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Topic: RE: bypass or lapand? HELP!!!!
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Hi,
Well, this is a personal choice. I had the MGB almost 11 years ago and I would do it again in a heart beat. It is an extremely powerful surgery and statistics show it being very successful. The RNY is good but many folks tend to gain a lot back. The lapband is ok. Less invasive but it will take a lot of fortitude to lose all you want and keep it off. Do some more research. Talk to as many people as you can on the OH boards. Search yourself and which ever procedure gives you a sense of right, go for it.
Well, this is a personal choice. I had the MGB almost 11 years ago and I would do it again in a heart beat. It is an extremely powerful surgery and statistics show it being very successful. The RNY is good but many folks tend to gain a lot back. The lapband is ok. Less invasive but it will take a lot of fortitude to lose all you want and keep it off. Do some more research. Talk to as many people as you can on the OH boards. Search yourself and which ever procedure gives you a sense of right, go for it.
Clueless about weight loss and weight loss surgery of any kind.
Topic: RE: bypass or lapand? HELP!!!!
I am new to this too.My understanding is with the lapband you usually only lose 45% of your goal. With the others you may lose 75% or so. Personally I am going for the 75%.
J.Whalen
J.Whalen
Topic: bypass or lapand? HELP!!!!
Just left the bariatric office in Reno, NV. My consultation was very informative but I'm still not sure if lapband or bypass is the thing for me.
Can anyone pipe in here and tell me if my original idea for the lapband was the correct choice?
I'm 5 ft six with about 100 pounds to lose.
Any help would be appreciated.
Can anyone pipe in here and tell me if my original idea for the lapband was the correct choice?
I'm 5 ft six with about 100 pounds to lose.
Any help would be appreciated.
(deactivated member)
on 2/21/11 11:00 am - NY
on 2/21/11 11:00 am - NY
Topic: RE: Had my Dec 10 and Im back home and feeling good!
I may be a little naive but what is the difference between MBG and the normal GBS?
Topic: Journal of Obesity article summary on Metabolic Bone Disease
I found an article on Metabolic Bone Disease from the Journal of Obesity. I am including the summary and highlighting the areas that I think are most important. If you want to read the complete article, click this link.
Bariatric surgery has proven to be an effective and life-saving measure that provides sustainable weight loss but it is not without risk of complications, to include metabolic bone disease (MBD).
There is a causal, multifactorial relationship between bariatric surgery and MBD and for that reason MBD remains an ever-present risk in bariatric surgery patients. Patients presenting for bariatric surgery should be evaluated for MBD and receive appropriate presurgical interventions. Postsurgically, the importance of consuming adequate protein and the correct combination of vitamins and minerals cannot be overstated, remembering that no bariatric surgical procedure is risk-free when it comes to the development of metabolic bone disease.
As clinicians, we cannot assume that our morbidly obese patients are well nourished or that they have normal bone quality. Dual-energy X-ray absorptiometry can be used to help assess bone status in the morbidly obese, however if the DXA table limitations prevent imaging the hips and spine, the nondominant forearm is a validated option for quantifying bone mineral density.
Not all abnormal DXA results represent primary osteoporosis and in fact, in the bariatric population, secondary bone disease is the norm and when the diagnosis has been confirmed, treating the underlying cause of the secondary disease must take precedent. DXA Z-scores, if abnormally low, suggest the presence of secondary MBD, however it is important to remember that secondary disease can be present even in the presence of normal scores. Clues such as proximal weakness, a history of renal oxalate stones, chronic steatorrhea, and undersupplementation should serve to alert the clinician to the possible presence of metabolic bone disease.
In addition to the AACE/TOS/ASMBS guidelines, a baseline and one year postoperative DXAs are recommended. The use of calcium citrate and cholecalciferol (vitamin D3) are the recommended forms of these supplements, and in order to achieve and maintain normal serum levels, very high doses are often required in the bariatric postoperative patient.
Caution is advised when considering the use of certain medications to treat common problems in this patient population. Cholestyramine or other bile acid sequestrants used to control diarrhea in this patient population increase the risk of exacerbating vitamin D malabsorption and osteomalacia, and may increase the risk of bowel obstruction. The use of bisphosphonates for presumed osteoporosis carries the risk of life-threatening hypocalcemia; efficacy has not been well established in this population, and the risk for ulceration from oral preparations at the surgical anastamosis has yet to be delineated.
Finally, there is emerging evidence that bariatric osteomalacia is a unique and increasingly common phenomenon in bariatric surgery patients that can have a subtle clinical presentation but potentially devastating consequences if left unrecognized. Investigations into the underlying mechanism of the disease, the response to aggressive repletion, and effective preventive strategies are ongoing. The treatment regimen at this point in time includes the use of cholecalciferol and calcium citrate with frequent monitoring and dose adjustments to attain and maintain normal lab parameters.
Bariatric surgery has proven to be an effective and life-saving measure that provides sustainable weight loss but it is not without risk of complications, to include metabolic bone disease (MBD).
There is a causal, multifactorial relationship between bariatric surgery and MBD and for that reason MBD remains an ever-present risk in bariatric surgery patients. Patients presenting for bariatric surgery should be evaluated for MBD and receive appropriate presurgical interventions. Postsurgically, the importance of consuming adequate protein and the correct combination of vitamins and minerals cannot be overstated, remembering that no bariatric surgical procedure is risk-free when it comes to the development of metabolic bone disease.
