would you recommend WLS if yours failed?

As some of you know, I started investigating WLS for my 16year old daughter. I had a RNY bypass in 1993 lost 70lbs, of 120 needed to lose. I then gained it all back to 320lbs in about 3 years. I have lost 60lbs in the last year by cutting out carbs and 2 hours of excersise a day. So what do I tell my daughter? I had not admitted to having the surgery to save myself embarrassment. We explored the lap band for her as a friend of mine had this done. But the MD said a RNY would be a better option for my daughter at her age and history of GERD. We sat in the car after that visit and I came clean and told her I had that done. At first she didn't believe me! She had to have it corroborated by my husband. She says how can I eat so much? Which is true I can eat more than one should, like a whole 6inch sub at subway. Then she was relieved saying she just thought I had great will power, always taking home my extra food from restaurant meals. She is 5'8" with a BMI of 43 at 275lbs So here I am, wondering why mine failed, and should we pay for her to have this done? It will cost at least $35,000, our insurance won't cover until age 20, BMI over 50 or BMI 40-50 if life-threatening co-morbidities exist (diabetes, sleep apnea, high blood pressure or leg ulcer from poor circulation) Really, that is the list. I work for my insurance company, so I looked it up. So far our options are: 1. surgery in WA state $35,000 2. surgery in Utah where mine was done $25,000 3 Mexico--cost ? 4. Wait until she is 20 and tell her to eat like crazy until her BMI is 50 5. Wait until she is suffering from life-threatening co-morbidities 6. Diet and exercise--I have lost 60lbs in the last year, all the while encouraging her to join me in these, not much luck. She will go to Curves, so I joined to do it with her and encourage her. We get there about 2-3 days a week. So what do you all think? Can I recommend this for her? Should I pay for it when it might fail as mine did? Your Wisedom is being requested

The DS is also an option to consider. Many go to Brazil or Spain for around $14,000 with the conversion rate for everything including airfare and hotel. I'm not sure what the rate is in Mexico. But essentially you could get a revision if you were interested in such an option and your daughter could get surgery for less then it would cost you for one surgery in the US. (The DS is also your best option for a revision of your failed wls.) If you'd like to read more about it go to: (www) duodenalswitch.com or join us at the DS site here on OH. or join the yahoo groups: http://groups.yahoo.com/group/DS_Revision/ A less extreme version of the DS to consider for your daughter might also be the VG which is just the first half or stomach portion of the DS. The stomach still functions normally and there is no pouch so there is less chance of GERD etc. The difference is that the intestines aren't cut which provides for better vitamin and nutrient absorption. With your daughter at such a young age it coukd be a concern for compliance of the lifetime vitamin regimen and lab followup that the RNY and full DS entail. Best to you Cassandra DS -105

I would personally never recommend RNY or DS for a not-yet-fully-mature body...possibly the lap-band, but only after being extremely convinced the teen really understood the changes required. Frankly, I view WLS as a last-resort, tried everything, nothing worked last ditch attempt and at 16, there's no way anyone HAS tried everything already... So of your list, I would recommend #6 at this point. Nancy 394/275/180

Honestly- I would take a joint trip to Brazil or Spain. Get her the one and only surgery she will ever need, get you a revision, all for about the cost of the single surgery for her in WA. Then come home and learn the DS way or eating 'normally' together.

I would alloy my daughter to have the surgery only if she has done the research and was very sure that she wanted it. I think that as a parent you will be helping your daughter live a better life. You should also let her know that this is not a quick fix it is hard work to make it successful. I would encourage your daughter to look on the teen website and ask others there experiences. I also had a failed lap band experience and now will have the rny. I wish you much luck and god bless. Julie H

By all means, do number 6! I would NEVER encourage an already overweight child of mine (or anyone else, for that matter) to eat until they had a BMI of 50. Wait until she has life-threatening co-morbidities? Just being overweight can be life-threatening. Be sure she knows people DIE from this surgery. Complications happen. And more often than they let on. I know. I spent 3 weeks in the hospital. I had to pay 18K up front, as I'm self-pay, which should have covered it, with no complications. Just got the bill from the hospital. According to them, I owe another 98K!!!! (The 18 was hard enough to come up with...) You ask why yours failed? I think you nailed at least one reason when you said, 'it's true. I can eat more than one should.' Best of luck with Curves! It sounds like you are back on the right track! And I hope she will follow your lead and lose the weight without the surgery.

Kathy Good day to you! I agree with previous posters regarding WLS being one of the last options ~ rather than the first. Eating program and exercise should be pursued first since this will be required anyway - WLS is only a tool your lifestyle matters as to how successful the tool is. I have had weight issues since approximately age 14 in varying degrees from 20 pounds to 200 pounds overweight. I have lost more than 100 pounds only to have gained it back. I wish that surgery had been an available option in my 20's. I would never recommend having her eat until she got to a 50 BMI. I would seriously consider self pay outside of the United States. When I priced for self pay in the United States, I was quoted between 35K-120K. I would also advise to check out all the options. I hesitated for a long time before getting WLS - I kept thinking I should be able to do it myself. I lost the weight, made lifestyle changes only to have the weight return. Finally, at age 43, I decided to have the duodenal switch with Dr Baltasar in Spain. He is quite experienced and proved to be one of the most competent and compassionate physicians I had encountered. I feel that the medical care that I received in Spain was of the highest caliber. I had the surgery in February of 2004 ~ I did have some complications in the form of a post operative infection and some other issues. I had had a previous post operative infection after a hysterectomy done in the United States - so perhaps I am just prone to them. I have now lost 173 pounds at 16 months post op and am living a life both movement and possibility wise that I could not have imagined before. Realizing that no one solution works for everyone ~ please check out all the options. www.duodenalswitch.com - the duodenal switch message board on obesity help - also www.bodybybaltasar.com - there are some excellent comparisons and histories available. Best of luck in your journey ~ take care! Judi C 02-12-2004/DS/Dr Baltasar/SW-330/CW-157