Ask Dr. Curry?

I believe I answered this over on the Ohio board.

Yes you DID!  I didn't expect such a quick response!!  So, I thought I'd ask you and the "general public" on the board!!

The answer was yes, if insurance covered WLS in most instances they also cover procedures needed due to complications.  Sometimes even if they didn't cover the WLS they will cover the procedures due to complications.

Although another poster pointed out that some policies have a $$$ amount limit so that I need to check with my insurance to determine the details.

Thanks again Dr. C for the good advice and your attentivness to this board!

Hi Dr. C.
I have a few questions. 

1.) RNY v/s LapBand. 
I am really scared to get RNY b/c of complications. However, reading this board I am seeing just as many people with complication with LapBand.  Which has more complications?  It's really hard to accertain on this board. 
2.) I am a Critical Care Nurse in a very busy critical care unit (very strenous job; lifting, pushing, pulling, reaching up to IV poles).  What do you believe to be a safe time after lap band surgery to return to work?

Thanks for your time.
Teri

Teri,
The complication rate is probably about the same, but with RNY the concern is more short term, and with band more long term.  The likelihood of having a major life threatening complication though is higher with a RNY for sure.

For a critical care nurse I'd say 2-3 weeks, probably 4 weeks until you could do full patient lifting.

HI My question is ...is it possible to have acid reflux and not be too tight and does it hurt anything in any way? The last couple of fills I've gotten I seem to have reflux really bad afterwards, but I'm not real tight. I feel like I have a good bit of restriction, but wake up throughout the night choking. The last time I got a fill, I had to have some removed and still didn't have much restriction. I got a fill Monday and feel great but the reflux is killing me. I started on Prevacid today, but am just wondering if I could be hurting my bad like this. ( I never had reflux until the band)

Thanks so much!
Christy

  Hey Dr. Curry! Hope you're  having a great Thursday. Ok so since being banded 1.5 yr ago. I have been puking if not a daily a regular basis. I did go about 3 weeks where I was ok. So at this point I have no fill. I am 0. I still feel total restriction. Honestly, at some points I felt I could eat more when I had a fill.  I am 20lbs. away from loosing 100lbs.! Exciting but still can't eat on a regular basis. I sometimes can't even eat soup. About every few days or so I can eat half a meal that will stay down. So sick of living on dairy and sugar. I have had swallow test, gone to visit dr......everyone says I'm fine.  I feel like the dr. thinks I'm crazy. Any suggestions? Thanks so much

Where is Dr. Curry? Hope you are doing well.I have been totaly unfilled,and have no restriction gained 10 lbs in one month, was having stomach pain all tests come out good, upper gi, scope, and then a espoxix test today, I thought I was 5 cc fill, he pulled out 7.5 cc, now he tells me I was primed at time of surgery when I asked him this befour he told me no, Said I was to tight had all these tests done, I am fine,all test good, never had a problem with vomiting,or sliming,May I ask to get your re fills do we start all over again or how much fill is safe to put in at once? I know all Drs are different in their practice, but I am asking you what is safe?

Dr. Curry,

       I was banded on Nov. 24, 2008 and have lost 67 pounds in the first 7 months.  However beginning in May I hit a plateau.  I found out my Vit D level was low (16) in the beginning of June and have since been taking 3000 units per day.  I will not be retested until August.  I have been going in to see my surgeon for the past 3 weeks and she has been looking at my food diary and making suggestions for the following week.  This along with increased exercise has restarted my weight loss (slowly).

      At the end of my last visit with my surgeon, she asked me what restriction felt like for me.  I described a feeling in the back of my throat of gas bubbles trying to gradually escape around the food I just ate.  Once they escape, the food seems to pass through the band immediately.  Ten minutes after I eat, I feel no sense of fullness or satisfaction and could eat again.  I can eat all foods from bread to steak.  The only time I have any problems eating is when I eat too quickly, but I have never felt the sharp intense pain in my chest like other patients describe when they overeat.  In fact, I have no feeling of food in my chest at all.  If I eat slowly and chew my food well, I can eat way more than 4 oz per meal.  I have been known to eat an entire bagel (no butter or cream cheese) without any restriction or uncomfortable feeling.  The last time I went in for a fill under a fluoroscope, it took several minutes for the barium to pass through the band.  Placement of band, pouch size, and esophagus all looked normal.  Needless to say, I did not get a fill.  I have always wondered why, if my band is tight, I can still eat large portions of food.

         Putting all the pieces together, my surgeon suggested that I might have low motility in my esophagus.  However, I have not been officially tested for this.  She suggested that my food may be stacking up in my esophagus and dripping into my pouch.  Since my pouch never completely fills, the food is passing through the band easily causing no restriction.  She has suggested slowing down my meal, taking smaller bites, and allowing the gas bubbles to escape before my next bite to insure the food gets into my pouch.   She also wants me to strictly limit food intake to 4 oz (volume).  I am to continue eating only solid dry dense foods with no slider condiments/sauces.  All of this is an effort to get the food to get to and fill the pouch.

          My questions for you are:

         Does this sound reasonable? Did I understand her correctly?

         Is there anything else I can do to promote the function of the   band and increase weight loss?

I am a highly motivated patient, try to follow all advice of my doctor, and would appreciate any advice you can give me.

Thanks,

Amy