Ask Dr. Curry!

Good morning Dr. Curry. Thank you for taking time to help answer questions. Here is mine... I have an up to two - two liter per day soda habit (diet dr. pepper).  I understand that after I am banded that soda is a no-no.  Yesterday evening I decided half way through a soda that I was done.  Today however, whew, headache, cravings, the whole she-bang. (still no soda yet though)...  I decided that if I don't have the will power to kick the soda habit I will not have the will power to kick the over eating and grazing habits either. Am I setting myself up for failure here?  How long does the misery of caffeinated carbonated withdraw last? Thanks again! Sheri

Sheri, It shouldn't be more than a few days of caffeine withdrawal, you are doing the right thing by trying to kick the habit before surgery.  Keep at it!

Hi Dr. Curry - I am getting banded tomorrow and my surgeon wants me to choose between a Realize and a Lap Band. I am conflicted, if you could offer any insight, i would appreciate it. Specifically can you address a couple of points:  Ok, so the surgeon says that in his mind, the bands are absolutely equal in tems of results, the only difference (which he really likes) is the Realize Band has good patient support with their website. To me, the patient support is nice, but not really a decision-making element. As an engineer, I am more interested in the structural differences between the two and why one design might be superior. In my mind here are the pros and cons: Realize Pros - Low Profile port, different port anchoring system (less chance of flipping), wider band, low pressure band, softer band material. Could be considered an improvement on an already good product Realize Cons - I was all set to go with the Realize until I went to LapBandTalk and there was one lone guy who brought up this issue - the band material is not pre-curved, so when it is buckled around the stomach it wrinkles and kinks onto itself (imagine bending a straw into a triangle) forming a triangle which could a) cause the band material to rub against itself and erode and b) prevent uniform pressure when the band is filled. also c) this odd triangular shape could create a non-circular stoma opening, which might be bad (? who knows). I know you saw some of those posts Dr. C, because I saw you posting. So that is, to me the big question. the non-pre-curved bit. Could this band wear out sooner? Could it cause problems for my stomach erosion, etc? Does just the potential (nothing is proven that I could find) of these problems outweigh the obvious pros? There was only one guy (who clearly had some sort of ax to grind) who brought this up. I have not found any mention of it anywhere else. Does it seem like a legit concern?  I also am slightly concerned about the fact that this band has not been used in this country for very long. My surgeon says the results are the same two years out. But I am thinking that two years of data is all we have on the Realize. That's not that much. Lap-Band Pros - A tried and true product. I like the pre-curved shape of the band - it seems more compatable with stomach anatomy.  Lap-Band Cons - The high pressure of the band - not really a con, just a difference that might be slilghtly inferior to the low pressure band. The high profile port (my surgeon won't use the low profile one) Overall,  the Realize has some VERY good points, but also one point that could be bad.  Since the Lap Band is the gold standard here, I could be not giving it enough credit in my frenzied psyco analysis. It is a perfectly fine band with good results, but I want whichever one is the best. I know at this point you are probably rolling your eyes and telling me to quit overthinking it and just pick one, but I am just like this. Any input you can give me is appreciated. thanks, Deb

Deb, They are both good bands, so it probably matters little which one you choose, that is the good news. The AP Lap Bands are actually low pressure bands also, albeit not quite as low as a Realize Band. My only preference is for an AP large band on higher BMI (50+) patients, otherwise I think it matters much more how compliant you are with diet and exercise than it does which band you choose. Good luck!

Dr. Curry, what does a low pressure band mean?  Why is it better?  I have the realize band and have 7cc' s and I still can eat more food than I should, mostly at night.  If I had a high pressure band would it be better at stopping me from eating?  Is the older lap band a higher pressure band (not the new AP Band)

A high pressure band is like filling a balloon with saline until it is under pressure.  I low pressure band would be like taking a latex glove, leaving the end of it open, and just pouring some water in.  It's there, but it's not under any pressure to squirt it back out.

High pressure does not mean better restriction.  Most likely you just need more saline in your Realize band.

Hello! Thanks for all the help!  I am confused.  What is an AP band??  So there are 3 kinds of bands??? Thanks! Jeannie

Jeannie, An AP band is the newest version of the Allergan Lap Band. Excluding their older models, there are essentially 3 bands available in the US:  The Realize Band made by Ethicon Endo-Surgery, and the AP standard and AP large Lap Bands, made by Allergan.

Hi Dr Curry,    I will be having a lapband consult next Friday. I am still not 100 percent sure this is what I want to do. My biggest issue is my sugar. My last A1C was 6.7. It has NEVER been that high. I am 75 pounds overweight.    One of the doctors in the practice said that if I simply lost about 40 pounds this problem would probably go away. The problem is that I already lost 40 pounds 6 years ago and HAVE managed to keep 30 of it off but no matter how much I work out I can't seem to ever get below 215. I am 5 ft 4 3/4.  This is such a major change and I DO want to lose weight but am scared witless. On another note I can eat wheat bread veggies and clean eating and STILL my sugar is high. I don't get it. I am so confused. How in the world can someone that doesnt even have flour,sugar white pasta,chips and garbage food anywhere in their house still have this problem? I went through this with my last 2 pregnancies. The last one the nurse yelled at me in her office and had me crying because she INSISTED I HAD to be eating sugar. She kept telling me that if I kept eating junk my baby could be way overweight and what a risk I was putting my child at. Right my last 2 only weighed 7 lbs 8oz and 7 lbs 4 oz.  My husband also know's I eat right and has even got on people for trying to tell me about "portion sizes",and even the types of food to eat.      Now what has been your success rate with type 2 diabetics? Any advice or question I should ask the doctor when I go?

Hi Dr. Curry ~ I was banded on May 27th and had my 1st fill of 3cc yesterday 7/10.  Procedure at my dr. office is fills only every 6-7weeks.  In reading other posts, that seems a little long in-between.  Is this unusual?  Needless to say I was a little disappointed.  I have lost a total of 22 lbs.