Revision from Band to Sleeve? MGB? RNY? Mexico...

Hi Everyone,  Hoping I can get some insight here from everyone..I am looking to have my band taken out.  I had lapband done in 2002. I lost 50lbs and have had a horrible time.  I have since gained all 50lbs back.  I cannot afford to pay US prices..I have done my homework and the prices in my area range from $17,000 to $30,000..both of which are not a possibility.  
Anyways, I am trying to figure out which surgery would be the best for me...I will say i am a SUGAR ADDICT!!!  Big time that this my main problem.  I don't eat alot but I graze all day because of habits made thru the band.  
I was looking at the Band to Sleeve but I am afraid I will end up with same problem of still being able to eat sugar and of gerd??  Is this something I should be worried about??  I don't see anything on the "sugar" or "dumping" with the sleeve?
I notice some that had GERD with the sleeve went to RNY to solve the GERD problem.  I am wondering if I should just try to find a Dr. that does Band to RNY?
Are there any Drs. in Mexico doing MGB??  This might be the best bet? I am not sure.  I think with my metabolism, Hypothryoidism and sugar addiction the RNY or MGB would be better for my situation.
Just looking for any insight on these from anyone on the list.

Thanks
Beth

The MGB is done by very few surgeons, and there's a reason for that. (*grin*) I'd mark it off my list right now.

The RNY is the go-to surgery for treating GERD. But---the Band is notorious for causing GERD, so getting rid of it may solve that problem, no matter which form of WLS you revise to.

The RNY is the only form of WLS that commonly causes dumping syndrome, but even so, only about 30% of RNYers actually do dump. From all I've seen and read, dumping is a horrible experience, and NOT something I'd want to have to deal with.

If you have metabolic problems---are you perhaps diabetic?---you need to really research a form of WLS you haven't even mentioned, the Duodenal Switch (DS for short.) The DS has the very best long-term, maintained weight-loss stats, and the best stats for resolving or preventing co-morbs like diabetes and high cholesterol. It makes a dramatic, permanent change in the metabolism. And---it's suitable for grazers, IF they can graze on foods high in protein and fat, not carbs.

Since you're going the self-pay route---is the no chance your insurance would cover this, since you're having medical problems with your Band?---I'd recommend Dr. Marchesni (sp?) in Brazil. Last I heard you could get the DS and two weeks after-care, air fare, everything, for about 16K.

 Thank you so much for the information...The problem is I am having No Problems with my band at this time.

 I also happen to work for the largest Health insurance company in the country for 15 years now.  They absolutely do not cover ANY type of WLS even revisional if the band were causing a problem. period they won't even consider it.
 
The band for ME personally did not work..I learned to eat thru the band of course the wrong way to survive basically..this is the reason I don't want to go to the sleeve..it lets you eat mostly all the same things just less.  I had severe Vitamin deficiency on the band which is supposedly not supposed to happen.  I had to fight with my surgeon to have my blood drawn only to have them realize I was dangerously low in Vitamin B to the point of giving me shots to regulate it!  I am just an odd case I guess with the band.

I am not a "volume eater" for lack of a better term...I am a grazer of JUNK FOOD...Sugar; chips, my regular meals are "clean"  Egg whites; chicken grilled; veggies..it is the in between and my hunger for Junk Food....The sleeve is basically just restrictive which for me is not what I need.

I have no Co-morbidities such as Diabetes or high anything..as my PCP says I am a Perfectly Healthy 43 year old except I have an extra 100lbs on my 5'4" frame! LOL...I am however, borderline for Hashimotos disease (thyroid).  I am not on any meds at this point as the numbers were not high enough to warrant it at this point..but of course that will change and the weight will be even more difficult to get off. I have heard that GERD can be a big problem with the sleeve so I don't want to have a 3rd surgery done if this happens and is a side effect of the sleeve.  The next one is going to be the last one.

I have looked into the DS but don't think that is the path I really want to take.  I have no comorbidities to get rid of.  I go to a personal trainers 3 times a week...I also run ALOT..usually 3.5 miles every other day...Like I tell my trainer I am the fittest fat person he has in the gym!! LOL

I am pretty sure I would be fine with either the MGB or the full bypass.  I just need help with the sugar issue..knowing I cannot have it without getting sick is what I need and to keep the hunger in between my protien meals under control.

I think I have the other parts of the journey already in line - such as knowing healthy eating..protien first; veggies second; no carbs or low carbs; and lots of exercise which I do already.  

That is pretty much where I am right now....I have talked to a few sleeve patients today and it is just not for me and my situation..it works well for others but not my situation right now.  So it's either MGB or Full Bypass (RNY)

Thanks again!

That's a shame about your insurance---they should be ashamed!

I still think you should cross the MGB off your list. I've really never heard anything good about it. And I still think you should research the DS further, and especially talk with people who've had their RNY revised to the DS. In my opinion, the DS offers the most 'normal' post-op lifestyle, while giving the very best long-term results. But the most important thing is choosing something that YOU can live with, forever.

