Ask Dr. Curry!

Hi Doctor Curry, I'll try to make this brief.

I had the Realize band surgery on 5/12 of this year.  I received my first fill of 4 cc's on July 11th through flouroscopy.  The P.A. doing the fill had me drink the barium swallow until it started slowing down (through the band) on the x-ray.  I never actually felt much restriction except every now and then if I ate bread.  I went in yesterday after 6 weeks for a check up and hopefully another fill.  I told him I could still eat what felt was too much to be at a good place of restriction (maybe around 2 cups of food?).  I lost about 7 1/2 pounds in the 6 weeks between my fill and yesterday, I was hoping for 10 to 12 pounds per month eventually.  He had me do another barium swallow on the flouroscopy.  He said it is still going through slowly through the band area but he would give me another 1/2 cc but said the picture doesn't lie (meaning he was seeing the fluid slow down through my band so that meant I had restriction).  I still don't feel much different.  He told me to come back in another 6 weeks for another check-up (possibly not even a fill).  I've also been told that if they decide not to do a fill at your check up, the would not schedule another possible fill until 6 weeks later (so basically going up to three months or more with no fill).

I feel they are being overly cautious and conservative.  I've technically only lost 15 pounds since my May 12th surgery date and I'm ready to get the real weightloss going here.

What is your take on this situation? 

There is another doctor is actually closer to me (15 minutes compared to the 1 and 1/2 hours it takes to get to my current doctor) who will take on new patients and give fills every 2 to 4 weeks and is very pro band that I'm considering moving to.  I really like and respecf my doc's office but feel they are too biased towards RNY and maybe aren't experienced enough with the band at this point.

Well sorry this actually wasn't brief, but I would appreciate your input.

Thanks!

I find that the Xray findings don't always correlate with the patients feeling of restriction.  As long as there is no evidence of pouch or esophageal dilation, if the patient is eating over a cup of food at a time and not losing, we usually do a fill.

Thank you for your reply!

Hello Dr. Curry.

I read somewhere that you encourage your  patients to do Medifast for their pre-op diet.  How do you feel about Medifast post lap band surgery?  

Thank you,
Mari

Mari,

I think Medifast is a good option for band patients post op. Especially those who are too tight to eat solids in the morning, they can start with a healthy shake.  Or for patients who have plateaued we do a 5-in-1 program for a month or so.  It works.

Dr. C,

What is the 5 in 1 program?  Can you explain it or is it something you would rather only share with your patients? I would like to try it because I need a boost here,.

Thank You
Jackie

It's a highly succesful top secret magical plan for my patients only.  Just kidding!  It's basically 5 medifast products a day and a lean grean meal for dinner.

DR C,
  I just read on this site that the pouch created for the Realize band is 4 oz and not 2 like the Lapband. Why would that be different between the bands?

Those are really just estimates, I don't think there is any difference in pouch size.

Right now, Dr. Curry, I don't really have any questions.  Just a little nervous about the surgery on Sept. 29th.  Dr. Michael Trehan is my surgeon and I like him very much.