Ask Dr. Curry?

Dr. Curry

Today I am on a rant about improper aftercare from adjustable gastric banding surgeons.  I would like your best advice on how to advise bandsters who are being "punished" for eating properly by being denied fills. 

For example, a bandster posted today that her surgeon doesn't "do fills" until 3 months out, especially if they are losing.  Of course, we all lose weight when we follow the rules, there is no malabsorption, the purpose of the band is to help with Hunger!

I get so angry Dr. C, because I have lost 58 lbs post-op in 4.5 months.  I could not have done that if I hadn't reached my green zone by September, although it took me until November to realize I was already there, the lack of hunger has been instrumental in my incredible success with the band.  I am referred to by many as a "poster child" but I give as much credit to Dr. Teel II and Premier Bariatric, not just because of good fill scheduling, but because of my second rant, which is Education - Preparation - Guidelines- patients are asking for them and not being given dietary guidelines.

Why are surgeons so difficult about aftercare?  I only saw the NUT twice but was given enough data to live off of for months, plus I can email her and she Answers me!

Hi Kernie,

Would you share with me how you have been so successful? I know you have followed the plan. and all that,.but say wha t kind of exercise have you been doing for how long etc? You are my role model and I want to be as succesful as you are..YOU AE THE BOMB!!!!

Tracy

I can't answer why there is such variability with regard to aftercare.  We are advocates of getting of to a fast start, which is why we use fluoro for initial adjustments.  However, down the road we find so many patients that are already too tight who think a fill is the answer to their slow weight loss.

Congrats on your success, and tell Dr. Teel I said hi!  Come down and see our exercise center some time.

Hi Dr. Curry,
It's me again!  Just wondered why a new post op would get reflux and why it would persist if it does persist?  I am taking my Pepcid 20 mgs BID faithfully and it seems to help along with not eating too close to bedtime, but I am curious just why a new post op would even get reflux.

Thanks!

Sue

It may be related to swelling that is causing enough restriction to lead to reflux.  If it goes away in the next couple of weeks, that's probably what it was.

Hi Dr. Curry,

I am 6 days post op and overall feel pretty darn good for the exception of gas pain....or a feeling of indigestion, like I'm swallowing air.  How do we get rid of the pain, and make it more comfortable lying down.  It seems to get worse when l'm sleeping at night....

Thanks for your time!

This type of pain is fairly typical but I would recommend you run it by your surgeon...

Usually it just takes time - there isn't any real good solution for this pain.  We sometimes recommend OTC Aleve twice a day for a week, that may help.

Hi Dr. C,

I am scheduled for my banding next week and my doc offers both the lap band and the realize band.  I'm having a hard time finding differences between the two and was curious as to your opinion.  Of course I would want to chose the one that would offer the best results with the least rate for complications!

Thanks in advance for your expertise!

Currently I'd probably recommend the Lap Band, I like it about 55%/45% over the 1st gen Realize band.  There is a new Realize-C band coming out soon, we have already put it about 20.  I think it makes them both equal in my mind as there are some improvements to the C.  Your surgeon probably does not yet have access to the C however.

Dr. Curry,

Thanks for reading our questions and replying, it is very helpful. 

My question:  I have been reading some posts on some of the boards on OH and have found some people who have had some issues with their bands.  Some can't eat at all, others say it's not working and they need a revision but they have too much scar tissue??? 

This confuses me, because in my readings of some research article and some posting here and reading your site and from talking with my docs, I get another message.  I know you can't know anyone's medical history, but if a patient gets the band and follows all the rules are they usually successful??
Or do they sometimes just have these problems with the band??

Thanks,
Cindy