Ask Dr. Curry

Dr Curry...I am 9-days post op and yesterday and now today I have this very sharp pain under my left rib cage....I'm thinking I'm gulping my drinks too fast.  Any idea what this pain might be.  I did put a call in to my doctor.
Thanks

I had the same thing.  It is gas.  It just had to works its way out.

Dr. Curry - I had lapband surgery on April 8th of this year & since then, my surgeon & I have been working to determine what the best amount of saline is for me.  The first fill (5.5 cc's) was way too tight & I ended up having quite a bit of vomitting, heartburn, & back pain.  After 17 days of that, I just couldn't take it anymore & called the doctor.  They squeezed in an appointment for me & removed 1.5 cc's, leaving me with 4. 

At my next appointment three weeks later, my surgeon & I found I hadn't lost any weight (less than 1 lb.), so he put back another cc of saline & I am now at an even 5 cc's.  Afraid of going through what I went through after the first fill, I've pretty much avoided solids, so my diet for the last 14 days has consisted of pretty much nothing but protein drinks & have lost 9 lbs in those 14 days.  The four times I have had solids (veggie beef soup one time, mini pretzels two different times, & crab topped portabella mushroom appetizer fourth time), I've had problems with some vomitting & have also experienced heartburn here & there.
 
I feel as if my band is again a little too tight, although it's not at all as bad as after I had my first fill.  I hate to bother the surgeon & his staff & request that they squeeze me in for a second time (for a second unscheduled appointment).  I'm fine with continuing to consume nothing but the protein drinks (I'm getting between 700 & 800 calories a day, but plenty of protein & am taking my chewable vitamins), however, a friend of mine is concerned that this isn't good for me & that waiting until my next scheduled appointment on August 21st could do damage to my system and / or metabolism.  (I should probably mention that I drink the same protein drink every time ("Egg Nog" flavored: 1 cup skim milk, 1 scoop vanilla flavored protein powder, 1/2 cup egg substitue, 1/2 teaspoon vanilla extract, & 1 tablespoon fat free, sugar free vanilla instant pudding mix (in powder form)), which turns out quite thick & causes a bit of constipation, so I have to admit that I have wondered if it might be "cementing my insides".)

Anyway, I'm fine with just continuing with this diet until 8/21, however, I was hoping to get your opinion on this.  Thank you.

Yesterday I had my EGD and contrary to most of the post that I’d read about this procedure it wasn’t a piece of cake. I was literally awake during most of my procedure. I remember gagging and feeling out of breathe so I naturally reacted and snatched the tube from  my doctor's hand and  yanked it from my mouth. I did this twice. They squirted more of that stuff in my throat and administered more of the sleepy meds and then I was off to sleep again only to wake violently and yank that tube from my throat a 3^rd time.  The assisting nurses were pinning me down to stop me from pulling away the tubes. A 2nd doctor came in to assist my doctor and it was all done.

My WLS surgeon is also the one that performed my EGD so I wonder if my EGD was this bad, do I really need to reschedule with a new surgeon in their group? I also want to know if my experience is common?

Dr. Curry - why do gas remedies (i.e. Gas-X) caution against going over the recommended dosage within a 24 hour period?  Trust me, I have no intention of overdosing on Gas-X, but for instance, Gas-X says take one after meals, and not to exceed 3 pills in a 24-hour period.  What if you take 4, or even 5, wthin a 24 hour period?  Would there be serious side effects?  Honestly, sometimes for me, it doesn't feel like 3 will help.

I'm not sure on this one but if it says don't do it I probably wouldn't...

Dr. Curry,
I have two questions:
1) I have read conflicting opinions on the Lap-Band & GERD.  I have severe GERD (w/ a hiatal hernia) and have had since I was about 14 years old; I am now 33.  My doctor did not mention this was specifically contraindicated, just that he would repair the hernia during surgery and that should resolve the issue.  He requested my latest EGD and we proceded with pre-op diet, etc.  So what is the overall medical opinion on this?  I stuggle with the GERD already, I certainly don't want to make it worse.

2) My surgeon wants me to lose 40 pounds prior to sugery to get my BMI under 50.  He sent me to his nutritionist who put me on a no/low carb plan.  I failed at that!  So, I was losing on my own with Weigh****chers, but VERY slowly.  I chose on my own to resort to the OptiFast, to get the weight off so I could schedule surgery.  I do fine until the afternoon, then I really struggle.  The surgeon's office continues to tell me NO food.  They do not realize this is not to "shrink my liver" per sey... but to lose the 40#.  Is it detrimental to my efforts to have the OptiFast two-three times a day and a small meal at night, or even a small snack or fruit???  Anything would help really!  Would this still help me lose quickly AND shrink my liver to a safe size for surgery?
 
Thank you!  Your help is greatly appreciated!
Tonya

The majority of patients who have hiatal-hernia related GERD do fine with a hiatal repair and band placement.  I have had one or two cases in over 1600 bands where the defect was just too big to close and these patients did not do well and ended up having their bands taken out.

We utilize Medifast and do a 5-in-1 plan for our extended medical weight loss patients.  5 Medifast products during the day and then a lean grean meal for supper.  There is probably some info on the Medifast web site.

Dr Curry,
I am 4 pounds away from my goal weight. Banded Aug 2007.  I have resently been refluxing at night. I have no idea why. I have thrown up before but not lately. Eating seems to be ok. I have not had a fill since Jan.  I have never done this before and it scares me. Waking up with throw up in my mouth and lungs. Not acid. What could be causing it?  Should I get my fill taken out? I am so close.

The protocol for our patients who develop nocturnal reflux is:

1. No solid food for 3 hours prior to bed time
2.  OTC prilosec 20mg a day
3. If no improvement a barium swallow to check band placement
4. If no improvement still then an unfill