Newbie - should I use Dr. Joya or Dr. Rumbaut?

Hi,  I am looking to have the Lap Band surgery in Mexico due to self-pay reasons.  I have 16 month old twins and need to be able to get in and out Mexico as quickly as possible.  I'm looking into either going to Dr. Joya or Dr. Rumbaut.  Any experiences, concerns, etc. regarding either that you can share with me.  I will be going alone because my husband will need to watch our kids.  Thank you.

If you are wanting to get in and out quickly there are closer options.

But between Rumbaut and Joya, Rumbaut!  Absolutely.  If you will check out my profile you can see how to research a Mexican Lap Band Surgeon.

Whoa... wait a minute...

You are in NM and you are considering a lap band?  Where will you obtain aftercare?  To my knowledge there is only one FCUSA and it's not very close to you.

Considering the state you live in is THE hardest state in the whole country to obtain aftercare and adjustments I would seriously consider the sleeve.  The weight loss is better, faster, the long term complications are a fraction of what the band is.  Also, studies show anywhere from 20-50% of people need a second surgery to correct something with the band such as a slip, flipped port, etc.  Will you go back to Mexico each time you need a fill or surgery to fix something?

Please read this:

www.medpagetoday.com/MeetingCoverage/ASMBS/14954

The lap band is NOT the safest procedure out there, not long term it isn't.  Check out the revision boards, it's full of banded people getting revisions from one procedure to another.  The band is not forever.  The doctors say it is but the band makers don't claim that by any stretch.

Here is a post I wrote to someone on a different board, she was asking about band vs. sleeve:
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>>I'm curious about the long term risks and complications you mention - besides the need for a replacement once every ten years or so?<<

Esophageal spasms (I had this)
Esophageal dilation
Esophageal motility issues (I have permanent damage due to the band)
Pouch dilation
Erosion
Slips
A slip causing necrosis of the stomach
Stoma spasms (I had this)
Port pain (I had this)
Port infections
Band intolerance (I had this)
Scar tissue begins growing on top of the stomach and under the band causing additional restriction that we don't necessarily want and even with an unfilled band you can have too much restriction and an inability to eat solid food.

Mechanical problems:
Tubing disconnected from the band
Tubing disconnected from the port
Port flips
Kinked tubing
Leaks throughout the band, tubing, or port

The ONLY way to fix a mechanical problem with the band is surgical.  Studies range from 30-50% of people need another surgery in the first five years to correct something with the band.

If you need your band surgically repositioned such as after a slip or if you have your band replaced for any reason your odds for a slip are 70% in the first couple of years after re-op.

Banding provides the slowest and the lowest weight loss of all procedures.  When I got a band I knew I'd have to work harder to lose and maintain than with a more drastic procedure and I was fine with that.  I was not fine with puking, sliming, foaming, and all the assorted ways to vomit.  I was prepared for it to be hard, but not that *kind* of hard.  The kind of hard that I had no control over.

>>With the sleeve, are the results still the same? I've spent 25 years overweight and while I'm not looking for a "quick fix", I really don't want something so drastic as surgery only to have it take years and years to actually loose a noticeable amount of weight.<<

No, the results are better with a sleeve.  You'd be surprised at just how NOT drastic a sleeve is.  It takes just a few minutes longer to do than a band and recovery is about the same as a band.

>>I am currently doing portion control and healthy eating and while I might lose a pound here or there, for the most part it's not doing a bloody bit of difference (SO frustrating). I know with the lap band that your portions become miniscule compared to what someone without the surgery would eat - is the sleeve the same?<<

Good questions, btw. ;o)

With a band absolutely everything affects restriction.  Everything.  Time of day, TOM, weather, humidity, altitude, stress and various emotions, food temp, types of food, swelling for unknown reasons, everything.  Anything can affect restriction.  When I was banded I was always one extreme or another.  I could either eat an entire porterhouse or I couldn't keep my own saliva down due to obstruction for unknown reasons.

