Band over Bypass possible complication.....help!
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!
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!
Snedly318
I haven't had my revision yet, but I agree with the previous post, immediate removal seems drastic.
Your surgeon should be able to run tests and identify exactly what the issue is and make the proper educated recommendations then.
So, I've never heard there could be issues with the port and an abdominoplasty. I've had an abdoinoplasty and several "touch ups" to it over the years. Hope that isn't going to be a problem!!! Have me concerned now.
I think I will post on the band board a question on that.
Sending peace & healing!
Jackie
Revision: 1/12/2010-Dr. Zapata; (338 RNY) HW 245/SW 215/CW 193 / GW 170
"One must still have chaos in oneself to be able to give birth to a dancing star." ~Nietzsche~
"One must still have chaos in oneself to be able to give birth to a dancing star." ~Nietzsche~
I know that we will run tests if the surgeon thinks this is abnormal. For example x ray to verify placement of band (actually they will fill under fluoroscopy to check everything).
Regarding the abdominoplasty I would ask your surgeon and ask your plastic surgeon as well as asking your surgeon to place the port higher. Mine is next to my umbilicus at my waist level.
I am seeing surgeon on Thursday.
Thanks for your good wishes!!!
Kar
Regarding the abdominoplasty I would ask your surgeon and ask your plastic surgeon as well as asking your surgeon to place the port higher. Mine is next to my umbilicus at my waist level.
I am seeing surgeon on Thursday.
Thanks for your good wishes!!!
Kar
Snedly318
I'd want more info from a band surgeon who knows what he's doing. Yours may not be that person - I could have given you that list of possibilities but they aren't really much help are they.
If the band has slipped it has come off your stomach where it was sewn and moved down (or up). A fill would therefore be useless. A surgeon can tell if a band has slipped through x-ray, by seeing that it isnt in the right place. They can also give you contrast to drink, and see if you have any restriction after a test fill. This is the first thing to ask for.
If the band has moved it might be possible to reposition it. Seems odd that it would have moved so quickly after your surgery though - especially if you havent had much fill in it.
Port problems I thought were fairly rare. The bit of equipment is just sewn to you, it doesnt do a lot normally. If it has moved then it can be put back. Once you rule out band problems the port is the next thing. Can the surgeon not do a blood test or swab or something? Seems a bit apathetic to me to just leave you like that. Whether your port sticks out or not depends what it is sewn to. Some surgeons sew it to your breastbone, and then it sticks out. Mine was on the side, between ribs and hips, and I could feel it only if I pressed it. It felt like the top of a golf ball mostly.
Even with the band working, you mainly have the band as your tool now. Unless your RNY was an extended one (I doubt it) you won't have any malabsorbtion, just restriction. The band is trying to replace that restriction. You may find that it works, but it does take time to get it adjusted right - look on the bandster board about this. In my case it never worked, but that doesn't mean it won't work for you. Give it a chance, once you've sorted it out.
If you get no joy from your surgeon, post on the bandster board for a good band surgeon and you might get more help from there.
Sal
If the band has slipped it has come off your stomach where it was sewn and moved down (or up). A fill would therefore be useless. A surgeon can tell if a band has slipped through x-ray, by seeing that it isnt in the right place. They can also give you contrast to drink, and see if you have any restriction after a test fill. This is the first thing to ask for.
If the band has moved it might be possible to reposition it. Seems odd that it would have moved so quickly after your surgery though - especially if you havent had much fill in it.
Port problems I thought were fairly rare. The bit of equipment is just sewn to you, it doesnt do a lot normally. If it has moved then it can be put back. Once you rule out band problems the port is the next thing. Can the surgeon not do a blood test or swab or something? Seems a bit apathetic to me to just leave you like that. Whether your port sticks out or not depends what it is sewn to. Some surgeons sew it to your breastbone, and then it sticks out. Mine was on the side, between ribs and hips, and I could feel it only if I pressed it. It felt like the top of a golf ball mostly.
Even with the band working, you mainly have the band as your tool now. Unless your RNY was an extended one (I doubt it) you won't have any malabsorbtion, just restriction. The band is trying to replace that restriction. You may find that it works, but it does take time to get it adjusted right - look on the bandster board about this. In my case it never worked, but that doesn't mean it won't work for you. Give it a chance, once you've sorted it out.
If you get no joy from your surgeon, post on the bandster board for a good band surgeon and you might get more help from there.
Sal
DS revision from failed lapband
Thanks Sal.
Glad to hear about your band/port. Mine is next to my umbilicus to the left. I like your analogy of the top of a golf ball.....Similiar in size to an apricot. I do still have the malabsorption from the RNY but I don't have any restriction without the band. They haven't filled my band at all yet. I intend on sticking with the band unless I have to part with it. I intend this to all be successful.
Thanks for offering to get me a list of band surgeons. My surgeon is top notch. He and his partner have done thousands of these surgeries. I have known him for over 6 years and have worked with him as an RN. When I last went to his office it was at the last minute because I was concerned about the skin irritation around the port site. Because of the day and the holidays, I saw the doctor who was covering for my surgeon - a new partner to the practice. My appointment on Thursday is with my surgeon.
Thanks again!!
Kar
Glad to hear about your band/port. Mine is next to my umbilicus to the left. I like your analogy of the top of a golf ball.....Similiar in size to an apricot. I do still have the malabsorption from the RNY but I don't have any restriction without the band. They haven't filled my band at all yet. I intend on sticking with the band unless I have to part with it. I intend this to all be successful.
Thanks for offering to get me a list of band surgeons. My surgeon is top notch. He and his partner have done thousands of these surgeries. I have known him for over 6 years and have worked with him as an RN. When I last went to his office it was at the last minute because I was concerned about the skin irritation around the port site. Because of the day and the holidays, I saw the doctor who was covering for my surgeon - a new partner to the practice. My appointment on Thursday is with my surgeon.
Thanks again!!
Kar
Snedly318
You're welcome. I've found that a surgeon good at one surgery doesn't necessarily specilise in all the others - my band surgeon admitted he knew little about RNY but he was good at banding through all the practice!
Hope you get answers - if not I'll ring them and shout down the phone for you, no charge...
Sal
Hope you get answers - if not I'll ring them and shout down the phone for you, no charge...
Sal
DS revision from failed lapband
I am so sorry to hear of your port complications (mine took months to heal)...keep us posted on how that is going please.
I have a band-over-bypass and did not feel any real restriction until I started up with my fills. Give it some time and you will get that glorious restriction you are seeking! That was when things REALLY changed for me for the better and I lost a ton of weight.
I am now loving the results of my revision surgery and I am sure you will too! Best of luck to you and please keep me posted on your progress. ((((HUGS))))
I have a band-over-bypass and did not feel any real restriction until I started up with my fills. Give it some time and you will get that glorious restriction you are seeking! That was when things REALLY changed for me for the better and I lost a ton of weight.
I am now loving the results of my revision surgery and I am sure you will too! Best of luck to you and please keep me posted on your progress. ((((HUGS))))
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