Hep C & Lap Band?

[m_strings]

I've got another question to throw out there: Are there any known contraindications of lap band procedure with a Hep C diagnosis?  I initially found out about my diagnosis by going to my doc and getting a second opinion on the Lap band procedure.  My blood pressure was high and he wanted to up my atenolol.  I advised my doc I am too fatigued now and would not want to up the med if possible.  He looked at my past labs and noted my liver enzymes have been abnormal for some time and ordered a Hep panel.  I'm certainly glad he did.  Anyhow, my general practitioner thinks that the surgery would still be a good option.  However, I thought I'd better wait and see if I get sick to my stomach on the treatment.  Vomiting and Lap Band are not a good mix.  I also know the procedure involves some manipulation of the liver so was waiting to make sure I didn't have much liver damage.  

So, I was just throwing this topic out there and wanted to know if anyone with Hep C had the lap band and what type of experiences they have had.  

Thanks in advance.  

[Kathy73]

I second that! It is very tough on the body and you won't get an argument from me on that. We are all individuals and doctors practice medicine. It is not a absolute/hard science. It is always changing and what works for one person doesn't for others.

[alagirl]

No doubt!  

[alagirl]

Its great that you are being successful and I sincerely hope - as I hope with each and every person who enters treatment - that you reach SVR.  I WANT SVR for everyone, trust me.

Certainly not everyone who is obese going into treatment will fail to reach SVR, just like not everyone with the optimal conditions and genotype for treatment will reach SVR.  The research just shows that obesity going into treatment is a risk factor for failure to reach SVR.

Treatment is so difficult on the body that sometimes people choose to change or modify as much as they can, any risk factors that are possible for them to change, beforehand in order to have the best possible chance of being successful.  That can include losing weight and getting one's blood sugar under control.

[m_strings]

Like cigarettes, there should be a warning label on Ben & Jerry's!  ;>)

[m_strings]

So, I'm curious.  Those with cirrhosis also have an independent risk factor for nonresponse to antiviral treatment.   Would you give the same warnings (or as someone else gave: advice of waiting for treatment) for someone with cirrhosis?  There seems to be some assumptions out there that obesity is just something that can be easily controlled, when in fact, research on obesity and heredity factors indicate otherwise.  If every obese patient waited to get to the perfect weight to begin treatment, their risks of liver damage and mortality would most likely rise.  If the person you referred to hadn't tried for numerous years to lose weight before or had major complications related to obesity, I can certainly see the justification for encouraging them to lose weight before tx.  However, it's dangerously ignorant to assume all people who are overweight have major health problems.  I'm not advocating for obesity.  I'm just trying to make sure that the facts out there about weight are not skewed.  

[Kathy73]

Pretty amazing then that I had almost a 5 log drop at 4 weeks and UND at 12. I started treatment at 250 lbs. I have two hepatologists that have decided that I have an 85% chance at SVR. So what does that do to your figures?

[alagirl]

I'm just quickly making a note here because I don't want folks to get the idea that obesity has no affect on the success of HCV tx.  It is a risk factor for failure to reach SVR.  We had someone on the forum whose doctor had him lose weight prior to treatment, and he did.

Also, not everyone loses weight on treatment.  I, ahem... managed to gain about 60 lbs during mine and I was teensy prior to treatment.  (All that damn Ben and Jerry's)

http://www.natap.org/2003/oct/102403_8.htm

"High body mass index is an independent risk factor for nonresponse to antiviral treatment in chronic hepatitis C  
  
  Hepatology; September 2003, Volume 38, Number 3

Bressler, Guindi, Tomlinson, Heathcote. Departments of 1Medicine, 2Pathology, and 3Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.

“….Obese patients as judged by their BMI, independent of genotype and cirrhosis, had approximately an 80% lower chance of a sustained response to therapy compared with normal or overweight patients…” "

[Kathy73]

Please keep in touch with your decision. If I can help at all, I'd be pleased to.

[m_strings]

You have good insight and it sounds like wise advice.  I've noticed just in the several weeks since diagnosis that I have had absolutely no problem sticking with a change in diet pattern.  There's something about receiving a Hep C diagnosis that crystallizes the reality of a shortened life expectancy if negative habits are not changed.  Maybe, like you, I won't even need to consider the band.  By the way, congratulations!  How exciting for you!  Thank you again for your input.  It's much appreciated!!!

[Kathy73]

From what I've heard about lap bands you will need to make considerable changes in your life to accommodate it. I responded to your previous thread to tell you not to over worry about being overweight on the Hep C treatment. I started over 3 months ago at a high BMI, high VL and am UND. The only good side-effect I've noticed about TX is that I easily lose 2 lbs a week without changing my eating habits. I'm sure this will change when I'm finished treating but I'm loving that aspect at this point. Each of us are individuals and will or will not respond to treatment according to that individuality. I've seen people on here in perfect shape that didn't accomplish UND. I would suggest that you wait on the lap band and either start treatment or wait for better drugs and try to lose weight indpendently.