5 weeks since Lap Band Revsion to RNY (long)

It has been 5 weeks since my revision from the Lap Band to the RNY and I finally decided I better write this out before I forget anymore.

I was banded in December 2003 at the weight of 262.5. In that first year I was able to get to my lowest weight of 198 but then had some serious dental problems in the 2nd year (unreleated to the band) and wasn't able to fully chew solid food so I spent 9 months of the 2nd year eating crappy soft foods like rice pudding. I still only regained about 5-10 pounds eating totally poorly so it could have been much worse.

I got the dental issue fixed and got a fill in Sept of 05 and lost a bit more until sometime in December when my port snapped in half (found that out when trying to get a Fill in Jan 06). It took some time for me to get back down to Mexico to get my port replaced and between Jan and March I regained up to 238.

I then spent the rest of 2006 and 2007 trying to get to the right fill level again. I was either suffering from reflux (never had this before) or I could eat everything. There wasn't a "sweet spot" of a fill for me anymore.

Then in November of 07 I found out I had successfully pouch packed enough to stretch my pouch etc. With direction from the doctor to go on liquids for 30 days and soft foods for another 30 days I spent the 9 months trying to actually do that without screwing up. (totally unsuccessful). I finally gave up on that in August 08 and decided to have my entire fill removed to try to get my pouch back down to size. During that floro it was discovered that my port had flipped and they couldn't do a fill or an unfill.

I remember walking out of radiology saying "screw it, I am done.. if I could rip this whole band out by reaching down my throat I would" (don't get me wrong.. some people do great with the lap band.. I just wasn't one of them and felt very frustrated)... At that moment I was on a mission to figure out how to get a RNY and be finished with the lap band. (I could have done a sleeve but after screwing around for over 5 years I wanted the malabsorbtion factor. If I had already gotten to goal then regained some I probably would have done the sleeve but I never got to goal with the band.)

That happened 5 weeks ago with the help of the ladies at Beliteweight and I am now down 28.7 pounds (Surgery date weight was 256.5). I had a choice of a whole host of great doctors from Aceves, Rodriguez, Lopez or Aguirre all of whom are great surgeons but I am probably not normal with the fact that I WANTED an open RNY. There was something "safer" in my thinking that I WANTED the doctor to see everything going on in there fully and not on a monitor. I choose Dr. Alejandro Aguirre in Ensenada.

I can not say enough about the care I received from everyone and let me tell you I am a NOT a normal calm patient... I pretty much freak out at the thought of surgery... The doctor was wonderful and even though the surgery was very difficult to get my band out he did a superb job. I will warn people though that the pain is not a walk in the park at all. It wasn't from having an open but from where they had to get my port & band out from scar and adhesions and having a longer surgery altogether.

The nursing staff at the hosptial was great. They were constantly checking on me to make sure I was ok and tried their best to make me comfortable with my pain.

The doctor appears to have a pretty liberal diet compared to some other doctors. I am fully back on normal food now except I am not allowed to have Beef until 2 months out from surgery. It's so different from the band. Instead of having pain when full to stop eating I just get a feeling of "ok I'm full and I'm done now".

I have to watch the carbs I eat or I get dizzy. For example if I have corn flakes & milk there's too much carbs/sugars so it makes me dizzy & disoriented. I haven't experienced a full blown dumping the some describe of the sweats & runs but I don't really want to test that out either. Dizzy is enough for me.

I am completely excited to be down 28.7 pounds... with my lap band I was only down 8 pounds during the first month. It's hard not to compare.

Sorry this is so long but I meant to post before I have just been so busy. I look forward to participating more on the board and seeing how everyone else is doing.

Take Care,
Jamie

Hello Jamie....

A few things...

The band.  It sucks.  You know, at first they had the mesh band.  It was the best they had at the time but it messed with revisions today.  Point being, it didn't work.

Then they came out with the non adjustable band, that was a failure.

Then they came out with the adjustable band and people were experiencing band intolerance, slips, erosion, and a host of other problems.  They decided the bands were too small.

Now they have the bigger bands with the promise of fewer erosions, fewer slips, and less band intolerance.  Erosion stats were doing down before they changed to the bigger bands, slips have more than doubled, band intolerance is on the rise, and now with the bigger bands there are quite a few people that aren't getting any restriction at all with a fully filled band.

Seems to me things were better with the smaller bands.  At least those folks could get restriction easier with much faster weight loss.

