Ask Dr. Curry

Hi Dr. Curry, I haven't been on the board in several months.  I had the lap band in February of 2006.  January 2007 I started having major problems.  I couldn't keep anything down.  All my saline was removed, but I continued to have the problems.  Bottom line my band had to come out.  I had lost over 100 lbs and I've already gained back 45 lbs.  I've been looking at the mini gastric bypass.  I would love to know what your thoughts are on this.  Also, I would value your opinion on any other options that may be available to me.  In advance, thanks! PParker

There are only a handful of surgeons across the country that advocate the mini gastric bypass.  I think it's not the greatest operation and offers no advantage over a gold standard laparoscopic gastric bypass.  Have you considered the sleeve?  We have converted a few band patients to sleeve with very good success. Trace W. Curry, M.D. Lap Band and Realize Band surgeon Cincinnati, Ohio http://www.TheBandDoctor.com 513.559.1222 / 877.442.BAND DISCLAIMER:  Any information contained within is meant to be general medical advice only.  Please consult your surgeon on your specific problem!

Dr. Curry - I had fill #3 this past Thursday.  I have a little over 6cc's in a 10cc band.  I was on liquids Thursday and Friday, "mushies" on Saturday.  On Saturday, I tolerated all liquids well (unless I forgot and gulped then it hurt going down, but it did go down).  I even was able to eat about 2 oz of very moist chicken salad and crackers (Bumble Bee brand) without incident.  I also had some hot cereal the Saturday night (hominy). This morning (Sunday) I had to have a D&C.  I had asked my band surgeon if the D&C was okay to do so close to a fill and she assured me it was okay.  The D&C was done in my GYN doctors office with an anesthesiologist present.  I forget the name of the anesthesia, but I was told that it was short acting and that I'd only be out for about 20 minutes or so.   About an hour and a half after surgery, I attempted to eat some hominy (grits).  Wrong move!  It wound up getting stuck and the pain was unbelievable.  Finally after about an hour I vomited.  I felt instantly better.  Since that episode, I have been unable to eat anything at all (not even going to try) and drinking is a challenge too.  I feel "somewhat" better and I'm sipping pedialyte very slowly to stay hydrated.   My question is, how could I be fine the first couple of days after a fill, and then on the third day be too tight?  Could it be the effects of the anesthesia?  I definitely plan to follow up with my surgeon, but I thought I'd ask you in the meantime.  Thanks in advance.

Dear Dr. Curry, I have had my band for a year and four months. I lost the first 60 lbs. very quickly. I have been the same weight since June (85 lbs lost). My band is very loose but when it gets tightened I have problems with being stuck. The real problem is me. I have given up alot of my bad eating habits but there are two I really have a problem with. One is that I graze all day. I don't think two hours go by without me eating something. My biggest and most worrisome problem is at 3:30 to 4:00 in the afternoon. It is at that time of day that I usually blow enough calories to not be able to eat the rest of the night. It is like I can't get enough to eat. I don't know if my sugar drops and that is why I started eating frequently. I have gotten shaky if I don't eat. I have always gotten extremely tired around the same time of day (3:00 to 4:00). So tired in fact that if I lay down I could sleep. Besides the physiological issues is there anything physically that could cause me to hold on to these habits. Any insight would be greatly appreciated. Donna Maria

Donna Maria, If I were you I would research the glycemic index approach to eating.  Foods that are high in glycemic index will make you hungrier more quickly and are less nutritionally dense.  Stick to low index foods and this may help. Trace W. Curry, M.D. Lap Band and Realize Band surgeon Cincinnati, Ohio http://www.TheBandDoctor.com 513.559.1222 / 877.442.BAND DISCLAIMER:  Any information contained within is meant to be general medical advice only.  Please consult your surgeon on your specific problem!

I am currently breastfeeding my 6 month old.  Can I get the band while breastfeeding and continue breastfeeding?  I have never had any supply issues, she is my fourth child I have breastfed, and I have nursed them all until about 18 months.  If anything, I have too much milk right now!  I really don't want to wean her to get this surgery, but I also don't want to wait another year and risk more health problems.  Thanks! What about with the VSG?  I am trying to decide between the two.  Thanks! Cindy Johnson

VSG I would not recommend while breastfeeding but I think the band is ok.  Your caloric intake would be way to low with a sleeve to produce healthy milk. Trace W. Curry, M.D. Lap Band and Realize Band surgeon Cincinnati, Ohio http://www.TheBandDoctor.com 513.559.1222 / 877.442.BAND DISCLAIMER:  Any information contained within is meant to be general medical advice only.  Please consult your surgeon on your specific problem!

i am wondering as there are a lot of comments about stretching the stomach if you over eat. I do feel full and I stop.  Sometimes I feel fuller than others.  Does this really happen???  How much do you eat before you have stretched it out.  One person said she thinks of it as a plum size.  What is the real facts on eating a little bit to much and stretching out our stomach. 

It can happen, you need to learn to stop eating when you're full, not when your stuffed.  This is a difficult thing for most of us Americans (self included) to do! Estimate how much food you NEED, measure it out and put it on your plate.  Don't stack your plate with way too much food and sit down and eat until you're stuffed. Trace W. Curry, M.D. Lap Band and Realize Band surgeon Cincinnati, Ohio http://www.TheBandDoctor.com 513.559.1222 / 877.442.BAND DISCLAIMER:  Any information contained within is meant to be general medical advice only.  Please consult your surgeon on your specific problem!

hi Dr. Curry....I posted this in another thread, but someone reccomended that I ask you for your advice.... I was banded almost a year ago, Feb 5th 2007.  Everything seemed great until I went for my second adjustment in late August.  The doctor told me he believed my port had flipped and that I'd need a second surgery to correct it. Ok, so it sucked, but I went for the surgery and while I was under anathesia, the doctor also added some fluid to my band.  Apparently he put too much in, because less than 12 hours later I found myself in the ER, where they determined that I was too restricted and they had to remove some fluid.  The first resident that tried obviously had no idea what he was doing (he put the needle in more that 5 times, drawing blood, not finding the port, etc), so I demanded that he stopped and get someone else down to fix the situation.  A resident that works under my surgeon came down and got it on the first try....but needless to say, I was extremely bruised and sore from the first guy poking and prodding around, especially since I had just had surgery to repair the port not even 24 hours prior. So after that, I had to wait until all my brusing and swelling went down before I could have the band refilled so I'd feel some restriction (right now, there isn't anything in my band because they took it all out in the ER)  I finally just went back this past Thursday to be adjusted, and guess what----I was told the port flipped AGAIN!  The surgeon told me it could have been from when I was exercising, but I strongly suspect it has something to do with my experience in the ER.  Either way, he says I have to have surgery AGAIN.....for the 3rd time in just under a year! I honestly don't know what I should do.  I don't want to have to keep going back for surgery.  I'm pretty much at the end of my rope with this whole experience and I feel like I'm ready to give up.  What would you guys do in my situation?  I'm just afraid that the port will keep flipping, which is something my surgeon mentioned to me might happen, because there is no "100% guarantee that it will stay in place."  At the same time, I feel like I've come this far, so why give up now?  I don't know what I'd do if I went through the 3rd surgery only to find out that the port has flipped again.  Any advice would be strongly appreciated! Thanks :) edit:  just incase you were wondering, to date I've only lost 40 lbs, and I've stuck to my diet and exercise regularly. I believe I would have lost much more by now if my port/band was working correctly and I didn't have to keep having the port replaced and if they hadn't removed all the fluid from the band that night in the ER.