Ask Dr. Curry

Hi Dr. C,
Today i went in for my 3rd fill and found out through xray that my port has completely flipped. How does this happen?  My first 2 fills went perfect, he hit the port the first time with no pain at all. Wouldn't it hurt? Why didn't i feel the port flip?  How painful is the reposition? Will it be as painful like it was right after surgery? I am getting it next friday and i am hoping i can return to work the following monday. is that possible?
Thanks
Debbie

Port flips happen, having done 1600 bands we have a few hanging around.  Only 2 have I had to reoperate on though.  Did you surgeon try to access it under fluoro?  We can almost alway**** them that way.  Repositioning though is not painful, much less than original band operation.

Dr. C,
I went for my third fill yesterday and it was discovered that my port has completely flipped over. What causes your port to flip? Did I do something wrong? My doctor said he sutured it in 4 places. He said I am the first patient that had thier port flip. I will go back to the hospital next week to have it fixed. Now that it has flipped once, do i have a higher chance of more flipping?

Thanks for your help

Debbie

I have not seen a re-flip but it could be possible.

I was banded 6/11 everything went fine then a week out I ended up in the emergency room I had trouble breathing and pain in my abdomin. They did a CAT Scan and found I had fluid in my abdominal wall and infection as well. I started antibiotics and laid in bed, the incision opened and leaked for 2-3 weeks. I took it real easy continued on my antibotics for two weeks saw my doctor regularly. It started to heal on the outside and I had a small lump inside but all in all my doctor thought I was healing. He said he see's this more in the realize band because of the port clamp. Well, I had my first fill on the 17th of July (not much restriction) then a week later my incision started to open again and I was leaking again and a small peice of tissue was on the outside of my incision. I am now back on heavy antibiotics and I am much better still leaking somewhat. I go back to the doctor tomorrow. Not sure what to expect, one thing I noticed I don't see that this has happened to many people. Have you heard of this happening before with the realize band? At this point I am not even concerend about my weight loss, it bums me out I can't exercise for my weight loss and just to feel better. I lost 26lbs on my own before my surgery and now 47 in total about 10 a month since surgery. Which considering I think is pretty good.... I guess my question is have you heard of this happening to anyone else? Do you think I should get a 2nd opinion? What type of questions should I be asking at my doctors appointment tomorrow? I don't want to be sick for the rest of my life!!! ~ Thanks, Brandi

You have a classic port infection, and it will probably have to come out.  I have seen this myself in my own patients a few times.  Unfortunately, whether Realize or Lap Band, this can happen any time you are putting in a foreign body.  Treating it with antibiotics will just result in intermittent remission of the infection and it will always reoccur again.  The treatment is typically removal of the port with replacement after infection clears.  It's a pretty minor operation, but still an operation nonetheless.

Hello Dr. Curry, I am about 1 yr post op I have been on a platau for a while but I lost very rapidly in the first 6 months 80 lbs now only about 90 total however I bruise very easily now where I never used to and I just had a long overdue fill still not really feeling excessive restriction however high protein usually causes me to have lower esophageal like just anterior to sternum I will have severe pain that feels like it goes through to my back, I just have to keep spitting and spitting because I cannot swallow this was ocasionally before my fill so far none of that but I feel hungrey more and just nauseated still just hit or miss on what I can eat one day I can eat something the next day I try and I turn green. any suggestions?

This is way too involved to solve here...I think you need to see your surgeon and dietitian.

Hello Dr. Curry,

I was referred for LB surgery by my family doctor 4 years ago.  There is a long wait for this surgery in Atlantic Canada.  However, while I was waiting to see the surgeon, I was diagnosed with Barrett's Esophagus 2 years ago and have been taking Nexium 40 mg daily since then.  As you know, this condition is the result of years of acid reflux. 

So finally, I got a consultation with the only Bariatric Surgeon here in New Brunswick Canada.  I was worried that he would say that this condition would preclude me from having LB surgery.  However he seems to feel that it might even help the situation.  Since we only have this one Bariatric surgeon that does LB surgery in this area of the country, a second opinion is out of the question. 

This leads me to my question.  Would you consider doing LB surgery on a Barrett's patient and if so would you expect any out of the ordinary complications due to the condition?

Thanks for your time.

I would not recommend a band for a patient with Barrett's.  It's just not a good idea in my opinion, if you are a band patient who gets worsening reflux, this will be a big problem and you will probably have to get your band removed.