Re: Fluro vs. Upper GI

[Guest guest]

Sandy,

Thank you for your post. It brings up a question I've been pondering and

possibly you know the answer to.

My fills are under fluoro because my port is lose and tilted and I'm not

particularly interested in having a port revision surgery just yet. Personally,

I LIKE that he HAS to use fluoro. My own piece of mind I suppose. Though it

hasn't led to a good fill yet [i have the VG band].

But what I was wondering, with the docs that do all their fills under fluoro, is

the fluoroscopy xray active while they have their fingers on the abdomen

palpitating for the port? And if so, what about the radiation exposure to the

fill persons hands?

I know the first time I was filled under fluoro, he was putting his hands in

there because it was tough to get the angle right, but the xray guy was having a

fit. And the subsequent ones, he positions, pulls the hands back, takes the

image and then maneuvers again to keep his hands out of exposure.

And since I'm full of inquiry this morning, do most mexican surgeons do their

fluoro fills with the patient lying down or upright?

Deb, the inquisitive one

2/8/05

Sandy <MoonshadowRN@...> wrote:

The good MX, European, and Australian docs (all with a great deal

more experience than almost ANY US doc - with only a very few

exceptions) use a fluoro with nearly every fill - both to assess the

band, port, and their positioning, and also to assess the fill they

are givi9ng. A great many small band problems have been found with

these " routine " films, long before there are any symptoms of

problems. This allows most problems to be corrected with small

changes, even before symptoms appear. A small slip is a good example -

often has not symptoms at first, becomes larger if not found, and

can become as BIG slip needing surgical sorrection.

[Guest guest]

Fluoro is like an " xray movie " that they can watch. Nothing goes

inside you except for the barium you drink. Tastes like milk of

magnesia or a bad protein shake. No bit deal. In an upper GI they

sedate you somewhat and then stick a tube down your throat to look

around your esophagus and stomach.

dan

Tuesday, August 16, 2005, 7:47:24 AM, you wrote:

LC> Can someone tell me the difference between fluro and upper GI. My

LC> doctor always does the upper GI instead of the fluro and says that

LC> they do the same thing. Is this true. It just doesn't sound right

LC> to me because I never hear of any having the upper GI. He uses the

LC> Upper GI to check the band position when people in our group have

LC> problems. He doesn't use anything for fills.

Dan Lester, Boise, ID honu@... www.mylapband.tk

Dr. Ortiz, Tijuana, 4/28/03

323/209/199 Age 62 Fair is whatever God decides to do.

[Guest guest]

Well, the upper GI I had was a tube stuck down my throat, sort of the

reverse of a colonoscopy. What do you call that?

dan

Tuesday, August 16, 2005, 11:56:46 AM, you wrote:

S> They are basically the same and, for band purposes, either is fine.

S> Both show the outline of the esophagus, the pouch, the position of

S> the band, the lower part of the stomach, and part of the upper part

S> of the intestines (hence the name UPPER GI, as opposed to " lower GI " )

S> Most importantly, both show the rate of passage of the barium through

S> the stoma. This is an impt clue as to how a fill might be - but it is

S> only a clue.

Dan Lester, Boise, ID honu@... www.mylapband.tk

Dr. Ortiz, Tijuana, 4/28/03

323/209/199 Age 62 Fair is whatever God decides to do.

[Guest guest]

Deb, Fluoros and Upper GI's all utilize radiation, so there is a

small amt of radiation exposure with each one. The person getting the

fluoro (you and me) cannot avoid the brief exposure, but the person

giving the fluoro can and should minimize their own exposure. Some of

them are doing many many fills a week. They really should be using

lead aprons if they cannot get competely out of the room and behind a

lead shield. They are receiving exposure even if they are not in the

direct line of radiation from the machine. It is " flying around the

room " , so to speak.

If the fill person's hands are on your belly and in the field of

exposure, they are getting radiation, and even a bit more than you -

since their hands are closer to the source. I'm sure this is a big

reason why using a fluoro to locate a port is done only when needed,

both in the US and in MX and other countries. Lead sheilds for the

hands would not work - hard to manipulate a needle with lead gloves

on!

Fluoros before and after a fill, to evaluate the new fill, should be

done with the fill person pout of the room or as far away as

possible. The less radiation exposure for ANY of us, the better. But

it is hard to see the barium going through the stoma unless the

provider is right there.

