After 4+ years and things going well...not so good now!

I won't go into huge detail, but I had lap band surgery in April 2009 and have responded well to it. I had a couple bumps where I had to have a lot of fluid removed and gained, but when I was back to restricted, I did very well.

In December I had a bout of tightness that I felt needed to be resolved with some fluid being removed. A month or so later I went to get the fluid put back. I didn't have great restriction at first, but some. Then it just went away. I went back to get more in and the same. I've been to fluro twice to check for leaks and no sign of it. It does seem like there should be more in my band than they can get to come out. Again, no evidence of a problem.

Now 6 months later I am gaining at an alarming rate. I feel terrible about myself. I started running again because that was a big help for me early on after surgery. I just feel like the band isn't working at all. Could the pouch before my band be expanding and holding too much food? I've award that is really a myth.

My insurance will not cover a revision at all. I have been to the doctor so many times trying to get it back to the way it was. Feeling so discouraged and not sure what to do.

Sorry so long! Any insight is much appreciated!

I had the same issue after they went in the fixed a slip. Turns out it unclipped (or what i think is that they did not clip it correctly). Ask them to try that. Good luck!

Your pouch can stretch, absolutely!  I had to have my band removed because in my 4th year I went crazy and started ignoring all the rules and not only ate too much, but pb'd too much.  I was almost completely unfilled due to sudden tightness in December but still had some restriction due to the band just being around my stomach.  After many, many tests it was discovered that my band was in perfect position but my pouch was grossly dilated and I had compromised the junction between my pouch and esophagus to the point that there was nothing there keeping acid (and food) down.  I had my band removed last month.

It's terribly painful to come here and admit what happened.  I was a band superstar losing 100+ lbs in the first 9 months.  But in my case it wasn't necessarily the bands fault but the upward pressure that is naturally created, didn't help my case.  I'm being honest here because I want people to know what  MAY happen over time if you stop following the band rules and let the compulsive eating behaviors that got us here back into our life.  

For me, I need to work harder at the head issues.  No matter what surgery I have, it won't last if I can't change using food  to blunt out every emotional situation. I'm still grateful for what having the band has done for my quality of life, and while it hasn't been a perfect journey but I've learned a lot about myself.

Make sure your doctor does a UGI at a minimum and perhaps an endoscopy too.  If your pouch is stretched a total un-fill for several weeks may do the trick!

Best, 

Lisa O.

Thank you for sharing this. I think this could be what has happened. The crazy thing I think it was in such a short period of time, which makes me worried about else might be going wrong. I am really trying to get my head in the right spot. The combination of being able to eat a lot + starting to feel badly about myself is a really bad combination. I need to at least get myself disciplined so I can prove to myself I can do this.

I feel the same way as you do - when my band is working right, it's a great tool for me! I've done so well with it. It just depresses me so much that tool might no longer be available to me.

Just curious - why would a complete unfill make a difference? Will it allow everything to readjust itself? I need to get myself on a good path for now to show myself I can keep things moving in the right direction when I can get it fixed... I simply can't believe the extent I've gained as I've struggled to get it working right again...

Yes, releasing the band can allow the pouch to go back to shape.  I did this before and it helped but over time I just kept abusing portion size and with my band emptied already there was no place to go except for removal.  The reflux I was experiencing was too dangerous to mess with and I don't want to have an fundiplication surgery (surgery to repair the esophagus/gastro junction.  We are hoping that it will go back into shape now that the band is gone.

If you are dealing with stress please try to get some therapy.  It will help you deal with the inevitabilities of life!

Lisa O.

I had to have mine unfilled totally at 1 year for six weeks to rest and heal and again at 2 years for 8 weeks.  It is kinda like a balloon and once it stretches is is easier to stretch the next time.  I went thru what Lisa did but it wasn't from increasing large amounts.  I went to slider foods just so I could eat without PBing  

The upper GI showed nothing wrong but, the scope showed the story.

Good luck figuring out what is going on.  Hopefully it is an easy fix.

Another point to make is that sometimes it doesn't matter how many or what kinds of tests are done you don't know what exactly is wrong until they get inside and can actually see the band itself. Leaks can be anywhere along the system so unless they can pinpoint the spot of a leak or it is big enough to show up with dye you can't tell if there is a leak. I know one gentleman who was tested several times for a leak and nothing showed. However when the tubing and port were swapped out he had no more problems. So there are many reasons and treatments the first step is always the same see your doctor.

It sounds like you have pouch dilation, this can interfere with adjustments and feeling restriction. Also pouch dilation does not always show on Upper Gi's or fluoro if the pouch is not large enough.

Your insurance may not pay for a revision to another weight loss surgery, but IT MUST PAY to fix your band, pouch dilation is considered a complication and even if you have a exclusion to weight loss surgery it MUST pay for a complication, or change surgeons to code your situation as a complication that needs to be fixed.

If you have the AP band it is easy for the surgeon to unbuckle the band and fix the pouch, or you can get re-banded. You may have to get a second opinion also, I ended up getting a new surgeon to fix my hernia, remove my old band and get a new band all in one surgery, my insurance paid 100 percent even though I had an exclusion to wls -- at that time.

 

 

The band is a very iffy thing! Works for some. Doesn't work long term for most. I know of many that loved thier band and when there was a complication they gladly got re-banded because their band worked so well for them. The 2nd band..............completely different story! This is often the case of those that that lose well/quickly and then had a complication and had to have an unfill. Some just can never return to that optimal point they previously had. And some that haven't even had any serious complications will say that their band no longer works like it did initially. Wish I had a suggestion for you, but if revision is not a possibility then it's possible you might never effectiveness that your band previously did. :-(

Update. I shared some of what I learned with my lpn and she checked things over and does not see any evidence of a dilated pouch. She wants to fill me up to good restriction (which I've not seen in months) and see if I gradually lose it. The we'll look at next steps.

Stay tuned.