Just getting started

Hi, My name is Amy and I go to my class 2-26-09.  Have lots of questions.  How long is the process from class to surgery?  I want to do the RNY but have friends and family telling me to do the Lapband.  Can I please get feedback on both RNY and Lapband PLEASE.

My family thought that I should have the lapband too. I did a lot of research and I chose the rny. For me, I could not see myself dealing with all of the fills and releases of the lap band. Also, my insurance would not cover the fills, just the procedure. I needed effect of having the rny too. With the band, the amount of food you can eat will be limited but not how much sugar you can have. You can drink milk shakes from McDonalds or where ever and as long as you take it easy it will stay down. You can drink yourself fat. You can never take a pill or it could get stuck. My list was long. But, I know some people who have it and are very happy with it. I also know some that wish they had chosen the rny. Read as much as you can and talk with your surgeon. Good luck with your decision and let it be your decision not your family's.

I went to my first class at Southern Surgical in November of 2007 and had surgery 9 months later in August '08. Before you freak out - 6 months of that time was a PCP (primary care doc) supervised diet & exercise attempt to satisfy insurance requirements (CIGNA). Once I got my insurance approval my surgery was scheduled for within 6 weeks.

When you go for your info meeting they'll begin the process of scheduling pre-op appointments and the whole thing. Time will fly by. Dr. Mac is very thorough.

I had originally thought about the band BUT - I'm a huge chicken when it comes to needles so that was a definite NO. I also wanted to have the built in control for staying away from sugar as that was my biggest weakness prior to surgery - so the rny and the potential for dumping seemed to be the best fit for me.

Also look at how much weight you ideally want to lose. It's possible with both surgeries but the weight does seem to come off faster with RNY. Everyone has their own opinions about which option is best. Take the time now to read as much as possible about all of them. There is also a lap band forum here on OH you may want to post over there as well.

Feel free to PM me any time. I wish you much luck on this journey - it's absolutely amazing.

- Iris

Hi Amy,

Welcome to the forum.  I look forward to getting to know you as you make this incredible journey.

Iris provided you with a realistic look at what your timeline may look like and as she said, insurance is much more likely (or not) to gate your timeline than the Dr's office. It all depends on what your insurer requires and you may be able to find out about that now by contacting them to find out what they need. It varies a great deal from one insurer to another and even from one policy to another with the same insurer.

Re: type of surgery to have. Let me start by saying that as support group leader, I have been privileged to know people that have almost all of the surgery types available and I would say that there is no such thing as a 'one size fits all' answer. You will need to look at your lifestyle, finances, health issues, etc... when making a determination. I don't think that there is right or wrong decision in general.

That said, I was originally interested in the lapband because I felt like if/when I experienced regain, that I could use that tool to help me get the weight off again. I also knew that it was a less invasive surgery and statistically less 'risky'. Initially, I was under the impression that I could have the band removed if it was a problem. First of all, you should know that the lapband is not a temporary device. Once it's placed, it's in and generally not removed unless you are having a revision to something else. Scar tissue builds up around that band and that makes it dangerous to remove... Developing scar tissue around a foreign body is normal and a problem if you aren't having it removed. There are also risks with lapband that the band itself can slip, it can erode/perforate the stomach, and you can have issues with the fill port flipping. These are not common problems, but they do exist and need to be considered. The weight loss for someone with a significant amount of weight to lose with the lapband may not be quite what you would find with the RNY and it is slower in the beginning. The pro's for me with this option of course, where that I could have a fill down the road if I got into trouble to help me get the weight off and I would not have dumping issues to deal with.

With the RNY, you have malabsorption issues that work for and against you. They work for you to help you strip off the weight faster, but if you cannot gaurantee your ability to remain compliant with taking suppliments the rest of your life, you need to look at another solution because the risks associated with malnutrition issues are real and serious. That said, if you can and will be compliant with your nutritional suppliments you should do well and not have 'issues.' You should also know that while some do have dumping, the majority never do and if they do in the beginning, it wears off after the first 6 months to a year post op. So, if you are purely taking this route because you think you may 'out eat' your surgery with one that doesn't have the punishment of dumping, you need to realize that you can 'out eat' just about any surgery and the majority of patients do not have longterm dumping to deter them. Probably the biggest swing toward RNY for me is the 85% chance that type 2 diabetes will resolve with RNY immediately following surgery. Don't get me wrong, I'm delighted with all of the other health and quality of life changes, but if none of them had occured, but the resolution of my type 2 diabetes it would have been worth doing the surgery.

