first appt., lap vs RNY, excited and scared

We went to our orientation last week, mailed our applications the next day, and are scheduled for our first appt Feb 9 at Legacy's Obesity Center. It sounds like we can move in quite fast! (My husband and I are both getting it done.) I had planned, initially, on the RNY because it was all that our insurance covered (Regency BlueCross BlueShield.) However, when she called to set our appointments, she told me our insurance just started approving lapband too. So now I have to figure out which will be best for us. We have to lose our 5%... It seems that RNY has slightly better outcomes related to weight loss, and I like that the "dumping" is another form of behavioral therapy. I like that the LAP is reversible and that there are less problems with malabsorption. I am thinking long-term, in that we are both only 31, and I know we have many years of vitamins and such ahead of us. I am nervous about the infection issues at the cite of the fill and having the lap in for many years. I wish there were more longer-term studies on these things. Like, what's this gonna do to me in 20 years? Would like to hear what others have gone through in choosing between surgery methods. I hear that at higher BMI's (I am 45) they may just choose for you. Melanie

Hi Melanie, I just had the RNY this past Wednesday and I wish I could answer your question. I am a research fanatic when I get ahold of something that really matters to me. This question was no exception. I did locate some folks from the Graduates WLS forum and some came forward and shared that several years out, their labs were coming in just fine. In my case, I have a serious blood pressue issue (one that was not controlled well even with 2 blood pressure medications) and I had to chose between probably a guaranteed good 5 more years of quality of life OR take the chance of stroke or heart attack. In this case, in my eyes, it left little choice. I think I did what anyone would do under the cir****tances. I chose quality of life for as long as I can live. Nothing says there will be problems even 50 years from now and when others told me labs are great, I felt much more at ease. It is clearly and individual decision though. Doctors can't tell us what 20 years will bring because this has not been around/OR so many that have the surgery go off on their merry way and we never get to hear from them. Sad, but true. I know this is not an answer but I wanted to share with you how I reached my personal decision to go RNY (oh yeah, I didn't like the idea of a foreign object in my body for many years either and I am 47 years old so chose against Lap Band) By the way, I have been told that RNY is reversable in serious cases, hearsay only, and that neither RNY or Lap Band should ever be entered in to with the idea of a reversal. It should only be sought out if one is serious enough to make a lifetime committment. Again hearsay only. All my Hearsay has come from professionals and not common folks like me. Hope this helps you. Darla

I am a researcher by trade (working on my PhD in social research) and that's part of what I am doing here asking questions, getting it straight from the people who have been there, common folks are a great source of info! (plus docs, literature, and research studies)- doing homework best I can. When I thought that RNY was my only insurance option, I was still in for it- I know it's a big commitment. I am not really thinking reversal upfront, but thinking worst possible complication (outside of death!) it sounds like the lap is easier to go solve. Just one of several issues in trying to make a good choice, though! Wishing you much success! Melanie

Hey there Melanie, I made my decision because I wanted the most efficient form of weight loss and because of what I learned about t he bypass and the faster weight loss. besides we should all take a vitamin every day anyway as most of our food is so processed we just dont get what we need anymore. I also dont like the idea of a foren object in me for the rest of my life. In the end after I made the decision of the bypass I found out that the only option I had was the bypass so it worked for me. I know for me personally I need to loose this weight as soon as possiable. I need the dumping because I know me and I will cheat if I can. I have worked hard at making changes and I am still working hard at it but just didnt feel that the band would do it for me. I also am not big on new procedures. not sure if I help at all but that is my 2 cents worth and why I made the choice I made. Kelly

During our orientation, the doc said something (will have to look back at my material) about "rule of 1" for lap (one vitamin a day, 1 day hosp stay, so on) and I think a "rule of 3" for RNY-- more vitamins necessary because more malabsorption. It seems that the equipment, itself, is similar to that used in other proceducures that have a longer testing life, such as diabetes pumps and chemo spouts. (That's not the technical name! It escapes me!) But, yes, I imagine that with either surgery, there's probably some future surgery that will be related (I am already expecting the possibility of cosmetic/lifts.) I wouldn't be surprised if lap patients find the need to have equipment replaced after a number of years. Honestly, I am not even counting on this to improve my life span, but do hope it improves the quality of life. Best wishes to you, Melanie

