Failed Lap Band, trying to decide between GS or bypass

Hi everyone...I've been absent from here for some time now.  I am just so frustrated with my band and have finally proved to myself that this damn band was the worst thing that I have ever done.  I went back to the surgeon who sent me to the nutrition classes again.

I met with the surgeon again this week dead set that I wanted a sleeve.  She was leaning more toward bypass and now I am just confused.  My surgery is tenatively set for Dec 13 so I have time to think about it.  I am now being listed as Removal of band, sleeve vs bypass.
Any thoughts?

I too had the band (for 8 hellish months) and revised to RNY.  I did like the idea of the sleeve, but after so many years of constant dieting my metabolism was so messed up that I thought I would do better with the malabsorption of the RNY.  A purely restrictive procedure I don't think would have helped me.

I was right; I have lost 112 pounds (15 or 20 from the band) and kept it off for a year and a half - within a 5 pound window.

I am 5 feet tall and weigh 104 today.  I am very pleased, although my only *issue* with the RNY is no NSAIDS , i.e. Advil.  I wish I could take it when I get bad cramps or a killer headache, but a couple of tylenols really help sometimes.  If not, I take a couple valiums and then  I don't care if  I have a headache or cramps!

Only you know what got you here....was it sweets?  Just volume eating?  I *do* dump, so I have a bite or two of something sugary and step away, knowing there will be nasty consequences if I eat more.  

Kudos to you!  I am hoping that I will be able to say that I lost 100 lbs some day.

The first time I went to the surgeon 4 years ago I told him I wanted the band and he said, Are you sure you don't want bypass and I was dead set on the band.  Today, I just keep thinking that I chose wrong the first time so maybe I should listen to what the surgeon says this time.  I mean they do this every day.

Like you, I do get killer cramps and I take an occassional ibuprophen during that time of the month when I just can't take it any more.  My PCP offered to give me a script for vicodin...I never thought about valium, but it makes sense.

My weakness is carbs and I work in the medical field so we have little time to eat so the motto is eat when you can and usually as quickly as you can.  Other reasons I initially didn't want RNY was that I LOVE milk.  I am paranoid about getting osteoporosis and what if I can never drink milk again :(  Thanks for all of your comments.  I feel my self leaning more toward bypass every day...I'll keep you posted

Well you sure aren't the only one who hasn't loved their band! Personally I don't like the malabsorbtion idea, just my personal opinion. I do know lots of folks have done the sleeve and done very successfully, You might read or post on each of the other forums for feedback. Good luck to you!

Thanks!   And your concerns about malabsorption are my concerns too.  I work in orthopaedics and I see a lot of fractures after bypass and it scares the crap out of me...especially since I know that I could develop lactose intolerence! 

You know it just makes me mad because I waited so long before I even got the band to make sure it was safe...and yes I hopped on the "band wagon".  I gave up on this site because everyone on the band page LOVED their band and was successful and mine never worked from the get go and then I had the slip.  It is a bit comforting to see that now I am not the only one who has a failed band. 
  I am going to take your advice and check out the sleeve site...but in the back of my head I just wonder if it will be a repeat of 4 years ago where everyone loved their sleeve

Thanks again, and cute puppy pic!

I really think the sleeve is a whole different creature, after all it has been done since I believe the 40's for stomach cancer soit's far from new. It's just new to weight loss surgery. I had a bro-in-law that had stomach cancer a few years back and he lost ALOT of weight especially for him but he has had to really work at regaining so he doesn't get too thin. I think he has finally evened out and is back at a healthy weight for him but he was already skinny before the surgery. From all the revisions I've read I'd say 90-95% have been very happy,mthey don't lose quite as fast but they still lose. Good luck to you!

I can only share with you my very personal reasons to choose VSG over RNY for my revision choice from the band. I'll probably catch some **** from sharing this here, and that's okay, BUT these were my reasons, for my health, for my life. I'm not saying anything is "wrong" or "bad" with RNY for another person's choice, this is solely based on my needs, my research, and what I knew I could live with for the rest of my life. If I would have needed or wanted a malabsorption component, DS would have been the only choice for me:

 

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me

5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.

I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!

P.S. I wrote this before pregnancy. And, just as an update,   I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.