As with many things, there are choices to make and risks to assess. I

would be willing, for instance, to accept the small dose of radiation

with a fill for the greater and more urgent need to get a good fill

to lose weight - becuase the risks of remaining obese (with all the

cancer-related illnesses) is far greater than the tiny risk of

radiation exposure. That's my way of thinking, at least.

I'm going to send you something (when i find it) about the way some

of the European docs use fluoro to locate the port, that involves far

less radiation exposure for them. It's a way to " mark the spot " and

then move the fluoro machine away to do the actual fill.

You're right (and kind!) to be concerned for your providers - if the

port is hard to locate, and a fluoro is needed, the person's hands

could be under the fluoro for 5 minutes or more, trying to get the

needle in. If they do this often with many clients, there is

certainly a risk. How much? No one knows for sure.

But there are formulas to figure it out, and all people working with

radiation ar responsible to protect themseves. There are even

monitors to wear that totals the radiation accumulation for them. It

is their choice to wear them or not.

See you at the TJ Bash!! Sandy R

>

> The good MX, European, and Australian docs (all with a great deal

> more experience than almost ANY US doc - with only a very few

> exceptions) use a fluoro with nearly every fill - both to assess

the

> band, port, and their positioning, and also to assess the fill they

> are givi9ng. A great many small band problems have been found with

> these " routine " films, long before there are any symptoms of

> problems. This allows most problems to be corrected with small

> changes, even before symptoms appear. A small slip is a good

example -

> often has not symptoms at first, becomes larger if not found, and

> can become as BIG slip needing surgical sorrection.

>

>

>

>

[Guest guest]

For sedation and a tube - that is call an endoscope. An upper GI is just a

barium, they lay you on a table and flip you around all over looking at the

whole upper digestive system.. The flouro is a barium, you stand up and they

xray the band, port, etc.

An upper GI does not require sedation and tubes.

Any corrections??

Barb

-- Re: Fluro vs. Upper GI

Fluoro is like an " xray movie " that they can watch. Nothing goes

inside you except for the barium you drink. Tastes like milk of

magnesia or a bad protein shake. No bit deal. In an upper GI they

sedate you somewhat and then stick a tube down your throat to look

around your esophagus and stomach.

dan

Tuesday, August 16, 2005, 7:47:24 AM, you wrote:

LC> Can someone tell me the difference between fluro and upper GI. My

LC> doctor always does the upper GI instead of the fluro and says that

LC> they do the same thing. Is this true. It just doesn't sound right

LC> to me because I never hear of any having the upper GI. He uses the

LC> Upper GI to check the band position when people in our group have

LC> problems. He doesn't use anything for fills.

Dan Lester, Boise, ID honu@... www.mylapband.tk

Dr. Ortiz, Tijuana, 4/28/03

323/209/199 Age 62 Fair is whatever God decides to do.

[Guest guest]

I had an upper gi and there was no tube. Maybe different places do it

different ways?

Dan Lester wrote:

> Fluoro is like an " xray movie " that they can watch. Nothing goes

> inside you except for the barium you drink. Tastes like milk of

> magnesia or a bad protein shake. No bit deal. In an upper GI they

> sedate you somewhat and then stick a tube down your throat to look

> around your esophagus and stomach.

>

> dan

>

> Tuesday, August 16, 2005, 7:47:24 AM, you wrote:

>

> LC> Can someone tell me the difference between fluro and upper GI. My

> LC> doctor always does the upper GI instead of the fluro and says that

> LC> they do the same thing. Is this true. It just doesn't sound right

> LC> to me because I never hear of any having the upper GI. He uses the

> LC> Upper GI to check the band position when people in our group have

> LC> problems. He doesn't use anything for fills.

>

>

> Dan Lester, Boise, ID honu@... www.mylapband.tk

> Dr. Ortiz, Tijuana, 4/28/03

> 323/209/199 Age 62 Fair is whatever God decides to do.

>

>

>

>

[Guest guest]

Tuesday, August 16, 2005, 1:59:20 PM, you wrote:

S> You're right (and kind!) to be concerned for your providers - if the

S> port is hard to locate, and a fluoro is needed, the person's hands

S> could be under the fluoro for 5 minutes or more, trying to get the

S> needle in. If they do this often with many clients, there is

S> certainly a risk. How much? No one knows for sure.

