needing some clarification re MGB PLEASE READ , THANKS :)

Hi I have been researching the Mini Gastric Bypass for quite sometime now. I came across a website obesityhlps.com. My post was comparing the MGB to the Gastric Bypass.  I do not have any negative feelings on the MGB and I am thankful that Dr R I s able to help so many people with their obesity problems.  I am going to put what was sent back to me so please do not think in any way that I think this. I am thankful for people responding to my post. Here are the responses I was given

1. the effectiveness of the MGB is not high and has high failure rates
2. There a hardly any Canadian post or information re MGB
3. That OHIP would not cover me due to the fact that my BMI is 37 and that I have no immediate health risks. I do have a lot of Co- Morbidities though and I am 5’1 and weigh 200 pounds. This cannot be healthy for my body physically to be carrying around all the time.
4. from what they have heard and read to stay away from the MGB because it is dangerous
5. That a dr. in Las Vegas removes a large part of intestine which is not good. This Dr also removes the omentium and that he does not have medical insurance. I totally disagree with this above comment
6. OHIP does not approve the MGB
7. That I should have the Duodenal Switch. I have researched this and the whole procedure makes me uncomfortable. Also that the sleeve stretches back and you gain back all the weight.

 

I had one person respond to me with this very rude and upsetting comment

That with a BMI under 40 I need a Duodenal Switch as I need a nuclear bomb to kill a mouse.  This upset me a lot of cannot believe that someone who has obesity issues and was once where I am researching which surgery to go with would say that to me. I want to and feel most that the MGB is for me. I have struggled with weight my whole life and it is affecting every aspect of my life. 

 

Here are the Co- Morbidities I have-

Heavy snoring, shortness of breath and severe fatigue with minimal activity, decreased exercise tolerance, history in the family of breast cancer, prostate cancer, colon cancer. I have severe GERD (heartburn), abnormal menstrual cycles (irregular or absent), acne, varicouse veins, leg and ankle swellings, rashes, infections, excess sweating all the time, day time sleepiness, pain, lack of self esteem, social rejection, inappropriate coping strategies, anxiety, fatigue, decreased enduranced limiting daily activities included but not limited to walking, standing, housework, bathing, dressing, getting up, standing, sitting, travel, depression related to difficulty coping with frequent failures at diet attempts, stress incontinence, frequent constipation alternating with frequent diarrhea, stress incontinence, abdominal gas and frequent nausea, hemorrhoids, chronic leg pain, Fibromyalgia (would it improve with the MGB surgery?), binge eating disorder, social stigmatization, discrimination, impaired psychosocial and physical functioning causing negative impact of my quality of life.

 

I would like to thank you for taking the time to read my post and if you have any solutions or suggestions please email me. I apologize for the length of this post.

Katie

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Katie I have posted on numerous boards asking why people have such strong feelings against MGB. I don't know if it is that it is considered somehwat "new" or if Dr. R.'s sales-pitchy tactics (videos on You Tube, lame website) just rub people the wrong way? But really, I have found few people who have concrete legitmate evidence that the surgery is flawed or ineffective. I have come across some people who had complications -- including weight gain - but that is a a possibility with any surgery. Complications can occur with every WLS, why are people SO vehemently opposed to MGB, while there are a huge number of success stories? It just doesn't add up. Although I guess you could find the same is true for Rny. With every success story there is also someone with a stretched pouch or complications. And keep in mind, typically happy, succesful patients with no problems don't come to a forum and post. It tends to be newly post-op people, newbies doing reasearch, and people having problems seeking help. That is a general and personal observation anyway.

The type of complication that occurs with MGB is unique to MGB and that is bile reflux. This is due to attaching the bile producing end of the intestine to the stomach pouch. With the RNY gastric bypass, the bile-producing part of the intestine is not attached to the stomach. It is reattached to the intestine further down the intestine. Here is a government medical site that talks about revisions needed by MGB patients, most of which were due to bile reflux: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=1719644 MGB isn't new. Only the name is. It is similar to a loop gastric bypass that used to be performed which was abandoned for this exact reason in favor of RNYGB. Reference: http://www.surgicalweightloss.net/operation.htm I am not a doctor but when I look at pictures of the RNYGB compared to the MGB, it is clear to me why bile flows back into some people's stomachs. I agree with you though it is very hard to get info, good and bad on MGB. Before I had surgery, I was interested in MGB until I read about the complications and the fact that it is a renewal of an old procedure that was abandoned. Donna

You are misinformed.  It is a renewal of an old procedure but has been refined to improve the procedure which was reattached to close to the esophagus causing the bile reflux.  Please go to the CLOS site and look at the pictures.  The new pouch is elongated and the bottom of the pouch, further away from the espohagus, is reattached to the bypassed portion of the intestine.

