Expert: John Pilcher, MD - 9/10/2009

Question
hi, in Sept. of 2007 I had a lapband put in, at first I lost about 15 pounds due to throwing up all the time. I went back to my surgeon in Aug. 2009 after seeing the physician assistant 2 time before.  Per her suggestion I spoke with the surgeon at my Aug. appt. about a revision to bypass, (what a waste of my co-pay and time). He made me feel like a total loss, and recommended I go to weight watchers, because I was doing something wrong, He would not even consider revision. I had an upper GI and was told my band had possibly slipped, and I have a Hiatal Hernia. I had to have all the fluid let out of my band due to severe reflux and at night throwing up in my sleep, and severe esophagus irritation. I weigh as much now as I did when I had the band put in. I have border line type II diabetic, border high blood pressure, and I have severe sleep apnea. My GP is in total support of the revision, and has since counciled me for the past 4 months (again)to help with necessary ins. red tape. I have talked to another surgeon 127 miles away, but they will not take me due to being 2 hrs. away. What can I do to get this revision done? what recourse do I have? I'm desperately trying to get my life back. I'm 51 yrs. old, I weigh 232 #'s. 5'5" and a BMI of 38. Help, Please!

Answer
Linda,
I am really sorry to hear about your difficulties.  The information you have provided does sound like the Band has failed in your case, and given your weight with the other medical problems it does sound reasonable to move into serious consideration of gastric bypass.

I don't have any brilliant advice on how to get this done, because it is neither possible nor useful to push a surgeon into doing something he/she does not wish to do.

However, I don't think you should give up hope.  I suggest you look on the website for Center of Excellence and find a surgeon who is tolerably close to you.  I understood that the second surgeon refused surgery for you because you live 127 miles away; that may be a show-stopper for that program but most experienced surgeons do feel OK with gastric bypass surgery at greater distances.  In other words, my best suggestion is to keep trying programs and surgeons until you find one that is willing to take you on as a patient.

The search website is:
http://www.surgicalreview.org/locate.aspx

I wish you the best of luck,
Dr JP