lap-band

[pitagory]

Ok I am on PD and ever since January I have been gaining weight so far about 45 pounds my doctor says's its calorie in take but I don't eat much. well he referred me to doctor that does lap-bands. have any of you had this procedure done before.So that way I can qualify to do my transplant. I still have to wait a whole year because I just got some stints put in.

[lmunchkin]

His nephrologists has a nurse who had it done a couple years ago and did pretty good with it.  But as far as relative to what you want to do, I do not know! I really don't know if you should or shouldnt have it done!

Good luck, I know this didnt help at all. But I do know that she had it done and it has been a slow process for her but she looks much better!

lmunchklin
 

[Riki]

If you don't eat much, I don't know if the lap band will do much. Isn't it supposed to suppress the stomach so you feel full faster?  I'd be looking to see where it is you're taking in the calories before you go ahead with any surgery.  When I was on PD, I carried at least an extra 10kgs in fluid.  I didn't realize that until after I started HD.  I thought it was just fat that was causing my weight to stay so high, but it wasn't

[willowtreewren]

Pitagory,

you are absorbing glucose from the PD solution. Personally, I would advise against a lap band as it will affect how well you absorb nutrients from your food. 

Aleta

[billybags]

I agree with willowtreewren,, You are more likely to lose weight on PD. I would have to check to see if it is excess fluid you are carrying. The lap bands do not sound good to me. Are you following a renal diet?

[justjen321]

@pitagory

My husband is in the same boat as you are. He needs to lose weight, but PD is giving him a whack ton of calories a day. (We always, ALWAYS have to use at least 6l of reds, which is the worst offender)

He also has a sore on his heel that has him off his feet.

For these reasons, we will very soon be switching to home hemo, to rid us of the calories.

We have spoken with several of his doctors, as well as his Neph, and what they all say is sadly, very true. To lose, you have to keep your calories down (which PD fluid doesn't help with) and you have to MOVE. Often, it's hard to motivate to MOVE when ya don't feel particularly well, but the more you move, the more you'll lose, and the better you'll feel. Many, many of my husbands issues would get ever so much better by simply losing 100 lbs.

Good luck to you, I know it's a battle.

Jen

[cariad]

I seriously, seriously wouldn't, pitagory. So many potential complications.

Even if it is not fluid and you truly have gained that weight, I would seek out a transplant hospital that will let you on the list at whatever weight you are. There is just no solid evidence that increased weight leads to poorer transplant outcomes. If you do not have a choice of transplant center, perhaps you could use a different PD fluid, one without all the glucose? I know they make one for diabetics, so perhaps you could use those for a while and see if it affects your weight.

I would switch doctors. He is not listening to you and is referring you for dangerous, pointless surgery. You told him you do not eat very much and he obviously does not believe you. Fire him.

[glitter]

I can't remember where, but I read a study one time that said fatter people tend to survive longer on dialysis, and it pointed out the catch 22 of no transplant until you're thin

[pitagory]

Thank you everyone for all your advice. I have a doctor appoint tomorrow to see if this procedure is for me. I am sure they are going to try and sell me on this. I keep telling my doctor and my nutritionist its not the food I eat. I eat very little. I do follow the renal diet, I do cheat sometime but not offten I work on my feet all day I have always been a big girl but I have never been this big I weigh right now about 245. when I stared PD I weighed 185 and I eat a lot less than before. Before I use to eat lots of junk food and fast food, and now I eat healthy food, and the last time I had a hamburger was maybe 6 months ago. sometimes I only eat once a day and that is because my blood sugar drops and I have to eat so I just eat a chicken salad. I don't eat after 6 because then I cant sleep because I feel very bloated . In the morning I will have cup of coffee and a boiled egg with maybe some fruit like a strawberry and a slice of pineapple. In the afternoon I will have a chicken salad or some white rice and chicken and the chicken is  ovenbaked or steamed or charbroiled on a grill. for snacks I usually have fruit, if I do have a snack or sometime I will eat just a chicken taco with salsa and I make my own tortillas. the other problem I have is I cant walk to much I have peripheral vascular disease on my legs. I have had a bypass but it did not help at all.  I do work but I only walk form my car to the entrance of a store if its farther than that I have to take a brake for 5 minute and then keep going and I go to about 8 to 10 stores a day. I am lucky I have a very kind boss who understands me and is always ready to help when ever I need it.
@Cariad I don't know if I can find another hospital Loma Linda already turned me down and I was about 20 pound lighter then. I am trying to get in to San Diego. I don't know where else to go here in southern California.I did not know there was diabetic glucose fluid my nurse has never mentioned it but I will ask.

