i need help making a decision

hello!  i am hoping you all can help me.  i was ALL about getting the RNY, but now I am thinking the band.  I have LOTS  of weight to loose, i am 300 lbs and 5'7".  BUT I am in my 2nd year of nursing school.  I was thinking about getting surgery done the week before Christmas as we have untill jan 2 off of school, meaning i wouldnt miss a ton of school... i dont want to get kicked out of the program.  so my questions are...

w/ the rny how long are you in the hospital and taken out of work/school?

how about with the band... how long out of work/school and how long in the hospital?

i have my first surgeon appt in october...thanks for your help!!!

kristy

unless they're changing things, a laparoscopic RNY with no complications should have you home after 2-3 nights in the hospital... how long you're out of commission after that depends on how well YOU feel, how you're healing, and what will be expected of you.  I've seen people take anywhere from 2 to 8 weeks after surgery.  If you have a desk job and can deal with minimal pain meds, then you might be closer to 2 weeks... the thing that would concern me is being a nursing student, at this stage, are you exposed to patients?  if so, a couple things to consider is infection/illness... though you may be on antibiotics for a while post-op, your immune system will still be slightly compromised.... also, what if you have to help move a patient?  lifting, supporting, even pushing a gurney or wheelchair might be too much for your abdominal muscles and cause a hernia. Definitely ask Dr Clarke or Lirio about that... I'd assume they know what's involved in 2nd year nursing school... they would be best able to answer your question. Good luck.

Hi Kristy, For me it was a no-brainer: I do NOT have the discipline required to succeed with a Lap Band. Being there is no malabsorption, success is more dependent on us using moderation. Not that RNY doesn't require that as well, but in the first year when you're looking to lose the bulk of your weight, RNY is known to work better just due to the type of surgery that it is: restrictive -AND- malabsorptive. Once again, I'll post below a great article on the question you raise. By the way: I know many people at desk jobs who went back after 2 weeks (post RNY), but I also know that Nurses have the issue of lifting/moving patients and that's with EITHER procedure. Best of luck to you, Karen

Gastric Bypass Might Be Better Than Lap-Band

Extremely obese patients undergoing weight-loss surgery may do better with a procedure that bypasses part of the intestine rather undergoing a banding procedure that creates a small pouch in the stomach, according to a new study released Monday.

Researchers at the State University of New York, Health Science Center of Brooklyn and Lutheran Medical Center, also in Brooklyn, N.Y., looked at two commonly performed types of bariatric surgery in 106 patients who underwent the procedures between February 2001 and June 2004. The study appears in the July edition of the Archives of Surgery.

Sixty patients received a so-called Lap-Band device through a laparoscopic procedure which allows surgeons - through a small incision near the stomach - to place a silicone band around the stomach dividing it into two smaller compartments. The device is designed to restrict food intake and make patients feel full sooner than those with a full-sized stomach.

Forty-three patients underwent another type of procedure known as the laparoscopic Roux-en-Y Gastric Bypass, which involves sectioning off a small portion of the stomach into a pouch that bypasses the first part of the small intestine and connects directly to the lower portions, reducing the amount of calories absorbed by the body from food.

Overall, researchers found patients undergoing the laparoscopic bypass surgery had fewer long-term complications, lost more weight and had larger improvements in other co-morbidities, such as high blood pressure and diabetes, than patients who underwent the lap-band procedure.

The better outcomes of patients undergoing the bypass procedure is likely the result of better compliance among those patients rather than a particular problem with the lap-band. He said the lap-band can allow patients to cheat and consume more calories through liquids because they can still pass fairly easily through the small stomach.

For the band to be successful it requires significant will power, discipline and compliance.

Patients in the study were considered "super" morbidly obese and had body mass indexes of 50 or greater. On average patients in the study weighed roughly 340 pounds before surgery.

Patients undergoing the lap-band procedure were hospitalized for less time with an average of 1.8 days compared with 3.5 days for patients undergoing the bypass procedure. Short-term complications were statistically similar between the two groups.

However, long-term complications, or those that occurred after 30 days or longer, were more common in the lap-band group with 78% of patients experiencing complications compared to 28% in the bypass group. The most common long-term complication was vomiting and dehydration.

The study also showed that 15 patients with the lap-band needed follow up surgery compared to three in the bypass group. The lap-band can be adjusted after initial surgery to be made larger or smaller. Patients in the study were followed for an average of 16.2 months.

Patients who underwent the bypass had an average BMI decrease of 26.5 compared with 9.8 in the lap-band group, however researchers said both procedures produced "satisfactory" amounts of weight loss.

All patients reported fewer co-morbidities after surgery, but the decrease was more pronounced in gastric bypass patients. For example, rates of diabetes dropped to zero from 17.4% before surgery in the bypass group. Rates of diabetes in the lap-band group fell to 11% from 18.3% before surgery.

The typical gastric surgery patient has a pre-surgery BMI of 40. Some patients with BMIs of 35 or more are also considered good surgery candidates if they have another problem linked to being overweight like diabetes.

Although the study focused on patients with BMIs of 50 or greater, patients do better with a bypass rather than a lap-band. However, not every patient is a good candidate for a gastric bypass - for instance, those with certain liver problems, as well as those who've had stomach ulcers - and they might need a lap-band or similar device.

Hi Sweetie! 

You're definitely going to get loads of  information ^^^ from the internet/opinions posted here.  From what I have seen since I started here, everyone is very passionate about their respective surgeries.  The article Karen posts is AT LEAST 3 years old!  Bands are performed more and more each day!  You need to educate yourself on both procedures and take what we all say with a grain of salt.  What might be good for one of us, might not be for someone else.  The statistics, if you can call them that, on lap bands are ridiculous.  Lap bands have only been performed since 2001 in the US.  I am a bander down 58 lbs in 3 months, starting weight was 246.  Read the story on my profile.   There are at least 3 of us here in the NY forum, who have done awesome!  Self discipline is a must with a band.  We don't dump and we don't have malabsorbtion issues.  With both surgeries we can over eat, again.

Hospital stay for me?  If my dad hadn't left, I would have gone home within hours after surgery.  (surgery was at 2, doc came at 7 wanting to d/c me)  I could have returned to work within days, but since I was scheduled to have near 2 weeks off, I took the entire time.  I was raking the lawn 2 days after surgery and released to return to CURVES within 3 weeks.  Other than my BMI the only co-morbidity was a hiatle hernia.  I had heart burn from this MAYBE once or twice a month.

Again, read what we all tell you, educate yourself through your doc and as to what each procedure is about and what happens to your body with both.

Best of luck with your decision! As me anything you'd like to!

Congrats on your decision to change y our life.  I have to say that whatever you do choose it is such a personal decision.  Learn about both procedures, discuss them with your surgeon.  No two people are the same and surgery and recovery is going to vary from person to person.  Either way you go your life is going to change forever.  Get as much info as you can and then make your decision.  Best of luck to you which ever route you choose. LisaMarie