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jachut

End of my 12 year lap band journey :-( - But I would do it all again

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Feeling melancholy today - my band and I parted ways in dramatic circumstances last Tuesday.  Made a lot more stressful and emotional by some pretty appalling treatment by the very peple who are supposed to have your best interests at heart.  

As I have said here before, I've had a problem with a "pouch" for a few years now.  I've also had weird chest pain episodes - a kind of dull gnawing ache would start, and the radiate to my throat, jaw, ears, through my back and even down my right arm. Its been escalating for a while now and I've had lots of days where I've just felt "off".  I had also begun to gain weight - not seriously but I was feeling fat and unhappy. I went back to my clinic, ready to discuss revision surgery. The doc suggested putting fluid IN so we tried it, 0.3ml in my 4ml band. Took me up to 2.3ml where in my good days before problems I'd been at 3.  I was so very tight.  Had the nighttime reflux (which to be honest I had anyway), but it felt PERFECT in terms of eating and my weight begain to decline - very slowly, sigh. I had an appointment with my surgeon for six weeks hence so I toughed it out.  Of course he took the fluid back out even though we were concerned that it would set off the chest pain. And it did. Two hours later I was home and BAM, on it came, so intense. It must be what having a heart attack is like and causes me to hyperventilate and faint.  I had to call an ambulance as I could not get to see my surgeon, we went to The Valley and I was stabilised on lots of morphine - they had to max me out to settle it.  Had an ECG and such too of course.  I rang my surgeon and he said to go back to the clinic and put fluid in. But before I could do that I had another attack and had to call another ambulance. Same routines, maxed on on morphine and sent home, this time with a "cant help you here, go somewhere else next time".  My surgeon kindly fitted me in very early Friday morning as he was flat out finishing up to go on his own holiday. He put some fluid back in to settle it and prescribed a fair few medications and gave me the name of a colleague who was covering him over his break.   I was OK Saturday but woke up early Sunday in extreme pain again. So call the ambulance and back to hospital, dandenong this time. Another five or so morphine shots settled me down but again, nobody could say what was wrong.  And the minute they hear "lapband" they dont want to know you. but the did some chest and abdominal xrays which were clear however the doctor did give me some Coloxyl as he said I was really full of poo!  Thinking about it, I had had no output for days (I have a colostomy).  They called the covering surgeon who didnt want to know about me, he refused to do anything and said "tell her to go back to the clinic, they know her there" Anyhow, they too said "dont come back here".

So come Monday my DH took me in for a barium swallow which showed not exactly a slipped band but it was pretty horizontal and worse than I know it was before.  It was functioning perfectly though, the barium went through fine.  The instant the test was finished I was in trouble again, only this time, my husband took me straight into the clinic (not fun on the Monash). He was amazing, I was so numb all over because of hyperventilating.  We staggered in (they were expecting me) and the practise nurse and doctor were so amazing. In a long, scary and traumatic week, it was so comforting to see a friendly face and somebody who had some knowledge. The fluid all came out immediately and the doc got on the phone to this surgeon - and she had to fight for me, he was NOT keen.  They got me a bed in the hospital and off I went to be operated on the next day.  I did meet him briefly pre op and of course I was FULL of questions but he really didnt know me and couldnt answer then and all along, my symptoms have had everyone baffled.  So I had the op and it was quick and easy.  I came to very well and was a bit emotional but go over it and on with recovering. The next morning the surgeon came in and reported that it went fine and I said "please tell me it needed to come out". He shrugged and said "are you better?" So cold!  I mentioned that I was by now feeling extremely constipated, being full of morphine and barium and he put up his hands and said "Hey, not my speciality".  I then proceeded to have another full blown chest pain attack, and had to be kept in the entire day. I went home that night, sad about losing my band but sure that when I see my surgeon next, we will discuss where to go from here.

