Decisions, decisions, decisions...

Five years ago, I thought I was making a “good” decision for my health, to lose weight by having a gastric band placed. I researched it, consulted with my PCP and a surgeon, all thought it was something to consider. Never would I have expected to have complications. Sure I read the pamphlets with the risks listed, just never thought it would happen to me.

Fast forward to now, I am faced with another big decision. I have to have my band removed very soon. My surgeon has indicated that if I don’t revise to another procedure I will pack on weight. Logically in my head I know he is correct.  He is suggesting the RNY and so is my PCP.

My fear…is that in five years I will be in the same boat as I am now, having complications, and facing more surgery. I know there is no magic crystal ball to tell the future but I am getting older and I don’t want to do damage to my body. They want to move my surgery up as my symptoms are getting worse, I just can’t decide what to do. I know this is my decision, I’m just feeling conflicted.

Hi Karen,

I have been having the same doubts off and on over the past few months since deciding to pursue a revision to RNY. Although I don't *have to* have my band removed like you, I feel like I really NEED it gone. It makes me miserable every day.

Now, looking at the RNY, there are complications and risks with this procedure as well... however what helps calm me is its success rate.  Weighing the risks vs rewards, my thought process was this:

- I can only have my lap-band removed and not revised.

     WORST: I gain weight...

     LIKELY:  Stay around 340#

     BEST:  Continue to struggle dieting with little long-term success.

     IN ALL CASES: I've tried dieting most of my life and failed.  The best case scenario has me morbidly obese and just waiting for health complications to arise. I'm lucky enough to not have any co-morbidities, but they are lurking ready to come in (such as being pre-diabetic). In any scenario, I will become unhealthy and likely die early.

- I can have the lap band revised to a RNY.

     WORST:  Complications with surgery or afterwards. I could be in and out of the hospital for it. I could die from surgery or from a complication. In 5 years I could need another surgery. 

     LIKELY:  (Statistically) Have some difficulties after surgery that will require frequent trips to the doctor, a trial and error phase when learning what I can and cannot handle. In the long term, lose a significant amount of weight during the honeymoon phase. Start out rocky at first, but lose at least 100lb. I could regain the weight later on, especially after having kids, but will have an amount of time where I can live healthy and not worry as much about my weight being so high.

     BEST:  Lose my excess weight down to goal without any issues. Experience life for the first time as someone of normal size. Get to travel and fit in places I couldn't before. Live long enough to meet my future children's children. 

     IN ALL CASES: I tried my best to make a change towards a better healthier life.

This might be a little odd and/or extreme... but in my mind, the worst case scenario for having a revision is about the same as where you are right now, no?

Anyway, writing out something similar to myself helped me feel more confident in my decision to continue with my RNY. Maybe/hopefully something I said will help you make a decision for yourself as well.  Much love! -Felicity

Thank you Felicity for your support. I think I went into panic mode when my surgeon called me personally and felt like surgery was imminent.  I have an appointment Monday to talk this through with him. Not sure when he wants to move it up to, but I will find out Monday.  Warm regards, Karen

We're here for you!

Great post, Felicity. I like to use the same strategy to work through tough decisons and I think you are exactly right in your analysis :)

My understanding is that the complication rate with RNY is much lower than with the band. Sure you could have complications with RNY. But think about where you will be in five years without RNY. It is almost certain that you will gain weight and end up with obesity related complications, so you have to decide which is the worse path. 

Thank you, you are so right!

I can only imagine the concern arising with a revision. Ask a TON of questions, but I can lend a word of support about the long term success - make that complication free success - that is possible with RNY.

Now, let me add a few details.

You DO need to take vitamins every day. Some complain about a complicated regimen, or the cost. I actually did a cost breakdown and it's not prohibitive (far, far less than a drive thru stop!). I also organize my vitamins for a week at a time, so there is no time lost shuffling thru bottles, clutter on the counter, etc. The ones to really watch are the B vitamins, vitamin D, and calcium. My surgeon explained that deficiencies in any of these are extremely serious and not detectible until they are at a significant level....at which point you can't rectify problems. Also, we need to take calcium CITRATE (citrical) not CARBONATE. 

You WILL need to drink a lot of water. 

You WILL experience a "honeymoon" period of weight loss post RNY. Make the most of it. Eventually, your body adjusts and guess what? If you go back to your old habits and eat a lot of garbage....weight will come back. RNY is a lifetime lifestyle change, and a permanent commitment to yourself and your own well being. 

The traditional tools will definitely support your progress - logging your food daily, exercise, etc. 

In the long run, losing weight is the battle - maintenance is the war! You will need a plan to keep yourself at the weight or size you want to be! 

There's more to be sure, but let me assure you that there are MANY long term RNY-ers out there that are doing great. Check the RNY grads forum for a few testimonials. Attend some post op support groups or ask your surgeon if s/he can connect you to some success stories from their practice. And I am happy to answer questions from the 6 years out perspective. You may feel free to send me a PM any time. 

Best of luck as you make your decision!

Thank you! I have been thinking about this for months, working with a registered dietitian, and I've been using MFP and love it. I know this is probably a good thing but when surgery becomes urgent it makes you panic.

I know exactly what is going through your mind right now. And the responses you are getting should not be confusing or stressful. You do not have to make your mind up before your meeting on Monday. You can change your mind. We all have experience here and just ask little questions, relax this weekend and listen to what the surgeon has to say for your best option and health. Twenty seven years ago a gastric stapling was the very best solution to my problems. Well almost two years ago I was no longer able to eat any foods. For two years I have been listening to options, weighing pros and cons and living on liquids only. Honestly my surgeon and my family do not know how I survived til now. I could not get a revision to RNY until this July 10. I can tell you I couldn't be more pleased with the outcome. I can eat solids. You can see my skin and overall glow of health about me. I was unsure up until last April. Then my list had more pros to do this surgery than cons. I am not sorry. I needed this surgery ten years ago, but I never knew much about the RNY. Sometimes I would think that when surgery date got pushed or paperwork got misfiled that this was a sign not to have revision to RNY. Stick with us, ask us questions and read other stories. You do what is right for you but it sounds like you need to think of your health right now. Let the wheels go in motion and when you need to put on the brakes, you are at the wheel.