Band Complication?????

Hello!!!
I thought I knew it all until I had the band.  I am an RN and know how to spot an infection so I initially didn't worry...

I had the band on 11/24/09 and have since lost 10.5 pounds.  This is a revision surgery.  I originally had a RNY in 2004 and lost 114 pounds.  I gained about 40% and looked into revisions....I sort of didn't qualify for the ROSE procedure b/c my pouch wasn't dilated enough, but my anastomosis was over dilated.  So the surgeon suggested the band to reestablish the restriction b/c I was hungry all the time b/c food was not staying in the pouch to create fullness.

Anyway, things have been going well until about 3 weeks ago I noticed an irritation and slight redness around my port incision.  It was not swollen or tender just skin irritation.  Eventually it became more red and I saw one of my docs.  What he said stunned me:  It could be;
1) cellulitis - treated with antibiotics.  He gave me 7 days of Levaquin. (this is the option I prefer)
2) an indication that there is inadequate perfusion - blood flow - to the port site due to my prior abdominoplasty (I had 7 pounds of abdominal skin removed in 2006) and
3) an indication that the band has slipped.  This means it would have to be removed.  I was so stunned that I could not even ask questions, such as once removed can it be replaced???

Well, the skin irritation didn't improve with the Levaquin (but I got a sinus infection and that got better) so maybe the med couldn't tackle two infections.  I recently started applying cortisone cream to the site and see a very slight improvement.  However today the port site was protruding quite a bit and rather than feeling somewhat flat and like the size of a sweettart it now feels like the size of an apricot.   Please pardon the food examples.

I am going to see the surgeon on Thursday 1/7 for what was supposed to be my first fill, but I am not so sure about that.  I am worried that they will have to remove the band and that all of this will have been a fruitless and emotionally, painfully and financially expensive waste of time.  Most of all, I feel trapped.  I had the original surgery because I needed to get away from obesity and all the associated health problems.  For the same reasons I did the revision - because I felt I was headed back to where I came from and I am simply unwilling to return to that place!!  If the band needs to be removed I don't know what my options are.  I am left with a small pouch but an opening between the pouch and the intestines that is almost as large as the pouch and causes food to pass immediately into the intestines and I never have a feeling of fullness.  This is a physical reality that only surgery can repair and now it seems that that surgery may need to be reversed.  Needless to say I am FREAKIN' out!!!!!!!

So, have any of you experienced anything similar?  How large is your port?  Is it normal to protrude like I described?  If what I am experiencing has been experienced by anyone else it would help tremendously to know. 

Thanks!

Sorry to hear you are having problems.  Go over to the Lap Band board and post.  I am sure someone has been in your shoes and can offer some help.   I doubt it is the band but most likely the port itself.  However, the band can be replaced if needed.  Good luck!

Jenn Y.

There is also the revision board too; I had the band and had it removed.  My port was very noticeable, and since you lost weight already it may just be that much more visible to you.  I hated the port and was so glad when it was removed.

Good luck and keep us posted.

Hi
I have had the band for 4 years.  Contrary to what alot of folk believe the band can be a very useful tool.  It sounds like there is an infection.  Dr A can attempt to open up the port site and clean it out and allow the area to close by itself. or if bad enough it would have to be removed.  ANy fever ?

No fever.  No other signs of infection.  Dr. Ianacce just freaked me out.  And again today the port site is protruding and now feels tender on the upper portion.  I totally trust Dr. Abkin, used to work with him and Dr. Bertha, they are great!!!!  I just don't have experience with the band prior to this and don't know what to expect in terms of port size etc.  I am waiting expectantly until my appt. Thursday with Dr. A.

Thanks for your reply.

-Kar

well my port is about the size of a bottle cap and it does stick out, especially when I am lying down.  My port site was sore for months, and to this day if I get gassy, my port site is sore.

Snedly,

Stopping worrying until you see and speak to Dr. Abkin. All this speculating does nothing GOOD for you. While it could be something MAJOR it could just as well be something very MINOR or NORMAL.  

Now lets talk worst case senerio .. say it is a band slippage. That's not the end of the world. Bands DO slip, and knowing ALS they've know how to deal with it.

If for some reason the band isn't for you - THAT doesn't mean it's the end of the world. There are other options, such as the sleeve proceedure. This could be explored, if (and that's a BIG IF) you can't deal with the band.

Know we are here for you. We will see you through this.

Keep us posted how it goes, and what the Doctor says

While I can't speak to all your questions, I can tell you that my realize band, which supposedlly has the smaller/lower profile port looks ... apricot is a fair assessment.  It has shifted over time, I can tell you that.  It used to jab me in the ribs when I leaned over, and not now.  So, it could just be that your port moved to a place that is more noticable.

Dr A will sort it out.  Take a deep breath!!

I'm sorry to hear this, but don't see how this would be an indication of a slip. A slip is when the stomach moves up through the band which would change your tolerance for food and/or give you pain sensations across your chest or back, but your port site would not give you any signs of this. However, port site infection is one of the signs of band erosion, which is when the band's tightness (which it doesnt seem you wold have much yet since you haven't been filled, unless he put it in with some fluid already) rubs through the stomach wall, eroding it so to speak. Erosion wouldn't be great news, cause it would be a surgical repair and usually indicates that your stomach doesn't tolerate the band. However, it seems early in your recovery to encounter erosion without any fills. If you've had a tummy tuck and have already lost alot of weight, your port is likely to protrude and that area will feel strange for awhile...that port is sewn on to your muscle wall, and can give you strange twinges of pain depending on your use of your abdominals, etc. So that in itself doesn't seem odd, though the irritation is something to look into. I hope you get some clear answers from your doctor. Good luck!

Any update ?!?!?!? We're all wondering !!!!