So Thursday morning I wake up pretty uncomfortable - its now eight days since there's been ANY stool or gas output for me.  I took a huge dose of lactulose and walked on the treadmill for a bit, but I began to have some quite awful symptoms which I wont go into. To cut this very long story short, within two hours I'm in Cabrini emergency (my colorectal surgeon is there) with a bowel obstruction.  In the midst of writhing and screaming in agony, who should appear beside my bed but this surgeon, interrogating me as to why I came to Cabrini and why I'm seeing another surgeon.  I assured him this was a different matter and I did not think it was connected to his surgery two days before. He had a quick look and said "Well, I dont think its anything I did" and left!  I ended up enduring 9 hours of agony before having a decompression done later than night by my own colorectal surgeon and then spent two more days in hospital.

Thanks to anyone who's read this far. I just feel so upset and angry over how I've been treated, I really needed to write it down. I've not mentioned a single name becuase I dont want to raise concerns about anyone's doctor, clinic or surgeon as every case is individual.

I really dont know if I want any more weight loss surgery. My BMI is 24.5, and right now, I'm so traumatised, exhausted and drained that I cant even think about it.  But I do not regret being banded. It changed my life, completely.  I'm quite aware that most people regain eventually, so that whilst I'm full of resolve now, eventually that will wain and the inevitable will probably happen. So I dont know what lies ahead, I will speak to my surgeon in a couple of weeks. I'm not sure I can have another band.  

On a good note, despite a day or two where it continued, the chest pain has disappeared - although it happens so suddenly I cant say.  And I ate cherries! Bliss.

Edited by jachut

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I'm with you on the bowel obstructions-they are extremely painful and the surgery is no walk in the park. Christmas is not a time together complications as you found out in such a horrific way. Love the way (not!) he blew you off with the 'not my fault' comment.   Hope you recover soon and enjoy those cherries! They are delicious this time year.

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Eeek, what a hideous experience.  The pain, the worry, the disruption to your life and the way that you were treated by that nasty surgeon and staff at the hospital.   May I suggest that you write a letter of complaint to the Patient Liaison Officer of that hospital?  They were being biased and judgmental because you had a gastric band, and let that get in the way of good clinical investigations.

I also had a nasty time a couple of years ago when I was discharged post-op (incisional hernia repair) with a paralytic ileus and a small bowel obstruction.  (More info in my blog).

I am pleased for you that you are over and are recovering from that hideous time, and can only hope that things get much, much better for you. 

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Thanks for your empathy guys.  On a good note, yes, its scary to feel how you just dont get that hard stop without a band but thankfully, the foods my body is driving me towards are all the healthy ones - fruit, salad, and All Bran cereal!  I know from being completely unfilled for 9 months whilst I had my cancer treatment that this lasts a good 6 months or so before the desire for bad foods starts to creep in.  With my band, although I *could* eat anything, my taste for those healthy foods falls way off and I just want things like custard, chocolate, biscuits - easy things that take no work to digest. So no doubt, I will begin to feel pretty good on this healthy diet in the near future, like last time.

So I dont fear massive weight gain in the short term, as long as I stick to 3 meals, no snacks and reasonable portions.  In fact this whole ordeal has given me a real kickstart and I'm on the downward path, under 75kg for the first time in 3 years.  And I will follow the advice of mu surgeon when I see him.

Edited by jachut
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Just an update - a month later I have stayed under 75kg - I have not gained any weight at all.  Its really all down to making good choices - at first I was not hungry at all, and got full pretty quickly but as my stomach has healed, I am eating more.  I have a blanket rule - no eating between meals EVER and absolutely no biscuits, cake, chocolates or other junk. And stay away from alcohol apart from the odd occasion.  And I've been walking for an hour every day. I'm absolutely determined that if I do have another band put in, I will not spend the first six months of my new banded life working to get off the weight that I gained.

