Might upset some
Nancy....
AGAIN like I have said before it is my beliefs and opinions!
Over the years, I've seen more people end up too tight because of fillgivers attempting to "see" proper restriction than via conservative blind fills. I cannot begin to count the number of times I've seen people post that they tried to get an unfill because they knew they were too tight but the surgeon/fillgiver insisted they were not too tight because of what it looked like under flouro.
My surgeon WOULD never let a patient leave if they were overfilled. Based on the actually feeling of the patient as well as the fluoro images.
Actually, this is not true. You're more likely to get overfilled this way because barium is liquid and not solid food and doesn't behave anything like solid food and just because barium trickles through doesn't mean food will.
If the barium doesn't trickle thru then HOW can food possibly trickle thru an opening that food won't trickle thru?
And some people DO need more than 3.5cc in a 4cc band to get ANY restriction. It doesn't insinuate there's a leak by any means. I've known of folks who've needed over 5ccs in a 4cc band and their systems had no leaks.
Please re-read what I wrote.....that it would red flag that there MAY be a leak.....
I have to have mine under fluoro because I have a port thats angled and regular fills are to difficult, but I wanted to tell you that I have never swallowed barium. I think my surgeon only does that if he suspects somethings wrong. He uses the fluoroscope to see my port only and to insert the needle.
Your reasoning is very sound, imo, and differing points of view give no reason for people to be upset. points of view.
But I believe that it's impt for others to know that fluoros are still very imperfect, and - at best - a clue. You can be certrain that if they were the total answer EVERY band doctor would use one. With a very highly-experienced fill person, a fluoro is not needed often at all - maybe 1-2 x a year for assessment of the pouch and esophagus, largely.
an experienced fill person can also easily tell if the port is flipped, by yhe feel of the needle touching it. The membrane on the top has a very distcinctive feel. The hard titanium back has a very different feel. If a port seems to be flipped from the feell, then a fluoro can be used to confirm it.
Also, a good number of people need fills larger than 3.5 cc in the "4" cc band. and as people are banded at a lower and lower weight, they are litkely tyo need bigger and bigger fills as they go along. The 4 cc band can and doesd safely hold uch more than 4 cc.
"Overfills" occur hours after a fill, when the swelling peaks and after. The only thing thst fluoro tells is the the fill is not too much right then, in the office.
THEN, in thr next serveral hours-day, the swelling occurs - long after the patient has had any fluoro in the office.
fills are just a very imperfect science at this timne. The best solution is a very highly-skilled fill person, with or without fluoro..
Sandy R
DISCLAIMER: Any suggestions or comments are not intended as medical advice, but only as general information. Please always contact your own surgeon or his staff for any specific problems or concerns you are having. Although I have many years as a medical professional and band educator, I offer suggestions here only as an experienced Bandster.
(deactivated member)
on 3/6/07 11:34 am - Big Sky Country, ID
on 3/6/07 11:34 am - Big Sky Country, ID
I think you should get your fills however you want them. Me...I chose a dr. that doesn't use fluoro..I don't want the radiation; fluoro is useless when it takes your fill a week to kick in...you could be overfilled on fluoro as well as a blind stick in that case; I don't want to drink that yucky stuff; I don't want to pay a fortune for something I don't need and mostly my dr. has given me 8 fills with 1 stick.
Fluoro only shows the amount of restriction you have at the time of your fill. If you are someone like me that the fill kicks into high gear a week out...it truly doesn't matter how you got that fill...point is you are still overfilled.
If you want fluoro get it...it's your money and your band :)
Dee
Well said, Dee. Whatever works for your doctor is what you do. You need to trust your doctor from the very beginning. He is the "expert". I find that my doctor does a great job with the fills. It takes a week for it to kick in and he is pretty good at deciding what amount to insert. I have had three fills and have great restriction at this point. My next appointment is in 9 weeks unless I feel that I need more. I trust his opinion. If I didn't I wouldn't have let him operate.
Do whatever makes you comfortable. It is no one elses concern. If you can do the flouro, then go for it, imo.
Maggi
"Nothing is worth more than this day," Goethe
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