1st problem at 3 years post-op

Hi everyone,

I was banded just over three years ago. So far I've been very lucky and my doctor refers to me as the "poster-child" for the LapBand. Here's a breif history:

I was banded in August 2005 at 246 pounds.

A year out (August 2006) I was at my goal weight.

I stayed between 153-158 pounds for the next year until (July 2007).

In July 2007 I got pregnant (on purpose ) and in March I had my second child.

When I was five months pregnant my doctor removed my band's saline because the growth of the baby was pushing against my stomach and causing reflux. I gained a bunch of weight in those last 4 months, but all was well with the band.

After my son was born in March I went back to see my band surgeon and in May I got a fill back to my previous level. This was done under flouroscopy and the band and my stomach all looked perfectly fine.

I thought at first I was a little tight, but after a little while things went back to normal and I concluded I'd just forgotten what restriction felt like.

Since the May fill I've lost about 15 pounds (about 34 since having the baby).

I had an adjustment scheduled for today which was good because sometime in the middle of last week I suddenly felt like I didn't have restriction anymore.

I went in today and had the adjustment under flouroscopy. When I swallowed the barium the doctor showed me on the screen that I was very tight and that the portion of the stomach that is above the band had swollen and flopped over to one side. It was trapping food and making me feel like I didn't have restriction. This was not the case in May and he said it was a good thing we caught it so quickly because it can become a problem if not detected.

He recommended that I have ALL of the saline removed for a month and see if my upper stomach can contract back to normal. I'll have an adjustment in 30 days and see if it's repaired itself. If so, we'll start putting the saline back in. If it hasn't repaired itself, he said I may have to have surgery to re-position the band so that the bumping out doesn't get worse and possibly lead to a slip.

I have been with my doctor for 3 years and trust him completely. He has never steered me wrong. So I had all of the saline removed.

So, here's my questions to the board:

1. Has anyone else expereineced this? and if so how did it turn out?

2. As you can imagine, I'm a little freaked out and feel nervous about what I should or shouldn't be eating now. I asked my doctor and he said that there isn't really anything I can do so just give it time. But I'd like to be doing SOMETHING... so any suggestions? Should I stick to mushie-type- foods so as not to put strain on my upper stomach? Should I drink a lot of protein shakes instead of eating real food for the same reason?

3. In the 30 days that I have to wait until my next adjustment I'm worried about gaining weight. I really wanted to lose the rest of the baby-weight by Christmas. With a month of no saline I'm afraid I won't be able to do it. With the band I was really proud of the fact that I could have a very normal diet and still lose or maintain due to portion control. Now, I'm wondering if for the next month I should do Atkins or South Beach or something just to prevent any weight gain while I'm not filled. What do you think?

Thank you so much for reading this whole thing and any helpful suggestions anyone might have. I know that my doctor is reliable and knows what he's doing, so I know in the end this will work out, but I'm just nervous right now and would love some encouragement and info from the board.

Thanks everyone,
Elizabeth

P.S. Sorry I rambled on so long.

I'm not a bandster, so take my advice with about a lb of salt, but I think the SB eating program would probably be fine for you. 

You might get better input from others on the Lapband board;  good luck!

Hmmm.    I'm concerned about that "it's swollen" comment.   Does he mean that the band slipped, and there is now a larger percentage of the stomach above the band than there used to be?   Or is he actually implying that the upper part of your stomach has enlarged/stretched.  

If your stomach is actually reacting negatively to the presence of the band, you may need to have it removed, and possibly consider a different type of WLS.   Since you've done well with restriction alone, a different option might be a Vertical Sleeve Gastrectomy.   In this surgery, they actually remove a portion of the stomach, leaving you with a sleeve.   There are no fills, and no foreign objects to slip or break.   The stomach still functions like a normal stomach; it is just significantly smaller than it was originally.    I'm familiar with this because it is the top half of a DS.   My original restriction was about 4 oz.   My stomach now is about the size of a coke can. 

If the band has slipped a bit and just needs to be put back in place, that may be fine.  My concern then would simply be, what can be done to ensure it doesn't happen again?  

As for what to eat, the Band works best on people who eat a normally healthy diet, but who have issues with portion control.    So continue to eat the types of foods that have helped you be successful up until now, but pay close attention to how much you are eating.   Some helpful guidelines - 4 ounces of meat is about the size of a deck of cards.   Your finger is about an ounce. 

Also - if hunger were on a scale of 1 to 10 where 1 was starvation and 10 was Thanksgiving-stuffed, strive to stay in the middle zone.   Eat when you are a 3.   Stop when you are a 7.  Don't eat again until you are back to a 3.   Eat to make the hunger go away.   DON'T eat to get FULL.  If you're not sure that you're hungry, you're NOT hungry. 

Good luck!  

--BT

Thanks for your reply. The word "swollen" was my word choice not the doctors. He specifically said that the band has not slipped, just that the upper stomach stretched out a bit. He thinks it was because I was just a hair too tight and my stomach looked for a "path of least resistence" by stretching out a bit. I'm lucky enough that I have some retriction with just the band and no saline so I think I'll be ok, I was just really not sure if other people had experienced this and how they handled it in terms of what foods they ate during the down time. From other replies I've gotten on other boards it looks like it's back to liquids for a little while and a very slow work back through the stages to solids.
Thanks again!

I am glad that your doctor found your problem in time. My concern is the baby. If you are nursing you can't do the Atkins however you can do the South Beach. Take care of yourself and your family. You are doing a great job at both. Aloha, Asia

Thanks for your reply... things are going well, I was on liquids for two weeks and now I'm just chewing and chewing and chewing all of my food better than I've ever done before. FYI, I'm not breastfeeding... I wouldn't be dieting at all if I were but for better or for worse I've never been able to so... thanks again for your words of encouragement.

Mechanical break downs like the one you described are very common with the band. If you are doing well with restriction only...you might want to revise to the VSG. There is very little chance of any kind of mechanical break down....

Scott