P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.

As a very recent addition;  I was advised I would have to be given a steroid (prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG. My platelets dropped to 70K (normal is 150k-400k), and after just 10 days of being on steroids, my numbers are up 121K. I'm set and scheduled to deliver via repeat csection on 1 November with an epidural or spinal. This was truly my #1 concern with having a pouch again. My medical needs changing, and needing to take specific drugs that are not allowed with a pouch.

Thank you so much for sharing all of this with me.  It goes without saying that you have definitely done your research!  And congrats on your pregnancy.  I hope everything goes well.

I am on a see-saw everyday since I saw the surgeon.  She asked what my food weakness was and it is carbs.  I could eat bread, pasta everyday.  I was embarassed to say this to her because I know I am making a life decision but the thought of never eating one of my mom's sugar cookies at christmas just doesn't seem possible!  I don't eat a whole dozen of them but if I could have one or two I would be totally satisfied.  And the risk of lactose intolerence would be devistating to me.  I drink 3-4 glasses of milk a day.  I think I am a volume eater.  I just don't feel full and I guess that was my question:  do you feel full after VSG? 

 I hate my band.  I have what they call "first bite syndrome".  I eat 1 or 2 bites, food gets stuck and I am miserable.  I usually have to stand up or go to the bathroom and for people who don't know me it just looks like odd behavior that I decide to go to the bathroom just as we sit down to eat and the food is warm, but I cant spit up my food at the table.  Most of the month I can eat whatever I want and as much as I want, except for when I have my period.  I get this syndrome with everything I am eating except liquids.

  I'm worried that if I had VGS that I will just keep eating and eating.
Thanks again for your post!

Yes, you feel full. Honestly, the key to VSG and you'll see it repeated by several vets on the main VSG board to stop looking for this elusive full feeling. Learn satiety over fullness. You can still puke if you overeat with the sleeve just like any of the other surgeries, so learning portion control, measuring by volume saves you on 2 fronts; 1) It keeps you within your calorie/carb/protein guideline 2) And, it keeps you from overeating.

All of the surgeries can be cheated, there's no bulletproof cure all. It's just not that simple. For me, more than surgery, the constant restriction helps keep my portions in check, but if I wanted to, I can still suck down a 2000 calorie milkshake with the only consequence being my ass is going to get huge again. So, behavioral modifications, and ha*****anges are really the key to success.

I really ended up hating that "Thanksgiving day" full feeling, and still to this day, I'm not fond of it. If I overeat, it's typically in a social situation, and it's because I get distracted.

I'm 28 months post-op and still experience zero physical hunger. I attribute that to 90% of my success, the rest is the fact that I simply eat to survive. I was never an emotional or compulsive eater so that was not a concern of mine. Carbs will slow weight loss, and I avoided them through my losing stage. However, in maintenance, I eat all foods including white carbs, and I have a balance. Protein (meat) first, greens and then if I have room I'll eat a few bites of starchy goodness (that's my life about 85-90% of the time). Some days, I just want veggies or a salad, and that's what I eat. I honestly do not restrict any foods, and live a very normal life post-VSG, but I put in the mental work to make sure I'm equipped for the future.  It's finding what works for you, and how you want to lose weight. Some people are carb sensitive, and they literally have to cut those foods until they can get that compulsion under control. Also, carbs cause hunger in some people so it's one of those things that you'll have to make changes and find what works for you to get you to goal and successfully into maintenance. I do not personally suffer from the eat a carb, crave a carb thing that a lot of women experience. But, if I eat carbs, I'm not going to lose weight, my body likes to burn those foods instead of my fat stores.

I am the same as you.  I am not an emotional eater...I'm the opposite I can't eat if I am really upset about something.  What I worry about is if I eat a little and my pouch or sleeve empties and I am hungry again in an hour, b/c that is what my band is like now.  I can eat 1-2 bites than wham stuck, terrible feeling.  Sometimes it passes sometimes it comes up.  Other times I can eat like a pre-surgery meal.  I am just ready to get this band out.  
  I work in ortho and we see so many fractures from bypass so I think it is engrained in my head that bypass is evil.  BUT I am so afraid that I am going to fail the sleeve...much more to think about.  Thanks for your response!