Struggle between Lap and Rny
A few observations about your pro-con list:
LapBand Risks--- Although the early complication rate for surgery itself is lower with the band (although not by much) - you need to look at the long term complication rate. One study I read recently showed that at the 2 year mark, the complication rate for Band was about 25% to 35%... another said 50%. It's being shown that at 2 years, the band needs to be removed for medical reasons in about 25% of patients and that percentage increases with more time.
Surgery Risks -- As for being less invasive. Yes, you're not cutting the digestive tract. But the largest risk factor for morbidly obese folks is the surgery itself, any surgery where you are put under anesthesia. Even a simple gallbladder surgery comes with a higher risk for someone with a BMI of 40 versus someone with a normal BMI. So those are the risks you need to look at also.
"Reversible" -- the Band OR the RNY is reversible if it's medically necessary. Doctors don't take either revision lightly and neither should you. Band removal is a VERY serious surgery, life threatening and even more dangerous than the original surgery ... (not picking on you specifically) but the flippant way I hear about the Band being reversible as a positive thing is disheartening. You have to think of this surgery as a permanent situation because if you get to the point where the band needs to be removed, you're in some serious doo-doo and you don't want to be in that place. So DO NOT think of it as reversible, it's not.
GERD -- if you have heart burn and GERD now, the band may only worsen that. RNY and DS virtually cure GERD
Dumping -- only about 30-40% of RNY'ers will have dumping syndrome. The fear of dumping is what keeps most people in line along with lifestyle changes.
Getting Food Stuck -- this happens with both Band and RNY. Yep, it sucks and it's not all that fun. But I wouldn't list it as a pro or con for medical consideration. It's a behavior thing. In fact, if I were to list it anywhere, it'd be on the "Pro" side since this forces you to chew well, eat slow and take small bites. It's a good behavior modification tool.
Stricture -- not sure I'd list this as a con specifically. Yes it's possible with any surgery where the body has to heal itself (RNY, DS or Sleeve) because a stricture is simply scar tissue that's aggressive in its formation. It's a pretty rare complication and if you get one, it's easily fixed with a medical outpatient procedure but it's not life threatening necessarily.
Hormonal Changes -- this is going to happen to anyone losing weight no matter what the method - surgery or not. Estrogen is stored in fat cells and when you lose weight, the estrogen is released and plays havoc in the body. It can cause PMS-like symptoms for a while,but it's not the end of the world and it's not really that big of a deal. The hormonal changes that are GOOD are with RNY and DS when it's dealing with insulin (which is also a hormone) and how it changes the way your body deals with insulin production and utilization -- which is where the diabetics and insulin resistance cures come into play.
Other Surgeries -- if you haven't already, be sure to look at the other two options too. DS and Sleeve. Even if you don't think they aren't options for you, be sure you understand ALL the surgeries and pick the one that's best for you.
Which Surgery? -- You can't just look at the surgery itself. You have to look at YOU. Your medical needs and personality traits - need NSAIDS, have GERD, have diabetes or insulin resistance or metabolic syndrome, struggle with binge eating, sweet eater vs. salty eater vs. fat eater, liquid calorie addict, compliance mentality vs. a mentality of "finding a way around" the rules, are you someone who follows the rules well on your own or do you need a strict enforcer to make you follow the rules, etc.
Research, Read, Learn, Read some more --- Use "Google Scholar" to read medical journal reports. Visit the Revision or Regrets forums here on OH -- listening to success stories is fine, but you neeed to read about people who are struggling and find out why. Talk to your doctor and find out why he's recommending one surgery over another (his medical reasons, not just his opinions). Do some soul searching to figure out which surgery you can live the rest of your life with... because this isn't just about losing weight over the next couple years, it's about what you're going to do and what you can live with 20 or 30 years from now.
Good luck
Pam
LapBand Risks--- Although the early complication rate for surgery itself is lower with the band (although not by much) - you need to look at the long term complication rate. One study I read recently showed that at the 2 year mark, the complication rate for Band was about 25% to 35%... another said 50%. It's being shown that at 2 years, the band needs to be removed for medical reasons in about 25% of patients and that percentage increases with more time.
Surgery Risks -- As for being less invasive. Yes, you're not cutting the digestive tract. But the largest risk factor for morbidly obese folks is the surgery itself, any surgery where you are put under anesthesia. Even a simple gallbladder surgery comes with a higher risk for someone with a BMI of 40 versus someone with a normal BMI. So those are the risks you need to look at also.
"Reversible" -- the Band OR the RNY is reversible if it's medically necessary. Doctors don't take either revision lightly and neither should you. Band removal is a VERY serious surgery, life threatening and even more dangerous than the original surgery ... (not picking on you specifically) but the flippant way I hear about the Band being reversible as a positive thing is disheartening. You have to think of this surgery as a permanent situation because if you get to the point where the band needs to be removed, you're in some serious doo-doo and you don't want to be in that place. So DO NOT think of it as reversible, it's not.
GERD -- if you have heart burn and GERD now, the band may only worsen that. RNY and DS virtually cure GERD
Dumping -- only about 30-40% of RNY'ers will have dumping syndrome. The fear of dumping is what keeps most people in line along with lifestyle changes.
Getting Food Stuck -- this happens with both Band and RNY. Yep, it sucks and it's not all that fun. But I wouldn't list it as a pro or con for medical consideration. It's a behavior thing. In fact, if I were to list it anywhere, it'd be on the "Pro" side since this forces you to chew well, eat slow and take small bites. It's a good behavior modification tool.
Stricture -- not sure I'd list this as a con specifically. Yes it's possible with any surgery where the body has to heal itself (RNY, DS or Sleeve) because a stricture is simply scar tissue that's aggressive in its formation. It's a pretty rare complication and if you get one, it's easily fixed with a medical outpatient procedure but it's not life threatening necessarily.
Hormonal Changes -- this is going to happen to anyone losing weight no matter what the method - surgery or not. Estrogen is stored in fat cells and when you lose weight, the estrogen is released and plays havoc in the body. It can cause PMS-like symptoms for a while,but it's not the end of the world and it's not really that big of a deal. The hormonal changes that are GOOD are with RNY and DS when it's dealing with insulin (which is also a hormone) and how it changes the way your body deals with insulin production and utilization -- which is where the diabetics and insulin resistance cures come into play.
Other Surgeries -- if you haven't already, be sure to look at the other two options too. DS and Sleeve. Even if you don't think they aren't options for you, be sure you understand ALL the surgeries and pick the one that's best for you.
Which Surgery? -- You can't just look at the surgery itself. You have to look at YOU. Your medical needs and personality traits - need NSAIDS, have GERD, have diabetes or insulin resistance or metabolic syndrome, struggle with binge eating, sweet eater vs. salty eater vs. fat eater, liquid calorie addict, compliance mentality vs. a mentality of "finding a way around" the rules, are you someone who follows the rules well on your own or do you need a strict enforcer to make you follow the rules, etc.
Research, Read, Learn, Read some more --- Use "Google Scholar" to read medical journal reports. Visit the Revision or Regrets forums here on OH -- listening to success stories is fine, but you neeed to read about people who are struggling and find out why. Talk to your doctor and find out why he's recommending one surgery over another (his medical reasons, not just his opinions). Do some soul searching to figure out which surgery you can live the rest of your life with... because this isn't just about losing weight over the next couple years, it's about what you're going to do and what you can live with 20 or 30 years from now.
Good luck
Pam
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