Either surgery is going to provide you with a tool. To be honest, I think that the initial weight loss portion of the journey is probably easier for an RNY patient... I say this because of the initial mild dumping issues most have in the early part of the journey that keeps you on the straight and narrow. Also their seems to be a change in the amount of the hormone Grehlin that regulates hunger for RNY patients that keeps them from feeling as hungry. But once you pass that honeymoon period with the RNY, I think that the road levels out and it is just about as hard/easy for both... but the lapbanders can get a fill to help them restrict and get back in the saddle. Even without that, you can follow the rules about loading with lean protien, not drinking, not succumbing to calorie dense 'slider' foods and maintain your weight loss. Remember that this will be a huge lifechange. You won't be on a diet the rest of your life, but you won't have carte blanche to eat whatever, whenever either ...no matter which road you take.

I'm afraid I may not have cleared up anything for you... I hope that when you see you Dr. that they will be able to address the pros and cons of each procedure so that you can make the most educated choice possible.

All the best,

Amy - you have gotten some very good advice and info from Iris and Barb.  I chose the band because of the possible complications from RNY.  Let me suggest that you cross post on the Lapband forum and the Main board for some other opinions.  On the Lapband board, look for Jean M. posts.  She has been doing a daily Band Rule and is up to #20.  Some very good information that is good for RNYers, too.  She points out the obvious - no drinking with meals and why - the need to eat protein first, etc.

I am 6 months out with the band and feel great.  No complications and I am pleased with my weight loss.  I have had 2 fills and plan to have another one at the end of the month.

And welcome to the NC board.  Congratulations on making the first step on this amazing journey.

Shelia

Hi Amy,
Welcome to the NC Boards.
By all means do your research and keep in mind that you are the one who will have to live with whatever choice you make.
From my understanding depending on your weight and current BMI I have heard that if you have a higher BMI than 40 RNY is the best choice.
I have no regrets what so ever for choosing RNY.
Also be prepared for many preop testing that must be done before your surgery.
Sometimes this can be frustrating and you have to always stay on top of what has or has not been done then once all the testing in complete your doctor will submitt to insurance for approval.
I know in my heart and soul I chose what was right for me.
                                                     Annie

Hello,
Both surgerys are great for what they offer...and both have drawbacks...it simply boils down to what you want for you.

I started to go with RNY but had issues with it I didnt think i could live with (some of which i am sure some would think were silly)  Like the idea of cutting the stomach off but then leaving it in...  ok I know it sounds silly but I have issues with that.   I also have issues with perminance.  I mean i have no intention of removing my band but the fact that "I can" does alot for me...blame it on my ex and my now issues with perm commitment lol :)  ok so we cant really blame him....  :) I also had issues with the rapid weight loss increasing the loose skin.  I was in favor of the more rapid weight loss but not the greater skin folds.  

This is sorta the list I had that made my choice for me...granted there is much more both in favor and against each ot them.  One key factor is how much weight you have to loose.  My doctor wanted me to do RNY, saying that someone my size would loose much more that way.  I however disagreed, I think the band will be right up my alley...and if im wrong....all my parts are still in one place and I can do something different...  But in my favor...I AM down 4 sizes since surgery :) 

RNY Pluses
higher percent of excess body weight loss
more rapid weight loss

RNY Minus
several day stay in hospital
several weeks out of work
much longer on mushies and such post op
greater loose skin
stomach cut but still in body 
many small meals
dumping syndrome



Lapband Pluses
 
in and out of hospital same day
Less time off work to recoup
sooner to eating normal foods
less times per day i have to eat
more gradual weightloss giving me greater time to work out and try to limit loose skin

Lapbands Minuses
going for fills and unfills to get it right
fear of it not working well for me
idea of something around stomach kinda odd feeling
long list of foods that i might not be able to eat after surgery (most of which has been fine in limits so far)
danger of port flipping needing more surgery
danger of band leaking  needing more surgery
lower percent of extcess weight loss predicted then with RNY

A friend and I both had surgery I had the band in Dec she had RNY in Jan....we have started to compare notes and so far we both still feel like we made the best decission for ourselves.

Hi Amy,  I elected to go the lapband route.  So far I have no regrets!  It is a very personal choice for each person, so good luck in making the right choice for you.  Also Welcome to the NC Boards.

WElcome Amy!!!
You, Pattie, and I should have lunch together on the 26th and compare notes! 

d