Revision from Band to Sleeve? MGB? RNY? Mexico...
Amy Farrah Fowler
on 9/5/12 8:57 am
on 9/5/12 8:57 am
I'm with MsBatt on this. You won't do better than the DS for any reason, so when you say,
"I am pretty sure I would be fine with either the MGB or the full bypass.", I have to wonder how you think either will serve you better, because there is a long list of how each may serve you worse. Especially the MGB. There is a reason it's nearly extinct, and if you think those are the top choices, you need to do more research to understand the surgeries. The MGB is a bad idea for any reason, and if I was needing malabsorption to help me lose and maintain, the DS has so many benefits over the RNY. If I thought I could lose and maintain without the malabsorption, I'd just get the sleeve.
But NO SURGERY is going to be forgiving of sugar.
"I am pretty sure I would be fine with either the MGB or the full bypass.", I have to wonder how you think either will serve you better, because there is a long list of how each may serve you worse. Especially the MGB. There is a reason it's nearly extinct, and if you think those are the top choices, you need to do more research to understand the surgeries. The MGB is a bad idea for any reason, and if I was needing malabsorption to help me lose and maintain, the DS has so many benefits over the RNY. If I thought I could lose and maintain without the malabsorption, I'd just get the sleeve.
But NO SURGERY is going to be forgiving of sugar.
Thanks so much for your input into my question. I am very curious as to why you are so against the MGB? I am looking for input as to why it is so bad. I have done years and years of research..I have had a failed lapband for 10 years now.
I dismissed the DS as I had a close friend that died due to the complications of that particular surgery. Also, trying to find a surgeon to do a DS is almost as extinct as any surgeon recommending it. I do agree with you that it is superior in the losing and maintaining the weight loss but the rish factors are very high on the other end also.
Can you give me some reasons the MGB or the RNY would serve me worse? I am just trying to get all the information I can gather.
I have talked to a surgeon in Mexico that does the DS but the price even there is no way a possibility to fit my budget any time soon it would take me years to save up enough to have the DS surgery.
The reason I said the MGB or RNY would be fine is I already exercise quite a bit...I run 3.5 miles every other day and I have a personal trainer 2 times a week and a group class with the same trainer once a week..I work out 6 days a week and on Sunday (my rest day) I walk 4 miles with my dog rain or shine or snow we go! LOL.
My meals are clean protein and veggies...it is all the junk in between for me that kills me...If my meals filled me then I would not be grazing all day. My brain tells me I am hungry all the time and I need sugar..so that was the reason I was looking at going with the MGB or RNY...I have read the RNY page and MGB and most people barely go out for walks a few times a week for exercise and they are losing good weight where as I am an avid exerciser and weight lifter and boxer these days I think for my situation I just need that extra help with the food part. hence the reason I said I was pretty sure the MGB or RNY would be "OK" for me. I hope this makes the situation a bit more understanding for you. It's not that I didn't research all my options but for my situation it will by okay.
I dismissed the DS as I had a close friend that died due to the complications of that particular surgery. Also, trying to find a surgeon to do a DS is almost as extinct as any surgeon recommending it. I do agree with you that it is superior in the losing and maintaining the weight loss but the rish factors are very high on the other end also.
Can you give me some reasons the MGB or the RNY would serve me worse? I am just trying to get all the information I can gather.
I have talked to a surgeon in Mexico that does the DS but the price even there is no way a possibility to fit my budget any time soon it would take me years to save up enough to have the DS surgery.
The reason I said the MGB or RNY would be fine is I already exercise quite a bit...I run 3.5 miles every other day and I have a personal trainer 2 times a week and a group class with the same trainer once a week..I work out 6 days a week and on Sunday (my rest day) I walk 4 miles with my dog rain or shine or snow we go! LOL.
My meals are clean protein and veggies...it is all the junk in between for me that kills me...If my meals filled me then I would not be grazing all day. My brain tells me I am hungry all the time and I need sugar..so that was the reason I was looking at going with the MGB or RNY...I have read the RNY page and MGB and most people barely go out for walks a few times a week for exercise and they are losing good weight where as I am an avid exerciser and weight lifter and boxer these days I think for my situation I just need that extra help with the food part. hence the reason I said I was pretty sure the MGB or RNY would be "OK" for me. I hope this makes the situation a bit more understanding for you. It's not that I didn't research all my options but for my situation it will by okay.