Then there are mechanical failures such as yours.  Add to that studies show that the change in anatomy that the band can create causes mega reflux.  Slips cause reflux, everything causes reflux.

There is no sweet spot for a LOT of people.  I don't know if it is the scarring or what but eventually soooo many people end up with no sweet spot.  My guess is that it is the scarring because if someone slips and they are surgically repositioned they are the prime folks to never have a sweet spot again.  What's the difference?  Scarring.  So it's just a hunch on my part but that's my theory and I'm sticking to it. ;o)

I guess my whole point here is that I hope you don't blame yourself for the band not working.  It really wasn't you.  There are many docs in the US that won't do banding anymore.  There are entire hospitals in Sweden that won't do banding anymore.  The country of Chile won't band anymore.  Is it us or is it the band?  I think it's clear.

(With that said, banding does seem to have far fewer complications with band after folks, people with bypass that are now banded, smaller anatomy?  Not sure)

One point that I want to make and I'm speaking as a revision patient.  You have an advantage here that newbies don't.  You were banded so you already went through the learning curve.  You know allllll about the small bites, chew well, eat slowly.  You have one chance with your stoma and pouch, don't blow it.  If you stretch either one your restriction is gone forever.  Burning your stoma (can't spell the name of the procedure) does not work well.  Rose, Stomaphyx, and the other one do not work at all. If you stretch out your pouch/stoma you are looking at revising to ERNY or DS.  Those are your options.  You can make this last for the rest of your life if you are mega careful for the rest of your life.

I see newbie sleeved people talking about foaming and sliming.  I mentioned in a thread prior to that discussion that since being sleeved I never foamed or slimed.  They didn't believe me.  That's when I realized it is because I used to be banded so I already went through the learning curve.  Had being sleeved been my first surgery I'd be sliming and foaming too.

So use your time as a banded person and take those skills and apply them here.  For the rest of your life watch bite and portion size, chew well, keep your pouch and stoma tiny and small so you can enjoy thin once again and forever.

The open bypass... I don't get that. ;o)  Me... I like lap.  Easier recovery but to each his/her own.  We all have to do what is right for us.

Aguirre... does he do DS?  Just wondering who in MX does DS as it seems to be a much wanted procedure lately.

I sincerely wish you luck with your revision!

I had a nightmare with my band too!  I wasted so much time and money...  It is a very long story but you can read my profile if you are interested. I had my band out in August in emergency surgery. I had my revision to RNY in September and I am thrilled!  I may not be a fast loser but I am losing!  I feel great and have never had a moment of reflux since the band came out.  I now have  joined the Century Club and my life keeps getting better and better.

I wish you continued success with you RNY!

I'm glad to hear everything is going good for you.  I am having my revison done on March 16.  I hope mine goes as well as yours did for you.

Cub Fan

 MidwesternGirl said:  "One point that I want to make and I'm speaking as a revision patient.  You have an advantage here that newbies don't.  You were banded so you already went through the learning curve.  You know allllll about the small bites, chew well, eat slowly.  You have one chance with your stoma and pouch, don't blow it.  If you stretch either one your restriction is gone forever.  Burning your stoma (can't spell the name of the procedure) does not work well.  Rose, Stomaphyx, and the other one do not work at all. If you stretch out your pouch/stoma you are looking at revising to ERNY or DS.  Those are your options.  You can make this last for the rest of your life if you are mega careful for the rest of your life."

That is GREAT advice!    Listen to everything she says and you will be OK.   BTW, the "burning" of the stoma is called "Sclerotherapy".   The go down your throat with some kind of apparatus and inject your stoma with a scarring agent which acts to swell it and close it up somewhat.   I've read where some have been successful with it at first, but it doesn't seem to work for anyone in the long term.    If you stretch out your pouch/stoma, the most prevalent type of revision is "band over bypass" and you've already had the band.   Then, like MidwesternGirl says, the ERNY or DS are your only two options.   They both provide more malabsorption, but it is hard to find a doctor *****vises from the RNY to the DS.   Most only do ERNY (extended RNY).
 
Good Luck with your new surgery!

Thank you everyone for your replies.

MidWesternGirl: Thanks for the information & advice. I'm so scared of blowing this one that I have been measuring out my portions and when I feel full I stop & get up from the table. Even if I am out at a restaurant eating with the kids I leave them the payment and tell them I'll wait for them in the car. I just don't want to take chances by sitting there picking & grazing on more food until they are done.  I'm such a freak before surgery that I really don't want to go for round 3 at all.

