Ask Dr. Curry?

Cindy,
Most patients are successful, however like any surgery gastric banding is not 100% perfect.  I think that patients who are having problems tend to be more likely to hang out here and post questions about their issues, so it may seem like everyone is having trouble when that's not the case.

Thanks so much for taking the time to reply.  I guess I have been worrying about nothing.

Cindy

Dr. Curry,

Hello! I recently posted a question to the rest of the OH members, but thought I'd ask a doc too. :)

I am curious as to what the typical post-op process and experience is for patients who have been on long term anti-hypertensive medication (most specifically Beta blockers) pre-op. I am 32 years old and have been on anti-hypertensives since age 18. I have been on Metoprolol ER 200 mg BID and Hydrochlorothiazide 25 mg QD for at least 5 years. That combination has controlled my rapid heart rate and hypertension very well even through pregnancy. Believe it or not this is the one aspect of my upcoming surgery experience that I am nervous about.

When I was hospitalized following an emergency C-Section in May, the attending physician could not believe how much Metoprolol I was on and actually WITHELD(!) some of it until he could verify my dosage with my PCP. Within 2 hours of the missed/lowered dose, I experience rapid heart rate at rest (over 110 bpm) and increased blood pressure (135/90 up from 110/70) on this reduced (100 mg) dose.. And that was while on narcotic pain relievers which tend to lower BP. After becoming a beligerent/assertive patient, I finally got my meds! 

I understand that Beta blockers such as Metoprolol cannot be simply stopped and should be titrated. I should trust that my surgeon and team will know this, but I guess I am experiencing some last minute jitters.

My surgery date is set for 1/20/09 at Temple University  (Jeanes) Hospital in Philadelphia.

Thanks for your help!

Dawn (LiamsMommy)

Dawn,

Often times beta blockers need to be weaned very slowly, a sudden change in dose can indeed result in a rapid heart rate.

As you lose weight you will quite likely need to be weaned down, you don't want to have a heart rate of 40 and a blood pressure of 60/40 or you'll fall and give yourself a subdural hematoma.

As many have already stated thank you for your time on OH. I had total band revision 2 weeks ago. I was banded 4 years down 100 pounds but suspected a leak and needed to repair a hernia. As it winds up the band moved down and created a larger pouch which enabled me to gain 20 lbs. P.S new band
!At the site of the port I have a swollen lump about the size of the inside on my hand ( small hands). 35 cc's have been extracted . The contents were blood the rest appears to be like a gelatinous substance. I was told to add hot compresses then told cold and to wear an abdominal binder. The area is sore , does well with the compresses but in the mornings seems to be full again.

How long should I give this before I get concerned ? Do you recommend hot or cold compresses. How unusual/usual is this condition. Any advice/suggestions would be very much appreciated.Happy New Year and thanks.

Michelle

For a hematoma probably heat is the best option.  It could take a month for it to resolve.  Jus****ch for signs of infection as hematomas can sometimes get invaded by bacteria.

Dr Curry,

I had lap-band surgery 03/27/08 and have been doing pretty good with my weight loss, until Nov.  Ive had several asthma flare ups, one being severe and had to go back on a high dose of prednisone, 80mg. then tapering back down to 10mg. and have since gained 34 pounds. Im still eating like Im suppose to, but just dont seem to be dropping any weight. I know that most of the weight is fliud, so would taking fluid pills be wise and is weight gained from long term use of prednisone harder to lose? If so, why?

Michelle

It is very hard to lose weight while on Prednisone.  Your best bet is to get off of i****er pills won't help.

Hi Dr Curry, i was glad to see a post about the prednisone. I took a 10 day round of it about 5 wks or so ago, and of course gained 9lbs in about 4 days. After i was done taking it, i lost about 6lbs. I started exercising at the gym 5 days a wk shortly after starting the pred. and have now gained back 10lbs. Is this due to the pred., exercise and gaining muscle, or a combo of both? I'm eating the right foods about 80-20 and have increased my cals to around 1200-1300 a day. The weight gain is starting to freak me out. Any ideas?
Thanks so much for you help.
kristi

Dr Curry, I did post this before but the thread was archived almost immediately afterwards and it may be that you didn't see it. If you did and just decided not to answer, sorry to pester!

I am a band success story and as such come back to OH regularly to share my experiences with others who are less experienced. I never give medical advice and always tell people to check things with their own medical team. But here's my question:-

I see a lot more posts recently from newly banded people who are eating solids much earlier than we used to be allowed to. I tend to answer by saying that many docs feel that people should wait until at least a month before eating normal foods but that they should follow their own doc's advice.

Do the most recent bands have a different post-op diet requirement? 

Kate