SECOND revision?

I had RNY (OPEN) in 2003.  In 2007 I had a revision to LAP BAND.  Now.... My band is as tight as it can be made.  It's even tighter than they wanted to make it.  It's been that way for months.  Barium won't even go through easily...it too stops.  But I can still eat just as much as always.  Everything I eat now simply builds up in my esophagus, then slowly (probably over several hours) goes through.  I have no sensation of this, no shut off mechanism, no fullness sensation (at least not where it should be), no reflux, and no answers.  The band probably does help slow down the process of digestion, but it is causing my body to work in an unusual manner.  I am now wondering if a THIRD bypass (perhaps a DS) is a possibility, because I am fearful that a rupture on my esophagus could happen. In the meantime, I have been losing albeit ever so slowly.  My concerns are more than my ability to not lose much, but what is happening over the long term with this method.  I think I've exhausted my resources at HCMC.  I don't want to go through this again, but wonder if I should.  I think I have fallen into a category so unique that insurance may question anything else.  I've heard that the U does well with extremely unique cases, but I don't even know where to begin. I think my revision would have worked very well had my esophagus not lost its sensations. I'm kinda bummed about this, but feel good otherwise.  Have you heard of this happening to anyone else? Paul

Hi Paul I didn't have an RNY but I did have the band, and like a few other people on the DS board had similar problems - couldn't get it tight enough to work without giving me problems. The problems developed into acid reflux, inflamed esophagus and waking in the night choking. Eventually (apart from getting sick of having no sleep) I started to worry that I was damaging myself. Is there any point in having a little fill removed and following bandster rules to the letter for a few weeks and seeing what happens?  Do you still have any of your RNY plumbing - might it be worth revisiting that and being revised to distal? Sal

Hi,

It sounds like you have esophageal motility issues either that were there before banding and now exacerbated by the band. Using your esophagus as a third pouch is very unhealthy. I am also a revision from lapband to sleeve and my esophagus simply stopped working the way it should. Food would sit there for hours before going down. I had no sense of satiety either and actually gained weight everytime they refilled it. I lost weight with an empty band because usually the esophageal dilation will go back to normal without the resisting force. Essentially based on what you are describing you are not a good banding candidate. This is not your fault. You may be a good candidate for a sleeve, but before considering a 3 rd revision, you might want to a litmus test as to whether or not some of the problem that you are experiencing also involves self sabotage, issues with compliance etc... I am NOT saying that you are doing anything of the things I mentioned, just saying that since the other two surgeries were not right for you, you will need a revision surgeon who can help you pick the right surgery for you based on your previous history. Any good revision surgeon will look at that history and your self reporting about eating behaviors before recommending whether or not you would be a good candidate for a sleeve or DS.

Babs

You need to measure what you put in your stomach. You will have dialation of your esophagus if you don't already! This is too important to just eat as much as always. Your health depends on it, and I'm not referring to losing weight.

If you need a revision, I hope you get it, but until then please measure your portions. Eat smaller amounts, and just eat every few hours if you must.

Best wishes.

I'm curious what your doctor has to say about this.  He should be very concerned if food is sitting in your esophagus.

You are absolutely right...he watched as the barium stopped, gave me .2 cc more restriction, sent me on my way knowing what was happening.  I asked him if it is a problem if food sits there.  He said no, it's not a problem.  I've scheduled a second opinion with a revision specialist surgeon. Paul