A Choice...

I think I have a very level head on my shoulders, I'm a do-er, creative and fairly intelligent but that doesn't seem to be enough. I'm faced with needing to make a life altering change that I want and I NEED....but which is right for me - the full bypass or the banding? What is going to be best for me in the long run? In the long run how are the two different? I figure if I'm going to make this huge alteration to my life I REALLY want it to work...I'm not in this to drop 20 lbs. I'm a little over 100 lbs over weight I want to get rid of it for good and I'm willing to work at keeping it off....I just don't know what that really means. I've talked to people who have had the full bypass and they are pleased with how they look and how things are progressing. I don't personally know anyone who has had the banding. I do know that I have always been heavy - sweets are NOT my problem (wrong time of the season to test this on me however). I'm a carb-o-holic, give me a bagel or a potato any day over a bag of M&M's. I have a twin sister (my evil twin) who is a size 6 - try living with that! Can someone help me decide what surgery is best for me? Or at the very least give me some new pros and cons?

Hi Ronda,This is a choice you will have to make on your own, You may want to read the profiles of different people on the board to see all the sides of both procedures. I belive Betty Blackwell is a lap bander and she has done a wonderful job . So just keep looking into it and take your time to decide what you will end up doing.It is a life changing decision and you have to be ready to make the changes that will let you to suceed .Which ever way you decide to go. Having either surgery is not a garentee that it will work. The choices you make after surgery will play a big part in the outcome. Take Care, Julio

Because banding does not bring with it the same disincentives to overeating as does the RNY, and because I had eaten through (for years) feeling uncomfortable and full, I knew that the band would not be a good choice for me. Even though both procedures do require work, and do necessitate lifelong behavioral changes, I knew that for me, given my issues with habitual overeating (for me it was carbs and ice-cream), I needed a permanent solution that would inhibit my sweet eating and would more seriously limit capacity. Also, and this is just for me, I did not want to subject myself, as the band requires, to needing fills 3-4 per year (for the inconvenience factor, discomfort/pain issue and the cost of those visits). For me, my decision was made easier because of the comfort level I found with my surgeon (Dr. Ralph Crum at Norwalk Hospital) and the after-care program to which he was committed. First, I wanted to have the procedure performed laparascopically (which carries far fewer complications and has a quicker recovery time than the open version of the operation) and Dr. Crum was committed to that (even though my BMI was over 61). Secondly, I knew that I could not lose weight on-command (despite my long term success following surgery of losing over 300 pounds and sustaining that loss), so I avoided surgeons who have mandatory pre-operative weight loss requirements (after all, if I could lose weight on command, I wouldn't have needed gastric bypass). And, lastly, I appreciated that Dr. Crum was involved in not just his pre-operative meetings, but also his post-operative meetings as well. Good luck in your choice-- remember, all the statistics that can be cited (and numbers played with) will not make the decision for you-- rather, you need to personally try to figure out what lead you to being obese and what changes in your relationship with food you're willing to make to avoid remaining at an unhealthy weight. As you start to get some clarity on those issues, you will see the surgical method (if any) and the program that is best for you. Good luck.

Have you had this conversation with Dr A? He'll be more than happy to sit with you and weigh the pro's and con's. I think you could go either way...your BMI is just over the 40 mark which most Ins. Co's require- do you have co-morbids? Carbs are hard- I agree- have you looked into South Beach as a starting point- to see what you can do with that- I wasa self proclaimed carb-aholic. I followed Phase One of South Beach religiously- and you know it worked- it banished those nasty "the bag of chips is calling me" cravings. I no longer have to have bread in my life- no potatoes- no french fries!!! No pasta or rice- I was surprised- but the idea behind it works. In the long run I know I can't stay on it forever- but its gotten me down 30 pounds preop. Also know from what I have heard at the MMH support groups from bandees- you are physically hungry for the month or so you are on a liquids only diet while the band heals. you don't have that with the RNY. What does your insurance cover? Mine won't cover the band- so it wasnt an option- Bottom line- if I were in your shoes? Probably the RNY - you want to lose more than 75-80 pounds I think its the way to go. BUT again- talk to Dr. A and do some soul searching- the answer will come to you.