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Sorry to hear about your horrendous experience!! Glad your health is OK now and hoping you are able to manage with all the knowledge and experience you would've gained in the many years since being banded. Good luck with you choice re whether to get more surgery or not xx

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I finally saw my own surgeon - he was a bit shocked. I dont know what it is with these doctors (my colorectal guy is the same) but they just dont believe me when I say I'm experiencing pain. They seem to write me off as a hysterical female but he was really shocked when he looked at my barium swallow - he called it a slip this time, not a pouch. Ok, so the way I experienced it was not text book - no vomiting, no restriction, no difficulty eating, just heart attack like pain, but jeez, when I say its 10 on the pain scale, I mean it! I dont mean a 5 but I'm a big wimp!    

I asked if I had a "window" for this to be revision surgery and the answer was it would really have had to have been done at the time, in the one operation for it to be a revision, as it stands now, he will not replace it because I am a normal weight.  This is more than OK by me, I have not gained any weight at all and I am so enjoying eating normally.  Nor will he replace it even if I regain 10kg!  I pretty much will have to be well on my way to morbid obesity again.  

Its been a really big lesson.  Being without my band now, has made me realise it has been doing absolutely nothing for me for the past four or five years.  Other than some weird,  inexplicable altering of the foods I find desirable. With my band I could eat anything - I never vomited. But I had gone off fruit, salad, meat, bread, anything healthy basically.  All I wanted was soup, chocolate, biscuits and coffee. And that's what I ate for the last three years.  Once it was out, that sugar dependence disappeared like magic. I have not even thought about those foods and suddenly I really love healthy ones again. So it has been effortless to control my weight - all I have to do is be strict on portion size, but choosing the right foods is no effort at all.  

Have I been hungry?  To be honest yes - but it is normal to get hungry in between meals after a few hours, especially if you are trying to be moderate on portion size. And you dont die from having a grumbly tummy for an hour or two.  I've just accepted that hardly anyone can eat what they want, when they want and be a normal weight.  Especially 50 year old post menopausal women!

The moral of this story is that a tight band is not really the answer. I have no doubt I am partially responsible for what happened, but I do think that my doc knew about this problem and should have done something about it two or three years ago rather than just unfill me and hope it went away.  But I was definitely looking for my band to do the work and it was way too tight and all that happened was I was living on sliders.  It really was down to my choices the whole time!

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I am cautiously optimistic that I can follow you lead.  I had another bowel obstruction a few weeks ago and they said they 'needed' to take out my fill-all 10mls.  After taking out the fill they had 5 failed attempts to put in NG tube (a nurse and a doctor).  I have an absolute dread of these devices.  I refused further attempts as well as the several attempts to cannulate me.  I stand for as long as the pain lasted and went home and stuck to fluids for a few days.  Went back for a consult with my Bariatric doctor and she told me she can't just put back the same amount of fill-has to be done gradually.  I'm going overseas for a month and there wasn't enough time for gradual fills so she asked if I would like to try it without. I thought of all the food I've been missing (not junk but heathy food) and decided to give it a try.  It's been 3 weeks and I still eat the same portion and walk 45mins+ a day and I've manage to lose 400gms in that time.  (I won't lie-a few chocs have made their way down but only a few-not a whole block!)  I'm feeling that I can manage ATM without having to worry about getting 'stuck' while I'm away.

I know i have the option of getting more fill in the future, however if things go a bit berserk before I go (Doc said if I suddenly put on 2 kgs in a week to go straight back!!) I have that little safety net.  Wish me luck!! (Lap band has been in 7+ years)

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I've had my band for 12 years too and am facing the prospect of losing it on the suggestion of my new surgeon. I wish I could say I wouldn't gain like you without it, I had volume removed for a scope (lots of strange pain and symptoms too) and gained 5kg in 5 weeks. I'm 10kg over my happy weight and he suggested I go back on Optifast 800cal a day to stem the gain & consider sleeving or ESG.  Not keen on these options at this point, maybe I'm just scared.

Keep us posted with how your are traveling!

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