Nervous and need advice (sorry my post is so long)

Two years ago, I lost 100 pounds on Weigh****chers. Everything was great but within a year and a half, I have regained 80 of those pounds AND my endometriosis/PCOS pain. I went to my OBGYN about a month ago because the pain was so severe that I had to have my husband's help just to get out of bed and go to the restroom. My OBGYN stated that I need another surgery but it would not be as successful as it could be if I was still 80 pounds lighter. He recommended that I go to see Dr. Spiegel in Houston for LapBand weight loss surgery.

I have now seen Dr. S twice for pre-op insurance requirements, he is recommending the RNY or DS over lap band due to the rapid weight loss and resolution of pre-diabetes.

My husband is not at all happy about this change in plans as he feels that the LapBand was much less risky. (We just got married in October and neither of us wants me to die from complications. This is a concern even though my surgeon stated he has never lost a patient.) My hubby also is concerned about the "dumping" I'd potentially get from RNY. We aren't big drinkers but occasionally, we like to have drinks with friends and he's afraid I won't be able to. He has also mentioned that I like to bake and I won't be able to eat my cupcakes for fear of dumping. I think that alcohol and cupcakes contributed to my current weight so it is wise to limit them, but I am afraid of missing them.

How did you know which procedure was right for you? What was the hardest thing to get used to? How did you decide to put your fears aside and just go on faith that everything would work out?

Oh, please don't use Spiegel. Bad reputation, sorry. Just hearsay, but still.  Please consider seeing Dr Stewart and researching on www.dsfacts.com.  They are pulling out dysfunctional lap bands as fast as they put them in. Talk about complications! Check out the revisions board here on OH if you don't believe me. Some surgeons won't even do lap bands any more.

--gina

I have been researching lately and just saw indicators of Dr. Spiegel's bad reputation. Is dsfacts.com where I can see actual numbers of procedures,etc? Where is Dr. Stewart located?

Dr Stewart is in Texas - his contact info including address is on DSfacts.

BTW listen to Major Mom for she is wise.

I had the surgery as I felt I couldn't go on as I was - I didn't feel like I had much to lose and was prepared to 'risk it'.  My recovery was pretty smooth going (the usual getting used to new bowel habits but nothing at all unexpected).

I got lucky, Dr. Keshishian has an office within 30 minutes of my house.  He went over all the options, spent about 2 hours with me at my initial consult.  He had documentation, even used sharpies of different colors to draw all the different surgeries and how they work.  He's amazing.

He made his recommendations (1.DS, 2. Sleeve, 3. lapband) , I researched it, decided to go with the DS.  He refuses to even do an RNY and said he will refer to another doctor anyone who chooses that option.

I have 2 friends with lapbands.  One has lost no weight at all and the other has had so many complications, she had to have it drained for 3 months so her esophagus could heal from all the vomiting.

Good luck in whatever you decide!

I decided on the DS because I trust my doctor to know what would work best for me and that is what he suggested.  Of course I did my research and educated myself - but the DS was really the only thing I considered.  As far as putting fears aside - I wasn't really scared I was going to die from complications.  Of course, there is the normal fear, but I was more afraid of dying from a heart attack or stroke - and every ache or pain I felt I was convinced was going to be the end.  And that's a lot of stress to live with.  Most importantly, I wanted to fully participate in my life.  I didn't want to be embarrassed by my size, or hear hurtful comments.  I wanted to be able to move - to walk more than 100 feet without huffing and puffing.  I wanted the pains from all the excess weight to go away.  And the DS was my best chance to lose it, and keep it off.  So, it really was a pretty easy decision for me.

The hardest thing to get used to?  Well, I just feel differently when I eat.  I gurgle a lot.  When I get hungry, I get HUNGRY and it's a weird feeling.  I didn't really have any nausea, dumping, etc.  I came home from the hospital with no restrictions as to what I could eat, other than to follow the guidelines or getting in enough protein and water.  I could have eaten anything I wanted, but couldn't eat much.  The first few weeks are a little frustrating, but you have to know that it's going to get better - because it does.

