgery.  However, the dr. is doing it in two surgeries.  She will take the band out first and then do the sleeve to lessen the problems.  It does scare me to go without a band for two months, but I know what's coming so it will be ok!

Sorry to hear that you are still having problems!!  (((HUGS)))

I know that there are some people's stomas that just do not react well with the band.  I would gladly revise to a sleeve or RNY if I could, only because after losing over 60% of my excess weight, I don't think the band is going to do much more for me.  Your insurance situation sounds a bit cumbersome, but worth it, if they are willing to pay for another surgery!

Mel!!!!  Good to see you on hear again.  Never see you on FB! Yeah here I am still kicking and screaming but not giving up!  I think that is what my Dr. was trying to convey to me as well with band and some people. 

I sure will keep everyone posted on the results of my barium swallow.  (well fluorosopy)
Oh and to the first poster.  I have had several of them before and they do clearly show you the band and the position of it around the stomach - your pouch is visiable and if there is a slip the barium goes in an odd way down through the pouch.  I've already gotten to see the xray of mine up against one that had a slip and they are very different.  Perhaps if he is not satisfied with the xray he will send me for an Endo but I hope not.  I had one of those in the recent past as well but not since the reflux kicked up so bad.  

I know in the past you struggled with carbs and eating some stuff you really shouldn't and it would cause a snowball effect.

Until you get this all resolved my suggestion to you is not to attempt foods you haven't eaten like a hamburger if you feel this will trigger a snowball affect. We have to be HONEST with ourselves we have food issues period. dot. end.. if we didn't we wouldn't of let ourselves get to 300+ pounds (and I'm speaking really for myself I let myself gain that weight because I love food) but be super honest with yourself with the choices you make while you are unfilled.. you can still lose weight or at least maintain as your waiting to hear back from the dr and until you get revised.

I know before surgery I went on a want to try that before I get banned gorge and I gained an additional 10 pounds and I regret it.. I wish I would of attempted to lose some weight on my own before I was banded.. but hey that's just me.

Good Luck.

I know where you are coming from.  I went through that initial stage of having regrets about food I felt I could never eat.  Most of which I don't even care about anymore but I certainly can't eat the things well that  I should be eating which is now a concern.  I would have chosen a grilled chicken breast 9/10 times even pre-surgery when I was trying to be diligent - that's not so much an option for me now.  It just doesn't work.  Then with reflux I sometimes just don't want to eat at all because the burning is too severe.

I've never eaten a burger or a sandwhich since surgery - doubt wit the band still in place that I could now even with no fill. 

i'm quite honest with myself and my doctors about how my choices aren't always the best but if they were I wouldn't be here in the first place - none of us would.

I realize now after being unfilled I have to be extra careful as the band probably won't do as much.  I just hope I don't encounter stress and discouragement in the process which could drive me to food as a source of comfort.

I did the same funeral diet for 2 months before my band and probably gained the same as you..maybe more.  I never even had a true presurgery weight before I started my liquids.  Mine was jut an estimated and probably a conservative one.   I too regret doing that and do not intend for that to remotely take place before any revision or maintenance to my band. 

I too do not have anything against the band, despite my struggles and food issues that persist I still have lost quite a bit of weight an anytime I have been in a gaining phase I've always only fluctuated between 5-max of 10lbs.  I really do try to stay on top of my WLS - I went through all I did to have surgery, I'm not just throwing my hands up so now with these new issues persisting I'm just going to stay on top of it again and see where it takes me...all I can do!

Thanks for replying!

I'm so sorry for your problems with the band .

As far as you losing weight with no fills yes you can do it ,  if you go back to your way of thinking oh I can eat this , that and it dont matter now you will gain weight.

I am three months post op and I have never had a fill . My band is totally empty and I'm going to be see my doc here in a two weeks and I Will yet again skip another fill .

I eat low carb nothing above 50 carbs a day sometimes I go to 60 depends but not very often. I keep my calories around 800 to 1200 per day.

I exercise 4-5 times a week .

I have it set my mind that I all I need is one cup of food no matter if I can eat more or not.   I eat at least 25 grams of protein per meal and I can go as long as 3-5 hrs without physically being hungry.

Now , I can sit here and obsess about food . Say , boy I wish I could eat that, or I cant wait till my next meal and I can make myself physically hunger anybody can do that. 

I dont allow food to become my obsession anymore and I believe that is why I have been so successful without any fills yet.

I see my doc every four weeks and I lose nothing less then 7 pounds every four weeks !!

I'm starting to get alot of self control and alot of willpower since I had this surgery . If you dont have them two things anyways I dont think any kind of WLS  will work , but that is my opinion only :o)

Good Luck I hope things work out for you !!!