[Whamo]

My hospital won't let you get a transplant if your BMI is too high. 

[looneytunes]

We have heard there is a hospital in Columbia MO that will accept patients for transplant that are overweight and smokers....A gentleman in our hometown is both of these and is on his 2nd transplant from that hospital. 

[vcarmody]

@pitagory

My husband is in the same boat as you are. He needs to lose weight, but PD is giving him a whack ton of calories a day. (We always, ALWAYS have to use at least 6l of reds, which is the worst offender)

He also has a sore on his heel that has him off his feet.

For these reasons, we will very soon be switching to home hemo, to rid us of the calories.

We have spoken with several of his doctors, as well as his Neph, and what they all say is sadly, very true. To lose, you have to keep your calories down (which PD fluid doesn't help with) and you have to MOVE. Often, it's hard to motivate to MOVE when ya don't feel particularly well, but the more you move, the more you'll lose, and the better you'll feel. Many, many of my husbands issues would get ever so much better by simply losing 100 lbs.

Good luck to you, I know it's a battle.

Jen

Jen I know where your coming from.  My husband needs to lose weight also, he also has a diabetic ulcer, had one for over two years,  finally got it healed now he has a new one that was just operated on and the infections is in the bone. He has been on non-weight bearing status for so long he is like the marshmallow man just all fluff no muscle tone and even when his foot was healed exercising was out of the question because #1 he didn't feel good and #2  he is so out of shape it isn't even funny. I am old an achy but I still go to the gym but when I tell him he is out of shape he is like yea so are you, you hurt and moan and groan all the time... I feel like yelling at him of course I hurt I exercise you just meander around the house, but it does no good.  I figure if he wants to get off dialysis it is up to him to take the bull by the horns and do it.  Sooner or later he is going to realize that life is not being tied to a machine 5 days a week over 4 hours a day.  I stand behind him 100% but I just wish he would put some effort into losing weight.  He was also considering gastric bypass but then we had this last hurdle with his foot.  I think all he has to do is cut out the sweets (which he says he don't eat a lot of but when your overweight even 100 calories of sweets is to much) and do some chair exercises #1 to gain mobility and #2 to gain some muscle tone back. But in the end it is his decision not mine to decided he wants it.  He is only about 5 lbs from getting on the list and his BMI is 39, they told him if he loses 5 more pounds they would get him on to start earning points, but would not transplant until he is at a BMI of 35.

[cariad]

Thank you everyone for all your advice. I have a doctor appoint tomorrow to see if this procedure is for me. I am sure they are going to try and sell me on this. I keep telling my doctor and my nutritionist its not the food I eat. I eat very little. I do follow the renal diet, I do cheat sometime but not offten I work on my feet all day I have always been a big girl but I have never been this big I weigh right now about 245. when I stared PD I weighed 185 and I eat a lot less than before. Before I use to eat lots of junk food and fast food, and now I eat healthy food, and the last time I had a hamburger was maybe 6 months ago. sometimes I only eat once a day and that is because my blood sugar drops and I have to eat so I just eat a chicken salad. I don't eat after 6 because then I cant sleep because I feel very bloated . In the morning I will have cup of coffee and a boiled egg with maybe some fruit like a strawberry and a slice of pineapple. In the afternoon I will have a chicken salad or some white rice and chicken and the chicken is  ovenbaked or steamed or charbroiled on a grill. for snacks I usually have fruit, if I do have a snack or sometime I will eat just a chicken taco with salsa and I make my own tortillas. the other problem I have is I cant walk to much I have peripheral vascular disease on my legs. I have had a bypass but it did not help at all.  I do work but I only walk form my car to the entrance of a store if its farther than that I have to take a brake for 5 minute and then keep going and I go to about 8 to 10 stores a day. I am lucky I have a very kind boss who understands me and is always ready to help when ever I need it.
@Cariad I don't know if I can find another hospital Loma Linda already turned me down and I was about 20 pound lighter then. I am trying to get in to San Diego. I don't know where else to go here in southern California.I did not know there was diabetic glucose fluid my nurse has never mentioned it but I will ask.