As clinicians, we cannot assume that our morbidly obese patients are well nourished or that they have normal bone quality. Dual-energy X-ray absorptiometry can be used to help assess bone status in the morbidly obese, however if the DXA table limitations prevent imaging the hips and spine, the nondominant forearm is a validated option for quantifying bone mineral density.
Not all abnormal DXA results represent primary osteoporosis and in fact, in the bariatric population, secondary bone disease is the norm and when the diagnosis has been confirmed, treating the underlying cause of the secondary disease must take precedent. DXA Z-scores, if abnormally low, suggest the presence of secondary MBD, however it is important to remember that secondary disease can be present even in the presence of normal scores. Clues such as proximal weakness, a history of renal oxalate stones, chronic steatorrhea, and undersupplementation should serve to alert the clinician to the possible presence of metabolic bone disease.
In addition to the AACE/TOS/ASMBS guidelines, a baseline and one year postoperative DXAs are recommended. The use of calcium citrate and cholecalciferol (vitamin D3) are the recommended forms of these supplements, and in order to achieve and maintain normal serum levels, very high doses are often required in the bariatric postoperative patient.
Caution is advised when considering the use of certain medications to treat common problems in this patient population. Cholestyramine or other bile acid sequestrants used to control diarrhea in this patient population increase the risk of exacerbating vitamin D malabsorption and osteomalacia, and may increase the risk of bowel obstruction. The use of bisphosphonates for presumed osteoporosis carries the risk of life-threatening hypocalcemia; efficacy has not been well established in this population, and the risk for ulceration from oral preparations at the surgical anastamosis has yet to be delineated.
Finally, there is emerging evidence that bariatric osteomalacia is a unique and increasingly common phenomenon in bariatric surgery patients that can have a subtle clinical presentation but potentially devastating consequences if left unrecognized. Investigations into the underlying mechanism of the disease, the response to aggressive repletion, and effective preventive strategies are ongoing. The treatment regimen at this point in time includes the use of cholecalciferol and calcium citrate with frequent monitoring and dose adjustments to attain and maintain normal lab parameters.
Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
Topic: RE: MGB vs Sleeve
You should look into revision to the duodenal switch if you want to lose more weight. The sleeve is the first half of the DS surgery. Sometimes sleeve or MGB patients need the more powerful malabsorbtion of the DS.
Topic: RE: Very Frustrated!
I did not come out and flat out ask...but this is the info that i got from all of my docs....
the MGB surgeon will not do the procedure until my fam doc signs off on it, my fam doc wont sign off on it until i get the results from the liver biopsy...i am stuck in the tricke down effect......the biopsy is set for Feb 7....i see the specialist on the 18th of feb for the results, i am hoping to see the fam doc on the 21st of feb and have labs done and mail my packet in to the surgeon by the 25th of feb to keep my March 11 surgery date......aaarrrgggghhhhhhhhhh!!!
the MGB surgeon will not do the procedure until my fam doc signs off on it, my fam doc wont sign off on it until i get the results from the liver biopsy...i am stuck in the tricke down effect......the biopsy is set for Feb 7....i see the specialist on the 18th of feb for the results, i am hoping to see the fam doc on the 21st of feb and have labs done and mail my packet in to the surgeon by the 25th of feb to keep my March 11 surgery date......aaarrrgggghhhhhhhhhh!!!
Topic: RE: Very Frustrated!
I to had elavted liver tests as well as a fatty liver I was able to have my surgeon speak with the liver specialist and he agreed to do the biopsy during my bypass it went well and all was happy so I was able to keep my sceduled date. Hope it helps. It's sure worth asking.
Topic: Good News - WLS Cuts Lbs & Adds Years
A recent article I found on the NIH Medline site documents the long term benefits of bariatric surgery. For those who are concerned about having the surgery, this might set your mind at ease.
http://www.nlm.nih.gov/medlineplus/news/fullstory_108314.html
Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
Topic: RE: Very Frustrated!
I am not having it in Vegas with Dr R. I am having it done in Fl with Dr. Peraglie..he trained under Dr R.
They know about this hiccup. my surgery is still "scheduled" for March 11.....as long as my family doc signs off, i am waiting for her to do this...and in between, i have to get the biopsy done.....
Flo, Dr Peraglie's med. assistant and I have been on close communication, i told her that i wanted to stick with the 3/11 date if we could, depending on everything else....and she said that it was not a problem, and just to take my time and if we need to push the date back a little that that was ok, just to keep in touch with them and when i am cleared and ready that we can go from there......
by no means are they 'upset' that i may have to take a little more time, they are very understanding and do not have any problems keeping the date or pushing it back by a week, month, doesn't matter.......
BUT, that does not help with my frustration, I was so happy and anxious to get the ball rolling with my new life, now..slam, into this brick wall........
Stephanie
They know about this hiccup. my surgery is still "scheduled" for March 11.....as long as my family doc signs off, i am waiting for her to do this...and in between, i have to get the biopsy done.....
Flo, Dr Peraglie's med. assistant and I have been on close communication, i told her that i wanted to stick with the 3/11 date if we could, depending on everything else....and she said that it was not a problem, and just to take my time and if we need to push the date back a little that that was ok, just to keep in touch with them and when i am cleared and ready that we can go from there......
by no means are they 'upset' that i may have to take a little more time, they are very understanding and do not have any problems keeping the date or pushing it back by a week, month, doesn't matter.......
BUT, that does not help with my frustration, I was so happy and anxious to get the ball rolling with my new life, now..slam, into this brick wall........
Stephanie
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