I can eat anything I want to know.  I don't have any foods that cause me great distress.  I haven't tested my limits as far as high carb foods go.  I've had a piece of chocolate, and I think I had a cookie or two at Christmas time.  I didn't have any ill effects (I wish I would have).  I just choose not to eat those kind of things at least for now because I have a short opportunity to lose the most amount of weight, and I am committed to seeing that happen without me getting in my own way.  My DS isn't going to do all the work for me.  I can't eat crap and all the things I'd much rather eat, and expect it to magically take the weight away. Do I miss cupcakes - hell yeah!  Sometimes food is all I can think of.  But I like losing 115 pounds better than I like frosting (maybe).  And I like the fact that I feel pride in what I'm doing and I haven't felt pride in myself in a long time.

Really well said, AllegedlyLisa!  As for myself, I have a 3 1/2 year old daughter, and wanted to see her grow up.  I'm 46, was hovering around 380, and had done all the diets and bounce backs.  Like you, Mrs. Stiles, I have a bad sweet tooth.  After researching, I was convinced that DS was the best, because you will lose the weight, and you will be able to keep it off.  You have to become religious about your vitamins and labs over everything else.  I felt I can handle that.  When I went to the doctors here in NYC, the practice here has three docs.  Two of them are convinced on doing the sleeve only, and figure you can always do the DS revision later.  The third goes around the world talking about DS and how it can change someone, and feels anyone with BMI over 50 should consider DS.  I also had severe psoriasis and inflammation, and he is convinced this will help.  Obviously, you can guess which surgeon I went to.  BTW, he mentioned that their practice is dominated by people doing removals or revisions of lap bands - by 5 years out, a lot of people find them ineffective or need removals, and they do not remove too easy - lots of scar tissue.  Their practice won't put any in anymore.

Had the surgery two weeks ago, and ran into complications.  This is a downside of DS, more complication risk.  They had to open me up to do some repairs, which meant a longer stay in the hospital, but I am home and healing now, and doing fine.   Thankfully, I had an awesome surgeon!  He removed the stitches yesterday - I am tender, but feeling the healing!  I do seem to be more sensitive to artificial sweeteners, so I'm not allowed any at this moment.  Still basically on near liquid diet and peanut butter at the moment.  Already down 12 pounds since surgery day.  Feeling stronger day by day.  

The great thing later is, with this surgery, you will be able to eat, your way of eating will change, though.  Talking to people who have had surgery for many years, many talk about eating well, and a lot look at food in much less processed way.  I am trying to look at food a whole new way.  As others will tell you, though, this is a tool only - it s not a magic wand, and you cannot change it afterwards, so you have to be fully committed.  BTW, DSers can drink after a good year out (with moderation).  As for the hubby, best way to get him on board is to educate him on the procedure, too.   My wife went with me to Dr. meetings, and she learned until she became comfortable this was a good choice.  Don't do it unless you are fully committed to changing your life.  I have no regrets!

I guess part of my problem is that I don't feel very trusting of my current surgeon. I have been doing research all day and made an appointment with a doctor who has better reviews (and no pending lawsuits). Based on what everyone has said, I have pretty much eliminated the band as one of my choices. I don't think I'll have any trouble with the weighing and measuring of foods, as I have been doing that for years.

Thank you everyone for being so supportive and sharing your stories. Based on everything you all said, I think my number one right now is to find a surgeon I TRUST. That said, I didn't necessarily have a *bad* experience with the current surgeon, I just didn't feel *right*.

Again, thank you so much!

In actuality,the lapband is not less invasive. You still have to have a major surgery plus they are leaving two plastic foreign objects in your body. foreign objects cause lots of irritation to the tissues. the port site can flip,get the tubing twisted and get infected.