I did well with the band intially and then got to the point where I was vomiting 8-10 times daily. I was so inflamed that I couldnt even keep gatorade down. I'm a nurse, and I was so frustrated that I seriously thought about going to the ER one night because I was so miserable. I gained back about 50 pounds after losing 90. I looked into different options and decided on the sleeve, in Mexico. I had to have an EGD first here in the states which showed that I have Barrett's esophagus now, from the band. So, had the revision from band to sleeve in Jan 2011. I am very happy with the decision. I lost 35 pounds in the 2 months following the sleeve, and I will admit that my weight fluctuates some, and doesn't just fall off anymore. I too have a terrible sweet tooth and love to bake. I exercise regularly and I'm trying to eat better. I have had zero reflux with the sleeve (terrible with the band), I have a friend who has the sleeve and has occasional reflux. I have no vomiting. I can eat any food I want, just not much of it. I can eat about 1/2 a sandwich. At subway I can eat 1/4 sandwich and be full. After the sleeve, I could not handle sugar for about 6 months. I got what I assume was a type of "dumping" syndrome, even though I know that phsyiologocally, sleevers can't dump. I would get nauseous, shaky, sweaty and just feel awful, sometimes diarrhea too. It would pass in about 30 minutes. Unfortunately, I don't have that anymore (i just had some cake...lol). My weight fluctuates around 150-155, depending on how much Im watching carbs. I still drink protein shakes 3-4 times a week for breakfast usually, just because I hate eggs and milk. I am very happy that I went with the sleeve.
Thanks so much for your input...I really do appreciate you sharing your experience..This was the type of information I was looking for from different revision surgeries. I have done my research but I have been told by many to come to this forum and ask about others experiences with the revisional surgeries. This is exactly what I was inquiring about.
Thanks so much and good luck with it! I know it's a life long journey for all of us no matter what surgery we have done!
Thanks so much and good luck with it! I know it's a life long journey for all of us no matter what surgery we have done!
Amy Farrah Fowler
on 9/8/12 4:09 pm
on 9/8/12 4:09 pm
I'm a bit frustrated at what seems like your lack of research and REAL information and feel like you want us to do it for you.
The American Society for Metabolic and Bariatric Surgery (AMBS) has condemned the mini gastric bypass. If you have latched onto one of the very few surgeons that do this surgery, then they are an unethical quack, that I would have nothing to do with REGARDLESS of what surgery I ended up choosing.
As far as the danger of the DS, again, surgery, ALL surgery has risks. As far as the DS being any riskier, according to actual studies, the RNY and DS statistically have about the same risk.
As to what the exercise or protein and veggies have to do with anything, I'm not sure what the point is. I have a DS, and I exercise and lift weights most days as well. We should exercise regardless of what surgery we choose. I think my DS would keep my weight off regardless, but I'd certainly be flabbier if I were sedentary.
My diet is mostly protein with veggies, then whatever else I want as filler. Again, this is a good diet regardless of surgery, but you may have problems eating dense protein or some veggies with band or RNY. The difference now is that I'm actually sated with a small meal. If I want a bit of something junky, I'm usually satisfied with a few bites, and my surgery can deal with it, but there is no nagging need for junk when my meals now satisfy for hours.
It doesn't always work that way for some of my RNY friends, whose pouches can empty too quickly (maybe a stretched stoma?) and are hungry and empty in a very short time. I DO know some "successful" RNYers, but they certainly work harder at the maintenance than I do.
Again, when you seem to have some really bad information, I have to wonder where you've been getting your "facts". There are links to many peer reviewed articles and studies at DSfacts.com, as well as a list of vetted DS surgeons (or sleeve) that you seem to find so elusive. Will they be a stones throw from you? Not likely, but I thought it was easier to travel a ways for a great surgery that would WORK for me for the rest of my life, rather than get a crappy one that would cause me problems or not serve me well.
If you are getting some of your bad info from a surgeons office that does the MGB, you need to consider the source, and understand that they don't turn away paying customers. You will be in a LOOOONG list of us that have been lied to by surgeons to sway us to getting one of the surgeries (and limited choices) they happen to offer. I'm on that list, but was steered in the right direction where I could find some facts by posters on this very board.