I don't know much about PD so I could be wrong about this, but I thought Baxter's Extraneal provided less 'glucose exposure' and was indicated for diabetics. Is that what you are using? It has a generic name.

Pitagory, please stand up for yourself at this appointment and do not let them talk you into anything that you do not want to do. It is your body. SoCal has more transplant hospitals than pretty much anywhere else in the country - I was told 11 of them. All I can recommend is to avoid USC. Karol's daughter had a good experience at Scripps. Marc is at St. Joseph's I think. I thought Cedars was great but I don't envision them making any exceptions on their criteria as, like most famous hospitals, they seem pretty full of themselves. I generally liked how i was treated there, though, but because of my overall good health (touch wood) and several other details about my history, I knew I was in a privileged position with them. Most people are not so lucky and that makes me angry.

vcarmody, sorry to read about your husband's difficulties. Why they would keep someone off the list over five pounds will always be a mystery to me. I would stay on dialysis for life before considering gastric bypass. Read about some of the complications, not the least of which is a painful death. Excess weight can be a sign that your husband is not controlling his lab numbers, but if his labs are stable, what on earth do they think losing a few pounds is going to do for his overall health? It is lunacy.

Interesting about the place in Missouri. I don't know that I agree that smokers should be offered a transplant, but I guess I can see their point. Trying to control how we live our lives before and after transplant is degrading and turns health into a moral issue. I would be most curious to see their statistics on how people with high BMI fare after transplant. My guess is that if the sample size ever becomes large enough, we will see no statistically significant difference between high BMI recipients and lower BMI recipients. And that would be quite a valuable bit of data....

[Riki]

I don't know much about PD so I could be wrong about this, but I thought Baxter's Extraneal provided less 'glucose exposure' and was indicated for diabetics. Is that what you are using? It has a generic name.

Extraneal (my nurses called it Icodextran.  I'm not sure if that's the generic name) is a higher percentage soloution, meant to take off more fluid.  It's mostly used with people who don't want to do an extra run through the day.  They use is as their day fill.  I used it for about a week once, it dried me out so bad I needed to be hospitalized.  I don't know if there's a difference in the glucose in the solution.

[justjen321]

@cariad - I'm sorry to hear that, I know the struggle. His Neph actually gets that we are in a big ole catch 22. On D, they just don't feel good (although I am extremely hopeful that nocturnal hemo at home will help with that) which makes it harder to exercise and then more weight and... it's a merry go round. Much, MUCH luck with the foot ulcers. They are such a battle.

@Riki - I'm not sure if you are in the US or not, but here, in Indiana Ico (purple) cannot be used as a primary source. I've questioned it a million times, because the beauty of Ico is that the glucose is too large to pass into their systems. So, you pull lots of fluid, and you don't get the extra sugar. Plus, Ico can dwell FAR longer than any of the other strengths. When we travel, we use Ico for our travel time.

Our unit explained that it simply isn't approved yet for a primary source. My husband's final fill on the cycler is Ico every day, then overnight he uses greens and reds, which is where all the sugars come from.

Jen

[Riki]

I don't know what you mean by primary source... your husband is using it as I described.  I couldn't use it, because just having it in through the day dried me out.  I occasionally used a  2.5% mix (I don't remember the colors) but mostly just used 1.5%.

I miss PD greatly.  If I could, I'd go back in a heartbeat.  If I couldn't do hemo, I'd be screwed