The actual band can twist,slip up or down and get infected. many people spend thousands of dollars on fills and NEVER get the

"sweet spot" that lets them eat but lose too. People from months out to years out and begging ANYONE to get those things out of their bodies. They are not called "crapbands" for nothing. Even the manufacturer says they have a 10 year lifetime and were never intended to be placed forever. I hope you will wipe the band completely off the list. check out the failed lapband forum before you make a final decision.

RNY,in addition to dumping and just so you know only a very small percentage dump and no one knows who will and who wont until they dump; There is also reactive hypoglycemia that occurs for some people and again don't know you will have it till you do. There is an issue with the "blind ' stomach...it can't ever be accessed or reached to scope it or check for ulcers or really,fix anything that happens to it and things CAN happen to it.

T

he malabsorption of food only lasts for about 3 years and then hunger overwhelms some and ,trust me ,EVERY WLS can be eaten around if one is determined to do it. ,and then weight gain starts happening.

You can no longer take NSAIDS( motrin,advil ibuprofen,etc) after having the RNY. the risk for ulcers to develop,even in the remnant stomach is very high,so you can't take them. The pyloric valve is bypassed when they make the pouch so nothing is controlling the income and outgo of food.it is like a free for all.

The VSG has the least ampount of problems associated with it and when the 85% of your stomach is removed they take the stretchy part and the part that produces ghrelin,the hunger hormone. I had vsg 3 years ago and am seldom hungry even now. I have to eat by the clock or I will starve to death. There are no real side effects as you have all the same plumbing ,just a smaller vessel. The pyloric valve is preserved so your food goes in and out as it should.

some people have more trouble with reflux after the VSG since it is pretty highly pressurized in there but some have no trouble at all.

The DS is the sleeve from the VSG above stomach plus rerouting of the intestines to effect malabsorption. the difference in the malabsorption is that in the DS the malabsorption lasts forever which helps with less regain down the road.If you eat a lot of carb y foods(cupcakes) you will have the stinkiest gas. no carbs,no trouble. But since cupcakes have helped you to get to this point in your life they are not that good of a friend anyway. You do have to take a lot of vitamins for the rest of your life,cause the malabsorption affects  vitamins too,but that is not a real problem when you get used to it.

this is just a brief overview of each surgery type and my parameters for choosing. Three years post VSG I decided to convert on to the DS. After 2 years of trying and being well on plan,I had only lost an additional 6#  and I felt like I needed the malabsorption to ever reach my goal,so I am nearly 6 weeks out from the Ds.

GL. it is a big decision but one of the best things I have ever done for myself.

Same for drinking. Liquor is carbs . You will be stinking up the restroom if you have much or maybe any,i don't know. There is nothing to say you can't drink water with lemon and still enjoy the company of your friends?

How to know what operation is best for you? great question! Two answers:

1. research, research, research. For the DS, start at dsfacts.com. Lots of great basic, accurate information there.

2. know thyself, so to speak. It's crucial to take an honest look at yourself, at what changes you can live with and what you can't live with, to figure out what will work for you and what won't. For example, back when I was faced with this decision, I looked very closely at gastric bypass, the only thing my insurer would cover at the time. I knew I needed to do something. But in the end, the combination of negative side effects of gastric bypass (possible dumping, not being able to take NSAIDs, huge list of foods you are never supposed to eat ever again, etc.) combined with the high failure rate, made me decide I just couldn't do it. I researched further and learned more about the DS. At some point in my research, I knew it would work for me and that I could live with it.

    You need to do the same kind of research and soul searching before making your decision. I'm glad you are getting so much negative feedback about lap band. As Vitalady likes to say, it has less complications for ONE DAY. After that, the problems begin. And the failure rate, and rate of people having them removed either for complications or because they have proven ineffective, is high. I also think, as you have noted yourself, that part of your indecision is due to lack of comfort with the surgeon you met. It is so very important that you walk into the OR confident of your decision and your surgeon, no matter what operation you decide on. Dr. Stewart in Denton, TX, has a stellar reputation, and a consult with him migiht make all the difference.

Larra