Below I'm pasting statements by two major insurers (Aetna and Anthem) regarding why they no longer are willing to cover the MGB;
Recently a variant of the gastric bypass, called the "mini gastric bypass" has been popularized. Using a laparoscopic (periscope-type) approach, the stomach is divided, similar to a traditional gastric bypass, but instead of creating a Roux-en-Y connection, the jejunum is anastomosed directly to the stomach, similar to a Billroth II procedure to the stomach. The unique aspect of this procedure is not based on its laparoscopic approach, but rather the type of anastomosis used. While this surgical approach may result in shorter operating time, it creates the risk of biliary reflux gastritis, in which bile flows back into the stomach and causes irritation. That is one of the reasons that this procedure has been abandoned in favor of the RYGB.
The American Society for Metabolic and Bariatric Surgery (AMBS) has condemned the mini gastric bypass. If you have latched onto one of the very few surgeons that do this surgery, then they are an unethical quack, that I would have nothing to do with REGARDLESS of what surgery I ended up choosing.
As far as the danger of the DS, again, surgery, ALL surgery has risks. As far as the DS being any riskier, according to actual studies, the RNY and DS statistically have about the same risk.
As to what the exercise or protein and veggies have to do with anything, I'm not sure what the point is. I have a DS, and I exercise and lift weights most days as well. We should exercise regardless of what surgery we choose. I think my DS would keep my weight off regardless, but I'd certainly be flabbier if I were sedentary.
My diet is mostly protein with veggies, then whatever else I want as filler. Again, this is a good diet regardless of surgery, but you may have problems eating dense protein or some veggies with band or RNY. The difference now is that I'm actually sated with a small meal. If I want a bit of something junky, I'm usually satisfied with a few bites, and my surgery can deal with it, but there is no nagging need for junk when my meals now satisfy for hours.
It doesn't always work that way for some of my RNY friends, whose pouches can empty too quickly (maybe a stretched stoma?) and are hungry and empty in a very short time. I DO know some "successful" RNYers, but they certainly work harder at the maintenance than I do.
Again, when you seem to have some really bad information, I have to wonder where you've been getting your "facts". There are links to many peer reviewed articles and studies at DSfacts.com, as well as a list of vetted DS surgeons (or sleeve) that you seem to find so elusive. Will they be a stones throw from you? Not likely, but I thought it was easier to travel a ways for a great surgery that would WORK for me for the rest of my life, rather than get a crappy one that would cause me problems or not serve me well.
If you are getting some of your bad info from a surgeons office that does the MGB, you need to consider the source, and understand that they don't turn away paying customers. You will be in a LOOOONG list of us that have been lied to by surgeons to sway us to getting one of the surgeries (and limited choices) they happen to offer. I'm on that list, but was steered in the right direction where I could find some facts by posters on this very board.
Below I'm pasting statements by two major insurers (Aetna and Anthem) regarding why they no longer are willing to cover the MGB;
Mini Gastric Bypass:
The "mini gastric bypass" has been promoted as a new surgical treatment for severe obesity. It involves laparoscopic construction of a large and elongated gastric pouch and a loop gastric bypass with distal diversion (200 cm or up to half of the small bowel) to reduce food absorption. While the name mini gastric bypass implies "small" and "simple", this is a major surgical procedure. The mini-gastric bypass uses a jejunal loop directly connected to a small gastric pouch, instead of a Roux-en-Y anastomosis. In this way, the mini-gastric bypass is similar to the loop gastric bypass; the latter procedure that has been abandoned by bariatric surgeons because of its inherent risks. Specifically, performing a loop, rather than a Roux-en-Y, anastomosis to a small gastric pouch in the stomach may permit reflux of bile and digestive juice into the esophagus where it can cause esophagitis and ulceration, and may thus increase the risk of esophageal cancer. The Roux-en-Y modification of the loop bypass was designed to divert bile downstream, several feet below the gastric pouch and esophagus to minimize the risk of reflux. The trend towards use of Roux-en-Y and away from loop gastric bypass was based on sound surgical experience of multiple surgeons with large series of patients. The published evidence supporting the mini-gastric bypass comes from descriptive reports and case series; the potential biases inherent in reports of case series are well known in clinical epidemiology. The evidence for the mini gastric bypass has come from a single investigator, thus raising questions about the generalization and validity of the reported findings. The mini-gastric bypass has not been subjected to a prospective clinical outcome study in peer-reviewed publication.