I am not sure if Dr. Aguirre does DS. That procedure wasn't on my radar because it's a bit too drastic for what I wanted so I didn't ask (but I do understand why some choose it for themselves.)

Jamie...

I do understand why you are worried, I worry about the same thing.  It's an obsession with food.  We like the taste, the texture, the feel of a full mouthful of food.

I just keep telling myself that I CAN have it, just later;  It's okay that I can't have more food now, I can have it later.  You have to find little ways to trick your mind.  You know how before surgery you do the last meal routine?  You eat 100 of them?  It's a fear you can never have that food again.  I don't think it is AS bad for us during revisions but it's still there.  I think it's the same mentality.  You CAN have the same foods, just smaller quantities.  If you want more, have it... in a couple of hours.

I don't really worry about stretching my stomach due to the surgery type that I have but if you push anything hard enough and long enough... things happen.  If I am going to gain weight it's going to be from eating small quantities every 2 hours, not from large quantities every 8 hours.  You know what I mean?  Then at least I protect my surgery type so that if I do screw up and gain, I will be able to depend on my surgery type to work later when I get my act together.  Knock on wood, crossing my fingers, pitching salt over my shoulder... it's not been an issue for me since my revision but I believe the fat mentality will ALWAYS be there.  I don't bank on it ever going away so I have plan B in case I screw up. ;o)  I know, it's neurotic thinking but so is an obsession with food.  Maybe it takes neurotic fixes to deal with neurotic behaviors. heh...  I don't EVER want another revision surgery.  Something I suspect you relate to well.

Okay, as I reread the above I realize (and hope) that another fellow fattie would understand what I am trying to convey above. ;o)

For me it's just another mind game I play with myself to keep myself in check.

I was just wondering if Aguirre does DS.  So many are revising to it I was interested in who in MX is doing it since I'm a huge fan of MX for WLS.

Can I ask why you are eating carbs at all at only 5 weeks out?

As another revision patient, I can't stress highly enough how important it is to change your eating habits for this revision to work. Throw the cornflakes away and pick protein. Carbs will make you hungry and don't provide the nutrition you will need.

I do think it's a fact, that lapband doesn't work well, but RNY won't either if you don't limit the types of food you are eating. I'm not sure what you mean by "normal" food, but at only 5 weeks that scares me a bit. I was on pureed foods at 5 weeks after my revision. I wasn't allowed beef until 1 year out and even then I seldom touch it because it doesn't break down well and I don't want to stretch my stoma.

If your doctor doesn't have a nutritionist in his program, it's really important to get with one and plan out a really good eating program for not only while you lose the weight, but once you get to goal.

Revision has been the best thing I ever did, but it sure hasn't been easy. Anyway - just a gentle reminder - toss those carbs. They are not your friend. The one thing I've had to realize is that I cannot ever, for the rest of my life, eat "normal foods" if I want to keep this weight off. It's really easy for us to think we can eat what we used to, just in smaller portions and we'll be okay but there's just nothing further from the truth.

Good luck - congratulations on your revision - I'm excited for you!!!!!!!!

Aww, CM... I know what you are saying and to a point I agree with you but you know how it is, each doctor is different in their post op diets.  Aguirre is good, he's a safe surgeon with a good track record.

My doc appears to be like yours, mega conservative.  Conservative to a HUGE degree.  But not all docs are and they have good stats, too.

Food/diet changes, I agree with you but remember, surgery doesn't fix your head, that comes with time.  As a nurse when I look at what people eat on the post op diet I don't much care if it is a diet of mashed potatoes as long as they aren't getting sick, getting basic nutrition, and they aren't bumping up the stages of their diet.  When they are fully healed and fully ready to make use of their "healed" tool then the head work seriously begins.  People do not typically turn off head hunger and old habits at the moment of surgery.  If we could do that we wouldn't have needed surgery.  Some things just need to be taken in steps.

You know as well as I do what banded life is like.  We fatties have food issues as it is, banding makes those issues even worse.  Give the OP time, she'll figure out what works for her.

You're right - I tend to be way too obsessive, but only because I really care. My heart's in the right place. I have a friend who is doing everything wrong and not losing and I'm just really worried about her, so it makes me a little crazy. I know we all have to find our own way, but I worry when people test things out really early on. I settle down - sorry!