Ask a surgeon

Hi folks.. Dr. Tom Sonnanstine of the Tristate Surgical Weight Loss Center, in Florence Kentucky.. is going to join us in a discussion ..I just received an email from him and he did explain he has surgery and seeing patients today..But he will reply to your questions as soon as he can. If you have a question you would like to ask you may post it here or start a new thread putting "Attention Dr. Sonnanstine" in the heading. Ask away!! Brenda

Dr. Sonnanstine, Just wondering if you have many post op patients experiencing issues with low blood sugar. I struggle with this daily and have to eat every couple of hours when I really don't want to do so. I've learned alot about simple and complex carbs since I've been having issues, but was just wondering if you have seen this in your patients and if so, do you think it could be a result of bypass surgery. Thanks, Sherry

Sherry..there many reports of low blood sugar after gastric bypass...people usually self-treat themselves just as you have -- by eating frequent and healthy snacks to keep their level up... Dr. Sonnanstine

Dr. Sonnanstine, I was reading Cynthia Miller's post where she was expressing her frustration as a lap-bander with being able to eat much more than she expected to be able to and still feeling hungry...in your experience, is this a common problem with the lap-band? Is this why people say that you can eat your way around the band? Also, Cynthia mentioned that her surgeon would only do fills on her band at six-week intervals...what would be the reason for that? Thanks, Lisa Eastridge

Lisa...you have mentioned my two major criticisms of the Lap-Band -- 1. it does not take away appetite and 2. people can "eat around it"...the Band does, typically, require more disciplie in order to be successful than does Gastric Bypass...most surgeons have different regimens of how they do and how they schedule their fills -- in my opinion, if a fill is inadequate over a 2 week or so period, there is no point in waiting 6 weeks for the next adjustment......... Dr. Sonnanstine

Lisa, wanted to add my observations..... Lapband WLS has a different "footprint" from RNY, especially in the period immediately following surgery. While RNY patients experience improvement in hunger and usually experience dramatic weightloss from the day of surgery, band patients experience delayed gratification. Once post-op swelling subsides, hunger and the ability to eat like a pre-op returns for most band patients, until their bands are adjusted appropriately - which usually takes 3 to 5 fills. Cynthia was banded 7/8. If I counted right she was 6 weeks post op on Friday Aug 19. So it was time for a fill. Unfortunately, the resumption of hunger after post-op swelling subsides and before fills begin take many bandsters by surprise. However, it is a frequent topic of conversation on the bandster forum. We refer to it as bandster he$$. Also, she is unlikely to feel much restriction or cessation of hunger from her first fill. What Cynthia is experiencing AT THIS POINT is perfectly normal at this stage in her journey. With additional adjustments, I expect she will experience a improvement in both hunger and satiety/volume. My experience - with my second fill I felt a great deal of restriction. I definitely have to eat slower and chew my food better than before or I suffer unpleasant consequences. I have also experienced a significant decrease in hunger - I no longer constantly think about food. I am not constantly hungry. So while it may be true that the band does not create a significant decrease in hunger out of the gate, with proper restriction, I think most bandsters do experience it. Someone posted a reference to this post/response on the band forum and it got a number of responses. I've included a link in case you are interested. Most bandsters replied that they are definitely less hungry. http://www.obesityhelp.com/morbidobesity/surgtype-forums/LapBand/postdetail/211906.html?vc=0