You sound like a normal bander to me.  Don't know why you
think you are the odd case.  The band can cause gerd.  Know
big time for it.  When the band is gone it usually it to if you didn't
have it before the band.  Eating thru it is normal when you are
always hungry and throwing up. 
The band re-enforced my bad habit of grazing on junk as I could
eat good stuff without throwing up.  This lead to Vitamin deficiency which happens alot in banders.

So don't feel adnormal, just one of the many of us. 

If you do the sleeve, you can convert it to DS.

 Thanks at least I don't feel like the only one!!!!  Horrible past 10 years for me!!  I will keep it in mind!  I will look at the sleeve again and see if it will be the best fit for me.

You also need to look into the DS.  The only surgeon to go to in Mexico for a revision to DS is Ungson.  I am not sure on his pricing.  Visit the DS forums and dsfacts.com to get more info on the DS.  It has the very best stats at amount of wgt loss and keeping it off.  Just mentioning this so that you make sure to look into ALL of your options.

There is no dumping with the Sleeve or the DS, but there is only a 30% chance that you would have dumping with the RNY (Not sure why anyone would WANT dumping--it is miserable).  So, you can't COUNT on dumping to help with aversion therapy.  Any weight loss surgery is going to require you to cut back on sugar/carbs. 

 Thank you so much for the information...
 
The band for ME personally did not work..I learned to eat thru the band of course the wrong way to survive basically..this is the reason I don't want to go to the sleeve..it lets you eat mostly all the same things just less.  I had severe Vitamin deficiency on the band which is supposedly not supposed to happen. 

I am not a "volume eater" for lack of a better term...I am a grazer of JUNK FOOD...Sugar; chips, my regular meals are "clean"  Egg whites; chicken grilled; veggies..it is the in between and my hunger for Junk Food....The sleeve is basically just restrictive which for me is not what I need.

I have no Co-morbidities such as Diabetes or high anything..as my PCP says I am a Perfectly Healthy 43 year old except I have an extra 100lbs on my 5'4" frame! LOL...I am however, borderline for Hashimotos disease (thyroid).  I am not on any meds at this point as the numbers were not high enough to warrant it at this point..but of course that will change and the weight will be even more difficult to get off. I have heard that GERD can be a big problem with the sleeve so I don't want to have a 3rd surgery done if this happens and is a side effect of the sleeve.  The next one is going to be the last one.

I have looked into the DS but don't think that is the path I really want to take.  I have no comorbidities to get rid of.  I go to a personal trainer 3 times a week...I also run ALOT..usually 3.5 miles every other day...Like I tell my trainer I am the fittest fat person he has in the gym!! LOL

I am pretty sure I would be fine with either the MGB or the full bypass.  I just need help with the sugar issue..(more mental than anything!) Knowing I cannot have it without the possibility of getting sick is what I need (for my brain!) and to keep the hunger in between my protien meals under control.  With the band I ended up just to get food down eating just junk food..it made my eating WORSE!

I think I have the other parts of the journey already in line - such as knowing healthy eating..protien first; veggies second; no carbs or low carbs; and lots of exercise which I do already.  

That is pretty much where I am right now....I have talked to a few sleeve patients today and it is just not for me and my situation..it works well for others but not my situation right now.  So it's either MGB or Full Bypass (RNY).  

Thanks again!

I had a RNY in May of 2008.  I had lots of complications with it, and like you with the band, it made my eating worse.  I did not get sick from 'dumping' at all.  Dense foods like protein and veggies did not sit good in my pouch and I was throwing up daily from food getting stuck.  I had several EDG's to open strictures.  I never made it to normal BMI--barely made it into the obese category.  I stayed there for about 5 minutes and then started to regain.  I regained almost back to were I was day of surgery.  It is a well known fact that you loose malabsorption of calories around 18 months out.  After that, all you have is the restriction and it is severe diet (under 1000 calories a day) and excercise, for life, to maintain.  Maintainence stats are not good for RNY.  I just wanted to give you this information and a little more about my journey.  I revised to a DS in April of this year.  It has been the very best decision that I ever made.  I am at a normal BMI for the first time....ever I think, lol.  

You are right that GERD can be a problem with the sleeve.  With the DS you also have a sleeve stomach.  If GERD is something that you currently deal with or are prone to, I think you could discuss with your surgeon the possibility of making the sleeve larger.  This could be a possibility with the DS and would help with the GERD issue.  The tighter the sleeve, the higher possibility of GERD....or so I would gather. 

Good luck on your journey and keep us posted! 

 Thanks so much for the information and your insight.  I am famiiar with the DS and know that it is by far the best out there for permanent weight loss.  I had a friend about 12 years ago that had the DS done...She was much heavier than me at about 398....the sad part is she died due to the surgery....She ended up even with proper vitamins becoming way under weight and died of Kidney failure.  It is the best but also I know the biggest risk and not many surgeons offer it.  I spoke with Dr Ungson in Mexico and even going out of the states the surgery is totally out of my budget.  It would take me years to save up the money needed for the DS surgery.  

Did you have your DS surgery here in the states or out of the country?  Just curious..I would love to give it a go as it seems you can eat normally and the weight loss is maintained much longer.

Wish I could hit the lottery!!  Thanks for your input you have given me something to think about!