New Member!! Need advice!

Hey everyone,

I thought I would try out these forums so I can get some advice.  I was banded almost three years ago.  I had great weight loss at first.  I lost about 80 pounds.  The problem was I was losing because it was just too tight.  I basically wasn't keeping anything down at all the majority of my weight loss but I just put up with it because I wanted to lose weight.  I eventually got to the point where I stopped losing even though I wasn't really eating anything.  We then decided to add some more fluid (knowing I was already probably too tight).  After that fill I got sick a lot and had night coughs.  Then I had extreme abdominal pain and they determined I had a slight slip (it flipped vertically so you could see through the band on the xray..not a common slip where it slips horizontally if that makes sense).  They took just 1 cc out and in 3 weeks I gained 15 pounds.  That was about a year ago and I have been struggling to find my happy place with the fill.  Even a .25 cc fill causes me to be either too tight, or no restriction at all.  And it is so different from day to day.  Some days I can't hardly get down fluids, and the next I can even eat pizza.  So on days that I can, I over do it because I am so hungry.  I have a feeling that my band is not very secure and as it shifts day to day I have different amounts of restriction.  A EGD showed that I do not have any erosion, but xrays have showed that I have had several slips now.  I have now put on about 50 pounds of my weight back.  We are now looking into a revision.  I am only 27 and never had children so my doctor didn't really suggest the bypass surgery.  He suggested the sleeve but did warn me that some people who do not have success with one, may not with the other.  I really want to try the sleeve but I am curious if people believe it is better to just do the bypass beings I didn't have great success with the band.  I feel like I did have success...it is just that my band is very sensitive and my restriction is not consistent.  I am starting the process now to set up to have the sleeve.  Any thoughts on whether this sounds like a good idea for me would be very appreciated. Thanks so much!

Hello,

I had my band back in '08, I have slight esophageal dilation and a slip so the band has to come out. My Surgeon told me that if one restrictive procedure didn't work then another one wouldn't either. I did however lose 90 pounds when my band had the right amount of restriction so I consider that successful. I have therefore decided to go with the sleeve, I am self pay so very nervous and scared that it won't work. For me the bypass is not an option even though insurance most likely would have paid.

You will make the right decision based on what your surgeon advises and the extensive research that you are doing. Good luck and keep us posted.

I know literally hundreds of people who have revised to the sleeve from band and had wonderful success. I belong to several failed band groups and this is such a common story. The variable restriction and keeping bands too tight causing so much damage and much of it can't be seen because it is under the band between the band and the stomach. Scar tissue also grows there and causes tightness over time. It is a good idea to revise to the sleeve, the restriction feels a bit different but and for the first few weeks you won't feel any because of the nerves being cut in the stomach but after a month or so you will feel more. It is very important to follow the post op diet so you don't over eat when you aren't able to feel restriction. However if you lost with the band you should do fine with the sleeve. The only reason I know of fo not doing the sleeve is if you have severe GERD or heartburn otherwise you should do well.

Thank you so much!! This was the advice I was looking for!! I think a second time around on WLS will  be just what I need to get it right this time! and hopefully without chocking myself to death with a band! Thanks so much!!

The surgeon in NYC that I plan to use has recommended a GB instead of the sleeve after LapBand because of the scar tissue that has occurred and he feels that leads to leaks after sleeve surgery.  In your perusing forums over time has this ever come up? I had my "heart set" on sleeve but have now been approved for GB. I have misgivings because I didn't want to get re-routed but that could just be all in my head.  

I have to say I have never seen anyone have too much scar tissue for a sleeve. Most surgeons remove as much of the scar tissue as possible, sometimes they will remove scar tissue when they remove the band and then wait a couple of months to do the sleeve so it all has time to heal up. It sounds like your doc prefers the bypass and doesn't feel comfortable with the sleeve. I think if I were you I would get a second opinion from another surgeon. If you are in NY there should be many to chose from! The only reason I know of for not doing the sleeve is because the person has reflux or there is too much damage to the stomach itself like an erosion situation. Otherwise I'd want the sleeve over the bypass myself Good luck!

People lose slower with a sleeve than rny, but after 3 years, the results are similar.  Both have a 60-70% success rate. You may want to research sleeve sizes and find out what size your surgeon will use. (google bougie size with gastric sleeve). I have 2 coworkers who used the same surgeon.  The first one wasn't as compliant with the diet and felt like her sleeve was too big. She also grazed. She lost 45lbs in 9 months and has regain half back.  The second one asked the doctor to make her sleeve smaller. She couldn't eat much at a time, the first 4-5 months, and ate 4-5 meals a day. She lost 90 lbs in 9 months, stalled for 2 months and lost another 30 since. Both ladies are extreme examples of the worst and best.

I started as a RNY 'er in 2002 and had great success. Over the past 6 years I have gained just over 100 lbs. of the weight back. I have been really frustrated and the doc I was going to did a resting metabolic on me and my rate was only 1400 a day. REALLY low.I have several medical weight related issues as well. But at this point, despite many plea's from my surgeon to Tricare- my insurance, the people who don't know me, feel I do not need the surgery for revision. So I am lost with that.

I did want to say though, back in 2002 when I had my original surgery- I have several support groups on line that had surgery the same time as I. 3 of them have had successful pregnancy's and have not only one child but 2 or 3. All had RNY first. One actually accidentally got pregnant at 6 months post op. I don't know if your band experience would make a difference in a pregnancy or not, but as I said, I do know many folks that had RNY and then children. It is possible.

Most of us post op need to eat 1300- 1400 cal to maintain.  Eating more causes weight gain. 

To maintain my 155-160 lbs body i can eat app 1500 call per day as long as it is low csrb. 1200 ...if i eat more carbs (carbs make me gain weight, even on a relatively low calorie diet.)

My metabolism was damaged most likely way before my RNY.

Welcome to the club.   

H.a.l.a.B.   My RMR is 1400-1500 calories to maintain 230 lbs. Prior to getting my RMR in Dec, I was eating 1600-1700 calories and hungry. After I had my rny, I noticed my HR has slowed down to the 40s at rest. A workup with a cardiologist and endocrinologist, found everything normal. I stopped losing weight at 18 months and began to gain at 24 months. After seeing my doctor about a revision, I went on a 1200 calorie diet with 200 calories of daily activity. I lost 3 pounds in 4 days (fluid) and another 2.5 lbs over 4 months. I told my doctor how hungry I was during this time and he increased me back to 1500 calories. Within a week, I gain 3 lbs and a month regained the 2.5 lbs.  My insurance has denied x2. I'm now in the process of an appeal.