first appt., lap vs RNY, excited and scared

Thanks! Only speaking of my experiences.....I should cut & paste that post to my blog!!! Jackie

Yes you should. It was very well worded. See you around. Darla

Well, I did it.....I posted my responses on MY STORY. Just wanted you to know. Jackie

For some information, recent studies have shown that at the 5 year mark lap band and RNY patients have lost comparable amounts of weight (lap band loses slower and RNY tends to regain just a bit). So they are both about as effective in that regard. Only about 30% of RNY patients dump. Some do right after surgery but tend to lose that ability over time (like, say, six months or so out). There is no way to predict who will dump or on what. About malabsorption -- there is no malabsorption component with lap band at all. I like this. I take quite a few meds that I will have to take even after weight loss. I'd like to know how much of my medicine is really getting into my system. Also in RNY patients the body begins to adapt and start forming new cilia that can, basically, reach out and grab the nutrients (good and bad) you ingest. Revisions. What can I say about revisions. Yes, there are people who have lap band who get revised to RNY but there are also people who have RNY who are getting revised to lap band. It goes both ways. It isn't necessarily the tool that requires the revision, either. Sometimes its how we use it or how good our surgeons or aftercare are. The bulk of the people I see with lap band who get a revision are either (a) not patient enough to let the band work for them as a tool -- the weight loss can be a lot slower or (b) have a mechanical reason why the band doesn't work for them. I would only suggest a revision in the first case if there was a medical reason for more rapid weight loss. In the second case, then, yes, a revision may be warranted. Now, I'm not going to steer you toward any one surgery. That's a decision for you and your surgeon to decide. My BMI was significantly higher than yours (65 +/-) when I had lap band with Dr. Jan. I like the lap band because it holds me accountable and makes me interact with my surgeon. I do go in for fills (I've only heard of a few people getting port infections -- my niece has had far more trouble with her chemo port than I've had with my band) which I appreciate. I will admit that I fully expect one or two more surgeries in my lifetime due to my band (I'm almost 38). I can't believe it would be problem-free for the next 50 years. It might and if it were I'd consider myself blessed. But, with RNY, the surgeons are often going in blind without an idea of why you may have complications. Sometimes they have to trace miles of intestine to find and fix a problem. The lap band system is pretty identifiable and doesn't even necessarily require exploratory surgery. Many repairs -- like port replacement -- may even be able to be done in the doctor's office, not in surgery. Perforated intestines can kill you. Lap band shouldn't perforate anything. It may erode into the stomach but, again, that is something that should show up on an x-ray or fluroscope and be a relatively easy fix. I like the fact that my band can continue to be adjusted and that I don't have a window of time to lose my body weight. I can use this time to assure proper eating habits are established. RNY isn't all that old, either. It is based on older surgeries, though. It is considered the "gold standard" because of its reliability. I have confidence in the Legacy surgeons that they will do the best that they can for you with minimal risks. As far as which surgery, well, that depends on you. I wasn't willing to take the risk of being routed and replumbed. At least not yet. I feel I'm far too young to need that aggressive of a surgery. If my life depended on it, I would have gone for it. Now I've learned that DS would most likely be the better route for me if I ever needed a revision. At this point, even though I haven't lost much, I'm not blaming my band and I'm not disappointed. I would choose the lap band all over again if I were given the choice. It is also the preferred surgery for anyone hoping to get pregnant. I verified this with Dr. Jan. This is because there is no malabsorption component. If you have any questions, just ask. I think that you'll find most of us are happy with the surgery we picked, though, so getting an impartial answer may be difficult. Take care, Lori

Thanks, that was a helpful post. One of my considerations is that I have fibromyalgia, for which I take pain meds. I would hate to have to keep adjusting the intensity of pain meds because of malabsorption. (I hope the fm symptoms decrease as the weight comes off.) Not looking for impartiality... (would rather hear passionate arguements on both sides!) Just looking to hear experiences. (I am a qualitative researcher!) No pregnancies in my future, one less thing to worry about. ;) I did have a c-section 13 years ago, though, and hear that can potentially change some of the kinds of work done (mostly cosmetics). Be well, Melanie

I had lap band 2 years ago and have gone from a size 20-22 to a size 8, I lovemy band and havent had any problems and I know if I start to gain weight in 2 or 5 years they can just adjsut it in a matter of minutes. Both surgeries have their success stories. Its hard to know whats right or you. You should hang out on the lap band board as well and see what others are thinking. You can check out my pictures on my profile, Im sorry I dont have my whole story listed as I havent figure out how to move it to the new profile with out retyping two years of history. I would be happy to answer any questions you might have. Also check out the complication board as well, its a god source of information. Good luck to you and your husband ! Gail

woohoo! I was a size 8 once... when I was 13. I am on the large size of a 24 now. I would eat sand for a 12. Congrats to you! And thanks for the lead to the comp board. Melanie

Hmmm sand, doesn't sound good but effective!!! Julia

Wow! Great posts by Jackie and Lori. I love the fact that lots of people really do their homework on this subject. Gives me more stuff to think about. I'm pretty sure I'll still go with RNY, but as you all say, it's an individual choice. Thanks for the information! Linda

Hi Melanie, I was reading through your post and wanted to share something that my husband had never heard of before he had his surgery - we went through all the same arguments ourselves, and he had made the choice to have an RNY. He was resigned to take the vitamin supplements daily for the rest of his life and deal with the malabsorbtion, because the alternative of continuing along the same path was unthinkable. We found out about the Vertical Sleeve Gastrectomy (VSG) from the surgeon the night before his surgery. (We traveled to another state, and didn't meet him unitl the night before.) The VSG does not rearrange your intestines in any way, so there is no malabsorbtion. There is a gland in your stomach that secretes a horomone called ghreline that is responsible for cravings and the feeling of never being satisfied that is removed during surgery, which is a wonderful benefit, and a big key to success. I encourage you to research it and see if it might be something that could work for you. There is a forum here on OH that has a FAQ page attached that gives some wonderful information, if you're interested. It certainly was the best way for him, and the way I will choose when it is my turn. Best wishes to you no matter which way you decide....It sounds like you are doing a great job doing your homework! Kim