http://www.aetna.com/cpb/medical/data/100_199/0157.html
4. Mini Gastric Bypass
http://www.anthem.com/medicalpolicies/policies/mp_pw_a053317 .htm
Recently a variant of the gastric bypass, called the "mini gastric bypass" has been popularized. Using a laparoscopic (periscope-type) approach, the stomach is divided, similar to a traditional gastric bypass, but instead of creating a Roux-en-Y connection, the jejunum is anastomosed directly to the stomach, similar to a Billroth II procedure to the stomach. The unique aspect of this procedure is not based on its laparoscopic approach, but rather the type of anastomosis used. While this surgical approach may result in shorter operating time, it creates the risk of biliary reflux gastritis, in which bile flows back into the stomach and causes irritation. That is one of the reasons that this procedure has been abandoned in favor of the RYGB.
Hi Amy, I am very sorry that you are frustrated by me. I appreciate and respect your input and I am sorry that I seem to have pissed you off or irritated you. That was not my intent at all. I was told by several different surgeons to come to this site and post my question to get some "experiences" from others that have had revisions to the different surgeries. THAT is what I did and ALL I did.
I assume from your last post that you didn't appreciate me asking my question to begin with or with me questioning your last post but I honestly was interested as to why you thought the MGB was so bad...I have had much info from a MGB surgeon actually Two of them (obviously, I know they want any paying customer they can get, I wasn't born yesterday as you seem to insinuate hence the reason I have not had it done yet!)...I also have been to a Bariatric surgeon here in my area and spoke to him about all my options. So I DO not expect you to do my research for me!
I was recommended to come here for some experiences from other Revision people and that is it.
I don't know you or your situation and you don't know mine hence the reason I was told to come here to get different experiences!
As for my POINT with the exercise and protien..Many people have surgery and think they do not have to do either of those things!! I was trying to say that I am already exercising and know that protein comes first. (In a perfect world) Everyone would eat right and exercise and Bariatric surgeons would be out of work. That was my only point in saying that!
I have already been on DSfacts.com and contacted a Vetted Surgeon before you posted this, so it is not elusive to me as you insinuate! I really appreciate your input and insight and I am looking much more into the DS!
You sum it up in your sentence above about "being steered in the right direction by posters on this very board" That is what I was asking for just as you did, not for you to attack me with these kinds of posts!!! You stated above you find it frustrating to have to do the research for me then you say you did the same thing by being steered by posters on this very board wtih facts! I asked you for facts on why you didn't like the MGB and you send me this post about me frustrating you!
I do take the information everyone gives me into consideration and I do my own research since I have my own mind and it's my own body...I was just looking for input plain and simple..no need to get so mad about it. if I or my post frustrates you then you don't need to post anymore! I don't know what else to say except I am here to gather information to make a decision on which surgery is best for me and my situation. That's it Plain and Simple.
I assume from your last post that you didn't appreciate me asking my question to begin with or with me questioning your last post but I honestly was interested as to why you thought the MGB was so bad...I have had much info from a MGB surgeon actually Two of them (obviously, I know they want any paying customer they can get, I wasn't born yesterday as you seem to insinuate hence the reason I have not had it done yet!)...I also have been to a Bariatric surgeon here in my area and spoke to him about all my options. So I DO not expect you to do my research for me!
I was recommended to come here for some experiences from other Revision people and that is it.
I don't know you or your situation and you don't know mine hence the reason I was told to come here to get different experiences!
As for my POINT with the exercise and protien..Many people have surgery and think they do not have to do either of those things!! I was trying to say that I am already exercising and know that protein comes first. (In a perfect world) Everyone would eat right and exercise and Bariatric surgeons would be out of work. That was my only point in saying that!
I have already been on DSfacts.com and contacted a Vetted Surgeon before you posted this, so it is not elusive to me as you insinuate! I really appreciate your input and insight and I am looking much more into the DS!
You sum it up in your sentence above about "being steered in the right direction by posters on this very board" That is what I was asking for just as you did, not for you to attack me with these kinds of posts!!! You stated above you find it frustrating to have to do the research for me then you say you did the same thing by being steered by posters on this very board wtih facts! I asked you for facts on why you didn't like the MGB and you send me this post about me frustrating you!
I do take the information everyone gives me into consideration and I do my own research since I have my own mind and it's my own body...I was just looking for input plain and simple..no need to get so mad about it. if I or my post frustrates you then you don't need to post anymore! I don't know what else to say except I am here to gather information to make a decision on which surgery is best for me and my situation. That's it Plain and Simple.