Hi Ronda, I had/have Dr Aranow for my surgeon and I opted (before my initial consult w/ him) for the full bypass because I just thought [for me] that it was the best choice. I knew it would limit the amount of food that I could eat and that in the long run, it was for life (even though the band is in for life too..according to Dr A, he won't remove it if you don't like it, he will remove it to give you a full RNY after you find you don't like it though) and that I probably would lose the most weight. Also, just knowing that I had the "filling port" inside of me and could feel it to the touch kind of freaked me out! And, I had gastric reflux and Dr Aranow told me that the band wasn't an option because of this. That the reflux would get a lot worse because of the squeezing of the band. My BMI was a 49 and I had only 2-3 co-morbidities. I've lost almost 65 pounds already and feel good. Have you had your initial sit down with Dr Aranow yet? He will discuss all of this with you, or should have during that appointment. If you haven't, write down all of your questions and concerns and he will discuss them with you. I know that he kind of leans on the side of doing the RNY over the band, that's the sense I got in the seminar. Good luck with your decision. paula

Dear Ronda, Dr. A does not do Gastric bypass larporscopically (spelling - oops!). Sorry. When I went to his seminar in October he said he does the RNY open because he has a better visibility. If it is any consolation the incision should only as wide as his hand (4.5 - 5 inches). I'll be having the RNY as I have gastritis and because I am a sweet eater. I can appreciate how difficult a decision this is for you, as it has taken me 2 and a half years to get to this point. I am wishing you the best and my support. Lisa

Dr. A does not do the lap procedure. He tells his patients that he has greater visibility doing the open procedure but I really think it's more because he is skilled in the open procedure but inexperienced in the lap procedure. If you truly want the lap procedure then Dr. Bell at Yale New Haven is the best choice. He starts all surgeries laproscopically and has only reverted to I think three as opens due to those patients having too much scar tissue from previous abdominal surgeries. He's done about 400 surgeries laproscopically. With the lap procedure, you will have less pain and less risk of complications like hernias. The lap procedure will give you six tiny little incisions....five about 1/3 of an inch and one about 1/2 inch. Open with give you one vertical incision about five inches long. Recovery is quicker with the lap procedure too. As for the banding, I can't really comment. You supposedly lose slower and I have heard of one person who became very ill due to an allergy to the band itself. I'm not sure how common that is but she had to have it removed. So you may want to ask your surgeon about possible complications with the band. There's a lot to consider when having WLS and the best advice I can give you is to see more than one surgeon for consults and then weigh you options to see what is right for you. Best Wishes, ~Sue

Ronda, Before I had my surgery, I had many of the same concerns that you had. Ultimately, I went with Lap Band for one simple reason - it is statistically safer then RNY from a death perspective. From the studies, RNY people do lose more and do lose faster; however, the lap band people do lose a lot, it just takes longer. My sister is a doctor and we had a long talk about the risks of getting you intestine opened up. Ultimately, it was not a risk that I was willing to take. I had my surgery in early March. As of this morning, I have lost 52 pounds. While I expected to have lost about 80lbs by now, I am happy with my results. With a slower weight loss rate (Now about 5lbs month), I hope for fewer skin issues in the long run. One benefit of the band is the ability to "open it up" if you need to. For example, when I reach my target weight, I can have the restriction set to meet my needs. Finally, I have been to my surgeon's office for follow ups and seen a lot of happy patients in the waiting rooms. A few of the women are spectacular.

Susan posted some very good advice-- no one should feel that their choice is between an open RNY and a Lap Band, because there are lots of highly skilled dedicated surgeons throughout CT who are committed to performing the RNY laparoscopically. And, quite frankly, there are many surgeons who have performed the RNY both open and now laparascopically who will tell you that visiblity is actually much improved when it is done laparoscopicially because the image is enlarged on the monitor and because there is less blood clouding the operative field.