Re: Question about pouch dilation

[Guest guest]

For what it is worth I agree with this option. Surgery will always be

there if it is needed, but with an unfill you should be ok for now.

But keep them checking it regularly.

dan

Monday, May 19, 2008, 7:25:50 PM, you wrote:

> surgeon #2

> said it is very difficult for even the most experienced surgeon to

> differentiate on films a true slip from just pouch dilation so we are

> taking the conservative route of unfilling first.

--

" It's OK to be a little broken, everybody's broken in this life " Jon Bon Jovi

Dan Lester, Boise, Idaho, USA www.mylapband.tk

Banded 4/27/03, Dr. Ortiz, Tijuana

Started at 355, at goal in the 210-220 range for almost 4 years

Ultimate goal of 195 Tummytuck in Boise and SmartLipo in Tijuana

[Guest guest]

hi, sorry you're having trouble!

A pouch dilation IS a type of slip, and it's the more minor kind.

(none is really minor,but the BIg slips with sudden inability to eat

or drink can be very urgent/emergency things)

These smaller slips can often be corrected by a total unfill and rest

period of at least a few weeks. I don't know exact percentages -

there are too many individual factors involved.

Yes, after a slip/dilaton, we must be extra careful , as it seems to

be true that the prblem can occur again more easily afterwards. Part

of this may be bcuase the esophagus is a bit damagd and no longer

gives clear " soft stop " signals - or perhaps it is that we no longer

heed them and get used to and ignore them.

the BAND , of course, is indestructible and uncompromised - it is the

stomach that is sensittized and needs extra care.

This means great attention to never getting/keeping a too-tight fill

again (the major cause of this type of slip/dilation) and self-

limiting to 1-1.5 cups of food even if wee " can " eat more. This can

be hard but is really necessary. We have to KNOW the signs and

symptoms of a too-tight fill to avoid or reduce them.

Unless you are totally unable to eat or drink (which i doubt, or you

would not be casually asking this question here :-)

I surely would go the conservative, non-surgical route first and get

the total unfill. eat carefully for mayb 3-4 weeks, (see what your

doc says) and then get another fluoro to see how the dilation has

healed. then, you can tell more about if surgery might be needed.

my bet is it will not be, and i'll keep my fingers crossed for you.

this is where a very highly experienced doc comes in, who has seen

and treated this type of thing fairly regularly.

few would rush you off to surgery as a first stp.

with a total unfill, you'll be able to eat more than 1-1.5 cups of

food, and this is ok at THIS time, since it will be going right thru

the band. we can only dilate a pouch (or not heal it) if there is a

fill causing the food to back up. I would try hard to limit to about

2 cups, though, and do your best to choose low calorie but filling

foods, so you don't regain much, (or any ideally).

please keep in touch, and let us know how you're doing. we care!

Sandy R

>

> I was recently diagnosed from a barium swallow with a pouch

dilation

> and/or slip. 2 doctors have looked at my films. Does anyone know

what

> percentage of folks have dilation correctd with an unfill and how

many

> end up in corrective surgery? Also, once the pouch has dilated and

> assuming it is corrected through and unfill and healing period is

the

> original integrity of the band compromised i.e. is it easier for it

to

> dilate again and/or slip?

>

> I have had 2 surgeions look at my band. One called my films

> a " substantial slip " and said only surgery would correct it and

that

> the stomach would not slip back up throught the band and surgeon #2

> said it is very difficult for even the most experienced surgeon to

> differentiate on films a true slip from just pouch dilation so we

are

> taking the conservative route of unfilling first.

>

> Needless to say I am confused and worried about how good of a shape

my

> band will be in if the dilation does correct itself with the

unfill.

> Any input would be greatly appreciated.

>

[Guest guest]

I can't answer you on the slip, but I can on the dilation. I had an esophageal

dilation and that was successfully corrected by a complete unfill. Since you

have one doc saying one thing and a second saying another, maybe get a third

opinion? Sometimes being a loser is a GOOD thing! 5'11 " 306 / 256 / 189

PreOp / Now/ Goal Banded 09/14/06

@...: lgrantham@...: Tue,

20 May 2008 01:25:50 +0000Subject: Question about pouch

dilation

I was recently diagnosed from a barium swallow with a pouch dilation and/or

slip. 2 doctors have looked at my films. Does anyone know what percentage of

folks have dilation correctd with an unfill and how many end up in corrective

surgery? Also, once the pouch has dilated and assuming it is corrected through

and unfill and healing period is the original integrity of the band compromised

i.e. is it easier for it to dilate again and/or slip?I have had 2 surgeions look

at my band. One called my films a " substantial slip " and said only surgery would

correct it and that the stomach would not slip back up throught the band and

surgeon #2 said it is very difficult for even the most experienced surgeon to

differentiate on films a true slip from just pouch dilation so we are taking the

conservative route of unfilling first. Needless to say I am confused and worried

about how good of a shape my band will be in if the dilation does correct itself

with the unfill. Any input would be greatly appreciated.

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