My fluoros in TJ with Drs. Ortiz and ez had the docs and tech in

lead aprons. They'd stick the needle in without fluoro, at least for

me. Then pull the fill. Then put some back in. Then do the fluoro

for a few seconds. Then drink the barium and do it again. Adjust as

needed. They were not having their hands under the fluoro while it

was going. Just put it in. Take the pictures. Adjust. More

pictures. Never had hands under radiation.

dan

Dan Lester, Boise, ID honu@... www.mylapband.tk

Dr. Ortiz, Tijuana, 4/28/03

323/209/199 Age 62 Fair is whatever God decides to do.

[Guest guest]

Ahhhhhhhhh now I'm getting it. The MX docs don't use it to find the port, which

is the primary reason I need it for my fills. They are using it to look at the

swallow after the fill...Doh!!!!!

For some reason I thought the did it for both purposes. Thanks for clearing

that up. And yes, he and the nurse both wear lead " dresses " that cover them

from neck to knees. I'm the only one uncovered

Deb

Yes, I'm so looking forward to the bash and seeing you again.

Sandy <MoonshadowRN@...> wrote:

Deb, Fluoros and Upper GI's all utilize radiation, so there is a

small amt of radiation exposure with each one. The person getting the

fluoro (you and me) cannot avoid the brief exposure, but the person

giving the fluoro can and should minimize their own exposure. Some of

them are doing many many fills a week. They really should be using

lead aprons if they cannot get competely out of the room and behind a

lead shield. They are receiving exposure even if they are not in the

direct line of radiation from the machine. It is " flying around the

room " , so to speak.

If the fill person's hands are on your belly and in the field of

exposure, they are getting radiation, and even a bit more than you -

since their hands are closer to the source. I'm sure this is a big

reason why using a fluoro to locate a port is done only when needed,

both in the US and in MX and other countries. Lead sheilds for the

hands would not work - hard to manipulate a needle with lead gloves

on!

Fluoros before and after a fill, to evaluate the new fill, should be

done with the fill person pout of the room or as far away as

possible. The less radiation exposure for ANY of us, the better. But

it is hard to see the barium going through the stoma unless the

provider is right there.

As with many things, there are choices to make and risks to assess. I

would be willing, for instance, to accept the small dose of radiation

with a fill for the greater and more urgent need to get a good fill

to lose weight - becuase the risks of remaining obese (with all the

cancer-related illnesses) is far greater than the tiny risk of

radiation exposure. That's my way of thinking, at least.

I'm going to send you something (when i find it) about the way some

of the European docs use fluoro to locate the port, that involves far

less radiation exposure for them. It's a way to " mark the spot " and

then move the fluoro machine away to do the actual fill.

You're right (and kind!) to be concerned for your providers - if the

port is hard to locate, and a fluoro is needed, the person's hands

could be under the fluoro for 5 minutes or more, trying to get the

needle in. If they do this often with many clients, there is

certainly a risk. How much? No one knows for sure.

But there are formulas to figure it out, and all people working with

radiation ar responsible to protect themseves. There are even

monitors to wear that totals the radiation accumulation for them. It

is their choice to wear them or not.

See you at the TJ Bash!! Sandy R

>

> The good MX, European, and Australian docs (all with a great deal

> more experience than almost ANY US doc - with only a very few

> exceptions) use a fluoro with nearly every fill - both to assess

the

> band, port, and their positioning, and also to assess the fill they

> are givi9ng. A great many small band problems have been found with

> these " routine " films, long before there are any symptoms of

> problems. This allows most problems to be corrected with small

> changes, even before symptoms appear. A small slip is a good

example -

> often has not symptoms at first, becomes larger if not found, and

> can become as BIG slip needing surgical sorrection.

>

>

>

>

[Guest guest]

The needle is very firmly pushed into the solid and thick port

membrane, which is the cossistency of a solid gel. You have to pull

hard to get the needle out, so it isn't going to simply fall out of

you when you stand up, or change position .....odd as that seems...

Sandy R

....uh....

> So Dan, he's got you lying down with the needle in you and then you

change to a standing up position with the needle STILL in you? Do I

have that picture correct? I thought I read somewhere where it was

said not to move around from lying to standing with the needle in you,

no?

>

> Again, very curious and trying to learn all I can about this.

> Deb