On September 9, 2012 at 5:44 AM Pacific Time, PonygirlCT wrote:
Hi Amy, I am very sorry that you are frustrated by me. I appreciate and respect your input and I am sorry that I seem to have pissed you off or irritated you. That was not my intent at all. I was told by several different surgeons to come to this site and post my question to get some "experiences" from others that have had revisions to the different surgeries. THAT is what I did and ALL I did.I assume from your last post that you didn't appreciate me asking my question to begin with or with me questioning your last post but I honestly was interested as to why you thought the MGB was so bad...I have had much info from a MGB surgeon actually Two of them (obviously, I know they want any paying customer they can get, I wasn't born yesterday as you seem to insinuate hence the reason I have not had it done yet!)...I also have been to a Bariatric surgeon here in my area and spoke to him about all my options. So I DO not expect you to do my research for me!
I was recommended to come here for some experiences from other Revision people and that is it.
I don't know you or your situation and you don't know mine hence the reason I was told to come here to get different experiences!
As for my POINT with the exercise and protien..Many people have surgery and think they do not have to do either of those things!! I was trying to say that I am already exercising and know that protein comes first. (In a perfect world) Everyone would eat right and exercise and Bariatric surgeons would be out of work. That was my only point in saying that!
I have already been on DSfacts.com and contacted a Vetted Surgeon before you posted this, so it is not elusive to me as you insinuate! I really appreciate your input and insight and I am looking much more into the DS!
You sum it up in your sentence above about "being steered in the right direction by posters on this very board" That is what I was asking for just as you did, not for you to attack me with these kinds of posts!!! You stated above you find it frustrating to have to do the research for me then you say you did the same thing by being steered by posters on this very board wtih facts! I asked you for facts on why you didn't like the MGB and you send me this post about me frustrating you!
I do take the information everyone gives me into consideration and I do my own research since I have my own mind and it's my own body...I was just looking for input plain and simple..no need to get so mad about it. if I or my post frustrates you then you don't need to post anymore! I don't know what else to say except I am here to gather information to make a decision on which surgery is best for me and my situation. That's it Plain and Simple.
It seems like you are getting a lot of info but I want to share my perspective. I was banded in 2009 and had it out in February. One month ago I got the DS. Here is why. With the band I developed very maladaptive eating, I couldn't tolerate dense protein or most veggies so I ate slider foods. I did a lot of vomiting. Yet I still ate the crap. So I thought to myself, if vommittng don't keep me from overeating with the band, would dumping really keep my away from sugar with the RNY? I have a very sweet tooth. I realized I needed to figure out a way to get past my carbs issue but I was not willing to part with them forever. With the DS I need to eat a protein packed diet, which I like. I find if I steer clear of sugar and othet white stuff I get past my intense cravings in less than a week. However, if I do want to carb-out for a meal or a treat very occasionally I can.
I'm optimistic about the DS. I know I will have to do a lot of work to get and stay healthy but I can do that.
I'm optimistic about the DS. I know I will have to do a lot of work to get and stay healthy but I can do that.
HW: 365, SW (August 11, 2012): 351
Thanks sooo much..this is the kind of information/input I was looking for I wanted to see if others had the same situation as I did with the band and then revising what they did with their particular problem of having a sweet tooth. I was EXACTLY like you with the band! I still have mine in as it is just sitting idle and not causing a problem now since no fill. I was trying to figure out for my situation which was best and you are literally my dilemma! My best friend went from band to horrible time then having it taken out then waiting and gaining all her weight back to going to bypass RNY..it worked great for her...she is not a Sweet eater..She is totally a Volume eater so for her worked perfect! Me I am afraid it won't so much as I am a Sweet tooth! I you are right I got used to vomiting it was normal for me in a scary way! So I wasn't so sure I wouldn't just eat the sugar then get through the dumping to do it all over again.
So Thank You so much for this information. I have gotten a ton of info from Dr. Aceves office in the last two days and going to sift through it tomorrow but it looks like I will be going that road as you did.
Thanks again for your input. I really do appreciate it.
So Thank You so much for this information. I have gotten a ton of info from Dr. Aceves office in the last two days and going to sift through it tomorrow but it looks like I will be going that road as you did.
Thanks again for your input. I really do appreciate it.
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