With a sleeve most people report that restriction is about the same all the time.  I can eat 2.5oz of solid protein and that's it, I'm done.  No more food.  Or, I can eat about 5oz of soft foods such as tuna salad, refriend beans, etc.  No more of "Today I have restriction, yesterday I didn't."  I have restriction 100% of the time across the board.  One thing that does make a difference for me is that if I drink something ice cold before a meal I can eat about half what I usually would.  Other than that, it's the same all the time.

>>I'm also curious if there are medical conditions brought on by excess weight that will make having this surgery impossible?<<

Not that I can think of.  For the most part if you qualify for a band (medically) you'll qualify for a sleeve.

>>I have GERD and a hiatal hernia. I also have arthritis, bursitis among others. I'm curious if the hiatal hernia would affect whether it would be possible to get the surgery (whatever one I end up deciding on) or if the surgery actually fixes or lessens the effects of these conditions.<<

If your GERD is from your hiatal hernia (likely, most of us have HHs due to excess weight) then fixing the hernia gets rid of the GERD.  If your GERD is not from a HH then the only surgery type that will be safe for you is bypass.

Most of us have HHs and especially if you carry a lot of weight in your stomach.  Most surgeons fix HHs at the time of WLS.

Sleeves have no maintenance and aftercare.

Bands have maintenance and aftercare for life.

Bands have the lowest and slowest weight loss.

Bands are not forever.

If you want to do yourself a favor I'd suggest finding 5 people that have been banded for 10 years or longer.  Not someone that your friend heard of or your doctor told you about, YOU find these people and YOU talk to them.  See how they still like their band.  I'll bet you won't find anyone banded for 10 years or longer.  It's been around for at least 18 years for US citizens (we've been going to MX for WLS since at least the 70s) so they should be around, right? ;o)  Bet you won't find any.  I've been posting on WLS boards for 3 years and the longest I've found anyone that had a band was 9 years and she was contacting me to ask about a revision to a sleeve.

Revisions are big big big business for WLS surgeons.  They are doing tons of them.

Never listen to a newbie about how much they love their surgery types.  They are in the honeymoon stage and they all love their WLS type and their surgeons.  At about 6 months they start getting more realistic and realize it isn't their surgeon that is doing the work to get the weight off, it's them.  But they still love their surgery type.

For bands at about 12 months out they are having problems but the scale is moving so they'll live with it.  At 18 months they are sick of the band problems and they are considering revisions.  At 24 months they are getting revisions.

There are some people posting here that have been banded 5-7 years and happy but not many.  They are certainly the minority.

Scan the band boards, scan the sleeve boards.  The band boards are all about not getting restriction, need another fill, getting stuck, dilated pouch, dilated esophagus, slow weight loss, etc.  Scan the sleeve boards, overall people are happy and losing well.  Sleeve people don't usually post long, they post before, during, and immediately after surgery.  Band people post for years trying to get support and information on how to overcome problems.

Just my experience.
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Again, please read the above link.  It's from the ASMBS.

Thank you for the information.  Why do you prefer Rumbaut over Joya?  Also, there is a fill center in Albuquerque so  I don't see that as a problem.  Thank you. 

Rumbaut has a longer standing rep than Joya.  He is Inameds preferred surgeon.  He has more experience than any other MX surgeon in banding.

Fills/unfills are not the only issue to consider with banding.  Repeat surgery is a big one.  Please read this:

www.medpagetoday.com/MeetingCoverage/ASMBS/14954

Depending on which study you read, anywhere from 20-50% of banded folks need a 2nd surgery in the first 5 years to correct something with the band.  Where will you go?  Back to MX. :o(

Please, think this through.

Is the fill center willing to work with patients banded in Mexico? How far is the fill center from you? If you were to develop a situation where you had to go several times a week is it convenient? Just some things to consider when you are getting banded.

i had vsg a week ago...................the recovery time is no joke so what i'm saying is there is no in and out quickness i can promise you that no matter wherer you go good luck

hi i had my surgery with Dr joya in 2/17/09 and am thrilled!!! i recomend it to everyone...my husband is getting his done in jan with Dr joya as well ..the experience was awoseome...great care, clean attentive staff and de surgeons are great as well not to mention recovery in a beautifull setting did not hurt ..let me know if you have any questions