Hello everyone. The following is a letter to our Lap Band patients. We posted this a while ago but thought it would be helpful to post it again as the holidays are approaching, which can pose a challenge to weight loss and weight maintenance. We hope you find this reminder helpful, and you are encouraged to come in for a follow-up with Dr. Liu to discuss your progress.
Dr. Liu’s Message to All Lap Band Patients
I am happy to hear that many of you are doing well with the Lap Band and continue to lose weight. Congratulations to you! I know that your commitment and work toward a healthier life style are paying off. This is a friendly reminder that regular scheduled follow-up visits at our office is vital to managing your weight loss and equally important in providing good after care for the Lap Band. Many patients are very happy with their Lap Band procedure and the weight that they are losing with the Lap Band in place, so they do not think that they need to schedule a check-up or follow-up to make sure that “all is healthy and working properly,” including the Lap Band itself. I urge all patients to make monthly follow-up visits in the first year, and thereafter, every six months to allow for a check-up and if necessary, an adjustment of the Lap Band. I know this may be difficult with your busy schedule, but our office will work with your schedule to find time. We also offer Saturday clinic appointments. The check-up at our clinic is important to make sure that the patient is not experiencing malnutrition or maladaptive habits. I believe either the Lap Band or the patient’s diet needs to be adjusted, and these follow-up visits are opportunities to do so appropriately. The Lap Band should be adjusted to allow consumption of a variety of healthy foods without an obstruction or “getting stuck” feeling. Yes, the Lap Band is working properly when you are able to eat four healthy small meals daily (breakfast, lunch, snack at 3 pm and dinner).
For those patients who are not having an easy time of it or becoming frustrated with their restriction with their band, please call our office for an appointment as soon as possible. Please do not think that you have to continue struggling on your own. This message also applies to patients who may have been successful, however have been experiencing discomfort with the Lap Band recently. The Lap Band may tighten over time slowly as caused by capsule contracture, which is a build-up of scar tissue. In either case, we may need to adjust your Lap Band and diet to get you on track again, so please come in to discuss what is happening and to determine how we can best resolve the issues and symptoms. The Lap Band is not working properly when the patient cannot eat solid foods without issue. These patients may drift towards the “ice cream, chocolate, and potato chip diet,” because these sweets and highly processed foods can be swallowed and digested easily. In addition, patients who are experiencing obstructions regularly are potentially stretching out their esophagus and damaging the Lap Band. In both cases, the Lap Band is too tight, and it needs to be loosened to stop the maladaptive behaviors and prevent malnutrition. I remind patients frequently that they will lose more weight when their Lap Band is loose enough for proper consumption of healthy foods compared to when their Lap Band is too tight for anything other than liquids and highly processed “junk” foods. Our goal is to determine and maintain the “sweet spot” for our Lap Band patients!
Patients who have experienced an obstruction, and had their Lap Band loosened urgently often become gun shy of follow-up visits. Unfortunately, the patients who take a “Lap Band vacation” may gain weight during this period, especially those who consume breads and pasta. I urge patients to avoid breads and pasta, which will frequently cause obstructions and makes losing weight more difficult. Based on recent Lap Band studies, I recommend that patients take small bites, take their time to chew before swallowing, and take sips of water (or natural fruit-infused flavored water) between bites to aid digestion. If you have been on a “Lap Band vacation,” please schedule an appointment with our office to get back on track.
For my long time Lap Band patients, follow-up visit every six months and periodic barium upper GI studies are necessary to ensure that the Lap Band remains properly placed. Our preferred radiology centers perform the barium upper GI studies under my orders regularly, and their specialized experience minimizes the chance of an incorrect reading, which could lead to an unnecessary surgery to remove of the Lap Band! At times, an upper GI endoscopy may be necessary to diagnose Lap Band slippage, especially if the patient is spitting up dark brown fluid. When you come in for your follow-up visit, we can discuss the need for either the barium upper GI study or the upper GI endoscopy. Our office can help schedule the procedure for you. Note that it is important to loosen the Lap Band prior to undergoing both of these diagnostic tests to minimize unintended damage to the Lap band itself and injury to the stomach.
These scenarios are just examples of situations that Lap Band patients experience, and with your participation, our office can provide good after care of your Lap Band and help support your healthy goals long term. Our office is committed to supporting you in your efforts to be healthy during the first year and beyond. Please give our office a call to schedule your follow-up visit. Happy holidays!