Lapband 2008, looking at sleeve or RNY, your thoughts?

I was banded in 2008 and enjoyed a 50lbs loss for several years but it crept back on.  My feelings over the years towards the band have been unpositive as I do not like having his plastic band in my body.  I just rejoined the forums today and was looking back over my blog post and even back then it looked like I wasn't happy about putting the band in but had to due to insurance reasons.

So I've gone to my original doc, he's happy to help and sent me to do the endoscope and barium X-rays.  Those results seems to show little trouble.  The band is digging into my stomach some probably due to some scarring but I'll know more about that when I re-meet with my doc.

So I'm making a list of questions for him to determine if RNY or the sleeve is a better choice for me.  For you who picked one over the other let me know what lead you to that choice.  Both seem to have positives and negatives.  I'll tell you a little about me which may help.

My BMI is at 40, I'm 5 9" 280lbs.  I'm 39 and am in reasonable shape such as I like to get out and go, I enjoy 2-4mile walks, and so far am lucky that my weight hasn't caused too many medical issues.  I do have high blood pressure but none of the other co-morbs.  My knees and joints are in good condition as well.  

I feel the reason I re-gained my weight is simply not paying attention.  I lost the weight in the first year and a half and felt great.  I was with a less supportive partner who could eat anything.  I am remarried 3yrs ago and enjoyed all of the eating out on dates and cooking for each other. Weight simply packed on each year and here I am back at my starting weight.  He is very supportive about a revision and looks forward to loosing weight himself along with me. 

I do have good restriction with my band but I do not get along with it very well, I do tend to eat mushy or wet food, I do sip water with meals, and I have never liked the feeling have having food sitting in my chest.  Long story short is the band and I didn't have a good partnership and I lost track of my weight over the years.  My port is right in my waist line and hurts depending on what pants I'm wearing and I can not wear a belt at all.  I call my band the little demon because some days I can't eat till lunch, others I'm wide open.  It's most likely due to water weight fluctuations but I've never enjoyed not knowing how it's going to act when to sit down to eat, especially with a friend.  I also am not a fan of not being able to take pills.  Funny thing is I never thought I'd miss being able to take a larger pill but having he band has restricted the types of medication my doctor can prescribe or I'm asking the pharmacy to fill the script with the liquid form.

Anyway my choice to do a revision stems from no longer wanting this plastic band inside me, we've never had a positive relationship with food, and and in hopes that I can find the correct tool for me this time around.  I am happy to eat less, happy to stay on plan, and happy to take vitamins or other directions as needed.  

I am also thinking of a revision. I lost 70 with the band, but got married and gained a bit. It is much easier when you live alone. Then I developed trigeminal neuralgia and was on Lyrica for several years and all total for magazines back 30 pounds. Now because of back problems I need to get the weight off. I was thinks no of bypass because of the malabsorption but now I am reading that the malabsorption only lasts for several months. I may go with the sleeve. Seeing a surgeon next week. I will be following your post. 

I'm also talking to my surgeon next week.  I'm trying to narrow down about 3-5 questions to help me decide between bypass or the sleeve.  

I admit I'm a sugar monster and bypass maybe a solid answer for me.  I'm a bit freaked out about rearranging my guts though.  

Be careful on picking the rny because you think you might dump on sugar. According to these boards only a small amount of people dump, its kinda a crap shoot with that, plus if you have a real sugar jones you'll easily find the amount of sugar you can have b4 dumping, or you'll find ways to eat around your pouch, i.e grazing/snacking all day etc etc. 

The real work starts with your head, not your stomach.

Mind you I am a newbie & never had a revision. I chose the sleeve & am very happy with my choice. You'll have to ask yourself if a restriction only procedure will help you get to goal & stay there or if you need a little more. You have to be especially mindful of what you eat past the honeymoon phase which is where I see people have a problem with regain. 

You can fail at any wls, in the end it really comes down to what you eat. Don't freak out about the gut rearrangement. Go to the rny & DS & VSG forums & post your question or use the search button. It's the magnifying glass in the top right corner. Read the prior posts, this question has been asked plenty of times.

Good Luck in whatever you choose to do. 

T,

Your so helpful and really   I like the fact that even though u didnt have the rny you still encourage others to not shun it. Some people on here if they didnt have a particular surgery its not good.  Oh well, it' just my opinion

I enjoy reading your responses and congratulations on your weight loss too!

RBlain

Agree on all points.  I'd love to say a sleeve only would be perfectly fine.  I've been really looking at my eating habits the last 6months and I do snack more often than I'd like, I do lean towards soft foods or ones with sauces over lean protein due to sticking issues, I do not have issues with salty snacks but I do have an issue saying no to sugary snacks.  

I'm really coming into a more clear mind about restriction and how that makes me feel and how it helps or doesn't help me.  Certainly helps me not overeat because at least with the band you pay for it with feeling bad such as nausea, uncomfortable, light headed and so on.

I do have a question for you about the sleeve.  When you eat where do you feel the food?  When I ate without a band I of course felt like food sat in my stomach.  However with the band it feels more like the food is up higher in my chest.  For me has always been unnerving.  

You're right about failing too.  It's 100% the truth, you can and will out smart any of there tools when you want.  For those who did one and failed and know the tricks of the trade I'm hoping this time I'm going to be smarter, I'll work the program and stay alert, I know I have a food issue I've had it all my life never a thin day in there past 1st grade.  I'm thinking I'm  going to invest in some mental help this time as well, I need to find a happy place with food which is not eating it because its comfort, yummy, or anything else that I think it is.

I'm glad you're taking an in depth look at your eating & dieting habits. As far as where I feel the food, well I feel it in my stomach. Usually whenever I don't chew something well like beef or something too dry like chicken I'll feel it higher in my chest, but it doesn't take long for it to work its way down. Usually I take it as a heads up to chew & savor my food, not wolf it down. lol

A popular saying I've heard on the vsg boards is to undereat your sleeve. I generally don't eat till I feel full, it can feel pretty uncomfortable. I eat till I'm satisfied, usually I have to slow it down & pay attention to those clues my body gives me to let me know that I need to stop.

I hope you find your happy place with food. 

Thanks again for your time to write me.  I agree about finding that happy spot.  I've had some very good talks with my husband who is understanding my issues with food, he has a lot of them as well.  He fortunately is able to loose weight as he likes so he's looking forward to doing this together.  

The band gives you quest to and I do like to under eat it.  Gone are the days of pigging out on some random food because with the band it hurts, or I feel queasy.  Friends or family will pig out and then go lay down saying they are sleepy, over eating with WLS means your more than sleepy, I certainly regret anytime I've ever pushed it by eating too much. 

I just had revision surgery last week from band to RNY. I was pretty successful with the band for about 5 years and then the weight crept back on (my error not the band) but then I started having horrible GERD so between the weight gain and GERD my Dr said to remove band and do RNY.  Before I went in I was going to say I wanted the sleeve but he said sleeve after band was not as affective.  I decided I didn't want to risk a second surgery that was not as successful so I agreed. I am feeling really well and just had post op appt and lost 16 pounds. I don't know if his facts are right but I trusted him and went with his suggestion. You may be able to research and see what you find on the matter. Best of luck in whatever you decided. Also I felt like you that I wanted the foreign body out of me!!!

Last night my husband and I went through at lot of info online and are seeing a lot of band to RNY.  It appears for similar reasons as you doc stated that it's the majority opinion.  I also walked in stating sleeve but my doc said we'd talk about both next week after my test.  So he's not ruled it out.