starting to consider revision...but need advice!

I have had my lap band for 1.5 years now. I have lost about 40 pounds...and that was in the first few months! After that I can not lose anymore. I am considering going for revision to something more drastic.  First question is, whats the chance of insurance acutally covering a second surgery because the first one didnt work?  My second question is that I have been reading on here people getting revisions to have the lap band...unlike me where i want to have it removed. Why would someone get a lapband after having a more serious surgery? If the more serious one didnt work, wouldnt the lap band not work even more? I hope this doesnt come off rude cause i dont intend it to be. This is my first time posting on this side (normally on the lap band forum). I am just very curious. Any advice or shared experiences would be SOOO appreciated!

Thanks!

Catalina,

It really depends on why the first procedure isnt working. IF there isnt anything wrong with your band and you dont have a complication like a slip, prolapse, esophageal motility issues, chronic reflux with an empty band or some other complication preventing the band from functioning properly then its harder to get a revision approved. I had my band almost 5 years and had numerous complications resulting in removal and revision to sleeve. To answer the second part of your question: I think you are referring to folks that had VBG or RNY and now want to have a band which is purely restrictive?? I think its mostly because they want the smaller pouch back since the malabsorptive component probably isnt what needs to be changed in certain instances. There are folks who will answer that question more clearly but I beleive the primary reason would be to reduce pouch size to an already smaller stomach of the RNY.

Babs

Thanks for your response. I think I understand a little bit better now. I don't believe there is anythign wrong with my band, except that it isnt really working for me!!!

How is it not working for you?  Are you unable to get a sweet spot?  Unable to obtain aftercare?  Unable to give up ice cream?  Unable to stop hurling?  Why isn't it working?

If restriction alone is good for you then a sleeve is great.  If you can't give up large quantities of other foods then something with malabsorption might be a better bet.

People with bypass often times stretch their pouch or stoma and they lose all restriction.  A band over their bypassed stomach affords them restriction again.

not working because...

sometimes too tight, cant eat anything except ice cream, mashed potatoes, sometimse too loose, and able to eat too large quanities of food...  still feel hungry often...and lately, i am so disguisted with the whole thing that i have absolutely no motivation to even try to follow the rules. just not happy with this band. I think something with malabsorption might really be better for me.

Well now, wait a minute.

If you can eat bad foods you can eat good foods.

If you can eat mashed potatoes you can eat yogurt.  If you can eat ice cream you can drink a protein shake.  See what I mean?

I'm not saying this is a quality life... I experienced it too.  That's why I have a sleeve now.  But if you can eat bad foods you can eat good foods.  You can take this as an opportunity to lose weight until you get your revision.  You really need a better quality diet anyway.  Ice cream and potatoes are not ideal.

Now, if you need a revision (and many do from banding) then you are probably right to lean towards RNY or DS if you have a hard time with the high fat, high carb foods.

 From what you have described it sounds as if, even if you had the RNY, you would eat your way back from the initial easy weight loss afforded by the surgery.   I have watched people go from lapband to RNY and be so excited because they started losing, only to see them gain most of their weight back 3 years later.   The RNY has "pouch rules" regarding eating and it's just another form of dieting that you will have to adhere to in order to achieve lifelong success.  

If food choices are your issue, the DS (or sleeve)  would be the surgery to get.   It is the easiest to live with and your food choices are more varied than with the lapband or RNY.   That is what everyone who has been unsuccessful with the RNY is trying to get revised to., however  if you don't have that much excess weight to lose,  the sleeve might work for you if the reduction in Grehlin is able to control your cravings for  non-healthy food choices.   The sleeve procedure (which is the restrictive portion of the DS surgery)  significantly reduces the amount of Grehlin (the hunger hormone) in your system because the surgery removes the portion of the stomach where it is produced.  

If you find that the Sleeve (VSG) alone is not enough for you, you can add the malabsorption portion of the DS later.    If you opt for the RNY, you will completely change the anatomical function of your stoma*****onstructing the pouch and if that procedure doesn't prove successful for you, it will be VERY difficult to revise you to a DS and only a handful of surgeons in the U.S. even perform that revision (RNY to DS).   As long as you stay away from the pouch, your options for other WLS are more varied down the line.  

Think long and hard about what you think you can live with long term.  Think twice (or three times) and cut once.  And, do your RESEARCH!!  Learn the "lingo".   View diagrams of all of the different procedures and educate yourself on how they work.  You don't want to have to put your body through 3-4 surgeries as some folks on here have.  

And, please don't let some doctor (or anyone else) confuse you using the old BPD/DS (Scopinaro procedure) to turn you against the DS.    Most (if not all) of the people who have had bad side effects and complications with the DS had the OLD procedure, which had a POUCH not the modern DS with the SLEEVE stomach.    It is important to realize that the old procedure is the one you read about with the horrible  side effects.  (And some with the ERNY have the same horrible side effects.)  They are both referred to as the DS and there is a great deal of confusion because of this.