Am I doing the right thing?

I had a lap band put in on 9/20/2010.  I lost NOTHING. I gained about 60 pounds in the first year. I do have severe Lyme disease/ Bartonella/ Babesia coinfections, and I know there is a connection to these diseases and weight gain in some people). My band was  always filled with 7cc out of a 10cc max fill and I had loads of pain, but it remains in its proper place and they say my gastric reflux is not related to my band.

So, last week I learned my conversion surgery to Roux en Y was approved by my insurance. I was overjoyed! I never thought I'd be so blessed. Gastric Bypass was my first choice in 2010, but my former surgeon didn't do it at that time, so my only option with him was the Lap Band.

I just now learned about DS. My BMI is at 59! I'm wondering if I'm making another WLS mistake by going with the Gastric Bypass instead of the DS because I have so much weight to lose. 

I fear trying to change surgeries now and not getting insurance approval because at 388 pounds, I so desperately need to lose weight as soon as possible. BUT, I want to lose a significant amount of weight so I am healthier.

Dumping syndrome isn't an issue for me. I've already had it prior to having any WLS (I think it is related to my Ehlers Danlos Syndrome). Because of this, I was conditioned from childhood to never eat or drink anything with sugar in it anyways.

In your opinion, with a BMI of 59, is choosing gastric bypass in 30 days over pursuing a *maybe* for future DS a mistake? Thank you, everyone *****plies. I really appreciate it. 

The DS has the best statistics of any bariatric surgery for percentage excess weight loss, for maintenance of that weight loss, and for resolution of almost all comorbidities. While it works well for the lightweights of the MO world, it is especially beneficial for people with a lot of weight to lose. The failure rate is also much lower than for gastric bypass. You have already experienced failure of one bariatric surgery, which, btw, is NOT your failure but rather the failure of a flawed operation with a high failure rate. It would seem to me that this is your opportunity to go for the surgery with the highest rate of success.

Having said all that, you also have a complicated and unusual medical history, and I don't know how that might factor into your choice of operation. Regarding dumping, you say that isn't an issue because you already have it, but what if you have gastric bypass and it makes the dumping even worse?? Not everyone who has gastric bypass has dumping, but a significant percentage of people do, whereas dumping is very rare with the DS. And dumping from gastric bypass can occur with foods other than sugars, such as fats, and in some people even with foods that you really wouldn't expect to cause dumping. So I think this is something for you to consider.

Now, before you do something permanent, would be your best opportunity to consult with a surgeon who is experienced in the DS, who can also take your unique medical history into account. Learn all you can before you make this big decision. This is a decision you will live with for the rest of your life, and waiting a little longer to get it right is, IMHO, the way to go.

Larra

Call your insurance co tomorrow and ask if DS is covered and if so, what do you need to do to change your approval to DS instead of RNY.  It may be a simple ppwk change, maybe a week or month delay.  

ok this is my opinion only, I would not get RNY, I would get the lap band again over RNY and that is saying a lot since that thing permanently trashed my esophagus.  you have to ask yourself a question, you have had the band, then if you get the rny with its high chances of dumping and feeling like crap will you want the 3rd surgery next?  there are some that have had band, rny to ds, it is a long hard road.   trust me when I say I know about wanting surgery now, my bmi was in the 50's before lap band, why wouldn't you get insurance approval?  you know there is NO documentation that insurance companies can use to justify that, if you are approved for RNY, you will get approved for DS, just not today, and if they try that bs of investigational-please hard to say investigational when it has been performed since about 1987.  so you will get it approved hold on to what you want I promise you will not regret it in the end.....wishing you a great journey

I have NO first-hand experience with the RNY. I do, however, know several people IRL who've had it, and most of the regret it. I also know many, many more on-line, and a significant per centage of them either have revised it to a DS, or want to.

There is not enough money in the world to get me to have an RNY. When I thought that was my only option, I chose to stay fat.