I am one year out with the MGB and have had no problems of any kind including the bile back up etc. I have come from 266 to 181 and am healthier than I have ever been. You are always going to have the good and the bad because there are always going to be those who might have some issues but compared to those who don't out of the thousands who have any of the WLS it just doesn't compare.  It all goes back to deciding which surgery is the right one for you. Good luck in your journey. Kat

Donna, I couldn't open that link, but is this the study? http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pub med&dopt=AbstractPlus&list_uids=17196443 If so, I have seen it before, and here's the thing...The study doesn't address how many total MGBers are out there vs. how many needed revisions. If there are 3000 patients, and 30 had trouble (obviously rounding here) that's 1% -- and I wouldn't call that "a lot" of people. No surgery is perfect, and every bariatric sugery carries some risk. How many RNY patients need a revision? How many Bandsters need a revision? It all has to be kept in perspective...and without knowing the total patients, how can you deduce what percentage failed? But with that said, I do feel like RNY has more data overall about everything that could go wrong and how to address it. Whereas with MGB, you just don't really know...and you don't know how many surgeons out there could help you. That's one of the things that scares me the most - the long term unknown.  Things that scare me about RNY: pouch stretching non-reversable dumping weight gain I don't know if it all balances out? This is just my opinion. I'm glad to hear from an RNYer!

I'm pre-op and so not an expert by any means, but I just wanted to pop in here with a correction.  In the research I've been doing to prepare, I've found that the RNY is reversable, though I imagine it's not pleasant to have to go through a reversal. Also, not everyone experiences dumping or pouch stretching.   From what I've seen every single one of these surgeries has it's scary aspects.  It's very intimidating. I don't know why when you look under certain surgeries on this site, it has helpful diagrams and loads of info and on other surgeries nothing.  It would be nice if those running the site could post equally helpful info about the other surgeries.  *LOL* Of course I know they aren't "all knowing beings" or anything.  It just would be nice.  This is a very scary undertaking. Hopefully through communication we can all help each other through this process, treating others as we would like to be treated.  I've seen so much ugliness on these boards while trying to research (not speaking about this thread) and it's completely uncalled for.  I just don't understand. Sorry to have gotten on a soap box there.  I didn't set out to.

I have to question the revision rate of 30, though I've had Dr. R. quote that state to me directly.  Since I am a candidate for revision, I believe the 30 he is referring to is 30 who need revision because of excessive weight loss.  I have personally been in touch with at least 15 people who have had revisions to go back and take more intestine because they did not lose enough weight.  And recently, since Dr. R. is using 6 feet as his new standard starting point because he had so many people retuning to get more taken, I know of at least 3 others besides me who have needed revision to put the intestines back.  Once the intestines are back, the result is pretty much a gastric sleeve, which I believe would have been a cheaper and less traumatic option to begin with since I will have to have two surgeries and two fees to achieve the same thing.

Katie,   Your concerns are legitimate, according to the information you were given.  However, it really rubs me wrong when folks post unfounded "facts" about the MGB. I participate in the Yahoo MGB board, and all the horror stories are just not supported by the first hand stories from the post-ops. Over 3000 patients have had the MGB with CLOS doctors, and the statistics support the benefits it offers over other surgeries.  Even the information you were given about OHIP in Canada is false!  There are folks on the message board every day who were covered, so the fallacy of this statement proves the inconsistencies in the report you read.  Join the Yahoo group (they will tell you at CLOS how to do this) and read the first person accounts of MGB patients.  I also did a LOT of research before making my decision, and with a loss of over 200 pounds and great reports from my doctor here at home, I am so glad I found this option.   Sandy

Hi Sandy, I apologise if my post rubbed you the wrong way. I did not mean to offend anyone I just get so many different messages re MGB and it can be very overwhelming. I was going to get the lapband but I did further research on the surgery and there were too many long term effects from it. Also the face that OHIP will not cover it cause they consider it an experimental surgery. The MGB is covered which is positive and makes me feel more clear about choosing the MGB. Could you please tell me the correct information about the OHIP. You had mentioned that the information I was given was not correct. I have been doing all this researching by myself and any extra help I can get I am so thankful for.  You are a inspiration for positive person to recieve a message from. Are you from Canada?  Congratulations on your 200 pound weight loss that must be the best feeling ever :)  Do you think when you have some time you could email me back with any helpful suggestion or even someone you know who lives near toronto. It would be so nice if I could have someone that I could get help and support. Thanks for you email I really appreciated it very much have a fantastic day Katie