Lap Band fixes RNY; RNY fixes Lap Band; Whose right.

I was just wondering how many people in here are banded and how many are RNY'ed. The belt people say that the belt fixes the unsuccessful RNY'ers and those that advocate RNY say they fixed the unsuccessful belt surgeries.  And me and Christ and many more are sitting here saying, Duh?  I know I must choose what's best for me but what are the criteria to decide what is best!?  If you need to lose more than a hundred pounds go for the belt, if you need to lose fast go for the RNY - is this the criteria.  Any dialogue is appreciated.  I just need your personal thoughts.

This is what I know about it.  When the RNY surgery is performed the stoma, where food enter the new pouch, is very small, that's why you hear so many saying "chew, chew, chew'. If you don't the food chunks DO NOT go down make it to the pouch and have to be vomited back up. However, over time one can easily keep shoving food in their mouth in large quanities and eventually widen things back out, along with widening the stomach. This allows for mass eating again, and mass gaining. Some have a revision that places a lap band around the stoma to restrict the mass amounts of food from going down.  When the Lap Band is performed there is no "malabsorption effect" because none of the intestines are rearranged. Any banded patient can continue to eat any food they like, just smaller amounts at a time. You can easily out eat this surgery by eating foods that easily slip by the band. Some of these foods include: mashed potatoes, ice cream, shakes, sweetened drinks, etc. All are absolutely loaded with carbs and WILL pack the weight right back on you. Patients ussuccessful with the band sometimes will opt to have a RNY revision to get them back track. Both of these surgeries have had success. However, it is up to the patient to make them successful. You can easily out eat either of them. They are a tool, and if used correctly, makes it easy to lose the excess weight. Just look around you here on the board. How many "unsuccessful" stories do you read. Not many. Take all your doctors advice. Follow you nutritionists diet. Take all your vitamins, etc. The decision on which surgery to have is yours only to make. Do your homework and the decision should come easy to you. Remember that you alone have to live with the decision.

See what happens when you don't proofread your post. I guess I'm used to the old system that gave me an extra chance to make changes. I'm supposed to be a college graduate for goodness sake.

Hi Jim, I would take the "fix" aspect out of it.  To be honest, I don't think the choice of which surgery matters all that much for long term success.   I chose RNY for a couple of reasons.  First, I had 150+ to lose and everyone said that it comes off the fastest with RNY and that if you are able to get to your goal in the first 9 months you are far less likely to gain the weight back.  I then factored in the surgeon, complication rates, etc.   The restricitive nature in food choices because of dumping and pouch sensititivity is a a pain, but a very good tool that you don't have with the band.  I can't tell you how much that has helped me with behavior modification.  That is another biggie. The first 9 months are critical because your body supposedly adjusts at that point and any future weight loss is much more difficult - and thus getting discouraged and giving up is more likely if you are not at your goal - hence the higher rate of people gaining weight back with the band. I basically came to the conclusion that for me this is both a sprint and a marathon.  A sprint to get to goal in the first 6-9 months before my body settles, yet at the same time running a marathon in the life change, choices, body image, healthy choices department.  The weight comes off faster than we are able to emotionally adjust.   Once again, it is not about fixing it....it is getting it right the first time.  For me, RNY was the way to go.  This was a last resort for me, no going back, no other choices.  RNY was the choice for me because of all these reasons even though it was $10k more in cost.  And I don't regret it for a second.   In 5 weeks I went from being diabetic for 10 years to non-diabetic.  Off 4 of 5 meds I was on pre-op in 8 weeks and down 87lbs in 14 weeks.  I would do it again in a heartbeat.   Once again both will work if the life change works.  For me, the tools of the pouch, the dumping, the challenges with certain foods that are bad for me that I like anyway is a big part of my success.  But that's just me. Jim, I read your home page and see that you were a believer.  I too struggled with this surgery for about 2 years because I tried several faith based weightloss things.  But I continued to fail.  The scripture that really got me was "If you hand causes you to sin, cut it off".  Essentially, my stomach and the lust of the gut was causing me to continue to sin.  And this is the only sin that is not talked about in the church or worse, is actually condoned with church suppers, etc.  As  I prayed through that I was led that this was what I needed to do and that it was my pride in my faith or lack thereof that was holding me back....yet God gave me this opportunity to "cut it out".  I struggled with my pride on this for a long, long time to the detriment of my family and my relationship with my wife who was at wits end with my yo, yo, dieting.  Once I sought some counsel from several men in my church (men on my board for our business), they really helped confirm the decision by their support.  I was terrified that there would be a stigma - it was the exact opposite.  From my pastor to these men, they were wonderfully supportive and challenged my stinkin' thinkin'.   I know this part doesn't have anything to do with the RNY vs. Band discussion - that was a separate decision once I decided this was the way to go.  I had a peace from God that I was doing the right thing.  So that would be my advice to you.  Forget about fixes, focus on which one makes the most sense for you and if you have a peace about it. Blessings, Greg

Bob, And there’s also the DS to throw into the mix…. They all work for different reasons. If you’re seeing stuff about one “Fixing” another procedure, Do keep in mind- (My personal thoughts...) Very rarely is The Problem a surgical malformed “tool.” Most often, (and this is for the small percentage that don’t succeed to start with,) By “Fix,” someone is blaming their procedure for not adequately keeping them from out-eating it.  In many, many of the cases, if you read more about the person seeking a “Fix,”  you may also find that - -They are Compulsive Emotional Eaters have not addressed the underlying psychological problems that cause their Over-Eating… -They are Self-Defeating their surgery by Over Eating to the point of pain and/or damaging there Pouch, Band, etc… -They have continued self-defeating activity such as Bulimia and extensive Vomiting has damaged their altered digestive system… - They are gorging on sweets (such as M+M’s) or drinking high calorie beverages such as malts/cola and even with the more mal-absorptive procedures such as Distal RNY and DS, High-Glycemic Carbs are still Fully absorbed into the system. Yes, sometimes something can be mechanically Wrong with a procedure. MORE OFTEN, (by a HUGE %) there is something Wrong in how the patient is using it.   Just my observations from reading the Message Boards for over 4 years…. Once someone has realized that WLS (of any sort) is NOT a Magic Bullet, Sadly, they may then move Heaven and Earth To Find “The Right Procedure” that will be a “Magical FIX!” (for lurkers reading in, do not assume that I don’t think that sometimes “The Surgery” is done wrongly.  I’ve seen that as well.  I’ve just seen the VAST Majority of people who are looking for a FIX to have other issues that WLS alone will never help.) “The Right Procedure,” is the one that is used correctly.  It rarely if ever will need "A FIX." Best Wishes- Dx

 

Jim,  The only advice that I can give to you my friend is to pray about it. I would also recommend a consult with your surgeon and get his professional opinion on the whole deal. My surgeon STRONGLY recommended the RNY as opposed to the Lap-Band for me, but was more than competent and willing to do either or. See which your surgeon recommends for you and really take that to heart. Keep us posted on your progress. Troy 

Paul, That is an excellent analysis--well thought out.  Good job. Jim

I asked this same question today of two Bariatric surgeons They agreed it depends on a  number of factors including age health other health issue, Blood Pressure, diabetes, heart condition etc... Both work well with RNY losing faster and a higehr % of your Excess Body Weight(EBW). There are fewer complication with the RNY because they have been around longer. Niether had any issues with either, they have a 99.99% success rate on their 1st time in. They have well over 2000  sugeries between them.  I am also still not sure which I will have BUT I will consider what my sugereon says is best and that will more than likely be the deciding factor.