Melanie - I also have Regence BC/BS. I've decided on the RNY because I like the idea that I can't absorb everything I eat. I've also noticed by reading the boards, that there are an awful lot of revisions from Lapband to RNY. Also - you mentioned that lapband is reversible. I would never go into this surgery if I thought for a moment that some day I would want to have it reversed. When I jump in, I jump in with both feet. There's no going back. Take some time, read a lot, make sure you're sure before you do it. Linda

I wasn't thinking reversible so much as "in an emergency, what's easier to repair"- I also had the thought that if, in 10 years, they finally "cure" obesity... what would keep me closer to taking advantage of newer technology. There's a lot to think about- and certainly, I think, one of those things is the possibility of wanting/needing a reversal in the future. Thanks for helping me sort through all there is to consider! Melanie

Melanie, I strugled with my decision (LapBand) for over 5 months! When I met with my surgeon, he recommended LapBand, do to the fact that I have spots (beginnings of holes) on my stomach as the result of taking Indocine (anti-inflamitory) for my foot/ ankle pain. The med also was helping other arthritis areas (back, knees & hip). He said that I should have the LapBand if I was going to keep taking the Indocine, because if I ever had a problem with my stomach (& I have other issue as well), they can not use the scope to see or repair a problem. As they had not done LapBands yet, it was a new technology & I didn't want a foreign body in me, etc. I chose the RNY. But, the more I looked into it, the more people I met & talked with, the more frustrated I became. I was changing my mind about what to do just about every 1-2 weeks. It was driving me crazy!!! I kept going through all the classes, preparing for my date of Jan 1st, even though I had no idea what I was doing & was not loosing the weight I was required to loose pre-op. When the Support Group/OH members had a breakfast meeting, I finally met (face to face) someone who had done the LapBand. After speaking with her & speaking with others on the LapBand site, I decided to have another chat with my surgeon. But, between Saturday & Thursday (my appt with him), I had received a message from a LapBand user who told me to listen to my doc, listen to my heart & listen to my body....as my brain was just getting in the way! As I walked into his office, I had made my decision & went on from there asking more detailed questions about the fills, port issues, foreign body issues, & what was best for me. He was surprised, he had no idea I was struggling with this.....he thought I was going with LapBand & was just waiting on me. As I have to pay for all this out of pocket (2nd mort on my home), it's not like I could pay to see him whenever I had a question!!! He also lowered my requirment of weight (from 20-30 lbs, down to 10-15 lbs). The next day, I paid for everything, set the date of Valentine's Day & made all my pre-op & post-op appointments. I have been on cloud 9 ever since!! What a relief to have all the decisions done, funds all paid, & now just to think of nothing else but drinking the shakes & working out!!! So, chat with those who have already had the surgeries....but remember, their results are mostly due to their bodies, their commitment, & their following their doctor's rules!!! Please keep this in mind, as you will get answers to questions from everyone, but not the WHOLE STORY!!! Take your time, do your research, ask tons of questions, write a list showing the good & bad of each surgery.....it helped me. Also, I just heard about the first patient who had LapBand in Eugene & they have lost 70 lbs in 6-8 weeks! That person was dedicated to the program & works out alot!! So, they have just proved that rapid weight loss can happen with LapBand as well! No matter what we do, no matter what surgery we have....it's only a tool, we still have to do all the work!!! Jackie (LapBand--February 14 @ 7:50AM!!!!)

All those variables make the research so tough! I think that I almost have talked myself in to the lap band, too... I was leaning toward RNY for a bit due to my fear about not having the self control, failure, all those bad feelings associated with my history of dieting. But I think that there is not much difference in outcomes for either choice, except for all those variables in our control and out (like indiv bodies, adherence to aftercare, etc.) I think in some ways slightly slower loss would be better, maybe give the skin more time to adapt to changes and make cosmetics less urgent... we'll see! I am ready to test that out! (won't complain about fast loss, promise) Melanie

Excellent post Jackie. I couldn't agree with you more. Darla